Hypertension is one of the major risk factors for coronary heart disease and the most important factor for cerebrovascular diseases. Adherence to treatment is a fundamental pre-requisite for therapeutic benefit in hypertensive patients. Adherence is a complex behavioural process that is strongly influenced by the way in which patients live, as well as the psychological and social support system.
Aim: To understand and conceptualize the experience of people on long-term antihypertensive treatment Method: Qualitative analysis using semi-structured interviews with ten hypertensive patients from the medical clinic of Kuala Lumpur General Hospital.
Results: Although the participants were aware of having high blood pressure they declined receiving any treatment at the early stage of the disease. Fear of death and disease complications are reinforcements for participants to adhere to medication. They perceived the label of “hypertension” will affect their self-identity and social role. Positive thinking regarding medication assists participants to adhere to treatment. Conversely, participants who perceived medication negatively also adhere to a medication regime, as adherence behaviour satisfies the family. Participants justified modifying their regimen or taking Complementary and Alternative Medicine (CAM) as they believe know the their body best. However, participants wished to obtain more information regarding hypertension and its treatment from the doctors.
Conclusion: In finding the fine balance between stepping in and holding back treatment and care, health professionals need to know their clients in context. This balance can only be achieved by establishing processes of negotiation within an ongoing therapeutic relationship.
Study site: medical clinic of Kuala Lumpur General Hospital.
The objective of this paper is to report on the reliability and validity of a knowledge, attitude and practice instrument used among young primary school children. The instrument was developed as an evaluation tool in the HELIC study and consisted of 23 knowledge, 11 attitude and 10 practice items. A total of 335 Year 2 students from 4 randomly selected primary schools in Selangor and Wilayah Persekutuan participated in the HELIC study. Students were divided into small groups and an enumerator verbally administered the instrument to each group. Reliability for each construct (knowledge, attitude and practice) was estimated as item to total score correlation and internal consistency (Cronbach's alpha). Construct validity was determined through factor analysis and Pearson correlation. Results indicated that 3 attitude and 3 practice items did not correlate significantly to the total score (p>0.05). However, the deletion of these items did not significantly alter the Cronbach's alpha coefficients. Internal consistency was good for knowledge (a=0.68) but low for attitude (a=0.37) and practice (a=0.36) constructs. Based on factor analysis, 5 factor-solutions emerged for knowledge and 4 factor solutions for attitude and practice. Sufficient variance was obtained for the factors in knowledge (51.7%), attitude (51.2% and practice (51.0%). There were also significant positive correlations among the constructs ( ~ 4 . 0 1 ) . In conclusion, the instrument was valid and reliable, especially for the knowledge construct. Further improvements, particularly on the attitude and practice constructs, are needed in order for the instrument to be an effective assessment or evaluation tool in various settings.
Distress thermometer (DT) is a single-item measure generated to assess the psychological distress among cancer patients. The aim of this study was to validate the translated DT as a tool to determine the psychological distress level and assess the factors associated with distress among the working breast cancer survivors and also to compare with the Hospital Anxiety and Depression Scale (HADS).
This pilot study evaluated the effect sizes associated with prerecorded hypnotic interventions provided during the perisurgical period for reducing risk factors associated with chronic postsurgical pain, including acute postsurgical pain, anxiety, depression, and pain catastrophizing. A total of 25 participants (N = -25) were randomly assigned to receive a hypnotic intervention (n = 8), minimal-effect treatment (n = 8), or treatment as usual (n = 9) during their hospital stay for total knee replacement (TKR). Participants were followed for 6 months after hospital discharge. Results indicate that prerecorded hypnotic intervention exerted medium effects for reducing acute postsurgical pain and large effects for reducing perisurgical anxiety and pain catastrophizing. The findings indicate that a fully powered clinical trial to evaluate the beneficial effects of prerecorded hypnosis to manage pain and psychological distress in patients undergoing TKR is warranted.
The objective of the study was to determine the proportion of sound HIV knowledge and common misconceptions about HIV among university students. A set of pre tested and validated questionnaire assessing sound HIV knowledge and common misconceptions about HIV was used in this cross sectional study. HIV knowledge was defined as sound when one was able to identify correctly two ways of preventing the sexual transmission of HIV and reject three major misconceptions about HIV. Out of 300 respondents, 298 completed the questionnaire giving a response rate of 99.3%. A total of 40.9% of university students have sound HIV knowledge. The majority of those who lacked sound HIV knowledge were young (60.2%) and female (60.4%). A significant proportion still believed that HIV can be transmitted via social contact (13.8%), by sneezing or coughing (11.4%) and mosquito bites (10.1%). About 6.7% were believed wrongly that HIV can be treated by vaccine and healthy-looking people cannot have HIV.
Study site: Universiti Putra Malaysia (UPM), Malaysia