Coping Strategy and Depression among Caregivers of Cancer Patients Receiving Palliative Care

Major depressive disorder (MDD) put caregivers of palliative cancer patients (CPCP) and the patients at risk for various physical and psychological complications. This study aimed to determine the prevalence of MDD and its contributing factors among CPCP. The diagnosis of MDD was determined using the Mini International Neuropsychiatric Inventory. Pro forma and validated questionnaires were used to assess sociodemography, caregiving and patient factors, coping strategy, and social support. About 6% of CPCP had MDD. Predictors for MDD were coping by behavioural disengagement and positive reframing. These coping strategies are crucial for CPCP to have optimum mental health status.   Keywords: Caregiver, Cancer, Palliative, Depression, Coping Strategy.   eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.   DOI: https://doi.org/10.21834/ebpj.v5i14.233

Reliability and Construct Validity of the Malay Version of Subjective Experience Exercise Scale (SEES) Among Smokers

SEES is an instrument used to examine the affective state of exercise associated with mood. This study was aimed to determine the psychometric properties of Malay version. The original scale underwent forward and backward translation, cognitive debriefing and field testing. The psychometric properties were evaluated based on reliability and construct validity among 152 smokers. The translated SEES had shown satisfied reliability with Cronbach alpha of 0.80, 0.73 and 0.73 and a significant positive correlation with Profile of Mood Scale (POMS). The current study provides psychometric evidence for an appropriate, reliable and valid tool for SEES Malay version. Keywords: Translation validation; Subjective Exercise Experience Scale; Construct validity eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bsby e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5iSI3.257

Functional dependence and nutritional status among leprosy survivors in Sungai Buloh, Malaysia / Mohamad Rodi Isa, Siti Munira Yasin and Mohammad Idris Zamhuri

Introduction: Leprosy is a chronic granulomatous disease which also known as Hansen’s disease caused by Mycobacterium leprae. The social rights and health requirements should not be neglected among the remaining survivors. Although nutritional status and leprosy invasion has been studied in the past, there is still an unclear relationship between these two. The aim of this study was to assess the relationship between nutritional status and disability among the leprosy survivors. Methods: A community based, cross-sectional study using convenience sampling was conducted at Sungai Buloh, Selangor area from June 2014 to July 2014. The degree of disability was assessed using Barthel’s Index and the nutritional status assessment was assessed using Mini Nutritional Assessment. The data was analysed using SPSS version 20. Results: A total of 73 patients were involved in the study (60.3% were male and 89.0% were Chinese). The prevalence of disability was 56.2% (95% CI: 44.5 – 67.8) with walking up-stair was the highest item that need help (50.7%). There were 9.6% malnourished and 49.3% were at risk of malnutrition. There was a negative strong correlation between Nutritional score and the Barthel’s index score (Spearman rho, ρ = -0.714, p < 0.001). Conclusions: Measures must be taken to improve their nutritional status in order to increase their ability to be more independent particularly those who are very old. The degree of disability increases with malnutrition

Prevalence of urinary incontinence, its risk factors and effect on the quality of life in women after their first delivery / Bahiyah Abdullah … [et al.]

Although urinary incontinence is commonly associated with increasing parity, there is however a lack of published data on urinary incontinence among primiparous women. This study aims to determine its prevalence among primiparous women at 6-8 weeks postpartum, its risk factors and effects to their quality of life. Methods: This is a crosssectional study involving primiparous women at 6-8 weeks postpartum. Women in their third trimester were recruited using convenience sampling. Data were obtained using a study proforma, and International Consultation on Incontinence Questionnaire – Short Form (ICIQSF) over a face-to-face interview. The same questionnaire with additional enquiries on delivery was completed over a telephone interview at 6-8 week postpartum. Data were analysed using chi-square and simple logistic regression tests contained in the Statistical Package for Social Science version 20.0. Results: Three hundred and six women participated in this study. The prevalence of urinary incontinence in the third trimester of pregnancy was 34.3% (95%CI: 29.0, 39.7) and dropped to 5.2% (95% CI: 2.7, 7.7) at 6-8 weeks postpartum. Childhood enuresis and postpartum body mass index were the two factors that showed significant association with postpartum urinary incontinence. Urinary incontinence in 95 (31%) women had resolved by 6-8 weeks postpartum, whereas 10 (3.3%) women still had persistent symptom. A small proportion of women (2.0%) developed urinary incontinence in the postpartum period. Majority of women with urinary incontinence did not feel it significantly affected their quality of life. The ICIQ- SF mean score was 6.13 (range 2- 12). Conclusions: Postpartum urinary incontinence is rather uncommon among primiparous women and does not seem to affect their quality of life. Childhood enuresis and postpartum BMI were risk factors associated with postpartum urinary incontinence

