Sami Abdo Radman Al-Dubai

Factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia: a descriptive cross-sectional single-centre study.

Objective To determine the prevalence and factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia. Design Descriptive, cross-sectional single-centre study with universal sampling of all patients with type 2 diabetes. Setting Endocrinology clinic of medical outpatient department in a Malaysian public hospital. Participants All 169 patients with type 2 diabetes (men, n=99; women, n=70) aged between 18 and 90 years who acquired follow-up treatment from the endocrinology clinic in the month of September 2013. Main outcome measures The validated Hospital Anxiety and Depression Scale (HADS), sociodemographic characteristics and clinical health information from patient records. Results Of the total 169 patients surveyed, anxiety and depression were found in 53 (31.4%) and 68 (40.3%), respectively. In multivariate analysis, age, ethnicity and ischaemic heart disease were significantly associated with anxiety, while age, ethnicity and monthly household income were significantly associated with depression. Conclusions Sociodemographics and clinical health factors were important correlates of anxiety and depression among patients with diabetes. Integrated psychological and medical care to boost self-determination and confidence in the management of diabetes would catalyse optimal health outcomes among patients with diabetes.

Patient Satisfaction in Malaysia’s Busiest Outpatient Medical Care

This study aimed to explore factors associated with patient satisfaction of outpatient medical care in Malaysia. A cross-sectional exit survey was conducted among 340 outpatients aged between 13 and 80 years after successful clinical consultations and treatment acquirements using convenience sampling at the outpatient medical care of Tengku Ampuan Rahimah Hospital (HTAR), Malaysia, being the countrys busiest medical outpatient facility. A survey that consisted of sociodemography, socioeconomic, and health characteristics and the validated Short-Form Patient Satisfaction Questionnaire (PSQ-18) scale were used. Patient satisfaction was the highest in terms of service factors or tangible priorities, particularly “technical quality” and “accessibility and convenience,” but satisfaction was low in terms of service orientation of doctors, particularly the “time spent with doctor,” “interpersonal manners,” and “communication” during consultations. Gender, income level, and purpose of visit to the clinic were important correlates of patient satisfaction. Effort to improve service orientation among doctors through periodical professional development programs at hospital and national level is essential to boost the countrys health service satisfaction.

Prevalence and associated factors of hepatitis C virus infection among renal disease patients on maintenance hemodialysis in three health centers in Aden, Yemen: a cross sectional study.

We aimed to assess the prevalence and factors associated with positive anti-hepatitis C virus (HCV) antibodies among patients on maintenance hemodialysis (HD) in three centers in Aden, Yemen. The data from 219 patients and their records over the period between 2000-2013, was extracted and analyzed. The mean ± SD age of the patients was 47.08 ± 13.9 years; 74.4% of them were married and 14.6% were employed. The prevalence of validated anti-HCV-positive cases was 40.2% (95%CI 33.64%-46.73%). The mean ± SD duration on HD of all the patients was 35.09 ± 38 months. On bivariate analysis, the duration on HD and attending more than one center for HD associated significantly with anti-HCV positivity (P <0.05). On multivariate fully adjusted Poisson regression modelling, controlled for age, Patients attending more than one center and those who underwent HD for longer durations were more likely to be positive for anti- HCV antibodies [P = 0.004, adjusted prevalence rate ratio (APRR) = 1.87, 95% confidence interval (CI): 1.22-2.88; P = 0.0005, APRR = 1.01, 95% CI: 1.00-1.02. In this study sample, the prevalence of HCV was significant. Patients attending more than one center and those who underwent HD for longer durations were found to be more likely to contract HCV. Enhancing existing infection control measures and allocating more resources to HD centers therefore warrants consideration.

Psycho-socioeconomic factors affecting complementary and alternative medicine use among selected rural communities in Malaysia: a cross-sectional study.

Introduction The use of complementary and alternative medicine (CAM) as a source of cure has gained much spectrum worldwide, despite skeptics and advocates of evidence-based practice conceptualized such therapies as human nostrum. Objective This study aimed to explore the factors affecting CAM use among rural communities in Malaysia. Methods A cross-sectional study was carried out on 288 occupants across four rural villages within the District of Selama, Perak, Malaysia. A survey that consisted of socio-economic characteristics, history of CAM use and the validated Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) were used. Results The prevalence of self-reported CAM use over the past one year was 53.1%. Multiple logistic regression analyses yielded three significant predictors of CAM use: monthly household income of less than MYR 2500, higher education level, and positive attitude towards CAM. Conclusion Psycho-socioeconomic factors were significantly associated with CAM use among rural communities in Malaysia.

