To expose or not to expose: the complexity of emotions in Pap smear acceptance

The Pap smear test has been established as a screening method to detect cervical cancer at a precancerous stage. Yet, the coverage is still low in many developing countries. The paucity of studies which probe into the emotional barrier drove this study to explore further the role of emotions among women in their process of making decision to do the Pap smear test. This qualitative study employed interpretative phenomenological analysis from semi-structured in-depth interviews of nine women who had undergone the Pap smear test. The results revealed two main emotions: embarrassment and anxiety. The sub-themes for embarrassment are embedded value, imperfections, doubt trustworthiness, enormity of emotion, sex of health personnel matters and temporal and conditional significance. Whilst, the sub-themes for anxiety are what are they going to do to me and what are the consequences. These emotions stemmed from values and past experiences of these women. The barriers set by these emotions signify the importance of their role in preventing women from doing the Pap smear test. The enormity of these emotions calls for interventions to focus on assisting women to overcome them before they can accept to do the Pap smear test

Case studies on decision for cervical cancer screening among working women

This study aimed at exploring working women’s perception on factors that influence their decision for cervical cancer screening or pap test. Specifically, this study looked at the influence of gender relations and gender roles among married working women in relation to the perception. This qualitative study was conducted with three women cases based on in-depth interviews. They represented three different cervical cancer screening behaviors which are, had regular pap smear, had pap smear but irregularly and never had pap smear. The study concluded that although gender relations between husband and wife is of egalitarian type, i.e. women have the freedom of movement, empowered to make decision and financial freedom, these did not guarantee that they would practice preventive health care. Recommendations for practice and further research are put forth

Prediction and explanation on adolescent aggression: a study protocol

Introduction: Adolescent aggression is an important public health concern with escalating prevalence of juvenile cases and violence among these age groups including robbery, homicide, and gang fights. The objectives of this study protocol are to determine the biopsychosocial predictors and explore the contextual factors of adolescent aggression among secondary school students in Hulu Langat. Methods: Explanatory mixed method study design will be used, consist of quantitative cross-sectional study followed by basic qualitative study. Proportionate population sampling among Form 4 secondary school students from selected public secondary schools in Hulu Langat will be executed. Questionnaires will be distributed to 481 students on aggression as the dependent variable, and several independent variables: demographic (ethnicity, family income), biological (sex, head injury, nutritional deficiency, breakfast skipping), psychological (attitude and normative beliefs, personality trait, emotional intelligence), and social factors (family environment, single parent status, domestic violence, peer deviant affiliation, alcohol, smoking, substance abuse). Subsequently, participants with moderate to high aggression scores will be further explored on the contextual factors of adolescent aggression by in-depth interview. Multiple linear regression will be executed using SPSS to determine significant predictors whereas thematic analysis will be applied for qualitative data analysis on the context of adolescent aggression. Both findings will be further integrated and discussed to give comprehensive description on the phenomena. Conclusion: Better knowledge and understanding on adolescent aggression may generate new framework to drive more effective preventive strategies and unravel adolescent aggressive related Public Health problems

Development and validation of perceived access to health care measurement instrument

Background: To achieve equity in access to healthcare, there is need for an appropriate method to measure and compare access to health care. Measuring access from user’s perspective in terms of satisfaction and perceptions on access dimensions has been found to be associated with healthcare seeking behaviour, self-reported health status, and quality of life. This study is an attempt to develop and validate an instrument to measure and compare access from user’s perspective. Materials and Methods: The instrument was developed using a standard methods including validating theoretical importance of items and constructs, ensuring representativeness and appropriateness for data collection, and the statistical evidence of the constructs and its reliability. A study was conducted where participants completed self-administered questionnaires. Structural and construct validity were measured using principal component analysis and the Pearson Correlation test for item-summary score correlation. Known groups validity was assessed using a two-sample t-test. Result: A 25-item AHC instrument and its subscales fulfilled content validity evaluation. Structural validity test found evidence for the existence of 6 components from the principal component analysis in data extraction: approachability, availability, accessibility, affordability, acceptability, and accommodation with an eigenvalue of above 1.0 and total cumulative variance of 63.67 percent. Construct validity test showed that the items of the instrument correlated with the hypothetical structure of the six summary scores and strong known groups validity. The result shows that the six latent factors and overall access have satisfactory internal consistency. Conclusion: The 25-item AHC instrument is a multidimensional, valid, and reliable instrument for measuring access to health care. Most importantly, with its all-encompassing indicators, the instrument can be used to measure and compare access to health care between population groups

