Mahadir Ahmad

Relationships between social support and depression, and quality of life of the elderly in a rural community in Malaysia

This study aimed to examine the role of social support and depression in predicting the quality of life among the elderly living in a rural Federal Land Development Authority (FELDA) community in Malaysia.

Loneliness and depression among the elderly in an agricultural settlement: mediating effects of social support.

Loneliness has long been known to have strong association with depression. The relationship between loneliness and depression, however, has been associated with other risk factors including social support. The aim of this paper is to describe the role of social support in the association between loneliness and depression.

Is the Bahasa Malaysia version of the Montreal Cognitive Assessment (MoCA-BM) a better instrument than the Malay version of the Mini Mental State Examination (M-MMSE) in screening for mild cognitive impairment (MCI) in the elderly?

INTRODUCTION Mild Cognitive Impairment (MCI) is a known precursor to Alzheimer disease, yet there is a lack of validated screening instruments for its detection among the Malaysian elderly. OBJECTIVE To compare the Bahasa Malaysia version of the Montreal Cognitive Assessment (MoCA-BM) with the Malay version of the Mini Mental State Examination (M-MMSE) in the detection of MCI among the Malaysian elderly. METHODOLOGY This is a cross-sectional study conducted at the primary care centre of Universiti Kebangsaan Malaysia, Kuala Lumpur from December 2011 to mid-January 2012. Subjects aged 60 and above were recruited using systematic sampling method. Cut-off scores of 22/23 for MoCA-BM and 25/26 for M-MMSE were adopted. Kappa value and Pearsons correlation coefficient were used to ascertain the correlation between MOCA-BM and M-MMSE. Data were analysed using Mann-Whitney and Chi Square tests. RESULTS The mean age of the 180 subjects enrolled was 65.3 years (SD=5.4). They had a median of 6 years (IqR 25-75=5-11) total formal education. The prevalence of MCI using MoCA-BM and M-MMSE was 55.6% and 32.8% respectively. The odds of developing MCI were 1.153 (95% CI=1.055, 1.261; p<0.05) for every 1 year increase in age, 0.813 (95% CI=0.690, 0.959; p<0.05) with every extra year of education. Increasing age and lower education level were significantly associated with MCI. The MoCA-BM showed good internal consistency with Cronbachs alpha of 0.80. It had moderate correlation with M-MMSE (Pearson correlation coefficient=0.770, p<0.001) and moderate agreement for detecting MCI with Kappa values of 0.497 (p<0.001). CONCLUSION The prevalence of MCI was higher using MoCA-BM compared to M-MMSE. Both instruments showed moderate concordance for screening MCI with correlation of their scores.

Loneliness and depression among the elderly in an agricultural settlement

Loneliness has long been known to have strong association with depression. The relationship between loneliness and depression, however, has been associated with other risk factors including social support. The aim of this paper is to describe the role of social support in the association between loneliness and depression.

Improving magnetic resonance imaging (MRI) examinations: Development and evaluation of an intervention to reduce movement in scanners and facilitate scan completion

OBJECTIVES The movement of patients in magnetic resonance imaging (MRI) scanners results in motion artefacts which impair image quality. Non-completion of scans leads to delay in diagnosis and increased costs. This study aimed to develop and evaluate an intervention to enable patients to stay still in MRI scanners (reducing motion artefacts) and to enhance scan completion. Successful scan outcome was deemed to be completing the scan with no motion artefacts. DESIGN AND METHODS Previous research indicated self-efficacy to predict successful scan outcome, and interviews with patients identified a need for procedural and sensory information to facilitate successful scan behaviour. A DVD intervention was developed which targeted self-efficacy and included procedural and sensory information. It was successfully piloted with 10 patients and then evaluated in a randomized controlled trial compared with the standard hospital information leaflet (intervention group N = 41; control group N = 42). The clinic radiographer, who was blind to group allocation, rated MRI scans for motion artefact and recorded whether the participant completed the scan; participants completed MRI self-efficacy and anxiety measures. RESULTS Only one participant reported not finding the DVD useful. Thirty-five participants in the intervention group and 23 in the control group completed scans and had no motion artefacts, χ(2) (1, 83) = 7.84, p < .001 (relative risk of an unsatisfactory outcome in the control group/intervention group = 3.09). The intervention effect was mediated by self-efficacy. CONCLUSIONS The DVD intervention was efficacious and warrants further research to examine generalizability.

