Biopsychosocial determinants of depression among the male inmates in Malaysia

Introduction: The increasing prevalence of depression has been a major public health concern. Being a marginalized population put the inmates at risk of depression. The main objective of this study was to identify the determinants of depression among the inmates according to the biopsychosocial model. Methods: A cross sectional study involving 460 male inmates was conducted at a medium security prison in Seremban. Only Malaysian adult prisoners who have been convicted and had spent a minimum of three months in the prison were eligible for the study. They were selected using the probability proportional to size using stratified random sampling. Data was collected using validated and pre-tested questionnaire by face-to-face interviews, with depression was measured using the Center for Epidemiologic Studies Depression (CES-D) Scale. The data were analyzed using IBM SPSS version 22 with a p-value less than 0.05 was considered statistically significant. Results: The results showed prevalence of depression were 40.70% (95% CI: 36.21-45.19) with its development being predicted by presence of communicable disease (AOR=2.145, 95% CI: 1.123-4.095), history of childhood abuse (AOR=1.762, 95% CI: 1.045-2.972), sentences of more than 5 years (AOR=3.801, 95% CI: 1.529-9.450), being non-Muslims (AOR=2.261, 95% CI: 1.461-3.497) and perceived stress (AOR=4.007, 95% CI= 2.610-6.151). Conclusions: This study revealed an alarmingly high prevalence of depression among the male inmates, with stress being the strongest risk factor. Reintegration of the prisoners into the community should be considered as part of the rehabilitation program to ensure continuation of psychiatric care and reduce relapsing

A review on determinants of depression among adult prisoner

Prisoner tend to be marginalized and deprived that it burdens them with psychological trauma, predominantly depression. This review will identify the determinants of depression among adult inmates. Literatures published from 2012 to March 2017 were searched from various databases. Inclusion criteria were English full text, adults with a diagnosis of depression while exclusion criteria were diagnostic instruments, clinical or drug trials. The review adhered to Preferred Reporting Items for Systematic Review and Meta-Analyses: The PRISMA Statement reporting. A total of 168 studies were identified although only 14 studies were eligible for final review. Factors associated with inmates’ depression range from the potentially modifiable to non-modifiable. Recognized modifiable factors were psychological, family support, and environment while non-modifiable were biological, demographic, individual, and social. Determinants identified should be addressed in formulation of better targeting therapy, in terms of both prevention and treatment of depression among inmates

Prevalence and socio-demographic determinants of depression among inmates of a prison in Malaysia

Depression is the most common form of mental disorder among prison inmates. The objective of this study is to determine the prevalence and socio-demographic determinants of depression among adult male inmates in a local prison in Malaysia. This cross-sectional study was conducted among 460 inmates who were systematically selected. Depression was screened using the Center for Epidemiologic Studies Depression (CES-D) scale. Chi-square tests and multiple logistic regression were applied to determine the association between depression and associated variables. Data was analyzed using SPSS software with a p value less than 0.05 was considered significant. The response rate was 90.7% while prevalence of depression was 40.7%. The presence of communicable disease (AOR=2.249, 95%Cl=1.217-4.156) and non–communicable disease (AOR=1.890, 95%Cl=1.132-3.156) identified as socio-demographic determinants of depression. The study suggest a high prevalence of depression among the inmates. Initiative must be given to address and improve the prison health care services

A mixed method study protocol on contributing factors of depression among adults inmates in a local prison Malaysia

Mental health is a global public health concern. Living in institutions, including imprisonment, make the inmates susceptible to depression. The objective of this research is to determine and explore the contributing factors of depression among adult prison inmates in a Malaysian local prison. The study utilizes the explanatory sequential mixed method approach. In the first phase, the quantitative hypothesis will be used to address the association between depression and biological, psychological, and social factors among the respondents. It will use a validated questionnaire from approximately 456 inmates using random sampling which was constructed based on the Biopsychosocial theory. The level of depression will be measured using the Center for Epidemiology Study Depression Scale (CES-D). In the second phase, in-depth interviews will be steered among depressed inmates recognized through purposive sampling. Univariate, bivariate and multivariate analyses will be used in quantitative statistics, meanwhile, the qualitative phase encompass a series of in-depth interviews where it will be discontinued once the saturation point is attained. The content of the interviews will be recorded and transcribe verbatim using thematic analysis. It is anticipated this study will enlighten the causative factors of depression and will gratify a novel modality to reduce depression

Baseline treatments and metabolic control of 288,913 type 2 diabetes patients in a 10-year retrospective cohort in Malaysia