Aloe emodin induces apoptosis in ER+-breast cancer cells; MCF-7 through IGF-1R signalling pathway

Two-third of breast cancer patients expressed estrogen receptors (ER)s and received endocrine treatment with established anti-estrogens such as tamoxifen. But the action and acquired resistance during treatment are largely unknown. In contrary, phytochemicals are more selective and less cytotoxic to normal cells. Accordingly, we found aloe emodin, an anthraquinone to inhibit the proliferation of ER+-breast cancer cells, MCF-7 with IC50 of 80 μM, but not affecting control breast cells, MCF-10A. Tamoxifen was non-selective to both cells with IC50 of 27 and 38 μM, respectively. Thus, we aimed to investigate the anti-proliferative mechanism of aloe emodin on MCF-7 and its underlying signalling compared to tamoxifen. Cells were treated separately with aloe emodin and tamoxifen at respective IC50 for 72 h. Apoptosis was determined using Annexin V-FITC/PI staining. The expression of insulin-like growth factor-1 receptor (IGF-1R), insulin-like growth factor binding protein (IGFBP)-2 and B-raf gene was investigated using QuantiGene 2.0 Plex assay. Paired-student t-test and ANOVA test were used to compare between untreated and treated cells on the measured parameters. Each treatment was conducted in triplicate and repeated three times. Significance was set at p<0.05. The presences of early and late apoptosis in MCF-7 were seen in both treatments. All target genes were down regulated. The anti-proliferation effect of aloe emodin on MCF-7 is similar with tamoxifen which mediates inhibition of IGF-1R signalling pathway. This suggests aloe emodin as a potential anti-cancer agent to be used in combined anti-estrogen therapy to enhance its efficacy in ER+-breast cancer treatment

Prevalence, Determinants and Outcomes of Traditional, Complementary and Alternative Medicine Use for Hypertension Among Low-Income Households in Malaysia and the Philippines

Background Traditional, complementary and alternative medicine (TCAM) is used to treat a broad range of conditions. In low- and middle-income countries (LMICs), TCAM use is particularly common among those with low socio-economic status. To better understand the patterns and impact of TCAM use on the management of non-communicable diseases in these populations, this study examines the prevalence and characteristics of TCAM use for hypertension, its determinants, and its association with hypertension management outcomes and wellbeing among low-income adults in two Southeast Asian countries at different levels of economic and health system development, Malaysia and the Philippines. Methods We analysed cross-sectional data from 946 randomly selected adults diagnosed with hypertension from low-income rural and urban communities in Malaysia (n = 495) and the Philippines (n = 451). We compared the prevalence, characteristics and household expenditure on TCAM use between countries and used multi-level, mixed-effects regression to estimate associations between TCAM use and its determinants, and five hypertension management outcomes and wellbeing. Results The prevalence of TCAM use to manage hypertension was higher in the Philippines than in Malaysia (18.8% vs 8.8%, p \u3c 0.001). Biologically-based modalities, e.g. herbal remedies, were the most common type of TCAM used in both countries, mainly as a complement, rather than an alternative to conventional treatment. Households allocated around 10% of health spending to TCAM in both countries. Belief that TCAM is effective for hypertension was a positive predictor of TCAM use, while belief in conventional medicine was a negative predictor. TCAM use was not strongly associated with current use of medications for hypertension, self-reported medication adherence, blood pressure level and control, or wellbeing in either country. Conclusions A small, but significant, proportion of individuals living in low-income communities in Malaysia and the Philippines use TCAM to manage their hypertension, despite a general lack of evidence on efficacy and safety of commonly used TCAM modalities. Recognising that their patients may be using TCAM to manage hypertension will enable health care providers to deliver safer, more patient-centred care

Prevalence, determinants and outcomes of traditional, complementary and alternative medicine use for hypertension among low-income households in Malaysia and the Philippines.

