Cross-cultural adaptation and validation of Bahasa Malaysia version of the Eating Disorder Examination Questionnaire (EDE-Q)

Introduction: As eating disorders such as anorexia nervosa and others are generally becoming more prevalent, it is essential to have a culturally accepted and locally validated questionnaire that is able to detect abnormal eating habits. Objective: To translate the Eating Disorders Examination Questionnaire (EDE-Q) into Bahasa Malaysia (BM) and to determine the construct validity, reliability and other psychometric properties of the BM version. Method: Two parallel forward and backward translations were done in BM in accordance to guideline. Its validation was determined by using confirmatory factor analysis among 298 secondary school children. Results: The BM EDE-Q had very good internal consistency with global Cronbach’s alpha value of 0.879. For construct validity, majority of the items managed to produce values of more than 0.4 for confirmatory factor analysis with four unforced distinct factors detected. Conclusions: Analyses of reliability and validity of this BM version of EDE-Q yielded satisfactory results. The BM version produced in this study had good psychometric properties and it is applicable to the Malaysian population. Findings indicated that cultural factors in eating habits certainly influences the effort to adapt the questionnaire within a Malaysian setting

Rates and profiles of self-harm presenting to Malaysian general hospitals: data from the Ministry of Health in 2011

Introduction: Self-harm is an important global health concern as it is a strong predictor and risk factor for completed suicide. This paper is aimed to estimate the incidence rate of self-harm and to describe the profiles of people who self-harmed in 2011. Methods: This is a descriptive study based on secondary data retrieved from the Ministry of Health (MOH) of Malaysia hospitals’ discharge records from the 1st of January to 31st of December 2011. Results: The overall self-harm rate was 16.6 per 100 000 population (n= 4 815). Adults in the state of Johor had the highest rate of self-harm. There were more female self-harmers within the peak age group of 20-29 years. Indians, Muslims and those who were unmarried had the highest rates of self-harm. Male mostly used unspecified chemical (45.89%) while female used non-opioid analgesics (24.79%). Conclusions: In 2011, the rate of self-harm was 16.6 per 100 000 population with slightly higher rate observed among adult females compared to males and twice as high among girls than boys. Less lethal methods of self-harm were employed

Comparison of family environmental scale (FES) subscales between Malaysian setting with the original dimension of FES

Introduction: Family Environment Scale (FES) was developed by Moos1, has ten subscales and was categorized into three dimensions. Objective: The objective of this study was to develop factor structure for the Malay-translated version of the FES subscales. Methodology: The study used Malay translated version of FES by Khairani et. al2. This study was a multi centre, cross-sectional study, involving four secondary schools consisted of adolescents, aged between 12-17 years old and a total of 295 participants were enrolled in this study. Exploratory factor analyses was done across two groups of analysis set on the subscales with Cronbach’s alpha more than 0.50 and 0.53 respectively. Results: Two distinct factors were extracted across the four subscales consisted of Cohesion, Conflict and Organization in factor 1 and only Control in factor 2. Conclusion: The finding indicated that element of Cohesion, Conflict and Organization has a good indicator of a good family relationship

Cross-cultural adaptation and validation of the Bahasa Malaysia version of the eating disorder examination questionnaire (EDE-Q)

Introduction: As eating disorders such as anorexia nervosa and others are generally becoming more prevalent, it is essential to have a culturally accepted and locally validated questionnaire that is able to detect abnormal eating habits. Objective: To translate the Eating Disorders Examination Questionnaire (EDE-Q) into Bahasa Malaysia (BM) and to determine the construct validity, reliability and other psychometric properties of the BM version. Method: Two parallel forward and backward translations were done in BM in accordance to guideline. Its validation was determined by using confirmatory factor analysis among 298 secondary school children. Results: The BM EDE-Q had very good internal consistency with global Cronbach’s alpha value of 0.879. For construct validity, majority of the items managed to produce values of more than 0.4 for confirmatory factor analysis with four unforced distinct factors detected. Conclusions: Analyses of reliability and validity of this BM version of EDE-Q yielded satisfactory results. The BM version produced in this study had good psychometric properties and it is applicable to the Malaysian population. Findings indicated that cultural factors in eating habits certainly influences the effort to adapt the questionnaire within a Malaysian settin

Reliability of Bahasa Malaysia version of family environment scale and its measurement issues

