PURPOSE: In this study, a framework comprising equivalence and cognition models was used to assess and finalize the Heart Quality-of-Life (HeartQoL)-Bahasa Malaysia (BM) questionnaire, which was derived from both forward-backward (FB) and dual-panel (DP) translation methods.
METHODS: Investigation and finalization of two initial versions of the questionnaire were conducted based on findings from an expert assessment (n = 3 sociolinguists blinded to translation methods) and cognitive interviews with purposively sampled patients (FB: n = 11; DP: n = 11). The equivalence model of Herdman et al. and the question-and-answer model of Collins were adapted to form a "cognition-and-equivalence" model to guide data collection and analysis through modified cognitive interviews. The final HeartQoL-BM was completed by 373 patients with ischemic heart disease from two medical centers, and the data were analyzed using confirmatory factor analysis to assess the evidence of equivalence.
RESULTS: Findings from the expert assessment and cognitive interview showed the existence of semantic and item equivalence on almost all of the FB and DP items, identified some subtle potential equivalence gaps, and guided the process of item finalization. Confirmatory factor analysis, including tests of factorial invariance on the final two-factor model of HeartQoL-BM, confirmed conceptual, item, measurement, and operational equivalence, which supports functional equivalence.
CONCLUSIONS: The potential use of the cognition-and-equivalence model for modified cognitive interviewing and the application of the six equivalence types of Herdman et al. were supported by the HeartQoL-BM showing functional equivalence with its source. HeartQoL-BM is a potentially valid measure of health-related quality of life for patients with ischemic heart disease independent of conditions such as angina, myocardial infarction, and heart failure.
Methods: This study took place at the National Heart Institute and Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia, between March 2013 and March 2014. A self-administered 75-item HFQOL questionnaire was designed and administrated to 164 multi-ethnic Malaysian HF patients. Exploratory factor analysis was performed to assess the instrument's construct validity. Cronbach's alpha coefficients were used to determine internal consistency.
Results: A total of 33 out of 75 items were retained in the final tool. The HFQOL questionnaire had three common factors-psychological, physical-social and spiritual wellbeing-resulting in a cumulative percentage of total variance of 44.3%. The factor loading ranges were 0.450-0.718 for psychological wellbeing (12 items), 0.394-0.740 for physical-social wellbeing (14 items) and 0.449-0.727 for spiritual wellbeing (seven items). The overall Cronbach's alpha coefficient of the questionnaire was 0.82, with coefficients of 0.86, 0.88 and 0.79 for the psychological, physical-social and spiritual wellbeing subdomains, respectively.
Conclusion: The HFQOL questionnaire was found to be a valid and reliable measure of QOL among Malaysian HF patients from various ethnic groups. Such tools may facilitate cardiac care management planning among multi-ethnic patients with HF.
OBJECTIVES: To identify educational needs for stroke patients and their caregivers in Malaysia. Another purpose is to report on the needs identified by stroke patients and their families related to salat.
METHODS: Descriptive qualitative study. Phase 1 involved semi-structured interviews with stroke patients (n = 5), family caregivers (n = 5) and health professionals (n = 12) in Kelantan Malaysia. Phase 2 involved presenting the findings from Phase 1 to the health professionals with the aim of establishing priorities and processes to develop education strategies for stroke patients and their families.
RESULTS: Preparing for and performing salat was challenging for both patient and family carers to do following a stroke. Themes identified were prayer and the meaning of the stroke events for participants, difficulties praying post-stroke, prayer as part of rehabilitation therapy.
CONCLUSION: Providing culturally safe care should include how nurses assess and support patients and their caregivers post stroke to meet their prayer needs. Nurses have a role in discussing with stroke patients and their families how in addition to its spiritual and customary benefits, prayer and for Muslims reciting the Holy Qur'an can have cognitive and rehabilitation benefits, as well as being a source of psychological support for stroke patients.
AIM: To examine the use of hermeneutic phenomenology and the ethnographic principle of cultural interpretation in a research study conducted with Malaysian nurses on part-time, transnational, post-registration, top-up nursing degree programmes provided by one Australian and two UK universities.
DISCUSSION: To enable the researcher to undertake international cross-cultural research and illuminate Malaysian nurses' views for the reader, cultural aspects need to be considered, as they will influence the information participants provide. Useful strategies that western researchers can adopt to co-create research texts with interviewees are outlined. The paradigm and research designs used in the study revealed the views and experiences of Malaysian nurses.
CONCLUSION: Hermeneutic phenomenology enabled the exploration of participants' experiences, and the ethnographic principle of cultural interpretation enabled the researcher's reflexivity to provide emic and etic views for the reader.
IMPLICATIONS FOR PRACTICE: This paper adds to the discussion of the paradigms and research designs used for international, cross-cultural research in Asia. It identifies the influence participants' cultural values have on their confidence and level of disclosure with western researchers.