Effectiveness of adjunct psychotherapy for cancer treatment: A review

Psychotherapies were offered to alleviate psychological and physical symptoms; however, most psychological interventions were only delivered after cancer treatment. Newly diagnosed cancer patients experienced psychological distress while waiting for treatments. This review paper focused on randomized control trial studies, aimed to investigate the effectiveness of psychological intervention among newly diagnosed cancer patients. Eight randomized control trial papers were found in recent 10 year period through electronic database. A moderate to large effect size was detected on the outcomes, ranging from 0.43 to 0.89. This indicated that psychological-based prehabilitation with standard care yielded better outcomes than standard care alone. Psychological-based prehabilitation provides evidence in its effectiveness to reduce psychological distress, functional impairment, recurrence of cancer, numbers of immune reactivity and sleeping quality; however, inconsistent with longer survival result among cancer patients. In conclusion, psychological-based prehabilitation before cancer treatment is necessary for better treatment outcome, and future research is needed to investigate more directly the outcome.

Parenting Stress and Maternal Coherence: Mothers With Deaf or Hard-of-Hearing Children

Purpose The aim of this study was to develop a substantive theory that explains parenting stress among mothers of deaf or hard-of-hearing (D/HH) children. Method Fifteen hearing mothers of children with severe-to-profound sensorineural hearing loss were interviewed. Interviews were transcribed verbatim, and a grounded theory approach was used to inductively analyze parental stress in mothers of D/HH children. Theory generation was achieved through triangulation of data sources and systematic organization of data into codes. The coding process identified salient themes that were constantly cross-checked and compared across data to further develop categories, properties, and tentative hypotheses. Results In general, two main themes emerged from the interviews: the contextual stressors and stress-reducing resources. The contextual stressors were labeled as distress over audiology-related needs, pressure to acquire new knowledge and skills, apprehension about the childs future, and demoralizing negative social attitudes. The stress-reducing resources that moderated parenting stress were identified to be the childs progress, mothers characteristics, professional support, and social support. The interaction between the identified stressors and adjustment process uncovered a central theme termed maternal coherence. Conclusion The substantive theory suggests that mothers of D/HH children can effectively manage parenting stress and increase well-being by capitalizing on relevant stress-reducing resources to achieve maternal coherence.

Nutritional status and feeding problems in pediatric attention deficit-hyperactivity disorder

Children with attention deficit–hyperactivity disorder (ADHD) may be at risk of nutrient deficiency due to the inability to sit through meals. This comparative cross‐sectional study was therefore carried out to determine the nutritional status and feeding problems of ADHD children aged 4–12 years.

The Internal Reliability of Family Crisis Oriented Personal Evaluation Scale (F-COPES) in Malay version among caregivers of individual with learning disabilities.

OBJECTIVES Caregivers face challenges to adapt while handling individual with learning disabilities (LD). The Family Crisis Oriented Personal Evaluation Scale (F-COPES) is a widely used instrument to measure coping strategies among caregivers. The current study performed cross cultural translation of F-COPES in Malay language. This study aims to examine the reliability by testing internal consistency of Malay version of F-COPES which is developed through back to back translation method from original English version. MATERIALS AND METHODS The Malay version of F-COPES was administered among 30 caregivers. RESULTS The reliability of F-COPES in Malay version is good with Cronbachs alpha coefficient value of 0.79. The internal consistency on sub domains of F-COPES such as reframing, acquiring social support and seeking spiritual support also acceptable with Cronbachs alpha values 0.67, 0.74, and 0.80, respectively. CONCLUSIONS The Malay version of F-COPES is a reliable tool to evaluate the coping strategies adopted by the caregivers of individual with LD.