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  1. Tan, C.E., Tong, S.F., Zuhra, H., Aida, J.
    Medicine & Health, 2016;11(1):72-82.
    MyJurnal
    The Hypoglycaemia Symptom Rating Questionnaire (HypoSRQ) is potentially
    useful for local research on hypoglycaemia. However, it requires adaptation and
    validation in local settings. This study reports the process and results of cross-cultural
    adaptation and linguistic validation of HypoSRQ for Malay and English versions in
    our local setting. The HypoSRQ underwent forward and backward translation and
    adaptation with support from professional translators and a clinical psychologist.
    Cognitive debriefing was done among patients with Type 1 and Type 2 diabetes
    mellitus from varying sociodemographic backgrounds. Discussion was done
    together with the original developers of the HypoSRQ to decide on the best version
    for local use. The finalised versions were proofread and formatted with the help
    of Health Psychology Research. Cognitive debriefing for Malay version involved 7
    patients and for the English version5 patients. Direct literal translation into Malay
    language was unsuitable due to technical terms which were difficult for laypersons
    to understand. Amendments were made based on findings from the cognitive
    debriefing process. Participants found the questionnaire fairly easy to understand.
    The HypoSRQ-My (Malay) and HypoSRQ-EMy (English) is easily understood by
    local participants. These tools may undergo psychometric evaluation for future
    use in local settings.
  2. Nor Hazlin, T., Leelavathi M., Zuhra, H., Adawiyah, J., Dawn, A.A.
    Medicine & Health, 2019;14(2):50-59.
    MyJurnal
    Traditional and Complimentary Medicines (TCMs) can potentially cause Adverse Cutaneous Drug Reactions (ACDRs). The aim of this study was to describe the characteristics of ACDRs due to TCMs and compare with those due to conventional medicine. This was a retrospective study with 134 cases being diagnosed with ACDR at the Dermatology Clinic of a tertiary hospital in Kuala Lumpur. Most (82.1%) ACDRs were caused by conventional drugs, while 17.9% were due to TCMs. Majority (70-75%) of the ACDRs were of mild to moderate severity. The most common ACDR to TCM was Exfoliative Dermatitis (ED) and Acute Generalized Exanthematous Pustulosis (AGEP) (both 16.7%) while maculopapular rash was the most common reaction for conventional medications (25.5%). The onset of adverse reaction to TCM was about 4 weeks (60.2%) while reactions due to conventional medication was earlier (1 to 6 days, 65.4%; p
  3. Radzniwan AR, Azimah NM, Zuhra H, Khairani O
    Medicine & Health, 2009;4(1):1-7.
    MyJurnal
    The advantages of breastfeeding have been well established. The objective of this study was to determine the practice and knowledge of breastfeeding in an urban com-munity and identify the influencing factors.  This is a cross-sectional study. All mothers attending the Maternal and Child Health Clinic during the study period, who fulfilled the selection criteria, were included in the study. The mothers were interviewed using a self administered questionnaire. A total of 162 mothers participated in the study. The prevalence of initiating breastfeeding during the first week after childbirth was 93.8%. Breastfeeding was found to be higher among Malay mothers (p value

    Study site: a Child Health Clinic in Cheras Baru, Kuala Lumpur
  4. Rahmah K, Zuhra H, Tohid H, Noor Azimah M
    Med J Malaysia, 2020 01;75(1):1-6.
    PMID: 32008011
    BACKGROUND: Primary care doctors are responsible to provide smoking cessation intervention (SCI) to smokers in a community. This study aimed to assess the SCI practice among primary care doctors themselves and its associated factors.

    METHODS: This cross-sectional study was conducted from July to October 2016. All the 140 doctors in 12 public primary care clinics in Kuala Lumpur were invited to participate in this study. However, only 122 doctors (females, 82.8%) completed the self-administered questionnaire that assessed their demography, clinical experience, SCI practice and its barriers, self-efficacy in delivering and knowledge on smoking and SCI.

    RESULTS: Only 42.6% of the doctors had good SCI practice. Almost all doctors assessed the smoking status of their patients (98.4%) and advised them to quit (98.4%). However, lesser proportions of the doctors followed up the practice of patients (50.0%), taught smokers on various methods of quit smoking (46.70%) and discussed about the barriers and resources to quit prior to the quit date (27.9%). Less than one-fourth of the doctors were confident in providing SCI. Although 69.7% had previous training in SCI, many felt they had inadequate knowledge (56.6%) and skills (47.5%). Only 11.5% of doctors thought their previous training was enough. Having higher level of knowledge on smoking and SCI was significantly associated with good SCI practice [adjusted Odds Ratio (95% Confidence Intervals): 1.21 (1.02, 1.43), p=0.026].

    CONCLUSION: The SCI practiced by the primary care doctors in this study was sub-standard, particularly in assisting smokers to quit and arranging follow up. Low self-efficacy in providing SCI was also common. These inadequacies may be due to poor knowledge and skills, which needs to be improved through effective clinical training.

