Intervensi kesihatan di tempat kerja bagi aktiviti fizikal dan atau nutrisi di negara-negara berpendapatan rendah dan sederhana: satu ulasan sistematik

Sebuah ulasan sistematik telah dibuat dengan tujuan untuk merumuskan program intervensi kesihatan di tempat kerja bagi aktiviti fizikal dan atau nutrisi bagi negara-negara berpendapatan rendah dan sederhana bermula Januari 2008 hingga Disember 2019. Objektif kajian ini adalah untuk mengenalpasti jenis-jenis intervensi kesihatan dan mengkaji kesan intervensi kesihatan bagi peningkatan aktiviti fizikal dan atau nutrisi di tempat kerja bagi negara berpendapatan rendah dan sederhana. Pencarian secara sistematik dilakukan dengan menggunakan pengkalan data Scopus, PubMed dan Web of Science. Kajian ini telah dilaporkan dalam Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA). Penilaian kritikal menggunakan kaedah McMaster yang telah diubahsuai bagi kajian kuantitatif untuk mendapatkan kualiti metodologi kajian. Oleh sebab keheterogenan data ini, sintesis secara deskriptif dilakukan. Daripada 6940 data kajian yang didapati, 36 kajian menepati semua kriteria inklusi yang merangkumi pendidikan kesihatan, perubahan persekitaran dan perubahan tingkah laku melalui amalan gaya hidup sihat. Rumusan hasil dapatan menunjukkan bahawa intervensi kesihatan di tempat kerja boleh memberi kesan positif terhadap kesihatan dan tingkah laku pekerja. Walaupun hasil dapatan menunjukkan kesan yang positif, namun dapatan kajian adalah kurang seragam dan kurang jelas dari segi parameter intervensi dan pengukuran hasil, maka ini telah mengehadkan perkembangan aplikasi hasil ini. Kesimpulannya, intervensi kesihatan di tempat kerja menunjukkan potensi untuk meningkatkan aktiviti fizikal dan menambahbaik nutrisi di kalangan pekerja. Walaupun saranan tentang keberkesanan intervensi tidak dapat dibuat, namun diharap, hasil dapatan ulasan sistematik ini dapat menjadi panduan bagi tujuan amalan dan polisi bagi promosi kesihatan di tempat kerja, pada masa akan datang

Discrepancy in patient-rated and oncologist-rated performance status on depression and anxiety in cancer: a prospective study protocol

Objective: Psychological distress is common in patients with cancer. We need a rapid means of screening for and identifying depression and anxiety in patients with cancer. The present study evaluates the potential of the Eastern Cooperative Oncology Group (ECOG) performance status (PS) scoring as a brief screening tool to assess psychological distress in routine cancer care. The ECOG PS is widely used by oncologists and the WHO, as a standardised measure to assess general well-being in patients with cancer and quality of life in cancer trials. We examine the discrepancy between patient-rated and oncologist-rated PS scores on the ECOG in a comparative assessment against the Hospital Anxiety and Depression Scale (HADS). Methods and design: This is a prospective evaluation of approximately 500 ambulatory adult cancer patients from a large academic medical centre. Participants will be asked to assess their own ECOG PS on a scale of 0–4, which will be compared to ECOG PS as rated by their oncologists. Higher ECOG PS scores indicate poorer daily functioning. Both patient-rated and oncologist-rated ECOG PS and their absolute differences will be tested for predictive and concurrent validity against the HADS. A HADS cut-off ≥15 will be used. Ethics approval for this study has been secured from the institutional ethics board. Outcomes are re-evaluated at 4-week to 6-week and 1-year follow-up. Conclusion: This study holds practical significance for rapid screening of psychological distress in the cancer clinic with the use of the ECOG PS scoring. Given the high prevalence of anxiety and depression in patients with cancer, screening is important to increase its recognition, which will, in turn, help to direct referrals and deliver appropriate intervention. This study also generates greater insight into the association between psychosomatic complaints and psychological distress. Trial registration number MEC 896.52

Effectiveness of training stop-smoking advisers to deliver cessation support to the UK national proposed standard versus usual care in Malaysia: a two-arm cluster-randomized controlled trial

