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  1. Tajik E, Zulkefli NA, Baharom A, Minhat HS, Latiff LA
    Electron Physician, 2014;6(1):771-8.
    PMID: 25763144 DOI: 10.14661/2014.771-778
    BACKGROUND: Many adolescents suffer from common mental disorders such as stress, which affects health through the psychosocial process, eating behavior, food choices and physical activity. During adolescence, dietary patterns are formed and can affect the occurrence of diseases in later life. This is a review of the results in the pertinent literature, from 1989 until November 2013, concerning stress and the contributing factors that lead to obesity among adolescents. The aim of this review is to identify obesity among stressed adolescents as well as the contributing factors.
    METHODS: A descriptive design was used for both quantitative and qualitative studies while, in addition, psychological theories were used for the qualitative studies. The articles were screened to ensure their quality and included in this review accordingly. Ten articles were included in the review comprising cross-sectional, cohort, review and meta-analysis. Interviews and questionnaires were used for data collection.
    RESULTS: The literature provided obvious information focusing on emotional stress and obesity for both boys and girls. This review revealed that stress results in overweight and obesity among adolescents through changes in lifestyle including decreased physical activity and increased food intake. Gender and economic status are the main components that affect obesity in stressed adolescents.
    CONCLUSION: Obesity is a consequence of stress among adolescents and is exacerbated by the wrong eating attitude. Developing proper food choices among adolescents can help prevent obesity and other complications in adulthood.
    KEYWORDS: Adolescent; Body Mass Index; Eating; Obesity; Stress
  2. Zarei M, Taib MN, Zarei F
    Electron Physician, 2013;5(3):687-97.
    PMID: 26120404 DOI: 10.14661/2013.687-697
    BACKGROUND: A student's lifestyle can change notably in a foreign country. The objective of this study was to determine factors associated with the body weight status of Iranian postgraduate students in Universiti Putra Malaysia (UPM) 2009.
    METHODS: A self-administered questionnaire was administered to 210 Iranian postgraduate students at UPM. Anthropometric factors also were measured using standard procedures. Body mass index (BMI) and waist-to-hip ratio (WHR) also were calculated. The chi-squared test, Spearman's rho, and the Pearson product-moment correlation coefficient were used to determine the associations between the variables that were studied. Multiple linear regression analysis was used to measure the amount of influence a predictor variable had on a outcome variable.
    RESULTS: There was no significant correlation between nutritional knowledge (P > 0.05), weight-management knowledge (P > 0.05), and smoking (P > 0.05) and BMI. There were statistically significant correlations between gender (P < 0.01), physical activity (P < 0.05), protein (P < 0.01), carbohydrate (P < 0.01), fat (P < 0.01), fiber (P < 0.01), vitamin C (P < 0.05), calcium (P < 0.01), and iron (P < 0.01) and BMI. There were also relationships between body fat (P < 0.01), waist circumference (P < 0.01), hip circumference (P < 0.01) and WHR (P < 0.01) and BMI.
    CONCLUSION: Our findings showed the need for a nutrition promotion program for the Iranian students to help them change their negative food habits and improve their lifestyles.
    KEYWORDS: Body weight; Dietary intake; Iran; Life style; Malaysia
  3. Rafhati AN, See CK, Hoo FK, Badrulnizam LB
    Electron Physician, 2014;6(3):877-82.
    PMID: 25763162 DOI: 10.14661/2014.877-882
    Generally, clinical presentations of Graves' disease range from asymptomatic disease to overt symptomatic hyperthyroidism with heat intolerance, tremor, palpitation, weight loss, and increased appetite. However, atypical presentation of Graves' disease with hematological system involvement, notably pancytopenia, is distinctly uncommon. Hereby, we present and discuss a series of three untreated cases of Graves' disease clinically presented with pancytopenia and the hematological abnormalities that responded well to anti-thyroid treatment. With resolution of the thyrotoxic state, the hematological parameters improved simultaneously. Thus, it is crucial that anti-thyroid treatment be considered in patients with Graves' disease and pancytopenia after a thorough hematological evaluation.
  4. Baharin J, Sahari NS, Lim SM
    Electron Physician, 2014;6(3):863-7.
    PMID: 25763159 DOI: 10.14661/2014.863-867
