Aniza Ismail

Correlates of depression, anxiety and stress among Malaysian university students

INTRODUCTION University students face not only challenges related with independent living, but also academic challenges. This predisposes them to depression, anxiety and stress, which are fairly common. OBJECTIVE The aim was to assess the prevalence of depression, anxiety and stress, and identify their correlates among university students. METHODS A cross-sectional study was conducted on 506 students between the ages of 18 and 24 years from four public universities in the Klang Valley, Malaysia. Through an anonymous, self administered questionnaire, they were assessed by the Depression Anxiety Stress Scale-21 (DASS-21). Data on socio-demographic, family characteristics and living arrangement were also obtained. Students t-test and one-way ANOVA were used to explore association between these aspects. RESULTS Analysis showed among all students, 27.5% had moderate, and 9.7% had severe or extremely severe depression; 34% had moderate, and 29% had severe or extremely severe anxiety; and 18.6% had moderate and 5.1% had severe or extremely severe stress scores based on the DASS-21 inventory. Both depression and anxiety scores were significantly higher among older students (20 and above) and those born in rural areas. Whereas, higher stress scores were significantly higher among older students (20 and above), females, Malays and those whose family had either low or high incomes compared to those with middle incomes. CONCLUSIONS The prevalence of anxiety is much higher than either depression or stress, with some differences in their correlates except for age. These differences need to be further explored for development of better intervention programs and appropriate support services targeting this group.

Disaster management: a study on knowledge, attitude and practice of emergency nurse and community health nurse

Background Disasters are unpredictable events that kill and affect people, demolish properties and disrupt environment. During such events, nurses play a vital role in dealing with the victims. It is therefore crucial for nurses to be prepared in facing the aftermath of disasters. The aim of this study was to determine knowledge, attitude and practice of emergency nurse and community health nurse towards disaster management. Materials and methods This was a cross-sectional study conducted in emergency departments and health clinics in Selangor, one of the states in Malaysia. Questionnaire forms eliciting information about knowledge, attitude and practice towards disaster management were randomly distributed to 468 nurses working at the aforementioned clinics. This survey was conducted from October to November 2011 and yielded a response rate of 84.6 per cent. Results Both groups of nurses had similar inadequate knowledge but portrayed positive attitude towards disaster management. They differ in terms of practice whereby 56.1% of emergency nurses reported having had adequate practice compared to 30.7% of the community health nurses (chisquared test, P<0.001). Emergency nurses who have been involved in disaster response are more likely to report adequate practice (P<0.01, AOR=4.008, 95% CI=1.691- 9.504) while those who attended disaster-related education/training are more likely to have adequate knowledge (P<0.05, AOR=3.807, 95% CI=1.584-9.153) and practice (P=0.001, AOR=4.145, 95% CI=1.804- 9.525). Attending disaster-related education/training is seen to be a predictor to adequate knowledge (P<0.001, AOR=3.511, 95% CI=2.097-5.881) and practice (P<0.001, AOR=4.080, 95% CI=2.326-7.156), and portraying positive attitude (p<0.05, AOR=2.042, 95% CI=1.025-4.069) among community health nurse. Nurses’ workplace (represent type of nurse) is identified as a predictor for the adequacy of practice (P<0.001, AOR=2.345, 95% CI=1.474-3.730). Conclusions Adequacy of knowledge and practice, and portraying positive attitude is driven by being involved in disaster response and attending disaster-related education. It is therefore paramount for health administrators to conduct disaster-related education/training for front-liners such as emergency and community health nurses to improve their knowledge and practice towards disaster management.

Hair arsenic levels and prevalence of arsenicosis in three Cambodian provinces

Natural, inorganic arsenic contamination of groundwater threatens the health of more than 100 million people worldwide, including residents of the densely populated river deltas of South and Southeast Asia. Contaminated groundwater from tube wells in Cambodia was discovered in 2001 leading to the detection of the first cases of arsenicosis in 2006. The most affected area was the Kandal Province. The main objective of this study was to determine the prevalence of arsenicosis in Cambodia based on acceptable criteria, and to investigate the use of hair arsenic as a biomarker not only for arsenicosis-related signs but also for associated symptoms. A cross-sectional epidemiological study of 616 respondents from 3 purposely selected provinces within the Mekong River basin of Cambodia was conducted. The Kandal Province was chosen as a high arsenic-contaminated area, while the Kratie Province and Kampong Cham Province were chosen as moderate and low arsenic-contaminated areas, respectively. The most prevalent sign of arsenicosis was hypomelanosis with a prevalence of 14.5% among all respondents and 32.4% among respondents with a hair arsenic level of ≥1 μg/g. This was followed by hyperkeratosis, hyperpigmentation and mees lines. Results also suggest a 1.0 μg/g hair arsenic level to be a practical cut off point for an indication of an arsenic contaminated individual. This hair arsenic level, together with the presence of one or more of the classical signs of arsenicosis, seems to be a practical criteria for a confirmed diagnosis. Based on these criteria, the overall prevalence of arsenicosis for all provinces was found to be 16.1%, with Kandal Province recording the highest prevalence of 35.5%. This prevalence is comparatively high when compared to that of other affected countries. The association between arsenicosis and the use of Chinese traditional medicine also needs further investigation.

