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

Comparison of knowledge, attitude and practice on stroke knowledge in Malaysia and other nations: A review of literature

Background: There is an increasing trend of stroke occurrence among Malaysian populations recently. Thus, there is a need for further early management and secondary prevention of stroke. Objectives: To provide an overview on knowledge, attitude and practice (KAP) had been carried out among stroke patients and general population. Data sources: Published survey studies on KAP had been carried out among stroke patients general population in Malaysia and globally. Review methods: Searches were conducted in two data-bases (ProQuest, EBSCOhost). Reviews were included, if these were based on a survey study that measures KAP between 2005 and 2015. The authors had focused the survey study design, population and sampling method highlighting the tools and interview strategy used in order to obtain the information on KAP. The scope of interest were perceptions towards stroke, knowledge on risk factors, signs and symptoms of stroke and its association with socio-demography background of the participants. Results: A total of 22 articles were reviewed included, but none of them from Malaysia studies. However, only 14 were reviewed systematically on the basis of its completeness for quantitative synthesis. In this article, we had reviewed the existing literatures on the scope mentioned earlier and compared it with those of developed countries. Findings highlighted the level of stroke knowledge on risk factors as well as signs and symptoms were range from moderate to poor. This knowledge level was found to be associated with age, gender, education level and income status. Conclusion: Study on KAP is crucial in order to increase the awareness about stroke disease on the risk factors management, administration of appropriate treatment as well as further secondary prevention. This findings may be adopted in Malaysia to improve awareness and knowledge specifically for the stroke patients and their family members and among the public generally

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

Knowledge and awareness about chronic kidney disease among undergraduate students in International Islamic University Malaysia Kuantan Campus

Chronic kidney disease (CKD) causes 70% of all death globally. The prevalence of CKD has shown an increasing trend for the past 20 years in Malaysia. Thus, determining the knowledge and awareness of CKD among healthcare students in preparing them to be a good healthcare provider in the future is important. This study aimed to determine the association between knowledge and awareness about CKD among International Islamic University Malaysia (IIUM) undergraduate students. A crosssectional study was conducted among 108 students using simple random sampling method. The questionnaire was given to the class representative to be self-administered to interested students. It had close-ended questions consisting of Part A to Part D. The scoring given for correctly answered items was one and the total score for Part C was 7 marks. Most of the students were female (70.4%). The mean knowledge score of CKD was 3.65 (SD = 1.12) with nearly half of the students (43.5%) classified as having poor knowledge. Most respondents were aware about CKD (99.1%) and have heard about it from medical personnel (48.1%) and the Internet (25.9%). Further analysis showed that only courses taken by the respondents were significantly associated with knowledge on CKD (p = 0.039). The level of knowledge among undergraduate students is still poor, yet they are aware about the existence of CKD and its aetiology. Therefore, the health sciences curriculum should emphasise on CKD management from a multidisciplinary aspect of care. It is recommended to conduct similar research among different student populations to create awareness and obtain important baseline findings

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

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

Translation and validation of the Malay version of the Stroke Knowledge Test

Background: To date, there is a lack of published studies on assessment tools to evaluate the effectiveness of stroke education programs. Methods: This study developed and validated the Malay language version of the Stroke Knowledge Test research instrument. This study involved translation, validity, and reliability phases. The instrument underwent backward and forward translation of the English version into the Malay language. Nine experts reviewed the content for consistency, clarity, difficulty, and suitability for inclusion. Perceived usefulness and utilization were obtained from experts’ opinions. Later, face validity assessment was conducted with 10 stroke patients to determine appropriateness of sentences and grammar used. A pilot study was conducted with 41 stroke patients to determine the item analysis and reliability of the translated instrument using the Kuder Richardson 20 or Cronbach’s alpha. Results: The final Malay version Stroke Knowledge Test included 20 items with good content coverage, acceptable item properties, and positive expert review ratings. Psychometric investigations suggest that Malay version Stroke Knowledge Test had moderate reliability with Kuder Richardson 20 or Cronbach’s alpha of 0.58. Improvement is required for Stroke Knowledge Test items with unacceptable difficulty indices. Overall, the average rating of perceived usefulness and perceived utility of the instruments were both 72.7%, suggesting that reviewers were likely to use the instruments in their facilities. Conclusions: Malay version Stroke Knowledge Test was a valid and reliable tool to assess educational needs and to evaluate stroke knowledge among participants of group-based stroke education programs in Malaysi

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

Influencing Factors for Malnutrition in Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis

This study reviewed the evidence on influencing factors for malnutrition in Chronic Kidney Disease (CKD) patients. A systematic search of PubMed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data Knowledge Service Platform for English and Chinese language observational studies published from 1966 to 2022 was conducted. RevMan 5.4.1 software was used for statistical analysis. A total of 13 observational studies with 7,790 study participants were included in the systematic review and meta-analysis. Seven risk factors and two protective factors related to malnutrition were identified. Age (OR=1.29; 95% CI:1.03–1.61), required feeding assistance (OR=3.33: 95% CI:2.55–4.35), living status (with family) (OR=0.49; 95% CI:0.34–0.71), protein intake (OR=0.89; 95% CI:0.85–0.94), comorbidities (OR=1.78; 95% CI:1.03–3.07), long dialysis duration (OR=1.61; 95% CI:1.16–2.24), inadequate dialysis (OR=1.25; 95% CI:1.12–1.40), hemoglobin level (OR=1.84; 95% CI:0.92–3.66), and depression (OR=3.44; 95% CI:2.21–5.34) were associated with an increased influence of malnutrition among CKD patients. This review provides comprehensive evidence of potential influencing factors of malnutrition among CKD patient