Faktor Penghalang dan Penggalak Kepatuhan daripada Perspektif Pesakit Tuberkulosis Cicir Rawatan di Kuala Lumpur (Barriers and Motivation Factors towards Treatment Compliance from the Perspective of Defaulted Tuberculosis Patients in Kuala Lumpur)

There is a large volume of published studies describing the adverse relationship between treatment non-adherence with tuberculosis treatment outcome. Non-adherence could result in increased risks of prolonged infectiousness, drug resistance, relapse cases and poor survival among tuberculosis patients. Nevertheless, few studies are to be found providing detailed on the reason of defaulting treatment among tuberculosis patients in Malaysia. Hence the goal of this paper is to find out the barriers and motivations factors that affect patients’ treatment compliance among our local tuberculosis patients. This is a qualitative study which included 12 in-depth interviews with tuberculosis non-compliance patients who were treated at Institute of Respiratory Medicine, Kuala Lumpur. All the conversations were recorded, transcribed and analysed by using thematic analysis. It was found that low knowledge, self-negative attitudes, traditional believes, negative perceptions towards health caregiver, drug side effects, stigma, financial problems, less family support and work commitments are the barriers that prevent the patients from religiously taking their anti-tuberculosis treatment. Meanwhile, factors that encourage them to continue their treatment were the believes of bad effects of the disease onto their lives and health, good relationship between patient and health caregiver and social support from people around them. In conclusion, non-adherence involved a dynamic influence of individual, socio-economic and treatment-related factors on the patients. The results presented here may facilitate improvement in the activities in promoting compliance among tuberculosis patients in the future which tailored to the patients’ specific needs

Faktor penghalang dan penggalak kepatuhan daripada perspektif pesakit tuberkulosis cicir rawatan di Kuala Lumpur

Terdapat banyak kajian yang diterbitkan sebelum ini mengaitkan perhubungan buruk antara ketidakpatuhan terhadap rawatan dengan hasil rawatan tuberkulosis. Ketidakpatuhan boleh mengakibatkan peningkatan risiko kepada kejangkitan yang berpanjangan, resistan ubat, kes-kes berulang, dan peluang kemandirian yang tipis dalam kalangan pesakit tuberkulosis. Namun, masih terdapat kurang kajian yang menyediakan maklumat berkaitan sebab di sebalik ketidakpatuhan dalam kalangan pesakit tuberkulosis di Malaysia. Maka, objektif kajian ini ialah untuk menentukan faktor-faktor penghalang dan penggalak yang mempengaruhi kepatuhan dalam kalangan pesakit tuberkulosis tempatan. Kajian ini merupakan kajian kualitatif yang mana melibatkan 12 temu bual mendalam dengan pesakit tuberkulosis cicir rawatan yang menerima rawatan di Institut Perubatan Respiratori, Kuala Lumpur. Semua perbualan telah direkodkan, ditranskripsi, dan dianalisis dengan menggunakan analisis tematik. Didapati bahawa kurang pengetahuan, sikap negatif diri sendiri, kepercayaan tradisional, persepsi negatif terhadap pemberi rawatan, kesan sampingan ubatan, stigma, masalah kewangan, kurang sokongan keluarga, dan komitmen masa bekerja adalah faktor-faktor yang menghalang pesakit daripada mengambil rawatan anti tuberkulosis dengan sempurna. Sementara itu, faktor-faktor yang menggalakkan mereka untuk meneruskan rawatan adalah kepercayaan terhadap kesan buruk penyakit ke atas kehidupan dan kesihatan, hubungan baik antara pesakit dan pemberi rawatan, dan sokongan sosial daripada orang sekeliling. Kesimpulannya, ketidakpatuhan melibatkan pengaruh yang dinamik antara faktor-faktor individu, sosioekonomi, dan rawatan ke atas pesakit. Hasil kajian ini dapat membantu dalam penambahbaikan aktiviti-aktiviti mempromosi kepatuhan dalam kalangan pesakit tuberkulosis pada masa akan datang disesuaikan dengan keperluan spesifik pesakit

Validation of the Malay version of the snyder hope scale among Malaysian cancer patients

Hope leads to lower depression and anxiety and is associated with improved quality of life of cancer patients. In this study, Hope Scale (HS) was translated into Malay, and the psychometric properties of the Malay version of the Hope Scale were investigated among Malaysian cancer patients. Concurrent translation and back translation of the original English version of the Hope Scale were performed, and the Malay version was administered to 195 cancer patients with different cancer diagnoses at baseline assessment and 2 months later at follow-up. The Hope Scale (Malay) total score (Cronbach’s α = 0.72; intraclass correlation coefficient (ICC) = 0.67) and its domains (Cronbach’s α [pathway] = 0.7; Cronbach’s α [agency] = 0.7; ICC[Pathway] = 0.64; ICC[Agency] = 0.70) demonstrated acceptable internal consistencies and test-retest reliability. Convergent and discriminant validities were also achieved by the Hope Scale (Malay). The Hope Scale (Malay) demonstrated construct validity, as confirmatory factor analysis demonstrated that the items in the Hope Scale (Malay) best fit into two domains, which was true for the original English version. The Hope Scale (Malay) had acceptable psychometric properties and thus is suitable for assessing hope in Malaysian cancer patients