Aims To assess the effectiveness of training stop smoking services providers in Malaysia to deliver support for smoking cessation based on the UK National Centre for Smoking Cessation and Training (NCSCT) standard treatment programme compared with usual care. Design Two-arm cluster-randomized controlled effectiveness trial across 19 sites with followup at 4-week, 3-month, and 6-month. Setting Stop smoking services operating in public hospitals in Malaysia. Participants Five hundred and two smokers [mean ± standard deviation (SD), age 45.6 (13.4) years; 97.4% male] attending stop smoking services in hospital settings in Malaysia: 330 in 10 hospitals in the intervention condition and 172 in nine hospitals in the control condition. Intervention and comparator The intervention consisted of training stop-smoking practitioners to deliver support and follow-up according to the NCSCT Standard Treatment Programme. The comparator was usual care (brief support and follow-up). Measurements The primary outcome was continuous tobacco smoking abstinence up to 6 months in smokers who received smoking cessation treatment, verified by expired-air carbon monoxide (CO) concentration. Secondary outcomes were continuous CO-verified tobacco smoking abstinence up to 4 weeks and 3 months. Results Follow-up rates at 4 weeks, 3 months and 6 months were 80.0, 70.6 and 53.3%, respectively, in the intervention group and 48.8, 30.8 and 23.3%, respectively, in the control group. At 6-month follow-up, 93 participants in the intervention group and 19 participants in the control group were abstinent from smoking, representing 28.2 versus 11.0% in an intention-to-treat (ITT) analysis assuming that participants with missing data had resumed smoking, and 52.8 versus 47.5% in a follow-up-only (FUO) analysis. Unadjusted odds ratios (accounting for clustering) were 5.04, (95% confidence interval (CI) = 1.22–20.77, P = 0.025) and 1.70, (95% CI = 0.25–11.53, P = 0.589) in the ITT and FUO analyses, respectively. Abstinence rates at 4 week and 3 month follow-ups were significantly higher in the intervention versus control group in the ITT but not the FUO analysis. Conclusions On an intention-to-treat analysis with missing-equals-smoking imputation, training Malaysian stop smoking service providers in the UK National Centre for Smoking Cessation and Training standard treatment programme appeared to increase 6 month continuous abstinence rates in smokers seeking help with stopping compared with usual care. However, the effect may have been due to increasing follow-up rates

Characterizing employees with primary and secondary caregiving responsibilities: informal care provision in Malaysia

There is a need to determine the extent to which Malaysian employees reconcile both paid employment and informal care provision. We examined data from the Malaysia’s Healthiest Workplace via AIA Vitality Online Survey 2019 (N = 17,286). A multivariate multinomial regression was conducted to examine characteristics for the following groups: primary caregiver of a child or disabled child, primary caregiver of a disabled adult or elderly individual, primary caregiver for both children and elderly, as well as secondary caregivers. Respondent mean age ± SD was 34.76 ± 9.31, with 49.6% (n = 8573), identifying as either a primary or secondary caregiver to at least one child under 18 years, an elderly individual, or both. Males (n = 6957; 40.2%) had higher odds of being primary caregivers to children (OR 2.06; 95% CI 1.85–2.30), elderly (OR 1.24; 95% CI 1.09–1.41) and both children and elderly (OR 1.87; 95% CI 1.57–2.22). However, males were less likely to be secondary caregivers than females (OR 0.61; 95% CI 0.53–0.71). Our results highlight the differences in characteristics of employees engaged in informal care provision, and to a lesser degree, the extent to which mid-life individual employees are sandwiched into caring for children and/or the elderly

Prevalence and characteristics of e-cigarette users among Malaysian current and ex-smokers

