Displaying publications 1 - 20 of 45 in total

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  1. Siau CS, Wee LH, Ibrahim N, Visvalingam U, Wahab S
    Inquiry, 2017 01 01;54:46958017707295.
    PMID: 28486042 DOI: 10.1177/0046958017707295
    Understanding attitudes toward suicide, especially among healthcare personnel, is an important step in both suicide prevention and treatment. We document the adaptation process and establish the validity and reliability of the Attitudes Toward Suicide (ATTS) questionnaire among 262 healthcare personnel in 2 major public hospitals in the Klang Valley, Malaysia. The findings indicate that healthcare personnel in Malaysia have unique constructs on suicide attitude, compared with the original study on a Western European sample. The adapted Malay ATTS questionnaire demonstrates adequate reliability and validity for use among healthcare personnel in Malaysia.
  2. Ibrahim N, Mohd Safien A, Siau CS, Shahar S
    Inquiry, 2020 2 6;57:46958020902332.
    PMID: 32009506 DOI: 10.1177/0046958020902332
    This study evaluated the effectiveness of a depression literacy program on depression literacy, mental health stigma, and help-seeking attitude among adolescents with a monthly household income of RM3900 a month or less (B40) in Malaysia. The program included a lecture, mental awareness activities, and a short video on depression. Residents from a boarding school for lower income families were involved in this study (N = 101); 53 of them underwent the program and another 48 served as the control group. There were significant improvements for all variables in the intervention group (better depression literacy, reduced self-stigma, reduced negative beliefs on mental health, and increased help-seeking) at posttest. However, the results were sustained at 3-month follow-up only for the depression literacy, mental help-seeking attitude, and self-stigma of seeking help variables when compared with the control group. The findings highlight the need to improve the program to enhance the effectiveness and sustainability of the outcomes.
  3. Sathiaray D, Kaur M, Hanim A, Ng CG, Siau CS
    PMID: 34706594 DOI: 10.1177/10105395211053730
    This study aimed to identify the prevalence of psychological distress and its association with sociodemographic characteristics, burden of care, and the coping strategies used by childminders in residential homes. A total of 151 childminders (median age = 39; 64.7% female) participated in the study. The prevalence of psychological distress was 59.4%, and 74.0% recorded mild to moderate burden. Multivariate analyses showed that caregiver burden (adjusted beta = 0.464, P = .01), lesser application of problem-focused coping (adjusted beta = -0.292, P = .012), lower salary (adjusted beta = -0.196, P = .040), and lower educational qualification (adjusted beta = -0.212, P = .038) predicted higher psychological distress. Regular screening of psychological distress and burden of care is recommended among this population.
  4. Chen WS, Siau CS, Bono SA, Low WY
    Asia Pac J Public Health, 2022 01;34(1):106-112.
    PMID: 34550027 DOI: 10.1177/10105395211047868
    The impact of the COVID-19 pandemic on mental health is an emerging problem globally. This study aimed to examine the mediating effect of chronic illnesses in the relationship between psychological health and the acceptance of the COVID-19 vaccine, prior to the national vaccine rollout in Malaysia. An online cross-sectional study was conducted in Malaysia between December 10, 2020, and February 9, 2021. In addition to the descriptive analyses, a mediation analysis was performed to examine the mediating effect of chronic illnesses in the relationship between psychological distress and the willingness to accept the vaccine. A total of 1738 participants completed the survey. The psychological distress levels were found to be significantly different across demographic factors such as age, gender, and social economic status. This study demonstrated a partial mediating effect of chronic illnesses in the relationship between psychological distress and vaccine acceptance.
  5. Ooi MY, Rabbani M, Yahya AN, Siau CS
    Omega (Westport), 2023 Mar;86(4):1312-1328.
    PMID: 33844601 DOI: 10.1177/00302228211005864
    The aim of this study was to investigate the relationship between religious orientation, coping strategies and suicidal behaviour among secondary school adolescents and college students. A total of 196 participants (73 adolescents and 123 adults college students) completed the online survey consisting of the Religious-Orientation Scale-Revised, Brief COPE and Suicidal Behaviours Questionnaire-Revised. Adolescents in secondary school had higher odds of suicidal thoughts and behaviour than college students (OR 4.40, 95% CI: 1.133, 17.094, p = 0.032). Individuals who employed an avoidant coping strategy had higher odds of suicidal thoughts and behaviour after adjusting for other relevant variables, which indicated that when a person engages in avoidant coping strategy, it is most likely that they have a higher odds of suicidal thoughts and behaviour (OR 1.118, 95% CI: 1.050, 1.189, p 
  6. Lew B, Kõlves K, Osman A, Abu Talib M, Ibrahim N, Siau CS, et al.
    PLoS One, 2020;15(8):e0237329.
    PMID: 32822365 DOI: 10.1371/journal.pone.0237329
    BACKGROUND: Although the suicide rate in China has decreased over the past 20 years, there have been reports that the younger age group has been experiencing an increased incidence of completed suicide. Given that undergraduate groups are at higher risks of suicidality, it is important to monitor and screen for risk factors for suicidal ideation and behaviors to ensure their well-being.