Aggressive behavior in adolescent: The importance of biopsychosocial predictors among secondary school students

IntroductionOvert aggression is a common type of aggression observed among adolescents, which is apparent and outward confrontational acts manifested physically and verbally, such as fighting and shouting. It has become a major public health concern, as it results in detrimental health impacts like injury, mental health, and social problems.MethodsAn observational study was conducted among 16-year-old school students to determine their biopsychosocial predictors, using stratified proportionate population sampling. Pre-tested surveys were distributed to measure students’ aggression, biological, psychological, and social factors.ResultsA total of 463 students from four public secondary schools participated in the study, with a median aggression score was 23.00 (IQR=12.00). The significant predictors of aggression from multivariate analysis were Malay race, frequent dessert intakes, attitude towards aggression, low family income, and peer deviant affiliation (F [8, 244] = 15.980, p < 0.001, adjusted R2 = 0.290).DiscussionAdolescent aggression determinants are collectively impacted as a result of biological, psychological, and social predictors and need to be focused on in interventional strategies

Predictors of depression among caregivers of disabled children in community based rehabilitation centres in Selangor

Background: Disabled children caregivers face challenges in their daily life as being a caregiver is not an easy task especially towards activities of daily living of dependent children. This study was carried out to determine predictors of depression among caregivers of disabled children. Materials and Methods: A cross-sectional study was conducted among caregivers of disabled children attending Community Based Rehabilitation (CBR) centres in four randomly selected districts in Selangor. Data were obtained using self-administered questionnaire. Depression was screened using DASS-21 questionnaire. All collected data were analysed using IBM Statistical Package for Social Science (SPSS) version 21, involving descriptive and multivariate analysis. Results: Response rate was 81% with a total of 348 respondents. Prevalence of depression was 21% in this study. Predictors for depression were caregivers level of education (AOR = 3.64, 95%CI=1.42-9.30), disabled child attainment of other education (AOR = 2.16, 95%CI= 1.06 - 4.42), financial assistance received (AOR =0.39, 95%CI= 0.29-0.93) and maladaptive coping strategy (AOR = 1.22, 95%CI= 1.13-1.31). Conclusion: This study showed that caregivers education level, coping strategy and financial support play an important role in developing depression. Thus these caregivers need a supportive circle for them to prevent depression in their life which could affect quality of care of their disabled children

A systematic review of internet-based family intervention for childhood obesity

Background: Family based interventions for childhood obesity has been demonstrated to be effective over the past several decades but parents are difficult to engage. Internet-based family intervention could be an alternative to face to face family intervention in meeting the barriers identified from parents. Objectives: This review provides an overview of internet-based family intervention for obese children, focusing on effectiveness and attrition rates. Methods: Randomized controlled trial studies published between January 2004 and March 2014 were selected from six electronic databases. Intervention using internet or web-based which involved parents of 2 to 17 years old and lifestyles and behavior modification were included. Intervention characteristics were reviewed and salient features were extracted. Results: Five related randomized controlled trials were included. Four of five studies found significant adiposity and behavioral changes. Attrition rates ranged from 2% to 47%. Intervention characteristics that could contributed to intervention effectiveness were theory based, used of more behavioral techniques and interactive features like online self-monitoring and e-mail contact with counselors. One of the factors that could have influence on attrition rates was monetary incentives. Parents’ empowerment and parenting aspects were lacking in the internet-based family intervention for parents. Conclusions: internet-based intervention has a short term impact on adiposity and behavioral changes and has the potential to minimize parents’ attrition in family based intervention. Improving the intervention elements in internet-based family intervention might improve effectiveness and attrition rates

Prevalence of musculoskeletal disorder among office workers in Lembaga Tabung Haji Kuala Lumpur

