Knowledge and practice of routine medical check-up Among elderly in Klinik Rawatan Keluarga (KRK), Hospital Universiti Sains Malaysia (HUSM)

Objective To examine elderlys' knowledge, health practice and attitude toward routine medical check-up. Design and setting A cross-sectional descriptive study was conducted at Klinik Rawatan Keluarga (KRK), Hospital Universiti Sains Malaysia (HUSM). Methods A convenience sample of 90 men and women aged 60 years and above, completed answering questionnaires of sociodemographic data, knowledge of routine medical check-up, practice and attitude. Findings Educational level and socioeconomic factor (income) influenced elderlys' knowledge and attitude. Meanwhile, health status influenced elderly practice. Conclusions The study revealed that one's knowledge does not necessarily reflect one's actual practice status. This finding deserves the attention of older adult and health care providers who consider patient awareness as fundamental to behavioral changes and health centre visits for regular medical check-up

Prevalence and Associated Factors of Chronic Constipation Among Adults in Penang

Background: Chronic constipation is a common digestive problem that affects people of all age groups over the world. It has a substantial impact on the patient’s quality of life (QoL) and consumption of healthcare resources. Purpose: The aim of this study is to examine the prevalence and associated factors of chronic constipation among adults in Penang, Malaysia. Methodology: An online survey using convenience sampling was conducted among adults aged 18 years old and above in Penang from October to December 2020. The questionnaire composed of items on the socio-demographic data, health status, assessment of chronic constipation, physical activity, dietary fiber intake, fluid intake, and smoking status. Chronic constipation was determined based on the Rome criteria. Data analysis was done by using SPSS version 22.0. Chi-square test was used to analyse the associated factors of chronic constipation with the p-value of <0.05 was determined as the significant level findings. Results: A total of 220 participants were included in the study. Their age ranged from 18 to 65 years old with the mean age was 31.5 (SD = 13.1). The prevalence of chronic constipation among adults in Penang was 6.4%. Factors of gender (p-value = 0.042), fluid intake (p-value = 0.008) and dietary fibre intake (p-value = 0.017) were significantly associated with chronic constipation. Conclusion: Chronic constipation was common in our study associated mainly with fluid and dietary intakes. There is a need for the health care providers to highlight on the dietary modification in prevention and management of chronic constipation among the adult people

Frequency patterns of core constipation symptoms among the Asian adults: a systematic review

Background: In clinical practice, assessment of constipation depends on reliability, consistency and frequency of several commonly reported or core symptoms. It is not known if frequency patterns of constipation symptoms in adults are different between the West and the East. This review aimed to describe core constipation symptoms and their frequency patterns among the Asian adults. Methods: Articles published in PubMed, MEDLINE, CINAHL and Science Direct from 2005 to 2015 were searched systematically. Studies were included if constipation satisfied the Rome II and or III criteria. Study populations consisted of Asian adults above 18 years old and with sample size above 50. Results: Of 2812 articles screened, 11 met the eligibility criteria. Constipation among Asian adults was characterized by three core symptoms of ‘straining’ at 82.8%, ‘lumpy and hard stool’ at 74.2% and ‘sensation of incomplete evacuation’ at 68.1% and the least frequent symptom was ‘manual maneuver to facilitate defecation’ at 23.3%. There was heterogeneity in frequency patterns of core symptoms between different Asian studies but also differences in core symptoms between constipation subtypes of functional constipation and irritable bowel syndrome with constipation. Conclusions: In general, Asian adults perceive constipation symptoms in a similar but not equivalent manner to the West. Recognition of core symptoms will increase the diagnostic confidence of constipation and its subtypes but more studies of the various specific Asian populations are needed to address their differences

Quality of life of patients living with a stoma and association with the socio-demographic factors

