Displaying all 15 publications

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  1. Marhani Midin, Salina Abdul Aziz, Phang, Cheng-Kar
    ASEAN Journal of Psychiatry, 2010;11(2):206-215.
    MyJurnal
    Objective: Mental health services in Malaysia often face competition from traditional healers especially among patients with psychosis. The objective of the study is to determine whether patients who sought help earlier from traditional healers had longer duration of untreated psychosis (DUP), and more adverse experiences in pathways to psychiatric care. Methods: This is a hospital-based cross-sectional study of 50 inpatients with first-episode
    psychosis in Hospital Kuala Lumpur. Structured Clinical Interview for DSM-IV (Diagnostic and statistical manual, 4th edition) Clinical Version for Axis I Disorders (SCID-CV) was used for establishing diagnosis. Onset of psychosis was defined as any one positive symptom with a score of >3 on the Positive and Negative Syndrome Scale (PANSS). Socio-demographic
    data, information on pathways and treatment delaying factors were determined through face-to-face interview and semi-structured questionnaire. Results: Fifty-four percent of the patients had at least one contact with traditional healers prior to consulting psychiatric service, and it was the most popular first point of non-psychiatric help-seeking contact
    (48%). Contact with traditional healers was not associated with age, gender, ethnic, education level, longer DUP or treatment delay, and admissions with violent behaviour or police assistance. Of those who had sought help from traditional healers, one third were recommended by at least one of their traditional healers to seek medical help. Conclusion:
    Consultation involving traditional healers was a popular choice, and not associated with treatment delay. Traditional healers in an urban setting may be potential collaborators in managing patients with first-episode psychosis. Future research should explore the frontiers of such collaborative work.
  2. Phang Cheng Kar, Keng Shian Ling, Chiang Kai Chong
    MyJurnal
    Medical students in Malaysia face enormous amount of stress that can compromise their medical training. A brief group Mindfulness-based Cognitive Therapy (bMBCT)/Mindful-Gym) programme has been developed to help medical students cope more effectively with stress. The intervention was found to be effective for reducing stress and increasing subjective well-being among medical students in University Putra Malaysia (UPM). One of the training methodologies used in the programme, ‘Mindful-S.T.O.P.,’ was particularly popular among the students. The aim of this paper is to describe the concept and application of this mindfulness-based psychological tool (Mindful-S.T.O.P.) for stress reduction in medical students.
  3. Phang, Cheng Kar, Firdaus Mukhtar, Normala Ibrahim, Keng, Shian-Ling, Sherina Mohd Sidik
    MyJurnal
    The aim of this study was to evaluate the effects of a DVDdelivered mindfulness-based intervention for reducing stress among medical students in a Malaysian university. Methods: A total of 76 medical students participated in the intervention program (Mindful-Gym DVD). They were stratified according to year of studies and randomly allocated to intervention (N = 38) and control groups (N = 38). The following outcome variables were measured at pre- and post-intervention: mindfulness (with Mindful Attention Awareness Scale, MAAS); perceived stress (with Perceived Stress Scale, PSS); mental distress (with Depression, Anxiety and Stress Scale, DASS); and self-efficacy (with General Selfefficacy Scale, GSE). Hierarchical multiple regression analyses were used to analyse the effect of group (Intervention vs. Control) on changes in the outcome variables. Results: One week after the intervention, participants in the intervention group reported significantly greater improvements with small to medium effect sizes in self-reported levels of mindfulness (β =0.19, ∆R2= 0.04, p = 0.028, f2= 0.07), perceived stress (β = -0.25, ∆R2=0.06, p = 0.006, f2= 0.11), mental distress (β = -0.27, ∆R2= 0.07, p =0.003, f2= 0.13), and self-efficacy (β = 0.27, ∆R2= 0.07, p = 0.003, f2= 0.13), compared to participants in the control group. The number needed to treat (NNT) to achieve ‘normal’ levels of depressive, anxiety, and stress symptoms (as indicated by the DASS scores) were 5, 8, and 6 respectively. Conclusions: This study found that the DVD-delivered mindfulness-based program is potentially a labour- and cost-effective and easily accessible stress reduction program for medical students.
  4. Maher D. Fuad Fuad, Munn Sann, L., Normala Ibrahim, Phang, Cheng Kar, Siti Irma Ismail, Balsam Mahdi Nasir Al-Zurfi
    MyJurnal