    OBJECTIVE: To examine the risk and protective factors contributing to suicidality among undergraduate college students in seven provinces in China.

    METHODS: We conducted a cross-sectional study involving 13,387 college students from seven universities in Ningxia, Shandong, Shanghai, Jilin, Qinghai, Shaanxi, and Xinjiang. Data were collected using self-report questionnaires.

    RESULTS: Higher scores in the psychological strain, depression, anxiety, stress, and psychache (psychological risk factors for suicidality) and lower scores in self-esteem and purpose in life (psychological protective factors against suicidality) were associated with increased suicidality among undergraduate students in China. Demographic factors which were associated with higher risks of suicidality were female gender, younger age, bad academic results, were an only child, non-participation in school associations, and had an urban household registration. Perceived good health was protective against suicidality.

    CONCLUSIONS: Knowing the common risk and protective factors for suicidality among Chinese undergraduate students is useful in developing interventions targeted at this population and to guide public health policies on suicide in China.

  7. Zhang J, Huen JMY, Lew B, Chistopolskaya K, Talib MA, Siau CS, et al.
    J Affect Disord, 2020 06 15;271:279-285.
    PMID: 32479327 DOI: 10.1016/j.jad.2020.03.076
    BACKGROUND: The etiological factors of mood disorders and psychopathologies are understudied. In this paper, we explored whether social psychological strains are related to depression, anxiety, and stress in non-clinical populations.

    METHODS: 6,305 college students (39.3% men; 60.7% women) from six Chinese provincial-level jurisdictions completed a paper-and-pencil survey with Psychological Strain Scales (PSS-40) and Depression, Anxiety, and Stress Scales-21 (DASS-21), both validated in Chinese populations.

    RESULTS: Both PSS-40 and DASS-21 have high internal consistency reliabilities, and are highly correlated with each other. Hence, Chinese college students with greater psychological strains (value, aspiration, deprivation, or coping) have greater depression, anxiety, and stress. These results still held after controlling for relevant socio-demographic variables in the multiple regression models.

    LIMITATIONS: This was a cross-sectional study, and the sample only included several provinces in mainland China, not a representative sample of all of them.

    CONCLUSIONS: Mood disorders and psychopathologies are linked to suicidal thoughts and behaviors. The results of this study extend the Strain Theory of Suicide from explaining the risk factors of suicidality to mood disorders and psychopathologies. Hence, these findings can inform prevention measures among college students, and possibly the general population.

  8. Lew B, Osman A, Chan CMH, Chen WS, Ibrahim N, Jia CX, et al.
    BMC Public Health, 2021 02 09;21(1):322.
    PMID: 33563254 DOI: 10.1186/s12889-021-10370-2
    BACKGROUND: There is a need to understand the psychological characteristics of suicide attempters to prevent future suicide attempts. This study aims to examine potential differences between individuals who have attempted suicide and those who have not done so, on several risk and protective measures.

