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  1. Salziyan, B., Norwati, D.
    MyJurnal
    Health care personnel are important role models for promoting healthy lifestyle to general populations. Being
    overweight and obese are commonly associated with stigmas and discriminations. Stigma against obese people is
    common and it may relate to individual’s attitude on obesity. The study objective was to determine the correlation
    between body mass index of nursing students and their attitude towards obesity. A cross-sectional study was
    conducted between December 2011 and February 2012. Self-administered questionnaires were distributed to 297
    nursing students in private colleges in Kelantan, Malaysia. Socio-demographic data, body mass index (BMI) and
    attitude towards obesity by using the ATOP score were obtained. Data was analyzed using SPSS version 20.0.
    Majority of the participants were Malays (99.7%), female (89.9%) and single (96.3%). About 64.3% had normal
    BMI, 18.9% underweight, 13.8% overweight, 2.4% obese type I and 0.7% obese type II. The ATOP score were
    ranging from 26.0 to 99.0 with mean (SD) of 62.8 (13.36). The attitude towards obese persons among the
    participants was more toward positive attitude. Body mass index (BMI) was skewed to the left distribution with
    the median (IQR) 20.8 (3.9). The correlation between attitude score and BMI was found to be not significant with
    p-value of 0.47 and Pearson correlation coefficient 0.04. Thus, there was no correlation between attitude towards
    obesity and individual’s BMI. Nursing students has positive attitude towards obesity. Their BMI does not seem to
    affect their attitude towards obese persons and reflects that there was no stigma towards obese person.
  2. Jeyachelvi K, Juwita S, Norwati D
    Asian Pac J Cancer Prev, 2016;17(8):3983-8.
    PMID: 27644649
    BACKGROUND: Cervical cancer though preventable is still the leading cause of cancer death among women secondary to breast cancer. Persistent infection with HPV has been causally linked to the disease. A school based HPV vaccination program was introduced in late 2010 in Malaysia and nurse support is essential for its success.
    OBJECTIVES: To determine nurses knowledge and attitudes about HPV infection and its vaccines, and factors associated with their knowledge.
    MATERIALS AND METHODS: This cross-sectional study was conducted among nurses working at primary health clinics in Kelantan from mid-June till the end of July 2014. Its involved 330 nurses selected through multistage random sampling. A validated self-administered questionnaire consisting of 11 items for the knowledge domain and eight items for the attitude domain was used.
    RESULTS: The response rate of the study was 93.7%. The mean knowledge and mean attitude (SD) scores were 5.37 (1.76) and 29.8 (3.51) respectively. Only 24% knew that HPV is the most common sexually transmitted infection and 67% correctly answered that Gardasil vaccine can protect against four types of HPV. Nearly 60% of participants wrongly answered that HPV vaccines cannot be offered to sexually active women. Likewise, 70.9% participants were not aware that HPV vaccine may be appropriate for females aged 9 through 26 years. Though 90% of participants believed that the vaccine is safe, nearly half of them were unsure about efficacy. From multiple linear regression analysis, among the factors tested only participant's level of education showed a statistically significant association with the HPV knowledge score (<0.001).
    CONCLUSIONS: This study indicates nurses have favorable attitudes towards HPV vaccination; however they have significant knowledge deficit and major misunderstanding in critical knowledge items. Among the factors tested, nursing qualification is the only factor that is significantly associated with the nurses knowledge score.
  3. Nurulhuda M.H., Najwa Haneem M., Khairi C.M., Norwati D., Aniza A.A.
    MyJurnal
    Introduction: Substance abuse is both a social and public health problem with a substantial burden to society. Opioid dependence results in unemployment, crimes, family disruption, and transmission of diseases. In Malaysia, methadone maintenance therapy (MMT) has been introduced as a harm reduction method. However, relapse during treatment remains an issue to be resolved that hinders successful outcome in the therapy. Spirituality in the treatment of substance abuse disorders has yet to be fully explored. This study aims to examine how MMT clients who relapsed perceive spiritual deficits as an influence and association of spiritual practice with relapse. Methods: This is a cross-sectional study done from June-July 2016. All MMT clients undergoing therapy at 3 treatment centers in Terengganu, Malaysia who fulfilled the inclusion and exclusion criteria and consented were included in the study. A semi-structured questionnaire was filled via face to face interview and spiritual practice was assessed using Hatta Islamic Religiosity Scale. 121 questionnaires were assessed and data was analyzed using SPSS version 22 for quantitative data. Results: All respondents were males of Malay race and Islamic religion. Current relapse, defined as any episode of intake of opioid for the past one month after a period of abstinence was 34%. Only three out of 42 clients who relapsed had some spirituality theme in their perceived cause of their relapse. However, a significant majority of those relapsed had a spiritual practice score of less than the mean practice score. Conclusion: Relapse in opioid addiction remains high in those receiving MMT in Terengganu, Malaysia. Spirituality may have a subconscious influence towards relapse in addiction in MMT clients. Further effort should be taken to inculcate spirituality intervention effective to prevent relapse which may contribute towards achieving a more successful therapy outcomes.