Background: Musculoskeletal disorders (MSDs) are considered an important occupational health problem with consequences for workers, employers, and society. Musculoskeletal diseases (MSDs) are on the rise in Malaysia as the country moves towards industrialization coupled with the rising average age of workers. Staffs working in Lembaga Tabung Haji (LTH) are considered as office workers and play roles either in the administration or support system and high accident reported under the public administration and defence/compulsory social security compared to manufacturing. Disease of the musculoskeletal system and connective tissue were the second top cause from 45 lists of diseases for invalidity scheme under SOCSO. Objective: The objective of this study is to determine the prevalence of musculoskeletal disorders among office workers in Lembaga Tabung Haji Kuala Lumpur. Materials and Methods: A cross-sectional study was carried out among 393 office workers who are working at the Lembaga Tabung Haji during the duration of the study. Sampling was conducted using universal sampling from the name lists obtained from the headquarters. A pre-tested self-administered questionnaire was used to collect data on socio-demographic factors, individual factors, occupational characteristics, work physical factors and psychosocial factors. Data were analysed using SPSS version 22. Results: The prevalence of musculoskeletal disorders among office workers was 82.3%. The results found that the highest prevalence of MSDs for the last twelve months was on the shoulder (68.1%), followed by neck (63.8%), lower back (56.0%), upper back (54.3%), knee (39.7%), wrist/hand (30.6%), hip (24.6%), ankle (22.0%), and elbow (15.5%). Shoulder (25.4%), upper back (22.4%), lower back (20.3%) and neck (18.5%) were identified as body parts which restricted the respondents’ activities in the past 12 months. Conclusion: In conclusion, the office workers at LTH are exposed to the risk of musculoskeletal disorders especially on the upper limbs proved by the high prevalence of MSDs. The study provides insight in developing the ergonomic intervention module in reducing the musculoskeletal disorders among office workers

Factors associated with parenting practices among preschoolers' parents in Ampang and Serdang, Selangor, 2016

Parenting practices is an important factor that determines child's behaviour. In the past 40 years, research proves that child’s development are affected by parenting. Hence, it is also important to know that there are factors that are associated with the parenting practice because that factors can determine whether the parenting being used is good or bad. To determine the factors (parents’ attitude, parental knowledge) associated with parenting practices among preschoolers' parents in Ampang and Serdang, Selangor. This was a cross-sectional study. Self-administered questionnaires were used to collect data from 252 preschoolers’ parents from 14 Tabika KEMAS in Ampang and Serdang, Selangor. The data collected were analysed by using SPSS version 21.0. Parental knowledge (source) and parents’ attitude (overprotective, interest in knowledge) were the most common factors affecting parenting practices of preschoolers' parents from 14 Tabika KEMAS in Ampang and Serdang, Selangor. Overall, parents play an important role in developing skills of good parenting practices to be applied on their children later on

Barriers to mental health treatment for children and adolescent: a systematic review

Background: Despite the higher prevalence of mental health problem among children and adolescent, the rate of mental health services utilization among this group is still low. Among small number of children and adolescents attended mental health treatment, many of them tend to prematurely terminate the treatment offered. Objective: This systematic review aims to provide an overview reported barriers to mental health treatment for children and adolescents from the perspectives of parents or caregivers. Methods: Quantitative studies published between 2005 to March 2015 were identified through electronic searching via four selected databases, PsycINFO, Psychology and Behavioural Sciences Collection, CINAHL and ProQuest. Studies which involved parents or caregiver of targeted children aged between 2 to 18 years were included. Relevant data were extracted and barriers to mental health treatment were reviewed. Results: Five studies were identified met the inclusion criteria included for this review. The most prominent barriers reported by parents or caregivers of children and adolescent aged between 2 to 18 were attitudinal barriers that include beliefs that nothing could help, seeking help is a sign of weakness or failure, reluctance to admit to having mental health problems, denial of problems, too embarrassed to seek help and barriers related to stigma. Conclusions: Attitudinal barrier especially believed that nothing could help is one of the main barriers to mental health treatment for children and adolescent. School-based program could improve children’s and adolescent’s mental health status by reducing the barriers