Depression, Anxiety, Stress and Perceived Social Support Among Breast Cancer Survivors in Tertiary Hospital in Malaysia

The emotional distress and psychosocial factors are links to the worst quality of life among cancer patients as well as survivors. It gives a negative impact on the survivors and their families. The objective of the study was to determine the correlation of depression, anxiety, and stress with perceived social support among breast cancersurvivors. This is a baseline finding of an educational intervention study. A total of 131 female breast cancer survivors were recruited while they went for their appointment at the Oncology clinic in one of the Tertiary Hospital in Kuala Lumpur. Baseline data was collected using the Depression, Anxiety and Stress (DASS) and Multidimensional Scale of Perceived Social Support (MSPSS) questionnaires. Descriptive analysis andcorrelation tests were used to determine the strength of a linear relationship between depression, anxiety and stress with perceived social support. The descriptive analysis showed that breast cancer survivors had a higher prevalence of anxiety (30.5%) as compared to depression (14.5%) and stress (12.2%). Perceived social support was higher among family support (96.2%) as compared to significant others (84.7%) and friends (71.8%). There was a fair negative correlation between: (i) depression and family support (r = -0.372, p < 0.001), and (ii) stress and family support (r = -0.342, p < 0.001). Other domains had a poor correlation (r < 0.030). The finding showsthat social support from the family and significant others have a significant but fair inverse association with the emotional aspect (depression and stress) of breast cancer survivors. Keywords: Correlation, DASS, MSPSS, breast cancer, Malaysia

Prevalens goiter dan performans mental di kalangan Orang Asli di Sinderut, Pahang

Prevalens goiter dan performans mental telah ditentukan di kalangan penduduk Orang Asli di Sinderut; suatu kawasan pedalaman di Pahang. Seramai 196 subjek telah dipilih untuk kajian dengan julat umur dari 4 hingga 60 tahun. Status goiter telah ditentukan oleh pakar endokrinkologi menggunakan pengkelasan yang dicadangkan oleh Pertubuhan Kesihatan Sedunia; manakala performans mental diukur menggunakan ujian Raven (Oxford Psychologists Press). Pengambilan spesimen darah juga dilakukan untuk ditentukan paras tiroksin (T4) dan hormon perangsang tiroid (TSH). Didapati prevalens goiter adalah 26.5% (521196); dengan prevalens goiter nyata 42.3% (22152). Min isipadu goiter keseluruhan adalah 21.4 ± 19.1 ml (julat : 3.0 - 90.8 ml), sementara prevalens performans mental bagi nilai persentil lebih daripada 5.0 adalah 26.5% (julat : 5.0 - 50.0). Min paras tiroksin adalah 75.4 ± 19.3 nmol/L (julat : 19.9 - 138.1 nmol/L) manakala min paras hormon perangsang tiroid adalah 4.9 ± 3.2 mU/L (julat : 0.4 18.9 mU/L). Tidak terdapat korelasi yang signifikans di antara paras hormon dan skor performans mental (Korelasi Pearson; T4 : r=-0.002, p=0.9736; TSH : r=0.10, p=0.1843), serta isipadu goiter dan skor performans mental (Korelasi Pearson; r=-0.02, p=0.8395). Prevalens goiter 20% menunjukkan kawasan ini mengalami endemia yang sederhana. Performans mental pula menunjukkan tahap pemikiran yang rendah di kalangan penduduk Orang Asli terutamanya di kawasan pedalaman

Depression, Anxiety, Stress and Perceived Social Support Among Breast Cancer Survivors in Tertiary Hospital in Malaysia