    Students-t test is the most popular statistical test. The test compares two mean values to judge if they are different or not. For small data it is possible to conduct it using manual calculation – however that is not the case. Researchers would need to use statistical software and packages to conduct their analysis. This guide will help the junior researchers to conduct independent- and paired-t test using STATA software.
  5. Lee Sze Chet, Wan Salwina Wan Ismail, Nik Ruzyanei Nik Jaafar, Phang, Cheng Kar, Teh, Ewe Eow
    MyJurnal
    Introduction: Caregivers of children with speech-language pathology experience psychological distress as speech impedes communication and interferes children’s development. This study aimed to determine the effects of a one- day mindfulness-based intervention (MBI) in reducing depression, anxiety, and stress for caregivers of children with speech-language pathology in a Malaysian hospital. Methods: Caregivers (n = 62) who fulfilled the selection criteria were recruited and randomly assigned to either MBI or treatment-as-usual control groups. The caregivers completed self-rated questionnaires, namely the Depression Anxiety Stress Scale 21 (DASS 21) and Mindful Attention Aware- ness Scale (MAAS) before and at one-month post-intervention. Results: Hierarchical multiple regression analyses demonstrated significant improvement in DASS 21 and MAAS scores in the intervention group compared to control group. There were significant improvements at one-month post-intervention in all outcome measures: depression (β = 4.20, ΔR2 = 0.09, p = 0.008, f2 = 0.10); anxiety (β = 5.12, ΔR2 = 0.13, p = 0.001, f2 = 0.15); stress (β = 5.36, ΔR2 = 0.14, p
  6. Chan, Lai Fong, Tuti Iryani Mohd Daud, Hazli Zakaria, Phang, Cheng Kar, Loo, Tsui Huei, Ong, Lieh Yan, et al.
    ASEAN Journal of Psychiatry, 2010;11(1):25-35.
    MyJurnal
    Objective: According to Malaysian law, defendants found not guilty by reason of insanity may be admitted to a psychiatric hospital and discharge is subject to the state ruler’s assent. The objective of this study is to examine the clinical, socio-demographic and forensic factors that influence inpatient duration of insanity acquittees in a Malaysian mental institution. Methods:This is a cross-sectional study of one hundred and twelve insanity acquittee inpatients in Hospital Bahagia Ulu Kinta from January 2007 to February 2007. Patients with a clinical diagnosis of schizophrenia, major depressive disorder and bipolar disorder were assessed using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD) and Young Mania Rating Scale (YMRS) respectively. Other relevant sociodemographic, clinical and forensic factors were also assessed. Results: The inpatient duration varied widely from three months to forty-seven years with a median of seven years. Seventy five percent of patients were in remission. According to the multiple linear regression model, the strongest predictor of a longer duration of hospital stay for insanity acquittees was older age (p
  7. Normala Ibrahim, Zubaidah Jamil Osman, Khin Ohmar Naing Noor Jan, Siti Irma Fadhilah Ismail, Phang Cheng Kar, Firdaus Mukhtar, et al.
    MyJurnal
    The 12- item General Health Questionnaire (GHQ-12) has been translated into many languages and widely used in different settings and countries. Its reliability and psychometric properties were extensively studied in many population groups which suggested that it measures psychological distress in multidimensional construct. Objective: The objective of this study was to assess the reliability and factor structure of the Bahasa Malaysia version of the GHQ-12 among university students attending a health program at a Malaysian public university. Method: The cross sectional survey was conducted on 306 undergraduate students aged between 18 to 27 years old who visited the booth set up for mental health screening at a health program. The screening was conducted using a self-administered, validated Bahasa Malaysia version of GHQ-12 questionnaire. Results: Using exploratory factor analysis, the Bahasa Malaysia version of GHQ-12 was found to have a three factor structures namely depressive symptoms, self-esteem and perceived abilities which accounted for 58% of the item variance. The overall Cronbach’s alpha coefficient of the scale was found to be high (0.84) with each factor having acceptable inter-item consistency ranging from 0.61 to 0.82. Conclusion: The findings of the study show that the Bahasa Malaysia version GHQ-12 is reliable and has good structural characteristics. It can assess a few domains of the psychological status of university students. It also helps in providing more information
    on the domain which may become a focus target of intervention in the prevention of mental illness.
  8. Ghawadra SF, Abdullah KL, Choo WY, Phang CK
    J Clin Nurs, 2019 Nov;28(21-22):4087-4097.
    PMID: 31294501 DOI: 10.1111/jocn.14993
    AIM AND OBJECTIVES: To determine the prevalence of psychological distress and its association with job satisfaction among nurses in a teaching hospital in Malaysia.

