Abdominal obesity and high-sensitivity C-reactive protein level among Malay obese adults in Kuantan, Malaysia

Introduction: Abdominal obesity and inflammation are two independent risk factors for cardiovascular disease. However, the inter-relationship between these two factors among Malay population is fragmented. The purpose of this study is to determine the association between waist circumference as a measure of abdominal obesity and high-sensitivity C-reactive protein as an indicator of inflammation status among Malay obese adults in Kuantan, Pahang. Materials and Methods: Ninety-three apparently healthy obese adults (BMI between 27.5 and 39.9 kg/m2) aged between 20 to 62 years old were recruited in this study (68% men and 32% women). Circumference tape was used to measure the waist circumference and fasting venous blood was obtained to determine the high-sensitivity C-reactive protein level. Results: On average, the waist circumference of obese men and women was 103 cm (SD = 8.7) and 94 cm (SD = 7.0), respectively. The median (IQR) of the hs-CRP level of the study participant was 3.80 mg/L (1.5, 10.1). The Kendall’s Tau correlation reveals that there is a significant positive linear correlation between waist circumference and hs-CRP level in obese men (r (30) = 0.355, p = 0.006) and women (r (63) = 0.177, p = 0.043). Conclusion: There is a significant inter-relationship between waist circumference and hs-CRP level among apparently healthy obese adults in Kuantan, Pahang. This study suggests that assessment of hs-CRP level is beneficial to predict the risk for future cardiovascular disease event and facilitate the management of obesity in this population. A prospective clinical study is recommended to confirm the findings

Pattern of herbal and dietary supplement usage and conventional medication adherence among patients with chronic kidney disease: a survey finding

Introduction: There is widespread use of herbal and dietary supplements worldwide among patients despite robust clinical evidence of its efficacy. This may lead to adverse effects, such as diabetes,hypertension, stroke, cardiovascular risk and kidney problems due to inappropriate self-prescription. This study was performed to determine the prevalence of herbal and dietary supplements usage among patients with chronic kidney disease and its association with the socio-demographic background and the conventional medication adherence. Materials and methods: A survey was conducted among 78 chronic kidney disease patients attending the Nephrology Clinic, Hospital Tengku Ampuan Afzan, Kuantan, Pahang. Data were collected using a questionnaire and analyzed using descriptive statistics, Chi Square Test and Fisher’s Exact Test. The p-value was set to be less 0.05 for its level of significance. Results: Most of the patients aged more than 50 years (89.7%), female (53.8%), unemployed (41%) and from lower socioeconomic earners (75.6%). Only 5.2% of respondents reported using herbal and dietary supplements. There was no association between socio-demographic background with the herbal and dietary supplements usage. Similarly, there was no association between herbal and dietary supplements usage and the conventional medication adherence. Conclusion: This study provides a good baseline on the usage of herbal and dietary supplements use among chronic disease patients. It can be concluded that the level of awareness among the patients is good. Nevertheless, a larger study shall be performed in the future to explore the pattern of association

The effect of Illness representation promoting program on treatment adherence among patients with end stage renal disease receiving hemodialysis

Thesis (M.N.S., Nursing Science)--Prince of Songkla University, 201

The illness representation and treatment adherence of patients with end stage renal disease receiving hemodialysis in Malaysia

This study aimed to explore the Illness Representation and Treatment Adherence of patients with end stage renal disease (ESRD) receiving hemodialysis (HD). Ninety patients with ESRD receiving HD were recruited from one public hospital in Kelantan, Malaysia. Questionnaires consisted of three parts: 1) Demographic Data Questionnaire (DDQ), 2) the modified Brief Illness Perception Questionnaire (B-IPQ), and 3) the Treatment Adherence Questionnaire (TAQ). The questionnaires were validated by three experts. The questionnaires were translated from English to Malay language using the back translation technique. The test-retest reliability was tested for the stability of the modified B-IPQ with the result of correlation coefficient of 0.90. The TAQ was tested for internal consistency yielded value of Cronbach’s alpha coefficient of 0.83. The data were analyzed using descriptive statistics and Spearman’s rho correlation statistic. The results revealed that the patients with ESRD receiving HD had the Illness Representation total mean score of 37.02 (SD = 4.17). The analysis also showed that the patients had a median score of 48 (IQR = 6) for the Treatment Adherence. The results also showed that Illness Representation has a negative correlation with Treatment Adherence, which was statistically significant as shown by Spearman’s rho correlation statistic (rs = -0.33, p < 0.01). This study identified the negative correlation between Illness Representation and Treatment Adherence of patients with ESRD receiving HD, implying that patients with more negative Illness Representation were more likely to have difficulty in following their Treatment Adherence. Therefore, it is recommended that an experimental study should be developed and tested the Illness Representation Promoting Program to enhance Treatment Adherence for patients with ESRD receiving HD