Objective: Family Environment Scale (FES) is one of the most widely used instruments to measure many family aspects. Cross cultural adaptation of the original FES is essential prior to local utilization as different cultures percept their family environments differently. We attempted to translate the FES into the Bahasa Malaysia language for adolescents, evaluate its reliability using internal consistency and compare its results with the original study. Methods: This is a cross-sectional study, involving adolescents aged 12-17 from four secondary schools. The adolescents were selected using quota sampling for different age, ethnic and academic performance. The study was divided into four phases, namely: i) translation of FES, ii) pilot test iii) internal consistency reliability test and iv) comparison of the study results with the original FES. Results: A total of 295 adolescents participated in this study. All of the reliability measurements generated (ranged between Cronbach’s alpha 0.10 - 0.70) were lower than those originally reported for this instrument (ranged between Cronbach’s alpha 0.61 -0.78). Five subscales in the Bahasa Malaysia version were found to be less than Cronbach’s alpha 0.5, which were below the acceptable level for practical or research use. There was considerable variation observed between the sample population of this study and that of the original study, which could be due to the social cultural differences. Conclusion: The Bahasa Malaysia version of FES requires further culturally appropriate revision. A new measuring scale could also be devised to provide an accurate evaluation of the family environment as perceived by Malaysian adolescents, which has acceptable levels of reliability and validity

Comparison of the Framingham Risk Score, SCORE and WHO/ISH cardiovascular risk prediction models in an Asian population

AbstractBackgroundCardiovascular risk-prediction models are used in clinical practice to identify and treat high-risk populations, and to communicate risk effectively. We assessed the validity and utility of four cardiovascular risk-prediction models in an Asian population of a middle-income country.MethodsData from a national population-based survey of 14,863 participants aged 40 to 65years, with a follow-up duration of 73,277 person-years was used. The Framingham Risk Score (FRS), SCORE (Systematic COronary Risk Evaluation)-high and -low cardiovascular-risk regions and the World Health Organization/International Society of Hypertension (WHO/ISH) models were assessed. The outcome of interest was 5-year cardiovascular mortality. Discrimination was assessed for all models and calibration for the SCORE models.ResultsCardiovascular risk factors were highly prevalent; smoking 20%, obesity 32%, hypertension 55%, diabetes mellitus 18% and hypercholesterolemia 34%. The FRS and SCORE models showed good agreement in risk stratification. The FRS, SCORE-high and -low models showed good discrimination for cardiovascular mortality, areas under the ROC curve (AUC) were 0.768, 0.774 and 0.775 respectively. The WHO/ISH model showed poor discrimination, AUC=0.613. Calibration of the SCORE-high model was graphically and statistically acceptable for men (χ2 goodness-of-fit, p=0.097). The SCORE-low model was statistically acceptable for men (χ2 goodness-of-fit, p=0.067). Both SCORE-models underestimated risk in women (p<0.001).ConclusionsThe FRS and SCORE-high models, but not the WHO/ISH model can be used to identify high cardiovascular risk in the Malaysian population. The SCORE-high model predicts risk accurately in men but underestimated it in women

Determinants of uncontrolled dyslipidaemia among adult type 2 diabetes in Malaysia: the Malaysian Diabetes Registry 2009

Numerous studies with compelling evidence had shown a clear relationship between dyslipidaemia and cardiovascular (CV) events in patients with diabetes mellitus. This was an observational study based on secondary data from the online registry database Adult Diabetes Control and Management (ADCM) looking into the determinants of uncontrolled dyslipidaemia in type 2 diabetes mellitus patients. Independent predictors were identified using multivariate logistic regression. A total of 303 centres (289 health clinics, 14 hospitals) contributed a total of 70,889 patients (1972 or 2.8% patients were from hospital). About thirty eight percent were reported to have dyslipidaemia. There were 40.7% patients on lipid-lowering agents and of those above age 40 years old, only 38.1% of them were on a statin. Malay ethnicity and younger age groups (<50 years old) were two major determinants of uncontrolled LDL-C, TG and HDL-C. Female gender and uncontrolled blood pressure were determinants of uncontrolled LDL-C, and poor glycaemic control was related independently to high TG. This study has highlighted the suboptimal management of diabetic dyslipidaemia in Malaysia. Pharmacological treatment of dyslipidaemia could be more effective. Healthcare stakeholders in this country, especially in the primary care, have to recognize these shortfalls and take immediate remedial measures

Psychometric Properties of the Malay Work-Related Quality of Life (WRQoL) Scale in Malaysia

