Rosediani Muhamad

The Lived Experiences of Transgender Persons: A Meta-Synthesis

This article synthesises findings from qualitative studies which have explored the lived experiences of transgender persons, using Noblit and Hares (1998) meta-ethnography method. Thirty-one qualitative studies related to the lived experiences of transgender individuals, published between 1998 and 2013, met the inclusion criteria. A literature search was conducted between November 2012 and September 2013 using computerized searches from nine databases as well as online manual searches of key journals. Results from these individual studies revealed five major themes: (a) crossing gender and physical problems in life, (b) experiencing psychological distress, (c) encountering discrimination and social exclusion, (d) having relationships does matter, and (e) dealing with difficulties in life. Yet, despite these negative experiences, transgender people have tried to find ways to help them deal with their difficulties. We conclude that there is a need for health care providers, social workers, and health promoters to support transgender individuals, for their health and well-being. This meta-synthesis provides a clear account of what transgender individuals experience in their lives, to support the development of sympathetic health and social care services to assist them with their difficulties, and enhance their health and well-being.

Duration of hypertension and antihypertensive agents in correlation with the phases of female sexual response cycle.

OBJECTIVE This cross-sectional study aimed to determine the construct of the phases of the female sexual response cycle (SRC) in women with hypertension and their association with the duration of hypertension and types of antihypertensive agents. METHODS The sexual response phases were measured with a validated Malay version of the Female Sexual Function Index (FSFI). The correlations structure of the items of the SRCs phases (i.e. desire, arousal, orgasm, satisfaction and pain) was determined using principal component analysis (PCA), with varimax rotation method. The number of factors obtained was decided using Kaisers criteria. A total of 348 hypertensive women were recruited for this study. Four constructs were extracted in the analysis of all subjects. RESULTS Using the factor analysis, the six domains (i.e. sexual desire, arousal, etc.) of the womens SRC among hypertensive women merged into 4 constructs. They were composed of (i) sexual desire and arousal, (ii) orgasm and sexual satisfaction, (iii) vaginal lubrication and (iv) sexual pain. Interestingly, vaginal lubrication stood out alone as one construct, compared to the non-hypertensive women. It was also observed that the duration of hypertension, beta blocker and diuretic antihypertensive medications had different influence on the SCR (in terms of constructs). CONCLUSION Duration of hypertension and types of antihypertensive drugs may affect the components of the SRC. A clear understanding would help the clinician in strategizing the treatment approach of sexual dysfunction in women with hypertension.

Meanings of Sexuality among Heterosexual Women: A Metasynthesis

ABSTRACT This metasynthesis presents the empirical evidence for heterosexual womens interpretation of sexuality using the Sandelowski-Barroso framework. Most women framed sexuality as the integration of patriarchal culture, gendered identity and religious understanding and placed intercourse at the centre of the sexual act. Some women acknowledged it from the negative point of view which may increase the risk for sexual difficulties. However, women who accepted male dominant partners and focused on self-gratification, found that this would lead to positive well-being; while those who internalized female centricity emphasized equality in achieving a quality sex life. Clinical implications of these findings are also discussed.

The effect of Tualang honey on the quality of life of patients with chronic obstructive pulmonary disease: A randomized controlled trial

Objectives This study aimed to assess the efficacy of a 6-months regime of honey supplementation in improving the quality of life (QoL) of patients with chronic obstructive pulmonary disease (COPD). Methods A single blind randomized controlled trial on 34 patients with COPD was conducted. The participants were divided into two groups, including honey (n = 22) and standard care (n = 12). St. Georges Respiratory Questionnaire (SGRQ) was used to assess the QoL. The QoL total score was analysed using repeated measure ANOVA. Result There were no significant differences between the honey and standard care groups for socio-demographic and QoL variables. The within-time analysis showed statistically significant differences between baseline and post 2, 4 and 6-months in the total QoL score in the honey group. Otherwise, only marginally significant difference was detected between baseline and post 2-months in the standard care group. A comparison of total QoL score between the two groups, based on time (between and within), favoured the honey group. The honey group demonstrated a significantly lower mean total QoL score compared with the standard group at 4-months (28.89; 95% CI: 21.19, 36.59 vs 42.38; 95% CI: 31.95, 52.81) and 6 months (22.91; 95% CI: 14.94, 30.87 vs 41.95; 95% CI: 31.17, 52.73). Conclusion Supplementation of honey in patients with COPD results in better intermediate and long-term changes in the overall QoL.