Introduction: Electronic cigarettes (ECs) are new devices that have been accepted widely by both smokers and non-smokers. However, the evidence on EC used in Malaysia is scarce. The objective of this study was to determine the prevalence of EC use and the socio-demographic and smoking characteristics associated with current EC use among Malaysian current and ex-smokers. Methods: This was a sub-analysis of data from a cross-sectional, national-population- based EC study conducted from May to June in 2016 in Malaysia. A detailed description of the sampling methods can be found in the National E-cigarette Survey (NECS) 2016 report. Briefly, data were obtained from 1396 individuals who had ever been smokers, i.e., 957 (68.6%) current smokers and 439 (31.4%) ex-smokers. Results: Current EC use was found predominantly among current smokers (8.0%) as compared with ex-smokers (4.3%). Among current smokers, the main reasons given for smoking ECs were wanting to try it (44.7%), followed by intention to quit tobacco smoking (15.8%) and to reduce tobacco smoking (10.5%). Using multiple logistic regression analysis, we found that among current smokers, current EC users were more likely to be younger, i.e., 18-44 years (aOR= 4.83, 95% CI= 1.97-11.86, p=0.001), urban residents (aOR= 1.89, 95% CI= 1.15-3.11, p=0.012), single/ divorced/ widowed (aOR= 2.11, 95% CI= 1.24-3.61, p=0.006) and students (aOR= 2.25, 95% CI= 1.01-5.01, p=0.048). Among ex- smokers, only younger respondents (18-44 years old) was reported as being more likely to be current EC users (aOR= 3.81, 95% CI= 1.14-12.76, p=0.030). Conclusion: This study showed that currently using and ever having used ECs were more prevalent among current smokers. The reasons given for initiating EC use among current smokers were mainly wanting to try it, followed by intention to quit and to reduce tobacco smoking. Current EC use appears to be common among current smokers who are younger, urban residents, single/divorced/widowed and students. Therefore, EC cessation intervention strategies and policies should target these high-prevalence groups

Perception of harms and benefits of electronic cigarettes among adult Malaysian men: a comparison by electronic cigarette use and smoking status

Little is known about the perceptions of harm and benefit associated with the use of e-cigarettes in Malaysia. This was a cross-sectional analysis of a nationally representative sample comprising 1987 males (≥18 years of age). Current, former, and never users of conventional cigarettes and/or e-cigarettes participated in a questionnaire study conducted via face-to-face interviews. The relationship between participant characteristics and perceptions of harm and benefit of e-cigarettes were determined with multivariable logistic regression. There were 950 current, 377 former, and 660 never users of e-cigarettes. Government employees (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.29-2.66, P = .001), private sector employees (OR = 1.67, 95% CI = 1.27-2.18, P = .001), and the self-employed people (OR = 1.68, 95% CI = 1.312.17, P = .001) were more likely to perceive e-cigarettes as more harmful than conventional cigarettes compared with respondents who were not wage earners. All current users in the form of e-cigarette users (OR = 7.87, 95% CI = 3.23-19.18), conventional cigarette smokers (OR = 1.80, 95% CI = 1.39-2.33), and dual users (OR = 8.59, 95% CI = 4.76-15.52) were more likely to perceive e-cigarettes as useful in quitting conventional cigarette smoking compared with former and never users. Our findings constitute an important snapshot into the perceptions of e-cigarette harms and benefits, which could inform targeted public health messaging strategies

Prevalence and factors associated with attempts to quit and smoking cessation in Malaysia

Smoking cessation significantly reduces risk of smoking-related diseases and mortality. This study aims to determine the prevalence and factors associated with attempts to quit and smoking cessation among adult current smokers in Malaysia. Data from the National E-Cigarette Survey 2016 were analyzed. Forty nine percent of current smokers had attempted to quit at least once in the past 12 months and 31.4% of the respondents were former smokers. Multivariable analysis revealed that current smokers with low nicotine addiction and aged below 45 years were more likely to attempt to quit smoking. Being married, older age group, and having tertiary education were significantly associated with smoking cessation. Only half of the current smokers ever attempted to quit smoking and only a third of smokers quit. Stronger tobacco control policies are needed in Malaysia to encourage more smokers to quit smoking. Improved access to cessation support for underprivileged smokers is also needed

A prospective evaluation of psycho-oncological factors on cancer outcomes / Caryn Chan Mei Hsien