Malaysia aims to be one of the developed nations by year 2020; therefore, it is crucial to gauge the quality of working life in a parallel manner using a well-established Work-Related Quality of Life (WRQoL) Scale. The goal of this study is to describe the validity and psychometric properties of the Malay WRQoL Scale in Malaysian population.A total of 572 respondents took part in this cross-sectional study giving a 97% response rate. The reliability of the Malay WRQoL Scale was assessed using the test retest reliability analysis after a 2-week period. Both the interclass correlation (ICC) and Cronbach’s alpha were within acceptable levels. However in the validity analysis, the exploratory factor analysis only revealed 5 factors instead of 6 in the original scale.The Malay WRQoL scale has demonstrated to have the appropriate psychometric properties and can therefore be used in Malaysia to assess the quality of working life

Translation, Cross-cultural Adaptation and Validation of the Malay Version of the Maslach Burnout Inventory (MBI) in Malaysia

The Maslach Burnout Inventory (MBI) has been widely used in research for more than 2 decades and is recognized as the leading measure of burnout. Malaysia is a multi-ethnic country and English is regarded as the second language. Therefore, it is essential to have a culturally acceptable translated Malay version of MBI, which can easily be understood by Malaysians, in order to study the burnout level in our population. Hence, the objectives of this study are to translate, cross-culturally adapt and validate specifically the Malay versions of the Maslach Burnout Inventory – Health Services Survey (MBI-HSS), Maslach Burnout Inventory – Educators Survey (MBI-ES) and Maslach Burnout Inventory – General Survey (MBI-GS) in Malaysia. Intraclass correlation was used to examine the test-retest reliability of the Malay versions of the MBI-HSS, MBI-ES and MBI-GS, while Cronbach’s alpha was used to assess the internal consistency of the subscales and the instruments as a whole. Exploratory factor analysis involving the principle component analysis extraction and varimax rotation were used to investigate the construct validity of the instruments. Overall, high intraclass correlation and Cronbach‘s alpha values were achieved in the Malay versions of the MBI-HSS, MBI-ES and MBI-GS. The eigenvalue in factor analysis revealed all items in the Malay versions of the MBI-HSS, MBI-ES and MBI-GS can be grouped into 3 components, which were very similar to the original English versions. In conclusion, the findings from this study had demonstrated the Malay versions of the MBI-HSS, MBI-ES and MBI-GS were valid and appropriate to be used in Malaysia

Predictors of poor glycaemic control in older persons with type 2 diabetes mellitus

INTRODUCTION: We assessed the predictors of poor glycaemic control among older patients with type 2 diabetes mellitus (T2DM) in Malaysia. METHODS: This cross-sectional study used the data of 21,336 patients aged ≥ 60 years with T2DM from the Adult Diabetes Control and Management Registry 2008-2009. RESULTS: Predictors of poor glycaemic control were: age groups 60-69 years (odds ratio [OR] 1.96, 95% confidence interval [CI] 1.66-2.33) and 70-79 years (OR 1.43, 95% CI 1.20-1.71); Malay (OR 1.53, 95% CI 1.41-1.66) and Indian (OR 1.32, 95% CI 1.19-1.46) ethnicities; T2DM durations of 5-10 years (OR 1.46, 95% CI 1.35-1.58) and > 10 years (OR 1.75, 95% CI 1.59-1.91); the use of oral antidiabetic agents only (OR 5.86, 95% CI 3.32-10.34), insulin only (OR 17.93, 95% CI 9.91-32.43), and oral antidiabetic agents and insulin (OR 29.42, 95% CI 16.47-52.53); and elevated blood pressure (OR 1.10, 95% CI 1.01-1.20), low-density lipoprotein cholesterol (OR 1.48, 95% CI 1.38-1.59) and triglycerides (OR 1.61, 95% CI 1.51-1.73). Hypertension (OR 0.71, 95% CI 0.64-0.80), hypertension and dyslipidaemia (OR 0.68, 95% CI 0.61-0.75), pre-obesity (OR 0.89, 95% CI 0.82-0.98) and obesity (OR 0.76, 95% CI 0.70-0.84) were less likely to be associated with poor glycaemic control. CONCLUSION: Young-old and middle-old age groups (i.e. < 80 years), Malay and Indian ethnicities, longer T2DM duration, the use of pharmacological agents, and elevated blood pressure and lipid levels were associated with poor glycaemic control. The presence of comorbidities, pre-obesity and obesity were less likely to be associated with poor glycaemic control