Level and Determinants of Knowledge of Symptomatic Knee Osteoarthritis among Railway Workers in Malaysia

Background. Symptomatic knee osteoarthritis, an ancient malady greatly impairing modern population quality of life, has stimulated global attention to find effective modes of prevention and intervention. Purpose. This study aimed to assess factors affecting knowledge of symptomatic knee osteoarthritis (knee OA) among Malaysian railway workers. Methods. A cross-sectional study was conducted among 513 railway workers involving eight major states within Peninsular Malaysia using population-based sampling. The assessment instrument was a face-validated, prepiloted, self-administered instrument with sociodemographics and knowledge items on knee OA. Results. Mean (±SD) age of the respondents was 41.4 (±10.7), with the majority aged 50 years or older (34.9%). Of the total respondents, 53.6% had low levels of knowledge of knee OA disease. Multivariate analysis found that four demographic predictors, age ≥50 years, family history of knee OA, self-awareness, and clinical diagnosis of the disease entity, were significantly associated with knowledge scores. Conclusion. The finding of a low level knee OA knowledge among Malaysian railway workers points to an urgent need for massive information to be disseminated among the workers at risk to foster primary prevention and self-care.

The role of psychosocial and belief factors in self-reported cigarette smoking among university students in Malaysia

This study aimed to explore factors associated, specifically belief factors, with self-reported tobacco smoking status. A sample of 300 students was recruited from a private university in Malaysia. Data was collected using a pre-tested self-administrated questionnaire that investigated various factors including socio-demographics, socio-economic status, smoking behavior and beliefs on tobacco smoking. The main tobacco use in this study sample was cigarettes and the estimated prevalence of self-reported cigarette smoking was 10.3%. In bivariate analysis, self-reported cigarette smoking was significantly associated with socio-demographic, behavioral factors and faculty of study (P<0.05). In multivariate modeling, being male and a non-medical student, did not exercise, having a smoker father and brother or sister, suffering from financial difficulties and having the belief that smokers had more friends, all had statistically significant associations (P<0.05) with self-reported cigarette smoking. Social and interpersonal factors were associated with self-reported cigarette smoking status. A comprehensive health model focusing on changing the social norms of parent and sibling tobacco smoking and students’ beliefs, alongside nurturing skills of dealing with stressful situations, warrant implementation.

Relationships among perceived quality of healthcare services, satisfaction and behavioural intentions of international students in Kuala Lumpur, Malaysia: a cross-sectional study

Objective The current study aimed to investigate the relationships among the perceived quality of healthcare services, satisfaction and behavioural intentions among international students in Kuala Lumpur, Malaysia. Setting A cross-sectional study on public universities in Kuala Lumpur, Malaysia. Participants All participants in this study were international students joining public universities in Kuala Lumpur, Malaysia. Primary independent variable Perceived quality of healthcare services measured on a SERVQUAL scale. Primary dependent variable Participants’ satisfaction of healthcare services assessed using five items. Secondary dependent variable Behavioural intentions measured on six items. Results Of the 556 international students, 500 (90%) completed the survey. The study used structural equation modelling (SEM) through the AMOS (Analysis of Moment Structures) software to analyse the data. SEM analyses showed that the perceived quality of healthcare services significantly and directly affected satisfaction, with a value of 89% and an effect size of 0.78. It also had a significant indirect impact on the behavioural intentions (0.78) of international students. The results indicated that participants’ satisfaction had a statistically significant impact on their behavioural intentions (0.77). Conclusion Perceived quality of care is an important driver of international students’ satisfaction and their behavioural intention with healthcare services. Such relations of effects among the three investigated factors were also positive and significant.

Pre-hospital delays in ischemic stroke patients in a Malaysian tertiary hospital

Dear editor, Stroke is the third largest cause of death in Malaysia and it is considered to be the single most common cause of severe disability. Early arrival to hospital and, consequently, initiation of thrombolytic treatment of ischemic stroke are critical in improving patient outcomes. Although, several studies were conducted in the developed countries, there is lack of data on pre-hospital delay in Malaysia. In this study, we investigated delays in presentation of stroke patients and explored factors associated with such delays in a tertiary health center of Malaysia. We conducted a cross-sectional study from 24 March to 25 June 2014 in the outpatient neurology clinic in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). We recruited 142 subjects who had ischemic stroke or transient ischemic attack in the last two years. Univariate analysis was conducted by using Chi-square test. Multiple logistic regression analysis was used to identify predictors of pre-hospital delay in variables selected from the univariate analyses with a significance level 0 05 The mean (SD) age was 63.5 (12.3) years. The median time from symptom onset to hospital arrival was 2 h with 68.4% of the patients arriving before 4.5 h. In previous studies, the median pre-hospital delay time was found to be from 2 to 15 h and the percentage of stroke patient who received thrombolytic therapy was 2.1% and 8.5%.Multiple logistic regression analysis showed that those who were conscious were more likely to be delayed compared to those who were unconscious (p1⁄4 0.035). Those who had stroke before midnight were more likely to be delayed compared to those who had stroke in the morning (p1⁄4 0.035 and 0.021, respectively) (Table 1). Previous studies showed similar findings. In conclusion, our study found that pre-hospital delay is associated with the consciousness status and the time of occurrence of stroke symptoms. Public education programs on stroke are recommended.