  4. Nurulhuda, M. H., Norwati, D., Sit Norazlina, J., Husbani, M. A. R.
    MyJurnal
    Background: Breast cancer is the most common cancer and the leading cause of cancer death among women in
    Malaysia, accounting to 32.1% of all cancer among women. Preventive activities of breast health especially
    mammogram screening was found to be effective in reducing the mortality and morbidities related to breast cancer. .
    However, the number of people who come for screening is still unsatisfactory. Many patients come in advanced stage
    of breast cancer attributed by lack of awareness and knowledge of the disease. The aim of this study was to introduce
    a multimodality online course on breast cancer and its screening; and to measure its effectiveness in providing the
    awareness and knowledge in breast cancer. Methodology: An online course was designed incorporating essential
    knowledge regarding breast cancer and its screening. Group sampling was done to sample 30 undergraduate students.
    Knowledge and awareness on breast cancer and its screening was measured using a validated questionnaire pre and
    post exposure to the online course. Results: There was significant difference in Pre- &Post-exposure test knowledge
    (p
  5. Norwati D, Harmy MY, Norhayati MN, Amry AR
    Asian Pac J Cancer Prev, 2014;15(6):2901-4.
    PMID: 24761922
    The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.
  6. Harmy MY, Norwati D, Noor NM, Amry AR
    Asian Pac J Cancer Prev, 2011;12(8):1957-60.
    PMID: 22292632
    Colorectal cancer is the commonest cancer among males and the third commonest cancer among women in Malaysia. However, almost 80% of patients sought treatment for cancer only when they were already in late stage due to lack of awareness. Hence, the objectives of this study were to determine the knowledge and attitude of colorectal cancer screening among moderate risk patients. A cross-sectional study was conducted between August 2009 till April 2010 in 44 health clinics with Family Medicine Specialists in West Malaysia. Stratified multistage random sampling was applied and a validated Malay version of the questionnaire with the Cronbach' alpha of 0.65 to 0.82 was used. Data were entered using SPSS 12.0 and analysed with STATA 8.0. A total of 1,905 (93.8%) patients responded. The mean (SD) knowledge and attitude score among moderate risk patients were 69.5 (6.11%) and 66.5 (7.07%), whereas, the percentages for good knowledge and attitude were 4.1% and 3.3% respectively. Less than 1% had undergone colorectal cancer screening and the main reasons were not bothered, busy and embarrassment. The majority of patients who had moderate risk for colorectal cancer had extremely low knowledge and attitude towards colorectal cancer screening. As a result, the majority did not undergo any form of colorectal cancer screening.
  7. Teoh SH, Razlina AR, Norwati D, Siti Suhaila MY
    Med J Malaysia, 2017 02;72(1):18-25.
    PMID: 28255135
    BACKGROUND: blood pressure (bP) control among Malaysian is poor and doctor's adherence to clinical practice guideline (cPG) has been a well-known factor that may improve it. this study was designed to evaluate patients' bP control, doctors' adherence to the latest hypertension cPG and their association. Factors associated with bP control and cPG adherence was also examined.

    METHODS: A cross-sectional study was conducted in Kuala Muda district's health clinics. 331 medical records were selected using stratified random sampling and standard proforma was used for data collection. the latest edition of the Malaysian cPG on hypertension was employed to define related variables.

    RESULTS: A total of 160 patients (48.3%) had controlled bP and it was significantly associated with patients' age (adjusted Odds ratio, aOr= 1.03, 95% cI: 1.004, 1.05, p= 0.016) and systolic bP at presentation (aOr= 0.95, 95% cI: 0.93, 0.96, p< 0.001). About 60.7% of the medical records showed doctor's good level of cPG adherence. this adherence has significant association with presence of chronic kidney disease (aOr= 0.51, 95% cI: 0.31, 0.85, p= 0.007) and cardiovascular disease (aOr= 2.68, 95% cI: 1.04, 6.95, p= 0.030) in the patients and physicians' treatment intensification (aOr= 2.00, 95% cI: 1.26, 3.19, p= 0.009). However, no association was found between bP control and cPG adherence.

    CONCLUSION: Hypertension control in this study was poor and the prevalence of physicians with good level of cPG adherence was slightly above average. these findings are important for relevant stakeholders to strategise an action plan to improve hypertension management outcome.
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