BACKGROUND: Traditional, complementary and alternative medicine (TCAM) is used to treat a broad range of conditions. In low- and middle-income countries (LMICs), TCAM use is particularly common among those with low socio-economic status. To better understand the patterns and impact of TCAM use on the management of non-communicable diseases in these populations, this study examines the prevalence and characteristics of TCAM use for hypertension, its determinants, and its association with hypertension management outcomes and wellbeing among low-income adults in two Southeast Asian countries at different levels of economic and health system development, Malaysia and the Philippines. METHODS: We analysed cross-sectional data from 946 randomly selected adults diagnosed with hypertension from low-income rural and urban communities in Malaysia (n = 495) and the Philippines (n = 451). We compared the prevalence, characteristics and household expenditure on TCAM use between countries and used multi-level, mixed-effects regression to estimate associations between TCAM use and its determinants, and five hypertension management outcomes and wellbeing. RESULTS: The prevalence of TCAM use to manage hypertension was higher in the Philippines than in Malaysia (18.8% vs 8.8%, p < 0.001). Biologically-based modalities, e.g. herbal remedies, were the most common type of TCAM used in both countries, mainly as a complement, rather than an alternative to conventional treatment. Households allocated around 10% of health spending to TCAM in both countries. Belief that TCAM is effective for hypertension was a positive predictor of TCAM use, while belief in conventional medicine was a negative predictor. TCAM use was not strongly associated with current use of medications for hypertension, self-reported medication adherence, blood pressure level and control, or wellbeing in either country. CONCLUSIONS: A small, but significant, proportion of individuals living in low-income communities in Malaysia and the Philippines use TCAM to manage their hypertension, despite a general lack of evidence on efficacy and safety of commonly used TCAM modalities. Recognising that their patients may be using TCAM to manage hypertension will enable health care providers to deliver safer, more patient-centred care

The impact of the applied progressive muscle relaxation training on the levels of depression, anxiety, stress and health-related quality of life among prostate cancer patients / Mohamad Rodi Bin Isa

Introduction The main aim of this study was to determine the impact of the applied progressive muscle relaxation training (APMRT) on the levels of depression, anxiety, stress and general health-related quality of life (HRQOL) among prostate cancer patients. Methodology A quasi-experimental trial with repeated measurements conducted at two tertiary medical centres in Kuala Lumpur with a follow up period for six months. The intervention group comprised patients who were being followed up at University Malaya Medical Centre (UMMC) and the comparison group were patients who were followed up at Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Baseline information on socio-demographic characteristics, history of chronic diseases, lifestyles practices of the patients, current urinary complaints and cancer status and treatment for prostate cancer were collected via face to face interview and review of the medical records. The scores for depression, anxiety and stress were assessed by using Depression Anxiety Stress Scales (DASS) and the scoring for HRQOL was assessed by using Short Form Health Survey consisting 36 items (SF-36). The assessments were achieved through self-administered questionnaires. Results There were 109 patients from UMMC and 84 patients from UKMMC who were eligible for the study. In both groups, majority of them were: in the age group 70 to 80 years, Chinese, male were married, staying with their family members or partner and had secondary school education. The baseline socio-demographic characteristics, history of chronic diseases, lifestyle practices of the patients, current urinary complaints, current cancer status were comparable (p>0.05) in both groups except for the treatment for the prostate cancer. In comparison group, more patients (79.8%) were treated with zoladex injection (p<0.001) and in intervention group, more patients (42.2%) treated with lucrine injection (p<0.001). Hypertension was the highest co-morbidity besides prostate cancer (67.6%) and nocturia was the commonest urinary complaint among the patients (87.3%). Only 77 patients from UMMC and 78 patients from UKMMC eventually agreed to participate in the study. At the end of the study, there were 70 patients from UMMC and 68 patients from UKMMC who completed the study. The completion rates were 90.9% for intervention group and 88.2% for the comparison group. After implementation of the APMRT, it was observed that there were significant improvement for anxiety (p<0.001) and stress (p<0.001) but not for depression (p=0.784). APMRT also significantly increased in the score for mental componen