    METHOD: Participants were 11,806 undergraduate students from seven provinces in China, of which 237 reported a non-fatal suicide attempt. We used the random numbers generator function within the SPSS to randomly select a control subset of 1185 participants to be used as the comparison group based on a 1:5 case-control ratio. Scores on three commonly used risk measures (depression, hopelessness, and psychache) and three protective measures (social support, self-esteem, and purpose in life) for suicidality were adopted to compare the responses of the two groups.

    RESULTS: Suicide attempters had indicated higher Median scores for all three risk factor measurements. Suicide attempters also reported significantly lower Median scores for all three protective factor measurements compared to non-suicide attempters. The results suggest that the suicide attempters' group had higher risks of suicidality compared to the non-attempter group.

    CONCLUSIONS: Suicide attempters continued to report higher scores of risk factors and lower scores of protective factors, indicating that they may continue to be at a higher likelihood of a suicide attempt. Key protective factors should be identified for each individual in order to deliver appropriate clinical interventions to reduce their risk of reattempting.

  9. Chan CMH, Wong JE, Wee LH, Jamil NA, Yeap LLL, Swarna Nantha Y, et al.
    Occup Med (Lond), 2020 Sep 09;70(6):400-406.
    PMID: 32537649 DOI: 10.1093/occmed/kqaa107
    BACKGROUND: Past research on work engagement has focused almost exclusively on either psychological or work-related factors in almost wholly separate literature. There is therefore a need to examine how these factors collectively influence work engagement.

    AIMS: To determine levels of work engagement and to identify psychological and work-related characteristics predicting work engagement in employees in Malaysia.

    METHODS: We recruited 5235 employees from 47 public and private organizations in Malaysia who responded to an online health survey. We assessed work engagement with the 9-item Utrecht Work Engagement Scale (UWES-9) and psychological distress using the 6-item Kessler scale. We performed multiple linear regression to determine predictors of work engagement.

    RESULTS: Employee mean age was 33.8 years (standard deviation [SD] ± 8.8). The mean work engagement score on the UWES-9 was 3.53 (SD ± 0.94). Eleven of 18 variables on multiple regression predicted work engagement, F(18, 4925) = 69.02, P < 0.001, R2 = 0.201. Factors that predicted higher work engagement were age, marital status, education level, job type, job permanency, longer sleep duration, lower psychological distress and no history of workplace bullying.

    CONCLUSIONS: Key factors associated with poorer work engagement in Malaysian employees include inadequate sleep, psychological distress and a history of workplace bullying. These are modifiable factors that individuals and employers can target to improve work engagement, ideally tailored according to occupational type.

  10. Chan CMH, Siau CS, Wong JE, Wee LH, Jamil NA, Hoe VCW
    Nat Sci Sleep, 2021;13:1109-1116.
    PMID: 34285616 DOI: 10.2147/NSS.S295537
    Introduction: Given the scarcity of data on sleep insufficiency in developing countries and its emerging importance in public health, this study aims to provide the prevalence and factors associated with insufficient sleep among working Malaysian adults.

    Materials and Methods: A total of 11,356 working adults (≥18 years) were recruited from a cross-sectional online health and work survey. Sleep duration was self-reported and was categorised as insufficient sleep (<7 h) and sufficient sleep (≥7 h) based on the National Sleep Guidelines' daily sleep time recommendation for adults. The 10-item Kessler scale was used to assess psychological distress levels (cutoff score ≥20). Bivariate and multivariable regression analyses were performed to examine the factors associated with insufficient sleep.

    Results: The mean age of the participants was 35.7 years (standard deviation, SD±9.2). There were more female (n=6613; 58.2%) respondents. The mean sleep duration was 6.49 h (SD±1.10). A total of 6212 individuals (54.7%) reported getting <7 h of sleep daily. After adjusting for gender, marital status and educational attainment, older age (odds ratio, OR=2.22, 95% confidence interval, 95% CI: 1.72-2.86), ever smoking (OR=1.38, 95% CI: 1.25-1.53), and high psychological distress (OR=1.33, 95% CI: 1.17-1.53) were found to be associated with insufficient sleep. Factors associated with sleep duration of <7 h per night included having children (OR=1.35, 95% CI: 1.21-1.50), lifestyle factors (OR=1.38, 95% CI: 1.25-1.53), poor sleeping conditions (OR=1.21, 95% CI: 1.07-1.36), and mental health issues (OR=1.32, 95% CI: 1.12-1.54).

