METHODS: A qualitative study using narrative inquiry was conducted at a public primary care clinic. Ten participants with type 2 diabetes of more than a 1-year duration were selected through purposive sampling. In-depth interviews were conducted using a semi-structured protocol guide and were audio-taped. The interviews were transcribed and the texts were analyzed using a thematic approach with the Atlas.ti ver. 8.0 software (Scientific Software Development GmbH, Berlin, Germany).
RESULTS: Three themes emerged from the analysis. The first theme, "Initial reactions toward diabetes," described the early impression of diabetes encompassing negative emotions, feeling of acceptance, a lack of concern, and low level of perceived efficacy. "Process of discovery" was the second overarching theme marking the journey of participants in finding the exact truth about diabetes and learning the consequences of ignoring their responsibility in diabetes care. The third theme, "Making the right decision," highlighted that fear initiated a decision-making process and together with goal-setting paved the way for participants to reach a turning point, moving toward engagement in their care.
CONCLUSION: Our findings indicated that fear could be a motivator for change, but a correct cognitive appraisal of diabetes and perceived efficacy of the treatment as well as one's ability are essentially the pre-requisites for patients to reach the stage of having the intention to engage.
OBJECTIVE: This study aimed to explore the postpartum experiences of Malaysian mothers with postpartum depression (PPD) symptoms and their perspectives on using an mHealth technology to improve mental health care during the postpartum period.
METHODS: We carried out in-depth interviews with six mothers, which were transcribed verbatim and thematically analysed. Collaborative discussions and consensus were employed to enhanced reliability.
FINDINGS: Five main themes related to mothers' postpartum experiences and perspectives emerged, namely, the existing circumstances of mothers, psychosociological reactions, maternal needs, innovation of care, and suggestions for pragmatic mHealth elements. These themes emphasized the emotional challenges of meeting societal, cultural, and personal expectations. The essential resources identified to be included in the mHealth technology were education on PPD, professional guided self-care, cognitive restructuring, validation of diverse infant feeding practices, and fostering partner support. Furthermore, interactive mHealth features such as mood trackers, notifications, platforms to share, and motivational tools aimed at elevating maternal well-being were also sought.
CONCLUSIONS: Mothers expressed a desire for mHealth services emphasizing the need for these educational tools to be culturally sensitive, accommodating local language and religious practices, and offering support during confinement, to effectively address the unique needs of postpartum mothers. This study highlights the importance of prioritizing practical mHealth interventions as strategic support services to enhance positive postpartum mental care in resource-stricken countries.
OBJECTIVE: This study aims to evaluate the effectiveness of the Leveraging on Virtual Engagement for Maternal Understanding & Mood-enhancement (LoVE4MUM) mobile app, which was developed based on the principles of cognitive behavioral therapy and psychoeducation and serves as an intervention to prevent postpartum depression.
METHODS: This single-blinded, pilot randomized controlled trial includes 64 mothers recruited from the postnatal ward and randomized using a 1:1 ratio to receive either postpartum care (treatment as usual) or postpartum care (treatment as usual) plus the self-guided LoVE4MUM mobile app. The primary outcome is the effectiveness of the mobile app at improving postpartum depression. Secondary outcomes are changes in the mental health literacy score and negative automatic thoughts, which are collected using a self-reported questionnaire.
RESULTS: Patient recruitment began on September 1, 2024. As of January 1, 2025, recruitment was successfully completed, with a total of 72 participants enrolled: 36 in the intervention group and 36 in the control group . The final results are anticipated to be available by March 2025, and publication is expected by the end of 2025.
CONCLUSIONS: By examining the LoVE4MUM app alongside standard postpartum care, this pilot randomized controlled trial seeks to offer preliminary evidence on the potential of mHealth tools to improve maternal mental health as well as to reduce postpartum depression symptoms. The findings are expected to contribute to the future development of effective, accessible, and scalable interventions for mothers.
TRIAL REGISTRATION: ClinicalTrials.gov NCT06366035; https://clinicaltrials.gov/study/NCT06366035.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/63564.
METHOD: This case report highlights the use of an integrated approach based on "Management of Really Sick Patients with Anorexia Nervosa" report in managing a case of extreme anorexia nervosa where a SEDU is unavailable.
RESULT: In this case, early psychiatric team support is key in the patient's path to recovery.
PRACTICE IMPLICATION: This highlights the importance of having a SEDU and staff trained in eating disorder.
METHODS: A multi-center study across four teaching hospitals in the Klang Valley, Malaysia was conducted between September 2021 and May 2022. A survey was conducted using a self-administered electronic questionnaire. The survey instruments included; (1) maternal perception and attitude toward COVID-19 vaccination, (2) COVID-19 pregnancy-related anxiety, and 3) generalized anxiety disorder.
RESULTS: The response rate was 96.6%, with a final number for analysis of 1,272. The majority of our women were Malays (89.5%), with a mean age (standard deviation, SD) of 32.2 (4.6). The maternal vaccine acceptance in our study was 77.1%. Household income (p < 0.001), employment status (p = 0.011), and health sector worker (p = 0.001) were independent predictors of maternal willingness to be vaccinated. COVID-19 infection to self or among social contact and greater COVID-19 pregnancy-related anxiety were associated with increased odds of accepting the SARS-CoV-2 vaccine. Women who rely on the internet and social media as a source of vaccine information were more likely to be receptive to vaccination (adjusted odd ratio, AOR 1.63; 95% CI 1.14-2.33). Strong correlations were observed between maternal vaccine acceptance and the positive perception of (1) vaccine information (p < 0.001), (2) protective effects of vaccine (p < 0.001), and (3) getting vaccinated as a societal responsibility (p < 0.001).
DISCUSSION: The high maternal vaccine acceptance rate among urban pregnant women in Malaysia is most likely related to their high socio-economic status. Responsible use of the internet and social media, alongside appropriate counseling by health professionals, is essential in reducing vaccine hesitancy among pregnant women.
METHOD: Participants of school-age and adolescent students from Klang Valley School completed the 21-item Malay OCI-CV using Google Form. OCI-CV English version was translated backward and forward to the Malay language. Face validity was conducted first before distributing the questionnaire to the participants. Exploratory Factor analysis (EFA) and Confirmatory Factor Analysis (CFA) was conducted to evaluate the psychometric properties of OCI-CV.
RESULTS: A total of 102 school-age children and adolescents with a mean age of 15.96 years (male: 41.2%, female: 58.8%) participated in the study. The Malay OCI-CV showed high internal consistency, with Cronbach Alpha values of 0.90 for the whole scale. EFA showed multifactorial components. Five factors were labelled as "Washing / Ordering, Doubting, Obsessions, Checking, and Hoarding,". In the CFA, the five-factor model indicates adequate fit indices of (χ2/df = 1.51, RMSEA = .071, GFI = .824, AGFI = .769, NFI = .724, CFI = .880).
CONCLUSION: The Malay OCI-CV has good psychometric properties and is suitable for use in the Malaysian context. Further validation studies should be conducted among a clinical population to enhance the generalization of this finding.