Quality of Life and Child’s Autism-Specific Difficulties among Malaysian Main Caregivers: A Cross-Sectional Study

Caring for children with autism spectrum disorder (ASD) negatively impacts quality of life (QoL). This cross-sectional study aimed to determine the factors associated with perceived QoL and how problematic a child’s autism-specific difficulties are among the main caregivers of children with ASD who attend specialized preschool programs at the National Autism Society of Malaysia and IDEAS Autism Centre located in Selangor and Kuala Lumpur. Utilizing the questions from Parts A and B of the Quality of Life in Autism Questionnaire (QoLA), the data from 116 responders were analyzed using univariate and multivariate linear regression. The mean scores of Part A and Part B were 88.55 ± 17.25 and 56.55 ± 12.35, respectively. The QoL was significantly associated with staying in an apartment/flat −11.37 (95%CI: −19.52, −1.17, p = 0.008), main caregivers attending two training sessions 10.35 (95%CI: 1.17, 19.52, p = 0.028), and more than three training sessions 13.36 (95%CI: 2.01, 24.70, p = 0.022). Main caregiver perceptions of their child’s autistic-specific difficulties were significantly associated with not receiving additional help for childcare: no maid −13.54 (95%CI: −24.17, −12.91, p = 0.013); no grandparent −8.65 (95%: −14.33, −2.96, p = 0.003); and main caregivers not having asthma 8.44 (95%CI: 0.02, 16.86, p = 0.049). These identified factors can be considered to inform main caregivers and health care providers on targeted ways to improve the QoL of main caregivers

Risk factors for tuberculosis-related death among adults with drug-sensitive pulmonary tuberculosis in Selangor, Malaysia from 2013 to 2019: a retrospective cohort study using surveillance data

Objectives Due to the paucity of literature on risk factors for tuberculosis (TB)-related death, we determine the sociodemographic and clinical risk factors associated with TB-related deaths among adult pulmonary TB (PTB) patients on treatment in Selangor, Malaysia.Design Retrospective cohort study.Setting Routinely collected primary care data from all government TB clinics in Selangor.Participants Data of 24 570 eligible adult PTB patients from 2013 to 2019 were obtained from Selangor’s State Health Department surveillance records. We included PTB patients aged at least 15 years old at the time of diagnosis with complete documentation of the dates of diagnosis, treatment initiation, end of treatment/follow-up and treatment outcomes. We excluded patients whose diagnoses were changed to non-TB, post-mortem TB diagnosis and multidrug-resistant TB (MDR-TB) patients.Primary and secondary outcome measures TB-related death, determined from the recorded physicians’ consensus during the TB mortality meeting.Results TB-related death was significantly associated with far (adjusted HR (aHR) 9.98, 95% CI 4.28 to 23.28) and moderately advanced (aHR 3.23, 95% CI 1.43 to 7.31) radiological findings at diagnosis; concurrent TB meningitis (aHR 7.67, 95% CI 4.53 to 12.98) and miliary TB (aHR 6.32, 95% CI 4.10 to 9.74) involvement; HIV positive at diagnosis (aHR 2.81, 95% CI 2.21 to 3.57); Hulu Selangor (aHR 1.95, 95% CI 1.29 to 2.93), Klang (aHR 1.53, 95% CI 1.18 to 1.98) and Hulu Langat (aHR 1.31, 95% CI 1.03 to 1.68) residing districts; no formal education (aHR 1.70, 95% CI 1.23 to 2.35); unemployment (aHR 1.54, 95% CI 1.29 to 1.84), positive sputum smear acid-fast bacilli (AFB) at diagnosis (aHR 1.51, 95% CI 1.22 to 1.85); rural residency (aHR 1.39, 95% CI 1.13 to 1.72) and advancing age (aHR 1.03, 95% CI 1.02 to 1.03).Conclusions Far and moderately advanced radiological findings, concurrent TB meningitis and miliary TB involvement, HIV positive, Hulu Selangor, Klang and Hulu Langat residing districts, no formal education, unemployment, positive sputum smear AFB, rural residency and advancing age are risk factors of TB-related death. Our findings should assist in identifying high-risk patients requiring interventions against TB-related death