    Discussion and Conclusion: More than half of the participants reported sleep insufficiency. Older age, ever smoking, and high levels of psychological distress were significantly associated with insufficient sleep. Our findings recognise sleep as an emerging public health issue. Smoking cessation programmes and addressing high psychological distress may be beneficial to improve sleep.

  11. Siau CS, Wee LH, Ibrahim N, Visvalingam U, Yeap LLL, Wahab S
    J Contin Educ Health Prof, 2018;38(4):227-234.
    PMID: 30036213 DOI: 10.1097/CEH.0000000000000213
    INTRODUCTION: There is a lack of suicide-related training in the nonpsychiatric health professional's basic education. We suggest that a continuing education through a brief gatekeeper suicide training program could be a suitable platform to improve suicide-related knowledge, self-efficacy, and attitudes. This study aimed at examining the effectiveness of the Question, Persuade, Refer gatekeeper program on improving the knowledge, self-efficacy in suicide prevention, and understanding of/willingness to help suicidal patients of Malaysian hospital health professionals.

    METHODS: The Question, Persuade, Refer program materials were translated and adapted for implementation in the hospital setting for nonpsychiatric health professionals. There were 159 (mean age = 35.75 years; SD = 12.26) participants in this study. Most participants were female (84.9%), staff/community nurses (52.2%), who worked in the general medical department (30.2%) and had no experience managing suicidal patients (64.2%). Intervention participants (n = 53) completed a survey questionnaire at pretraining, immediately after training, and after three months. Control participants (n = 106) were not exposed to the training program and completed the same questionnaire at baseline and three months later.

    RESULTS: Significant improvement occurred among intervention participants in terms of perceived knowledge, self-efficacy, and understanding of/willingness to help suicidal patients immediately after training and when compared with the control participants 3 months later. Improvements in declarative knowledge were not maintained at the 3-month follow-up.

    DISCUSSION: This study confirmed the short-term effectiveness of the gatekeeper training program. Gatekeeper suicide training is recommended for implementation for nonpsychiatric health professionals nationwide.

  12. Wee LH, Ibrahim N, Wahab S, Visvalingam U, Yeoh SH, Siau CS
    Omega (Westport), 2020 Dec;82(2):323-345.
    PMID: 30482086 DOI: 10.1177/0030222818814331
    This study explored health-care workers' perception of patients' suicide intention and their understanding of factors leading to particular interpretations. Semistructured face-to-face in-depth interviews were conducted with 32 health-care workers from a general hospital in Klang Valley, Malaysia. Interview data were transcribed verbatim and analyzed using the interpretative phenomenological analysis. The health-care workers were found to have four types of perceptions: to end life, not to end life, ambivalence about intention, and an evolving understanding of intention. Factors leading to their perceptions of patients' suicide intention were patient demographics, health status, severity of ideation/attempt, suicide method, history of treatment, moral character, communication of suicide intention, affective/cognitive status, availability of social support, and health-care workers' limited knowledge of patients' condition/situation. Insufficient knowledge and negative attitudes toward suicidal patients led to risk minimization and empathic failure, although most health-care workers used the correct parameters in determining suicide intention.
  13. Siau CS, Wee LH, Adnan TH, Yeoh SH, Perialathan K, Wahab S
    J Nurses Prof Dev, 2019 2 12;35(2):98-103.
    PMID: 30741918 DOI: 10.1097/NND.0000000000000520
    The aim of this study was to examine Malaysian nurses' attitudes toward suicide. Nurses from five hospitals participated in this study. Studying the attitudes of nurses toward suicidal patients and its application to nursing professional development practitioners is an important topic. Most nurses were agreeable to assuming responsibility and to be trained in suicide prevention. Suicide-related training should focus on improving the attitudes of nonpsychiatric nurses, those with no experience in caring for suicidal patients, and those with less nursing experience, all of whom reported more negative attitudes toward suicidal patients.
  14. Ibrahim N, Amit N, Shahar S, Wee LH, Ismail R, Khairuddin R, et al.
    BMC Public Health, 2019 Jun 13;19(Suppl 4):544.
    PMID: 31196033 DOI: 10.1186/s12889-019-6862-6
    BACKGROUND: Mental illness rates among young people is high, yet the frequency of help-seeking is low, especially among those from lower socioeconomic backgrounds. Understanding factors influencing help-seeking, such as mental illness beliefs, stigma and literacy among B40 individuals is important, but past studies are sparse. Hence, we aimed to examine the factors associated with mental help-seeking attitude among students from the B40 income bracket. Differences in beliefs toward mental illness, stigma and help-seeking attitudes among university and secondary school students were also investigated.