    BACKGROUND: Nurses constitute the majority of health care workers, and, compared with other professions, nursing profession is highly stressful and, hence, a cause of anxiety and depression. This may affect nurses' job satisfaction.

    METHOD: Using self-administered questionnaires, Depression Anxiety and Stress Scale (DASS-21) and Job Satisfaction Scale for Nurses (JSS), a cross-sectional study of 932 nurses from the inpatient departments of a teaching hospital was conducted in December 2017. Descriptive analyses and multiple logistic regressions were used for the analysis. The STROBE guideline was used in this study.

    RESULTS: The overall prevalence of psychological distress was 41%. The prevalence of stress, anxiety and depression were 14.4%, 39.3% and 18.8%, respectively. It was found that single and widowed nurses had a higher level of stress, anxiety and depression compared with married nurses. In addition, nurses in the age of 26-30 years had a higher level of depression than nurses in other age groups. Also, nurses who worked in the paediatric departments had a higher level of depression compared with nurses in other departments. The majority of the nurses were satisfied with their job at 92.0%. Those nurses who were not satisfied were found to be significantly associated with a high level of stress and depression.

    CONCLUSION: This study revealed that the level of stress, anxiety and depression is high. Stress and depression were found to be associated with nurses' low job satisfaction.

    RELEVANCE TO CLINICAL PRACTICE: Stress and depression can affect nurses' job satisfaction, it is important for nursing managers to institute strategies to address this issue.

  9. Ghawadra SF, Abdullah KL, Choo WY, Phang CK
    J Clin Nurs, 2019 Nov;28(21-22):3747-3758.
    PMID: 31267619 DOI: 10.1111/jocn.14987
    AIMS AND OBJECTIVES: To explore the studies that used interventions based on the Mindfulness-Based Stress Reduction (MBSR) for decreasing psychological distress among nurses.

    BACKGROUND: Because of the demanding nature of their work, nurses often have significantly high levels of stress, anxiety and depression. MBSR has been reported to be an effective intervention to decrease psychological distress.

    DESIGN: Systematic review.

    METHODS: The databases included were Science Direct, PubMed, EBSCO host, Springer Link and Web of Science from 2002 to 2018. Interventional studies published in English that used MBSR among nurses to reduce their psychological distress were retrieved for review. The PRISMA guideline was used in this systematic review. The included studies were assessed for quality using "The Quality Assessment Tool For Quantitative Studies (QATFQS)."

    RESULTS: Nine studies were found to be eligible and included in this review. Many benefits, including reduced stress, anxiety, depression, burnout and better job satisfaction, were reported in these studies.

    CONCLUSION: The adapted/brief versions of MBSR seem promising for reducing psychological distress in nurses. Future research should include randomised controlled trials with a larger sample size and follow-up studies. There should also be a focus on creative and effective ways of delivering MBSR to nurses.

    RELEVANCE TO CLINICAL PRACTICE: The results of this review are substantial for supporting the use of MBSR for nurses' psychological well-being.

  10. Fadzil NA, Heong WO, Kueh YC, Phang CK
    Malays J Med Sci, 2021 Dec;28(6):121-128.
    PMID: 35002496 DOI: 10.21315/mjms2021.28.6.12
    Background: Among healthcare workers, nurses have a particularly high risk of stress. Stressful conditions in the workplace increase the possibility of burnout and psychological distress. Short mindfulness-based interventions can help to decrease stress, anxiety and depression. This study aimed to explore the effectiveness of a mindfulness-based intervention in reducing perceived stress, anxiety and depression among public teaching hospital staff nurses.

    Methods: Thirty-five nurses from various specialities were recruited from Hospital Universiti Sains Malaysia (HUSM). The intervention comprised a 1-day brief mindfulness-based intervention workshop and 1 h group practice session each month for 3 months together with daily follow-up via WhatsApp group. All the participants completed a self-administered sociodemographic questionnaire validated for use in a Malay population. The Depression, Anxiety and Stress Scale 21 (DASS 21) and Perceived Stress Scale 10 (PSS 10) were used to measure perceived stress, anxiety and depression before the intervention, and 3 months later upon completion of the intervention.

    Results: There was a statistically significant reduction in the scores for stress perception (95% confidence interval [CI]: 0.06, 2.92; P = 0.04) and anxiety (95% CI: 0.06, 2.34; P = 0.04) post-intervention.

    Conclusion: A brief mindfulness-based intervention was effective in reducing perceived stress and anxiety among nurses.