    Rhabdomyolysis is a serious but rare side effect of Lamivudine treatment. Therefore, appropriate biochemical monitoring should be undertaken when it is used in the treatment of hepatitis B. This paper presents a case of Lamivudine-associated rhabdomyolysis in a 31-year-old man with congenital heart disease and hepatitis B. Three days after starting Lamivudine, the patient developed myalgia. Significant muscle tenderness and swelling of the upper and lower limbs was discovered during a physical examination. Creatine kinase was markedly raised. Lamivudine-induced rhabdomyolysis was suspected and the drug was discontinued. Symptoms and creatine kinase activity improved within four days of Lamivudine cessation and hydration. Early identification of Lamivudine-induced rhabdomyolysis is key in preventing this potentially fatal drug reaction; withdrawal of Lamivudine may contribute to complete remission of rhabdomyolysis.
  5. Hassan ST, Jamaludin H
    Electron Physician, 2014 11 27;6(4):927-31.
    PMID: 25763170 DOI: 10.14661/2014.927-931
    This autoethnography withdraws from information accumulated through a 10-year period of daily-weekly-monthly descriptive observation-recording (triangulated- parents & house-helper) of caregiving and rehabilitating of our brain injured son (survivor/care-receiver). We present it as an interactive voice of verbal conversation, thoughts, insights, and interpretations. It is delivered as a series of articulation intra-pulsated with our interrogation of societal-cultural-religious perspectives, norms and biases, and aligns with the CAP (Creative Analytical Practices) method of Ellis. This autoethnography glows from the richness of information which encapsulates the challenges confronting us the aging parent caregivers, the gradual incremental mind mending achievement of our son, and the interactive verbalizations and thoughts, of the caregivers, care-receiver, and other persons. The overwhelming mental and physical pain and struggle of the survivor and the aging caregivers and their sense of celebratory-satisfaction with rehabilitation progress are highlighted. Interpretation and valuation of positive and negative responses of other persons provide a critical matrix to this autoethnography. We intend to inform other caregivers and relevant healthcare professionals through this autoethnography.
  6. Rostami F, Syed Hassan ST, Yaghmai F, Ismaeil SB, BinSuandi T
    Electron Physician, 2015 Sep;7(5):1261-9.
    PMID: 26435826 DOI: 10.14661/1261
    INTRODUCTION: Family-centered care sustains the unity of the child's and the family's health. The aim of this study was to determine nurses' attitudes toward parents' participation in the care of their hospitalized children in Iran in 2015.
    METHODS: In this experimental study, 200 pediatric nurses from hospitals affiliated with the Shaheed Beheshti University of Medical Sciences in Tehran were selected using the multi-stage, random-sampling method. Data were gathered using a questionnaire that covered demographic information and nurses' attitudes. The questionnaire consisted of 31 items and was completed by the nurses in three stages: 1) before intervention (pre-test), 2) immediately after intervention (post-test), and 3) three months after intervention (follow-up). The data were analyzed via SPSS software and using descriptive and analytical methods. Descriptive statistics, the Spearman Correlation Coefficient, and Repeated Measure Analysis (the Bonferroni method) were used to assess the data.
    RESULTS: The results indicated that there was a significant increase in the mean score of attitude after intervention [M (pre) = 3.35%, M (post) = 3.97%, p < 0.001)]. Most of subjects had neutral attitudes toward family participation in their children's care. There were no significant relationship between the nurses' socio-demographic characteristics and their attitudes.
    CONCLUSION: The nurses' attitudes toward the family's participation in the care of their hospitalized children were moderate. The nurses' attitudes should be improved by taking part in continuous training programs.
    KEYWORDS: attitude; family-centered care; nurses
  7. Abass MA, Said NS, Zahed ES, Hussein WF, Hamid OI
    Electron Physician, 2015 Dec;7(8):1638-43.
    PMID: 26816591 DOI: 10.19082/1638
    INTRODUCTION: Effective communication in a clinical environment plays a vital role in patient assessment and treatment. The aim of this study was to understand the experiences of Malaysian medical students concerning communication barriers during clinical practice. The goal was to provide answers for three important research questions, i.e., 1) Are communication barriers an impediment to Malaysian students during clinical teaching? 2) What is the nature of the language barriers that the students encounter? and 3) What are the best ways of reducing these barriers during clinical teaching?
    METHODS: The qualitative method was used to conduct the research, and open-ended questionnaires were used to collect the data. The study was conducted on 95 fourth-, fifth-, and sixth-year students, 80% of whom completed the study.