Validation of the Malay Version of the Sources of Social Support Scale among Malaysian Cancer Patients

Objective: It is important to investigate the association between spousal support and psychology of cancer patients, thus a validated instrument to measure the degree of perceived spousal support is required. We translated and evaluated the psychometric properties of the Sources of Social Support Scale-Malay version (SSSS-Malay) among Malaysian cancer patients. Methods: In this study, the SSSS-Malay and Hope Scale-Malay [used to compare with the SSSS-Malay to assess discriminant validity] were administered to 195 Malaysian cancer patients during baseline assessment. The SSSS-Malay was re-administered 2 months after the baseline assessment during follow-up. Results: The SSSS-Malay total score (Cronbach’s α = 0.70, intraclass correlation coefficient (ICC) = 0.72) and its domains (Cronbach’s α ranging from 0.70 to 0.83, intraclass correlation coefficient ranging from 0.6 to 0.76) exhibited good internal consistencies and good test-retest reliability. The SSSS-Malay also demonstrated good convergent and discriminant validities. However, confirmatory factor analysis of the SSSSMalay showed that it was best fit into a 3-factor model instead of the 4-factor model of the original English version. Conclusion: The SSSS-Malay demonstrated good psychometric properties for use in Malaysian cancer patients

VALIDATION OF THE MALAY VERSION OF THE EXPLANATORY MODEL INTERVIEW CATALOGUE STIGMA SCALE AMONG COVID-19 SURVIVORS IN MALAYSIA

Abstract The Coronavirus disease (COVID-19) imparted unprecedented negative impact worldwide since it was declared as a global pandemic in 2020 due to its high infectivity and mortality rate. Consequently, those who have been infected with COVID-19 experienced significant amount of social stigma which resulting in deterioration of mental well being. Hence, this study aimed to translate the Explanatory Model Interview Catalogue Stigma Scale (EMIC-SS) into Malay and investigate the reliability and validity of the Malay version (EMIC-SS-M) among COVID-19 survivors in Malaysia. Initially, concurrent translation and back translation of the EMIC-SS was conducted followed by the assessment of its face and content validity. Then, the EMIC-SS-M was administered to 219 COVID-19 survivors recruited from three targeted centers for assessment of its reliability (internal consistency) and validity (convergent and discriminant validity, exploratory factor analysis [EFA] and confirmatory factor analysis [CFA]). The EMIC-SS-M reported an acceptable internal consistency with Cronbach’s α of 0.727, while its domains reported acceptable Cronbach’s α ranged from 0.708 to 0.795. EFA and CFA confirmed that the EMIC-SS-M consisted of 15 items in 4 domains. The EMIC-SS-M exhibited good psychometric properties and ready for use to assess stigma among COVID 19 survivors in Malaysia. It can be adapted for use to assess stigma in other disease conditions among the Malaysian population in future studies

Diabetes mellitus and its influence on sputum smear positivity at the 2nd month of treatment among pulmonary tuberculosis patients in Kuala Lumpur, Malaysia: A case control study

Objective/background: Many studies have suggested that sputum smear conversion after 2 months of antituberculosis treatment is an important determinant of treatment success and can be a predictor for relapse. The objective of this study is to determine the factors that influence sputum smear conversion after 2 months of treatment among pulmonary tuberculosis patients receiving treatment in the Institute of Respiratory Medicine in Kuala Lumpur, Malaysia. Methods: A total of 75 cases and 75 controls were interviewed, and their medical records were retrieved in order to extract the information needed. All analyses were conducted using SPSS version 17, and binary logistic regression analysis was used to determine the predictors of sputum smear nonconversion. Results: Results showed that the following factors were associated with sputum smear positivity after 2 months of intensive treatment: diabetes mellitus (p = .013, odds ratio [OR] = 2.59, 95% confidence interval [CI] 1.27–5.33), underweight body mass index (p = .025, OR = 1.67, 95% CI 0.80–3.49), nonadherent to tuberculosis treatment (p = .024, OR = 2.85, 95% CI 1.21–6.74), and previous history of tuberculosis (p = .043, OR = 2.53, 95% CI 1.09–5.83). Multivariable analysis identified diabetes mellitus (p = .003, OR = 4.01, 95% CI 1.61–9.96) as being independently associated with the risk of persistent sputum smear positivity after 2 months of intensive treatment. Conclusion: Based on the findings, identification of these factors is valuable in strengthening the management and treatment of tuberculosis in Malaysia in the future. This study emphasizes the importance of diabetes screening and integration of diabetic controls among tuberculosis patients in achieving better treatment outcome