Introduction: Stoma formation is a lifesaving surgery to help in the excretion of feces or urine from the body. Previous studies showed that stoma could compromise the patient’s quality of life (QoL), and this issue was associated with their background characteristics. This study aimed to assess QoL and association with the socio-demographic factors among the patients living with a stoma. Methods: A retrospective study was conducted in a teaching hospital in Pahang. Medical records starting from November 2018 until November 2020 were examined, resulting in 48 patients with stoma were selected. Telephone interviews using structured questionnaires were conducted to collect data on socio-demographic and QoL. Quality of Life Questionnaire for a Patient with an Ostomy (QoL-O) was used to measure the QoL of patients living with a stoma. The maximum score was 10, and the minimum score was 0. Result: 24 patients enrolled in this study (response rate = 50%). Their mean age was 56.8 (SD = 18.6) with 70.8% were men (n = 17) and 29.2% were women (n = 7). Almost all were Malay (95.8%) and 79.2% completed secondary school and above. Only 20.8% were employed, and 79.2% were unemployed or retired. About 58.3% had ileostomy, and 41.7% colostomy. The overall mean score of QoL was 7.1 (SD = 1.0). A significant association was only found between QoL and employment status (p = 0.025). Those employed had higher scores on QoL (8.4, IQR 1.0) compared to the retired group (7.1, IQR 1.0) and the unemployed (6.3, IQR 1.0). Conclusion: Most of the patients living with a stoma in this study had a moderate QoL, which was mainly associated with their employment status. Further research with a greater number of patients is needed to determine their QoL as well as to consider other potential factors that may influence their perspectives on QoL

Psychometric evaluation of a newly developed elderly - Constipation Impact Scale

Background. Chronic constipation is a common symptom among the elderly, and it may affect their quality of life (QoL). A lack of available research focused on the elderly means that this effect is not well understood. This study aimed to develop and validate a new scale (Elderly-Constipation Impact Scale (E-CIS)) to measure the impact of chronic constipation on QoL among the elderly. Methods. A pool of items was generated from a qualitative study, literature reviews, and expert reviews. Exploratory factor analysis (EFA) was performed on the original 40 items of the E-CIS and followed by 27 items for confirmatory factor analysis (CFA). A total of 470 elderly people with chronic constipation were involved. Results. The mean age of the participants was 68.64 ± 6.57. Finally, only 22 items were indicated as appropriately representing the E-CIS, which were grouped into seven subscales: ‘daily activities’, ‘treatment satisfaction’, ‘lack of control of bodily function’, ‘diet restriction’, ‘symptom intensity’, ‘anxiety’ and ‘preventive actions’. The scale was confirmed as valid (root mean square error of approximation (RMSEA) = 0.04, comparative fit index (CFI) = 0.961, Tucker-Lewis index (TLI) = 0.952 and chisquare/degree of freedom (chiSq/df) = 1.44) and reliable (Cronbach’s alpha: 0.66–0.85, composite reliability (CR) = 0.699–0.851) to assess the impact of chronic constipation on the elderly’s QoL. Conclusions. The E-CIS is useful to measure the impact of chronic constipation on the elderly’s QoL. A further test is needed to determine the validity and reliability of this scale in other elderly population

The caregiving burden of older people with functional deficits and associated factors on malaysian family caregivers

Providing care to older people can be an extremely complex task, given their increased functional deficits, which may lead to family caregivers experiencing burnout and a deteriorated health status. This study investigated the caregiving burden of older people with functional deficits on family caregivers and associated factors. Methods: This cross-sectional study was conducted on family caregivers of older people with functional deficits living in FELDA schemes in Pahang, Malaysia. A self-administered questionnaire was used to collect data, which included the sociodemographical profile, health status and caregiving demands factors. The caregiving burden was assessed using the Malay version of the Zarit Burden Interview (ZBI). Multiple linear regression was used to assess the factors associated with burden. Results: A total of 271 family caregivers completed the questionnaire. Their mean age was 45.8 (SD 0.9) years old. The mean score for caregiving burden was 18.5 (SD 13.6). Caregivers’ gender (3.5 [95% CI: 0.2, 6.8]; P = 0.037), older people with chronic disease (9.6 [95% CI: 2.4, 16.9]; P = 0.010) and the functional independence of older people (–1.1 [95% CI: –1.6, –0.6]; P < 0.001) were predictors of family caregiving burden. Conclusion: The caregiving burden among family caregivers was mild and influenced mainly by care recipients’ health status. A proper assessment should be conducted and relevant health education provided to prepare family caregivers to care for their family members before discharge from the hospital