    RESULTS: Medical students from Malaysia who have limited knowledge of the Arabic language experience some difficulties in communicating with staff members, patients, and nurses during their clinical practices.
    CONCLUSION: Successful orientation of students to the language used in the clinical environment will help the students overcome the communication barriers they encounter during their clinical practices.
    KEYWORDS: Arabic language; Malaysia; clinical environment; communication barriers; medical students
  8. Rostami F, Hassan ST, Yaghmai F, Ismaeil SB, Suandi TB
    Electron Physician, 2015;7(2):1078-84.
    PMID: 26120418 DOI: 10.14661/2015.1078-1084
    BACKGROUND: Family-centered care (FCC) involves holistic care and requires cooperation with the family in planning, intervention, and the evolution of the care that is being provided. Many previous studies have provided results that indicate the importance of the family's involvement in pediatric care, but there is still resistance in doing so within the organizational culture of the hospitals in Iran. The aim of this study was to determine the effects of FCC on the satisfaction of parents of children hospitalized in 2012 in the pediatric ward at Razi Hospital in Chaloos, Iran.
    METHODS: This Quasi-experimental study was conducted in 2012 in the pediatric ward at Razi Hospital in Chaloos, Iran. Seventy hospitalized children between the ages of 1 and 3 who suffered from diarrhea, vomiting, or pneumonia were selected through convenience sampling. They were divided randomly into two equal groups, a control group (routine care) and an experimental group (family-centered care). SPSS Statistics 14 software was used to analyze the data, and p<0.05 was considered to be significant.
    RESULTS: In the FCC group, the mean score of satisfaction among the parents of the children was 20 out of 90 before the intervention, but, after the FCC method was used, it increased to 83.2 out of 90. In addition, a significant difference was found between the scores of satisfaction for the control and experimental groups (p<0.001), and all parents of children in the experimental group expressed high satisfaction.
    CONCLUSION: Our findings showed that the practice of FCC in caring for the sick children can increase the satisfaction of their parents significantly. The role of the family's involvement is critical in every component of the intervention efforts, as shown by the constructs of participatory support, educational support, and psychological support. Thus, a notable implication here is that FCC may lead to increased quality of care and should be included in the educational programs of the nursing staff in pediatric ward.
    KEYWORDS: Family-centered care; Iran; Nursing; Parents; Pediatric
  9. Dashti S, Peyman N, Tajfard M, Esmaeeli H
    Electron Physician, 2017 Mar;9(3):3966-3973.
    PMID: 28461871 DOI: 10.19082/3966
    BACKGROUND: In order to provide a better healthcare education to the society, health care students should have an acceptable electronic health (E-Health) literacy.
    OBJECTIVE: The aim of this study was to assess the level of E-Health literacy of Medicine and Health Sciences university students in Mashhad, Iran.
    METHODS: This cross-sectional study was performed on 192 students of Mashhad University of Medical Sciences using a validated Persian translate of the E-Health literacy scale (P-EHEALS) questionnaire in 2016. Demographic data including age, monthly income, level of education, preference of website for obtaining health related information and minutes of Internet use per day were obtained from the subjects. Independent-samples t-test and analysis of variance (ANOVA) were used for comparison between groups, and Pearson correlation coefficient and linear regression were used to assess the correlation between study parameters and EHEALS score using SPSS version 21.
    RESULTS: A total of 192 (67.2% female and 32.8% male) subjects with mean age of 24.71±5.30 years participated in the study. Mean P-EHEALS score of the subjects was 28.21±6.95. There was a significant difference in P-EHEALS score between genders (p<0.001), department (p=0.001), education level (p<0.001) and health status (p=0.003) as well as monthly income (p=0.03), website preference categories (p=0.02). Male students were significantly more likely to gain higher P-EHEALS scores.
    CONCLUSION: The level of E-Health literacy was low in Medical and Health Sciences university students in Mashhad. More studies are needed to assess the contributors to E-Health literacy.
  10. Wan-Fei K, Hassan STS, Sann LM, Ismail SIF, Raman RA, Ibrahim F
    Electron Physician, 2017 Aug;9(8):4924-4933.
    PMID: 28979724 DOI: 10.19082/4924
    BACKGROUND: Depression and anxiety are common in stroke survivors as well as their family caregivers. However, it is not known whether each person's emotional distress contributes to their partner's quality of life (QOL).