This study examined the association between patient-physician fit, psychological distress and psychiatric morbidity on cancer outcomes. In this prospective single centre study, a total of 467 consecutively recruited adult oncology patients completed a battery of self-reported and objective assessments at four time points: within a month of diagnosis (baseline), and then 4-6 weeks, 6 months and 12-18 months after the first assessment. Questionnaires used included the Patient-Practitioner Orientation Scale (PPOS), Hospital Anxiety and Depression Scale (HADS), Patient Satisfaction Questionnaire (PSQ) and Job Satisfaction Scale (JSS). Psychiatric diagnoses were assessed using the Structured Clinical Interview for DSM-IV-TR (SCID). Physicians and nurses also formed part of the sample. Cancer patients and their oncologists were found to be patient-centred. Even when compared to physicians from three other specialties, oncologists were found to be the most patient-centred in terms of role orientation. There was a discrepancy in terms of performance status when rated by cancer patients and their own oncologists. Patient satisfaction was high despite a high level of psychological distress in both cancer patients and their oncologists. The level of treatment default (refusers, delayers, and non-completers of treatment) was also high, and was linked to psychiatric disorders and survival in this sample. Findings from this study contribute to the development of an important area of research through strengthening of what is known in the area of psycho-oncology by offering further insight and understanding of psychosocial factors and its subsequent outcomes in cancer

Assessing predictors of intention to prescribe sick leave among primary care physicians using the theory of planned behaviour

Abstract Background Providing sickness certification is a decision that primary care physicians make on a daily basis. The majority of sickness certification studies in the literature involve a general assessment of physician or patient behaviour without the use of a robust psychological framework to guide research accuracy. To address this deficiency, this study utilized the Theory of Planned Behaviour (TPB) to specifically gauge the intention and other salient predictors related to sickness certification prescribing behaviour amongst primary care physicians. Methods A cross-sectional study was conducted among N = 271 primary care physicians from 86 primary care practices throughout two states in Malaysia. Questionnaires used were specifically developed based on the TPB, consisting of both direct and indirect measures related to the provision of sickness leave. Questionnaire validity was established through factor analysis and the determination of internal consistency between theoretically related constructs. The temporal stability of the indirect measures was determined via the test-retest correlation analysis. Structural equation modelling was conducted to determine the strength of predictors related to intentions. Results The mean scores for intention to provide patients with sick leaves was low. The Cronbach α value for the direct measures was good: overall physician intent to provide sick leave (0.77), physician attitude towards prescribing sick leave for patients (0.77) and physician attitude in trusting the intention of patients seeking sick leave (0.83). The temporal stability of the indirect measures of the questionnaire was satisfactory with significant correlation between constructs separated by an interval of two weeks (p < 0.05). Attitudes and subjective norms were identified as important predictors in physician intention to provide sick leave to patients. Conclusion An integrated behavioural model utilizing the TPB could help fully explain the complex act of providing sickness leave to patients. Findings from this study could assist relevant agencies to facilitate the creation of policies that may help regulate the provision of sickness leave and alleviate the work burden of sickness leave tasks faced by physicians in Malaysia

Coping mechanism, psychological distress and counselling acceptance among victims of domestic violence in Malaysia

Domestic violence is a worldwide problem that is unaffected by race, age, culture, or gender. It charges have been on the rise in Malaysia in recent years. Thus this study was conducted to examine the inherent differences in coping mechanism and psychological distress among victims of domestic violence by counselling acceptance. A quasi-experimental design involving measures at baseline and three months follow-up was used. All domestic violence victims (N = 58) between September 2018 to March 2019 were recruited from a government funded victim care centre. Three Bahasa Malaysia translated versions of instruments were used: Beck Depression Inventory, Beck Anxiety Inventory and Brief Coping Orientation to Problems Experienced. Findings showed no significant differences between domestic violence victims who accepted counselling vs those who did not in terms of sociodemographic factors except for duration of abuse. Counselling acceptance rates were minimal as only 50% of participants accepted counselling. Both groups favoured approach coping mechanism (n=41, 70.69 %) compared to avoidant coping mechanism (n=10, 17.24 %). There was a significant reduction in symptoms of depression (BDI: r =0.82, p < .05) and anxiety (BAI: r= 0.71, p < .05) for both groups when levels were examined at 3 months follow-up. There is a need to examine ways to increase counselling acceptance rates among victims of domestic violence. Overall, this study offers insight into counselling acceptance rates and its psychological correlates among domestic violence victims at a single centre