Abstract Diabetes is one of the quickest-growing global health emergencies of the twenty-first century, and data-driven care can improve the quality of diabetes management. We aimed to describe the formation of a 10-year retrospective open cohort of type 2 diabetes patients in Malaysia. We also described the baseline treatment profiles and HbA1c, blood pressure, and lipid control to assess the quality of diabetes care. We used 10 years of cross-sectional audit datasets from the National Diabetes Registry and merged 288,913 patients with the same identifying information into a 10-year open cohort dataset. Treatment targets for HbA1c, blood pressure, LDL-cholesterol, HDL-cholesterol, and triglycerides were based on Malaysian clinical practice guidelines. IBM SPSS Statistics version 23.0 was used, and frequencies and percentages with 95% confidence intervals were reported. In total, 288,913 patients were included, with 62.3% women and 54.1% younger adults. The commonest diabetes treatment modality was oral hypoglycaemic agents (75.9%). Meanwhile, 19.3% of patients had ≥ 3 antihypertensive agents, and 71.2% were on lipid-lowering drugs. Metformin (86.1%), angiotensin-converting enzyme inhibitors (49.6%), and statins (69.2%) were the most prescribed antidiabetic, antihypertensive, and lipid-lowering medications, respectively. The mean HbA1c was 7.96 ± 2.11, and 31.2% had HbA1c > 8.5%. Only 35.8% and 35.2% attained blood pressure < 140/80 mmHg and LDL-cholesterol < 2.6 mmol/L, respectively. About 57.5% and 52.9% achieved their respective triglyceride and HDL-cholesterol goals. In conclusion, data integration is a feasible method in this diabetes registry. HbA1c, blood pressure, and lipids are not optimally controlled, and these findings can be capitalized as a guideline by clinicians, programme managers, and health policymakers to improve the quality of diabetes care and prevent long-term complications in Malaysia

Health planning in Malaysia: a case study of the National Strategic Plan Ending Aids 2016-2030 (NSPEA)

Introduction: Health planning is an essential part of healthcare system whereby policies will be translated into actions. There are many health planning theories that can be used which deal with the complexity of data and addressing the questions within the process. This paper reviewed the National Strategic Plan Ending AIDS 2016-2030 (NSPEA 2016-2030) which is one of the health planning in Malaysia. Methodology: A literature review was conducted through online database and related AIDS health planning documents in Malaysia were identified and reviewed. World Health Organization (WHO) recommendations were used as a reference tools to discuss the health planning process. Strength, weakness, opportunity and threat (SWOT) analysis was done as part of the discussion process. Recommendations are based on literature reviews and health planning documents of other countries. Result: The Malaysia Health Planning Framework consists of seven (7) processes which are situational analysis, goal setting, prioritisation, strategy, budgeting, implementation, monitoring and evaluation. There are various approaches being used. Rational planning used in situational analysis as a tool to identify the disease burden. Incremental planning also applied where all previous performances especially from AIDS National Strategic Plan (NSP) was considered in the making of the new strategies and budgeting. Meanwhile other process was based on selected alternatives which fits into mixed-scanning approach. Conclusion: From this case study, it can be identified that the health planning process and practices in NSPEA 2016-2030 comprises of seven (7) steps. It can be concluded that AIDS health planning in Malaysia mostly adopting the mixed-scanning planning approach. However, there are some steps and area of planning which can be benefited by adopting mixed-scanning planning

District health management cycle in Malaysia

Background: Imbalance between needs, demands and resources are commonly seen in the public sector. Management team needs to manage the available resources in the best possible way to meet the health needs. This is decided by the District Health Management Team (DHMT) in the district health. The concept of District Health Management Cycle (DHMC) was initially introduced by the World Health Organization (WHO) in its District Health Management Models as part of health sector reform initiatives. This review aim to discuss the principle and concept of DHMC in Malaysia. Methods: A literature review was conducted through online database such as Google Scholar and Pubmed to identify the current concept of DHMC. Related government documents on district health management was also identified and reviewed through official government websites. Initial keywords used are district health services and district health management. Then, combined keywords used are district health services in Malaysia and district health management in Malaysia. Finally, about 14 articles that are related were selected and reviewed. Logic framework for district management cycle and SWOT analysis was applied to highlight the internal factors (strength and weakness) and external factor (opportunity and threats) of district health management in Malaysia. Result: DHMC is a cycle involving situational analysis, planning, implementation, with continuous monitoring and eventually the evaluation. Situational analysis identified the current requirement of the district. Then district health plan will be carried out to get a clear picture of the range of inputs needed and how these inputs will be combined to achieve goals. Implementation is the process of carrying out the activity or intervention as well as using the resources without any interruption to the existing service delivery. Followed by monitoring, where it implies checking progress of District Health Plan. Finally, evaluation is a systematic way of reviewing at the implemented plan including the strengths and the shortfalls accounted during the entire process. District health management in Malaysia is not completely decentralized, therefore there are some different in its concept and principle. Conclusion: Healthcare system in Malaysia has some strength and threat. Some of the weaknesses are lack of human resources and top to down planning. The threat comes from internally such as resource constraints and externally due to social groups and political interference. District health management is the starting point of the district health service delivery. It aims to constantly balance the needs, and demands with the limited resources to improve the quality of health service