    METHODS: University and secondary school students from low-income households (N = 202) were involved in this cross-sectional study. Participants completed the Depression Literacy Questionnaire (D-Lit), General Help Seeking Questionnaire (GHSQ), Mental Help Seeking Attitudes Scale (MHSAS), Self-Stigma of Seeking Help Scale (SSOSH), and Beliefs toward Mental Illness (BMI).

    RESULTS: Mental help-seeking attitude had a significant relationship with self-stigma on seeking help (r = -.258, p 

  15. Siau CS, Wee LH, Wahab S, Visvalingam U, Yeoh SH, Halim NAA, et al.
    J Res Nurs, 2021 Dec;26(8):723-740.
    PMID: 35251280 DOI: 10.1177/17449871211008520
    BACKGROUND: There has been mixed findings on whether a healthcare workers' religious beliefs contribute positively or negatively to their attitudes towards suicidal patients.

    AIMS: This study aims to explore qualitatively the influence of religious/spiritual beliefs on healthcare workers' attitudes towards suicide and suicidal patients in the culturally heterogeneous Malaysian population.

    METHODS: Thirty-one healthcare workers from diverse religious backgrounds, professions and medical disciplines were interviewed. Thematic analysis revealed the centrality of religion in determining healthcare workers' acceptability of suicide, specific religious beliefs that influenced their views on the right-to-die issue, perceptions of the suicidal patient's religiousness/spirituality, and the aspects and extent of religious relevance in professional philosophy and practice.

    RESULTS: Healthcare workers who could perceive the multifactorial nature of suicide causation had a more empathetic response. There were high levels of paternalism in the care of suicidal patients, involving unsolicited religious/spiritual advice practised as a form of suicide deterrent and social support.

    CONCLUSIONS: The formal integration of religious/spiritual practices into the professional care of suicidal patients was indicated.