  11. Phang CK, Mukhtar F, Ibrahim N, Keng SL, Mohd Sidik S
    Adv Health Sci Educ Theory Pract, 2015 Dec;20(5):1115-34.
    PMID: 25697124 DOI: 10.1007/s10459-015-9591-3
    Pursuing undergraduate medical training can be very stressful and academically challenging experience. A 5-week mindfulness-based stress management (MBSM/Mindful-Gym) program was developed to help medical students cope with stress. The aim of this study was to evaluate the effectiveness of the intervention in reducing stress among students in a medical school in Malaysia. Seventy-five medical students participated in the program. They were stratified according to years of studies and randomly allocated to intervention (N = 37) and control groups (N = 38). The following outcome variables were measured at pre- and post-intervention: mindfulness (with Mindful Awareness Attention Scale); perceived stress (with Perceived Stress Scale); mental distress (with General Health Questionnaire), and self-efficacy (with General Self-efficacy Scale). Hierarchical multiple regressions were used to analyse the effect of group (intervention vs. control) on changes in the outcome variables. There were significant improvements at one week post-intervention in all outcome variables: mindfulness (β = 0.19, ΔR2 = 0.04, p = .040, f (2) = 0.05), perceived stress (β = -0.26, ΔR2 = 0.07, p = .009, f (2) = 0.10); mental distress (β = -0.28, ΔR2 = 0.10, p = .003, f (2) = 0.15); and self-efficacy (β = 0.30, ΔR2 = 0.09, p < .001, f (2) = 0.21). Six months after the intervention, those who had joined the program reported higher self-efficacy compared to those in the control group (β = 0.24, ΔR2 = 0.06, p = .020, f (2) = 0.08); but there was no difference in other outcome measures. More than 90% of the participants found the program applicable in helping patients and all reported that they would recommend it to others. This study indicates that the program is potentially an effective stress management program for medical students in Malaysia.
  12. Ghawadra SF, Lim Abdullah K, Choo WY, Danaee M, Phang CK
    J Nurs Manag, 2020 Jul;28(5):1088-1097.
    PMID: 32432795 DOI: 10.1111/jonm.13049
    AIM: To assess the effect of a 4-week mindfulness-based training intervention on improving stress, anxiety, depression and job satisfaction among ward nurses.

    BACKGROUND: Previous literature showed that mindfulness-based training is useful for helping nurses cope with stress.

    METHOD: Nurses who have mild to moderate levels of stress, anxiety and depression identified from a teaching hospital were invited to a randomized control trial. The intervention group had a 2-hr Mindfulness-Based Training workshop, followed by 4 weeks of guided self-practice Mindfulness-Based Training website. Both the intervention group (n = 118) and the control group (n = 106) were evaluated pre- and post-intervention, and 8 weeks later (follow-up) using the Depression, Anxiety, and Stress Scale-21, Job Satisfaction Scale and Mindful Attention Awareness Scale.

    RESULTS: There was a significant effect over time on stress, anxiety, depression and mindfulness level (p 

  13. Lee PF, Kan DPX, Croarkin P, Phang CK, Doruk D
    J Clin Neurosci, 2018 Jan;47:315-322.
    PMID: 29066239 DOI: 10.1016/j.jocn.2017.09.030
    BACKGROUND: There is an unmet need for practical and reliable biomarkers for mood disorders in young adults. Identifying the brain activity associated with the early signs of depressive disorders could have important diagnostic and therapeutic implications. In this study we sought to investigate the EEG characteristics in young adults with newly identified depressive symptoms.

    METHODS: Based on the initial screening, a total of 100 participants (n = 50 euthymic, n = 50 depressive) underwent 32-channel EEG acquisition. Simple logistic regression and C-statistic were used to explore if EEG power could be used to discriminate between the groups. The strongest EEG predictors of mood using multivariate logistic regression models.

    RESULTS: Simple logistic regression analysis with subsequent C-statistics revealed that only high-alpha and beta power originating from the left central cortex (C3) have a reliable discriminative value (ROC curve >0.7 (70%)) for differentiating the depressive group from the euthymic group. Multivariate regression analysis showed that the single most significant predictor of group (depressive vs. euthymic) is the high-alpha power over C3 (p = 0.03).

    CONCLUSION: The present findings suggest that EEG is a useful tool in the identification of neurophysiological correlates of depressive symptoms in young adults with no previous psychiatric history.

    SIGNIFICANCE: Our results could guide future studies investigating the early neurophysiological changes and surrogate outcomes in depression.

  14. Kader Maideen SF, Mohd Sidik S, Rampal L, Mukhtar F, Ibrahim N, Phang CK, et al.
    JMIR Res Protoc, 2016;5(2):e112.
    PMID: 27329333 DOI: 10.2196/resprot.4622
    Mental disorders are a major public health problem and are debilitating in many nations throughout the world. Many individuals either do not or are not able to access treatment. The Internet can be a medium to convey to the community accessible evidenced-based interventions to reduce these burdens.
  15. Tan SM, Jong SC, Chan LF, Jamaludin NA, Phang CK, Jamaluddin NS, et al.
    Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:74-81.
    PMID: 23857841 DOI: 10.1111/appy.12048
    Anxiety among house officers may impair functioning and health care delivery. This study aimed to determine the association between anxiety among house officers at Universiti Kebangsaan Malaysia Medical Center, sociodemographic and work-related factors.
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