Predictive Factors of Physician Visits in Older People with Chronic Constipation

Objective: The aim of this study was to examine the predictive factors of physician visits in Malaysian older people with chronic constipation. Methods: A retrospective cohort study was conducted among 129 community-dwelling older people aged 60 years old and self-reported chronic constipation. The data were obtained from a multicenter health clinics survey that was conducted in a state of the northeast of Peninsular Malaysia between November 2016 and January 2017. The participants were stratified according to the physician visit to manage chronic constipation (yes or no) within the past 12 months. The binary logistic regression analysis was used to identify the predictive factors of the physician visit. Results: A total of 11% (N = 14) older people had visited the physicians to manage their chronic constipation. The employed or retired older people (OR = 5.14, 95% CI = 1.29 - 20.48, p = 0.02), having between moderate and high physical activity (OR = 12.85, 95% CI = 1.30 - 127.10, p = 0.029), and presence of abdominal bloating (OR =7.7, 95% CI = 1.97 - 30.06, p = 0.003) and Bristol stool forms of type 1 and 2 (OR =4.59, 95% CI = 1.11 - 18.97, p = 0.035) predicted the physician visit in older people with chronic constipation. Conclusion: Older people who were financially independent, kept an active life, and presented with symptoms of abdominal bloating and hard stool, tended to visit the physician to manage chronic constipation. Clinically, monitoring satisfaction with chronic constipation management following a visit to the physician could be beneficial. Keywords: chronic constipation, older people, healthcare utilization, Malaysia, physician visi

Short-term repeated dose biochemical effects of Catha edulis (khat) crude extract administration in rats

The leaves of khat (Catha edulis) are reported to have stimulating and pleasurable effects and are chewed habitually by people of East Africa and Arabian Peninsula. Due to various effects of khat the present study was undertaken to evaluate the short-term repeated dose effects of freeze dried khat leaves crude extract administration to male Sprague-Dawley rats. In this study, the effects of catha edulis leaves extract oral administration on plasma concentration of Malonyldialdehyde (MDA), triglycerides, cholesterol, HDL-cholesterol, LDL-cholesterol, uric acid, albumin and testosterone and liver enzymes activities were examined. Four groups of rats were exposed to 0, 500, 1000 and 2000 mg kg 1 body weight/day for 6 consecutive weeks. Our results demonstrated that food consumption and body weights changes were non-significantly different relative to the control. There were no significant effects observed on the levels of plasma MDA, cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, uric acid, albumin, liver enzymes or Acid Phosphatase (ACP) in the treatment groups relative to the control. Administration of freeze dried crude catha edulis leaves extract for 6 weeks was found to increase plasma testosterone levels in the two high doses treatment groups (1000 and 2000 mg kg 1 body weight) in more than 2 folds, while it was non-significantly increased in the 500 mg kg 1 body weight treatment group, as compared to control. The data indicated that at the doses and time period tested, catha edulis freeze dried crude extract could be considered as aphrodisiac. Moreover, it did not produce any significant effect on the normal biological markers of liver toxicity or prostatic adverse effects

A pilot study of constipation among the elderly in Hospital Universiti Sains Malaysia

Background: Older people are susceptible for constipation, resulting in high prevalence particularly among those who are hospitalized. Poor mobility and longer stay in hospital are some of the indication for constipation to occur among them. Thus, understanding of its health-related impact among hospitalized elderly is essential for early identification and management of chronic constipation. Objective: This study aims to determine the prevalence of constipation in hospitalized elderly and to investigate the impacts of symptom severity on their quality of life. Methods: A cross-sectional sample of elderly patients were recruited from two medical wards (N=30). Subjects were initially screened for constipation using the Malay language Rome III diagnostic questionnaires. Severity of constipation and specific health-related quality of life were assessed using Patient-Assessment of Constipation Symptoms (PAC-SYM) and Patient-Assessment of Constipation Quality of Life (PAC-QOL). Differences between the scores were evaluated using independent t-test. Results: Overall, only 14 of the elderly (47%) had constipation and were included in this study. The majority was female (64%). Constipation symptom severity was indicated between mild and moderate (M=11.77, SD=9.11), with stool symptoms domain were commonly reported compared to abdominal symptoms and rectal symptoms domains. Significant difference was indicated between the mean scores of PAC-SYM and PAC-QOL in patients with and without constipation at the p<0.05 level. Conclusion: The prevalence of constipation in the elderly hospitalized patients was high and it obviously compromised their quality of life. Further research in larger scale and on symptom severity impacting the elderly’s quality of life is required particularly in patients who do not meet the Rome III criteria