Profiles and factors associated with poor glycemic control among inpatients with diabetes mellitus type 2 as a primary diagnosis in a teaching hospital

Context: Diabetes mellitus is a growing health problem in most countries. In Malaysia, there was an increase in prevalence over the years. This makes diabetes also a growing concern in Malaysia, which warrants strengthening of the prevention and control programme. Aims: This paper aims to describe the profiles of diabetes mellitus type 2 in tertiary setting and to identify the risk factors for high level of HbA1c among the study population. The findings will give a glimpse on current status of diabetes in our country and may reflect the achievement of the country in combating this disease. Settings and Design: A cross-sectional study was conducted in UKM Medical Centre. Methods and Material: Medical records of patient with E11 ICD-10 code were collected using Case Report Form. Statistical Analysis Used: Descriptive analysis done of mean and median while test of association were done using Spearman correlation and logistic regression. Results: The results showed that majority of inpatients of DMT2 showed mean age of 58.8 + 12.6 years and most were males (56.7%) with secondary level of education (41.7%). Median duration of disease was 12.0 + 11.0 years with median HbA1c level of 8.9 ± 4.4%. Only small proportion of patients achieved the desired level of HbA1c <6.5% (21.3%) and significant association was found with tertiary level of education [AOR = 0.10, 95%CI = 0.01-0.96] and with type of anti-diabetic therapy [AOR = 15.90, 95%CI=1;2.03-124.30]. Conclusions: In conclusion, diabetes mellitus type 2 inpatients still showed unsatisfactory glycemic control and holistic approach using health education should be advocated continuously in the future in view of education being one of the predictors for the good HbA1c outcome.

Patient satisfaction with services in physiotherapy clinics: a cross sectional study at teaching hospitals in Klang Valley

Background The physiotherapy service is a new and emerging field in most hospitals throughout Malaysia as well as internationally. As such, there is still a lack of scientific research and reporting about the finding of service quality studies in Physiotherapy Clinics at teaching hospital settings in Malaysia. It is timely and relevant then that research is conducted on the quality of services in teaching hospitals in terms of physiotherapeutic system which includes examination, treatment, advice and instructions for the purpose of connection with movement dysfunction, bodily malfunction, physical disorder, disability, healing and pain from trauma and disease. This study was to determine the level of patient satisfaction and its contributing factors as well as to determine the quality of services in Physiotherapy Clinics at Teaching Hospitals in Klang Valley.

Economic burden of managing Type 2 diabetes mellitus: Analysis from a Teaching Hospital in Malaysia

Background: Type 2 diabetes mellitus (T2DM) is a chronic disease that consumes a large amount of health-care resources. It is essential to estimate the cost of managing T2DM to the society, especially in developing countries. Economic studies of T2DM as a primary diagnosis would assist efficient health-care resource allocation for disease management. Objective: This study aims to measure the economic burden of T2DM as the primary diagnosis for hospitalization from providers perspective. Methods: A retrospective prevalence-based costing study was conducted in a teaching hospital. Financial administrative data and inpatient medical records of patients with primary diagnosis (International Classification Disease-10 coding) E11 in the year 2013 were included in costing analysis. Average cost per episode of care and average cost per outpatient visit were calculated using gross direct costing allocation approach. Results: Total admissions for T2DM as primary diagnosis in 2013 were 217 with total outpatient visits of 3214. Average cost per episode of care was RM 901.51 (US

Trend of head circumference as a predictor of microcephaly among term infants born at a regional center in Malaysia between 2011-2015

286.20) and the average cost per outpatient visit was RM 641.02 (US

Glycaemic control and associated factors among patients with diabetes at public health clinics in Johor, Malaysia

203.50) from providers perspective. The annual economic burden of T2DM for hospitalized patients was RM 195,627.67 (US

Clinical pathways: development and implementation at a tertiary Hospital in Malaysia

62,104) and RM 2,061,520.32 (US

Development of clinical pathway for non-surgical management of chronic periodontitis

654,450) for those being treated in the outpatient setting.Conclusions: Economic burden to provide T2DM care was higher in the outpatient setting due to the higher utilization of the health-care service in this setting. Thus, more focus toward improving T2DM outpatient service could mitigate further increase in health-care cost from this chronic disease.