  5. Azimah M, Radzniwan R, Zuhra H, Khairani O
    Malays Fam Physician, 2010;5(1):24-30.
    PMID: 25606182 MyJurnal
    BACKGROUND: Patients' education and empowerment are essential parts of a disease management. Patients have to be educated on the disease as well as lifestyle changes that they need to practise for a holistic and consistent improvement in their disease status. This study examined patients' knowledge on diabetes and nutrition as well as the role of dietician in the patient education.
    METHODS: This was a cross-sectional study of patients aged more than 18 years, in a primary care centre in Kuala Lumpur. Patients responded to a pre-tested self-administered questionnaire which contains socio-demographic profiles of patients, knowledge on diabetes and nutrition. Patients were also asked on dietician consultation and the number of dietician visits. Patients were conveniently selected on the data collection days. Only consented patients and those who could understand Malay or English language were selected.
    RESULTS: There were 110 patients who participated in the study. Overall the patients had good knowledge on diabetes and nutrition. The mean total knowledge score was 71.2% ± 9.34. Domains such as diabetes complications, exercise, meal practice, food sources and proportion need reinforcement. Only 60 (54.9%) patients had seen a dietician. Patients who had seen dietician showed significantly higher level of knowledge score (p=0.04). However frequent meeting with the dietician did not show any significant improvement in the knowledge (p=0.10). Factors such as patients' gender, ethnicity, level of education, employment status, glycaemic level, duration of illness and body mass index did not show any significant association with the overall diabetic and nutrition knowledge.
    CONCLUSION: There is still a need to improve the overall diabetic education particularly in areas that patients were lacking such as diabetes complications, exercise, meal practice, food sources and proportion. It is equally necessary to encourage all diabetics to see a dietician since it helps to improve their level of knowledge as shown in this study.
  6. Rashid AA, Zuhra H, Tan CE
    Med J Malaysia, 2018 08;73(4):197-201.
    PMID: 30121681 MyJurnal
    INTRODUCTION: Social support and self-efficacy are factors that influence patients' health behaviour. However, the relationship between these two factors among patients with Type 2 Diabetes Mellitus (T2DM) has not been adequately explored. This study aims to report social support and selfefficacy of Malaysian T2DM patients, and their correlations.

    METHODS: This cross-sectional questionnaire study involved 329 patients with T2DM who received their follow up at a public primary care clinic. Patients were selected via systematic random sampling. Patients self-completed locally adapted versions of the Medical Outcomes Study (MOS) Social Support Survey and Diabetic Management Self Efficacy Scale (DMSES). The scores of both tools were analysed to determine the association and correlation between social support and self-efficacy.

    RESULTS: The mean score for overall social support was 72.7±21.40 score range (0-100). "Affectionate support" was rated the highest averaged mean score at 78.31±23.71 (score range: 0-100). The mean DMSES score was 147.6±35.5 (score range :0-200), of which "medications" subscale was rated the highest with averaged mean scores 9.07±1.67 (score range: 0-10). Overall social support and self-efficacy were found to be weakly correlated (r=0.197, p<0.001). However, all subscales of social support were moderately correlated with "medications" subscale of self-efficacy.

    CONCLUSION: Social support is significantly associated with patients' self-efficacy in handling their own medications.

  7. Nazeera Fatimah K, Zuhra H, Hizlinda T, Noor Azimah M, Syahnaz MH, Rahmah K
    PMID: 37575358 DOI: 10.51866/oa.333
    INTRODUCTION: Erectile dysfunction (ED) negatively affects patients' emotions. However, its effect on spouses' psychological well-being remains largely unknown. This study aimed to examine psychological morbidities and their associated factors among spouses of men with type 2 diabetes mellitus (T2DM) and ED.

    METHOD: This cross-sectional study included 115 women recruited through their husbands who were patients at a selected government health clinic in Malaysia. A self-administered questionnaire containing the Depression Anxiety and Stress Scale-21 and items on health-related information, marital history, sexual history and perception of husband's ED was used to assess possible depression, anxiety and stress.

    RESULTS: The prevalence of psychological morbidities was 28.7% (depression=17.4%, anxiety=25.2% and stress=10.4%). Most respondents were middle-aged [median (interquartile range)=44.0 (11.0) years], were employed (55.7%) and had a low income (81.7%). About 47.0% of the spouses had a medical problem. The mean marriage duration was 18.7 (standard deviation=7.9) years. Almost all (90.4%) had sexual intercourse (SI) within the previous month. The majority had moderate-to-high interest in SI (72.2%) with a frequency of one to two times per week (69.6%). The majority (75.7%) did not perceive their husband as having ED. Multiple logistic regression demonstrated that medical illness was significantly associated with anxiety (adjusted odds ratio=2.85, 95% confidence interval=1.11-7.29, P=0.029).

    CONCLUSION: Psychological morbidities were present among the spouses of men with T2DM and ED. Psychological well-being was significantly affected by their medical illness. Despite their husband's ED, the women declared to have regular sexual relationships and did not perceive their husband as having erectile problems.

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