Prevalence of prehypertension and its associated factors among adults visiting outpatient clinic in Northeast Malaysia

Objectives Prehypertension refers to a systolic blood pressure of 120–139 mmHg systolic or a diastolic blood pressure of 80–89 mmHg. Estimation of the prevalence of prehypertension in the population and identification of cardiovascular associated factors are important to reduce progression to hypertension. This study aimed to determine the prevalence of prehypertension and its associated factors among Malaysian adults. Methods In 2015, a cross-sectional study was conducted among adults visiting an outpatient clinic in Northeast Malaysia. Face-to-face interviews were conducted using Malay and English versions of the Malaysia Non-Communicable Disease surveillance questionnaire. This instrument captured information about sociodemographic, lifestyle status, and anthropometric data. Blood pressure was measured three times with a sphygmomanometer, the first measurement value was discarded, and an average of blood pressure from the second two readings was recorded for further data analysis. Logistic regression was performed to analyse factors associated with prehypertension. Result A total 151 adults participated in the study, and the prevalence of prehypertension was 37.1% (95% confidence interval [CI]: 29.29, 44.69). Factors associated with prehypertension in this study were age (adjusted odds ratio [aOR] = 1.06 95% CI: 1.02, 1.11; p = 0.007), male sex (aOR = 4.44 95% CI: 1.58, 12.44; p = 0.005), and abnormal waist circumference (aOR = 31.65 95% CI: 11.25, 89.02; p < 0.001) as determined by multiple logistic regression analysis. Conclusion In this study, the prevalence rate of prehypertension of 37.1% is higher than that of hypertension reported in the literature. Age, male sex, and abnormal waist circumference are significant associated factors that lead to prehypertension.

Managing Women with Sexual Dysfunction: Difficulties Experienced by Malaysian Family Physicians

Recognizing barriers to managing sexual issues makes it more likely that effective ways to overcome them will be found. In Malaysia, where discussion of sexual issues is taboo, sociocultural factors may influence how physicians manage patients with these types of problems. This article focuses on the challenges encountered by 21 Malay family physicians when women experiencing sexual problems and female sexual dysfunction (FSD) attended their clinics, an uncommon occurrence in Malaysia, despite their high prevalence. This qualitative study employed a phenomenological framework and conducted face-to-face in-depth interviews. Three main barriers to managing women with sexual problems were identified that can hinder assessment and treatment: insufficient knowledge and training; unfavorable clinic environments; and personal embarrassment. Some barriers were associated with physician characteristics but many were systemic. These were further evaluated using social cognitive theory. Professional attitudes appear important as those physicians with an interest in managing women’s health seemed to make greater effort to explore issues further and work to gain trust. Physicians who appeared indifferent to the impact of FSD showed greater reluctance to find solutions. Systemic issues included unfavorable clinical settings, lack of training, and lack of local evidence. Any strategy to address FSD needs to be underpinned by appropriate policies and resources.

Meanings of Sexuality: Views from Malay Women with Sexual Dysfunction

In Malaysia, female sexual dysfunction (FSD) among Malays is common, so understanding the meanings of sexuality becomes crucial, as they can vary with identity, and this may influence each woman’s subsequent reaction to sexual experience. In this article, we explore the meanings of sexuality that Malay women had developed throughout their lived experience. This qualitative study, situated within a social cognitive theory and a phenomenological framework, was conducted through in-depth and photograph elicitation interviews with 26 Malay women who had self-reported experiencing FSD. The findings suggest that the meanings of sexuality for these women linked closely with fundamental factors of Malay identity, which is comprised of tradition (Adat), religion (Islam), and language, that all influence gendered roles. Malay women understood sexuality to be sexual intimacy within marriage, privileging their marital role as a “good wife” over their personal rights within a sexual relationship. This understanding of sexuality was reinforced by meanings attributed to procreation, which Malay women linked closely to the purpose of marriage and their role as a “good mother.” The findings should provide useful evidence that could be used in sexual health promotions to help reduce FSD and in clinical practice to generate appropriate therapy in Malaysia and elsewhere.

Risk and associated factors of female sexual orgasmic disorder in women with hypertension in Malaysia

The objective of this study was to examine the risk of female sexual orgasmic disorder among a group of women with hypertension in Malaysia. The associated factors were also examined.