The emotional distress and psychosocial factors are links to the worst quality of life among cancer patients as well as survivors. It gives a negative impact on the survivors and their families. The objective of the study was to determine the correlation of depression, anxiety, and stress with perceived social support among breast cancersurvivors. This is a baseline finding of an educational intervention study. A total of 131 female breast cancer survivors were recruited while they went for their appointment at the Oncology clinic in one of the Tertiary Hospital in Kuala Lumpur. Baseline data was collected using the Depression, Anxiety and Stress (DASS) and Multidimensional Scale of Perceived Social Support (MSPSS) questionnaires. Descriptive analysis andcorrelation tests were used to determine the strength of a linear relationship between depression, anxiety and stress with perceived social support. The descriptive analysis showed that breast cancer survivors had a higher prevalence of anxiety (30.5%) as compared to depression (14.5%) and stress (12.2%). Perceived social support was higher among family support (96.2%) as compared to significant others (84.7%) and friends (71.8%). There was a fair negative correlation between: (i) depression and family support (r = -0.372, p < 0.001), and (ii) stress and family support (r = -0.342, p < 0.001). Other domains had a poor correlation (r < 0.030). The finding showsthat social support from the family and significant others have a significant but fair inverse association with the emotional aspect (depression and stress) of breast cancer survivors. Keywords: Correlation, DASS, MSPSS, breast cancer, Malaysia

Selenium dan fungsi tiroid

Pengukuran selenium dan fungsi tiroid telah dilakukan terhadap 442 orang penduduk di lima buah kampung orang Asli di pedalaman Pahang dan Perak. Pengukuran isipadu kelenjar tiroid ditentukan menggunakan alat ultrasound. Serum diambil bagi pengukuran selenium, TSH dan T4 manakala sampel urin dikumpul bagi pengukuran iodin. Min paras selenium adalah 4.082 ± 1.922 ppm (Julat 0.244 - 9.030 ppm). Kajian menunjukkan terdapat perbezaan yang bererti di antara paras selenium kanak-kanak dan dewasa (p<0.0001) dan di antara remaja dan dewasa (p<0.05). Perbezaan paras selenium adalah bererti (p < 0.0001) di antara lima kampung tersebut iaitu Pos Tual (5.638 + 0.332 ppm), Pos Legap (4.545 + 1.794 ppm), Pos Perwor (4.412 + 1.180 ppm), Pos Sinderut ( 3.910 + 2.082 ppm) dan Pos Bertang (0.890 + 0.331 ppm). Perbezaan yang bererti didapati antara isipadu goiter (p<0.0001) dan T4 (p<0.0001) menurut umur. Korelasi yang bererti juga terdapat di antara selenium dengan isipadu tiroid (Korelasi Pearson, r= ­0.1664, p=0.0051) dan selenium dengan T4 (Korelasi Pearson r=0.1789, p=0.0027). Ini menunjukkan kekurangan selenium berkorelasi dengan peningkatan isipadu kelenjar tiroid dan kekurangan hormon tiroksin

Dietary intake and iodine deficiency in women of childbearing age in an Orang Asli Community close to Kuala Lumpur, Malaysia

A cross-sectional study was conducted in order to determine the prevalence of iodine Deficiency Disorders (IDD) and associated factors in women of childbearing age. The study was conducted in a small Orang Asli (indigenous Malay) community, 46 km south-east of Kuala Lumpur, Malaysia. Women without children or who were not pregnant with their first child were excluded. Of the 45 women eligible, four women did not participate as they were absent from the village for the duration of the study. Thyroid palpation and urinary iodine Level were used to determine the prevalence of IDD. The consumption of foods rich in iodine was determined using a food frequency questionnaire. The study population had a high prevalence (32.4%) of goitre and a very low median urinary iodine level (14.5 +/- 11.5 mu g/L, n = 34). This corresponds to 'severe iodine deficiency' according to World Health Organization classifications. Freshwater fish was the most frequently consumed iodine source. Cassava, which is considered goitrogenic due to its thiocyanate content, was a staple food and was consumed daily by 43% of the participants. Most staple foods were locally produced. Women with goitre had significantly Lower protein and energy intakes than did there without. The IDD prevalence found in this study was similar to the prevalence reported in remote Malaysian communities. Possible factors contributing to IDD in various other studies were dependence on locally produced foods from potentially iodine deficient soils, frequent consumption of cassava, and low intake of seafood. Although this Orang Asli community was close to Kuala Lumpur and not remote, these factors were reflected in the current study. This implies that 'pockets' of LDD in Peninsular Malaysia may be more widespread than previously thought and highlights the need for further investigation of IDD in Peninsular Malaysia