  16. Mutang JA, Chua BS, Hon KY, Siau CS, Wider W, Ismail R
    Int J Environ Res Public Health, 2022 Sep 07;19(18).
    PMID: 36141527 DOI: 10.3390/ijerph191811258
    The COVID-19 pandemic has had a huge impact not only on healthcare systems and economic threats but also on relationships. Due to the massive measures of the Movement Control Order, such as social distancing, strictly limited physical activities, and making adjustments to working from home-merged with the pandemic's fear-romantic partners may face challenges that affect the quality of their relationships. The purpose of this study was to (i) identify stressors experienced by participants during the COVID-19 lockdown, (ii) evaluate participants'psychological well-being before and during the lockdown, and (iii) see if participants' perceived relationship quality differed before and during the lockdown. An online self-report questionnaire was used to recruit 334 adults (58.1 percent female, 41.9 percent male) with partners (married = 304, engaged = 12, and in committed relationships = 17). Participants were asked about stressors they encountered as a result of COVID-19 using an open-ended question. The Depression Anxiety Stress Scales (DASS-21) were used to assess mental health, and the Perceived Relationship Quality Component (PRQC) Inventory was used to assess relationship quality. According to the findings, the top three common stressors reported by participants were financial problems, restricted movement, and fear of COVID-19 infection. Participants reported significantly higher levels of stress, anxiety, and depression during the lockdown than before. The findings also revealed that participants' relationship quality improved during the lockdown compared to before the lockdown. The current study contributes by providing information on the impact of the COVID-19 pandemic on mental health and the quality of couples' relationships during the pandemic.
  17. Lee MHL, Kaur M, Shaker V, Yee A, Sham R, Siau CS
    PMID: 36833827 DOI: 10.3390/ijerph20043136
    This study aims to determine the prevalence and factors associated with cyberbullying and social media addiction. This cross-sectional study was conducted among 270 medical students from a public university in Kuching, Malaysia. The instruments used in this study included the cyberbullying questionnaire survey, Bergen Social Media Addiction Scale (BSMAS), and the Depression Anxiety Stress Scale 21-item (DASS-21). The prevalence of cyberbullying victimization was 24.4%, whilst 13.0% reported cyberbullying perpetration over the past six months. Male gender was positively associated with both cyberbullying perpetration and cybervictimization, whilst social media addiction was positively associated with cybervictimization. Psychological motives such as positive attitudes toward cyberbullying and gaining power were associated with cyberbullying perpetration. Cybervictimization doubled the tendency to depression (aOR 2.50, 95% CI [1.23, 5.08], p = 0.012), anxiety (aOR 2.38, 95% CI [1.29, 4.40], p = 0.006), and stress (aOR 2.85, 95% CI [1.41, 5.77], p = 0.004), whilst social media addiction was associated with a higher tendency to depression (aOR 1.18, 95% CI [1.10, 1.26], p < 0.001), anxiety (aOR 1.15, 95% CI [1.08, 1.22], p < 0.001), and stress (aOR 1.21, 95% CI [1.12, 1.32], p < 0.001). Medical schools in Malaysia need policies and guidelines against cyberbullying.
  18. Ibrahim N, Chu SY, Siau CS, Amit N, Ismail R, Abdul Gafor AH
    BMJ Open, 2022 Jun 03;12(6):e059305.
    PMID: 36691236 DOI: 10.1136/bmjopen-2021-059305
    INTRODUCTION: The number of patients in Malaysia requiring dialysis is expected to rise substantially in the future due to the ageing population and increasing prevalence of diabetes mellitus and hypertension. Hence, more individuals will be expected to adopt the role of caregivers in the future. The upward trend of end-stage renal disease (ESRD) and caregiving for dialysis patients has detrimental consequences for both patients and caregivers in terms of their psychological well-being and quality of life. Despite the current circumstances, there are very few studies in Malaysia that have explored the psychosocial factors, specifically on the economic impact of the management of ESRD.

    METHODS AND ANALYSIS: This two-phase sequential explanatory mixed-methods design, incorporating a quantitative design (phase I) and a qualitative study (phase II), is to be conducted in 4 government hospitals and 10 other non-governmental organisations or private dialysis centres within Klang Valley, Malaysia. A cross-sectional survey (phase I) will include 236 patient-caregiver dyads, while focus group discussions (phase II) will include 30 participants. The participants for both phases will be recruited purposively. Descriptive statistics, independent sample t-tests and multiple regression analysis will be used for analyses in phase I, and thematic analysis will be used in phase II.

    ETHICS AND DISSEMINATION: Approval for the study has been obtained from the National Medical Research and Ethics Committee (MREC) (NMRR-21-1012-59714) and the Research Ethics Committee of Hospital Canselor Tuanku Muhriz UKM (UKM PPI/111/8/JEP-2021-078) and University of Malaya Medical Centre (MREC ID NO: 2 02 178-10346). Informed consent of the participants will be obtained beforehand, and no personal identifiers will be obtained from the participants to protect their anonymity. The findings will be published in peer-reviewed scientific journals and presented at national or international conferences with minimal anonymised data.

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