    OBJECTIVE: This study aimed to examine the effect of depression and anxiety on QOL in stroke survivor-caregiver dyads using dyadic analysis technique - the Actor-Partner Interdependence Model (APIM).

    METHODS: This was a cross-sectional pilot study with a total of 30 participating dyads (30 stroke survivors and 30 family caregivers) from Hospital Rehabilitasi Cheras, Kuala Lumpur, Malaysia. This pilot study was conducted over a period of 3 months, between December 2014 and February 2015. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS). QOL was assessed using the Short Form-12 Health Survey (SF-12). All analyses were carried out using IBM SPSS version 22. Dyadic data were analysed using multilevel modelling (MLM).

    RESULTS: Depression was uniquely associated with an individual's own QOL. Survivors and caregivers with higher depression had poorer physical component summary (PCS) scores and mental component summary (MCS) scores. Stroke survivor's depression exerted a significant actor effect on their PCS (b=-1.42, p=0.001) and MCS (b=-1.52, p<0.001). Caregiver's depression exerted a significant actor effect on their PCS (b=-2.53, p<0.001) and MCS (b=-1.51, p=0.004). Caregivers' anxiety negatively influenced their own MCS (b=-0.58, p=0.031). Furthermore, depression exerted a significant partner effect on PCS in stroke survivors (b=-1.19, p=0.003). Caregivers' depression was also related to their stroke survivors' poorer QOL, particularly PCS.

    CONCLUSION: The findings suggest that depression affects the QOL of both stroke survivors and caregivers, not only emotionally but also physically. This dyadic study also has evidence pointing to depression in caregivers and its association with stroke survivors' physical QOL.

  11. Javadi M, Jourabchi Z, Shafikhani AA, Tajik E
    Electron Physician, 2017 Jun;9(6):4655-4660.
    PMID: 28848644 DOI: 10.19082/4655
    BACKGROUND: Evidence shows that mental disorders among adolescents are associated with suicide, drug abuse, acute infectious diseases and low educational performances.

    OBJECTIVE: To determine the prevalence of depression and anxiety and their associations with body mass index (BMI) among high school students in Qazvin, Iran in 2013-2014.

    METHODS: A descriptive and analytical cross-sectional study using cluster-sampling method recruited 1,040 students among high schools in Qazvin, Iran from March 2013 to April 2014. Data were collected using questionnaires including demographic, Beck depression inventory and Beck anxiety inventory, and were analyzed with SPSS-19 by descriptive analyses, t-test, Chi-square and Pearson correlation.

    RESULTS: The prevalence of depression and anxiety was 31.8% and 14.9%, respectively and these amounts were significantly higher in girls than in boys (p<0.05). Respondents showed 23.75% and 11.07% mild to moderate symptoms of depression and anxiety, respectively as well as 8.08 and 3.75% severe symptoms of depression and anxiety, respectively. There was a positive and significant association between depression and anxiety (r=0.256, p<0.001) and between depression and body mass index (BMI) (r=0.333, p<0.001), however there was an inverse association between anxiety and BMI (r=0.086, p<0.006).

    CONCLUSION: The current study made a significant step forward in assessment of mental disorders and BMI to show the significance of depression and anxiety among adolescents in Qazvin. Therefore, effective interventions are necessary to improve this situation as well as the evaluation of the effectiveness of the interventions.

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