Keperluan pendidikan untuk penyakit buah pinggang kronik

This questionnaire is an output after the closure of RIGS16-143-0307 grant and was developed in a final year project entitled "Educational needs assessment among patients with chronic kidney disease'. It is suitable to be utilized by the healthcare professionals, students and society in general particularly to assess the clients or patients' educational needs related to chronic kidney disease. It consists of seven (7) specific domains of CKD: general information on CKD, management of risk factors CKD, management of complications CKD, medications, self-care management, treatment options and financial status

Educational needs of chronic kidney disease patients who presented to Tengku Ampuan Afzan Hospital: Preliminary findings

Knowledge limitation is a major cause of the increasing number of chronic kidney disease (CKD) patients in Malaysia and the world. Nurses are responsible for identifying the patients’ needs to come up with appropriate discharge plans which might include educational activities. The objective of this study was to determine the baseline information (sociodemographic background, as well as medical and lifestyle histories), along with educational needs of CKD patients. A total of 116 CKD patients who attended the Nephrology Clinic of Hospital Tengku Ampuan Afzan were recruited. Patients who fulfilled the inclusion criteria were selected between April and May 2017. Data were obtained via semi-guided questionnaires; the patients were given enough time to complete the required items. The CKD educational needs’ assessment consisted of seven domains: general information, chronic illness management, complications, self-management, medications, treatment, and financial status. Majority of the patients were men (53.4%), aged 54.65 ± 16.49 years, secondary school-finishers (49.1%), and jobless (48.3%). In terms of medical and life-style histories, most patients were diagnosed with end-stage renal disease (51.7%), hypertension (96.6%), diabetes (51.7%), and anemia (25.9%). The patients were interested to know the complications of kidney disease (57.8%), management of diseases like hypertension (58.6%), complications like edema (55.2%), indications for medication (73.3%), self-management or fluid control (37.9%), hemodialysis (37.1%), and financial status (21.6%). Thus, strengthening patient education strategies in the clinics, hospitals, and community settings should be given due attention by relevant healthcare professionals

Malnutrition risk among chronic kidney disease patients attending the nephrology clinic in Hospital Tengku Ampuan Afzan, Pahang

Objective: The prevalence of chronic kidney disease among adult in Malaysia has been increasing and it is forecasted that the pattern will remain. The risk for malnutrition is prominent especially in the later stage of chronic kidney disease. Early detection of malnutrition is important to prevent further complications. However, limited studies on malnutrition risk has been conducted in Malaysia. Therefore, this study was performed to determine the prevalence and associated risk factor of malnutrition among chronic kidney disease patient attending Nephrology Clinic in Hospital Tengku Ampuan Afzan, Kuantan, Pahang. Methods: A cross-sectional study was conducted among 70 chronic kidney disease patients using convenience sampling. All patients were explained about the study and informed consent obtained prior the administration of questionnaire. There were three parts of questionnaire to be answered which were on sociodemographic, clinical characteristic and dietary information along with Malnutrition Risk Screening Tool-Hospital to measure the risk for malnutrition. Results: Most of the participants were married (75.7%), had completed primary school (58.6%), currently not working (32.9%), had income between RM 1000 to RM 1999 (37.1%) and living with three or four members in a household (24.3%). Majority had at least one precipitating disease that causes chronic kidney disease such as hypertension (71.4%) followed by diabetes (61.4%) and high cholesterol (30.0%). Almost 21.4% of chronic kidney disease patients screened were at risk for malnutrition. Further inferential analysis shows an association between weight loss (p=0.001) towards risk for malnutrition. Conclusion: Overall, the risk for malnutrition among chronic kidney disease patient was fairly high. This warrant close attention of the healthcare professional that caring for the patients particularly in detection of detrimental weight loss during each follow up visit. A referral to the dietician is important to ensure the patients received adequate counselling and education on dietary management