Previous treatment, sputum-smear nonconversion, and suburban living: The risk factors of multidrugresistant tuberculosis among Malaysians

The number of multidrug-resistant tuberculosis patients is increasing each year in many countries all around the globe. Malaysia has no exception in facing this burdensome health problem. We aimed to investigate the factors that contribute to the occurrence of multidrug-resistant tuberculosis among Malaysian tuberculosis patients. An unmatched case-control study was conducted among tuberculosis patients who received antituberculosis treatments from April 2013 until April 2014. Cases are those diagnosed as pulmonary tuberculosis patients clinically, radiologically, and/or bacteriologically, and who were confirmed to be resistant to both isoniazid and rifampicin through drug-sensitivity testing. On the other hand, pulmonary tuberculosis patients who were sensitive to all first-line antituberculosis drugs and were treated during the same time period served as controls. A total of 150 tuberculosis patients were studied, of which the susceptible cases were 120. Factors found to be significantly associated with the occurrence of multidrug-resistant tuberculosis are being Indian or Chinese (odds ratio 3.17, 95% confidence interval 1.04–9.68; and odds ratio 6.23, 95% confidence interval 2.24–17.35, respectively), unmarried (odds ratio 2.58, 95% confidence interval 1.09–6.09), living in suburban areas (odds ratio 2.58, 95% confidence interval 1.08–6.19), are noncompliant (odds ratio 4.50, 95% confidence interval 1.71–11.82), were treated previously (odds ratio 8.91, 95% confidence interval 3.66–21.67), and showed positive sputum smears at the 2nd (odds ratio 7.00, 95% confidence interval 2.46–19.89) and 6th months of treatment (odds ratio 17.96, 95% confidence interval 3.51–91.99). Living in suburban areas, positive sputum smears in the 2nd month of treatment, and was treated previously are factors that independently contribute to the occurrence of multidrug-resistant tuberculosis. Those with positive smears in the second month of treatment, have a history of previous treatment, and live in suburban areas are found to have a higher probability of becoming multidrug resistant. The results presented here may facilitate improvements in the screening and detection process of drug-resistant patients in Malaysia in the future

Psychometric Properties of the 34-Item Short-Form Supportive Care Need Survey (SCNS-SF34) Scale in the Malaysian Cancer Healthcare Context

(1) Background: This study aimed to assess the psychometric properties of the Malay version of SCNS-SF34 among Malaysian cancer patients. (2) Methods: This cross-sectional study involved 171 cancer patients. Data were collected using the structured five-factor survey via telephone call or face-to-face interviews. The internal reliability and the construct validity of SCNS-34M were analysed using principal component analysis with varimax rotation. (3) Results: The health system and information need (HSI) was the domain with the highest mean score (2.73 ± 0.88), followed by patient care and support needs (2.16 ± 0.90), as well as physical and daily living needs (1.99 ± 0.98). The confirmatory factor analysis indicated a moderate model fit for RMSEA with 0.070, TLI = 0.911 and CFI = 0.924. (4) Conclusions: The SCNS-SF34M was found to be a conceptually applicable and culturally appropriate scale in measuring the supportive care for cancer patients within the Malaysian context

Multicentre prospective cohort study of unmet supportive care needs among patients with breast cancer throughout their cancer treatment trajectory in Penang: a PenBCNeeds Study protocol

Introduction Proper assessment of unmet supportive care needs of patients with breast cancer and its influencing factors at different treatment intervals will improve the rehabilitation of patients with breast cancer. Therefore, this study aims to determine the prevalence of unmet supportive care needs, changes of needs over time and associated factors during the treatment period.Methods and analysis This multicentre, prospective cohort study will be conducted in three governmental hospitals and one tertiary cancer institute in Penang, Malaysia. Adult women diagnosed with primary or recurrent tumour, node, metastases stage I–IV breast cancer based on pathological biopsy will be eligible for this study. At least 281 samples are required for this study. Participants will undergo follow-up at three time intervals: T1 at breast cancer diagnosis; T2 at 3 months after diagnosis and T3 at 6 months after diagnosis. Patients will complete a set of questionnaires at each time. The primary outcome of this study includes the changes in supportive care needs over three time points, followed by the secondary outcome examining patients’ characteristics, coping behaviours and positive psychological components as they affect changes in unmet supportive care needs over time.Ethics and dissemination The study has received ethics approval from the Medical Research and Ethics Committee, Ministry of Health Malaysia (NMRR-19-268-45809 IIR) and the Human Research Ethics Committee of Universiti Sains Malaysia (USM/JEPeM/17100443). The results of the prospective study will be submitted for publication in a peer-reviewed journal