Effectiveness of a combined dance and relaxation intervention on reducing anxiety and depression and improving quality of life among the cognitively impaired elderly

Objectives: Cognitive impairment is a common problem among the elderly and is believed to be a precursor to dementia. This study aimed to explore the effectiveness of a combined dance and relaxation intervention as compared to relaxation alone in reducing anxiety and depression levels and improving quality of life [QOL] and cognitive function among the cognitively impaired elderly

Methods: This quasi-experimental study was conducted between May and December 2013 in Peninsular Malaysia. Subjects from four government residential homes for older adults aged >/=60 years with mild to moderate cognitive function as assessed by the Mini-Mental State Examination were included in the study. Subjects were divided into an intervention group and a control group; the former participated in a combined poco-poco dance and relaxation intervention whilst the latter participated in relaxation exercises only. Both groups participated in two sessions per week for six weeks. Anxiety and depression were self-assessed using the Hospital Anxiety and Depression Scale and QOL was self-assessed using the Quality of Life in Alzheimer's Disease questionnaire

Results: A total of 84 elderly subjects were included in the study; 44 were in the intervention group and 40 were in the control group. When compared to control subjects, those in the intervention group showed significantly decreased anxiety [P <0.001] and depression [P <0.001] levels as well as improved QOL [P <0.001] and cognitive impairment [P <0.001]

Conclusion: Dance as a form of participationbased physical exercise was found to reduce anxiety and depression levels and improve QOL and cognitive function among the studied sample of cognitively impaired elderly subjects in Malaysia

Validity and reliability of the clinical competency evaluation instrument for use among physiotherapy students pilot study

The aim of this study was to determine the content validity, internal consistency, test retest reliability and inter-rater reliability of the Clinical Competency Evaluation Instrument [CCEVI] in assessing the clinical performance of physiotherapy students. This study was carried out between June and September 2013 at University Kebangsaan Malaysia [UKM], Kuala Lumpur, Malaysia. A panel of 10 experts were identified to establish content validity by evaluating and rating each of the items used in the CCEVI with regards to their relevance in measuring students' clinical competency. A total of 50 UKM undergraduate physiotherapy students were assessed throughout their clinical placement to determine the construct validity of these items. The instrument's reliability was determined through a cross-sectional study involving a clinical performance assessment of 14 final-year undergraduate physiotherapy students. The content validity index of the entire CCEVI was 0.91, while the proportion of agreement on the content validity indices ranged from 0.83-1.00. The CCEVI construct validity was established with factor loading of >/=0.6, while internal consistency [Cronbach's alpha] overall was 0.97. Test-retest reliability of the CCEVI was confirmed with a Pearson's correlation range of 0.91-0.97 and an intraclass coefficient correlation range of 0.95-0.98. Inter-rater reliability of the CCEVI domains ranged from 0.59 to 0.97 on initial and subsequent assessments. This pilot study confirmed the content validity of the CCEVI. It showed high internal consistency, thereby providing evidence that the CCEVI has moderate to excellent inter-rater reliability. However, additional refinement in the wording of the CCEVI items, particularly in the domains of safety and documentation, is recommended to further improve the validity and reliability of the instrument

Reliability and Validity of the Malay Version Chronic Respiratory Questionnaire for used among COPD Patients

Introduction: Chronic Respiratory Questionnaire (CRQ) is one of the disease-specific questionnaires to assess health related quality of life (HRQoL) among chronic obstructive pulmonary disease (COPD) patients. Objectives: This study investigate the validity and reliability of Malay version CRQ among COPD patients. Methods: The CRQ was administered twice to 46 patients with COPD (mean FEV1 44% predicted, FEV1/ IVC 37% predicted) from Medical Center of University Kebangsaan Malaysia (PPUKM).Test-retest reliability was assessed using intra-class correlation coefficients (ICC). Internal consistency was determined using Crohnbach’s alpha coefficients (α = 0.7). Spearman’s correlation coefficient was done among the scores of CRQ, St George Respiratory Questionnaire (SGRQ) and sixminute walking test (6MWT) to examine the concurrent validity of the CRQ (p 0.70) was observed for 3 domains of CRQ with exception of dyspnoea domain (α = -0.631). Test retest reliability demonstrated strong correlation (ICC >0.80). Concurrent validity of CRQ, showed significant correlations observed between domain of SGRQ’s symptom, impact and total scores of SGRQ with CRQ’s dyspnoea and emotional function (-0.3< r < -0.4; p<0.05). Significant correlation was observed between 6MWT and CRQ’s fatigue domain (r= 0.390; p=0.007). Conclusions: The Malay version of CRQ is a reliable instrument for measuring health status of patients among chronic respiratory disease especially COPD. Items of fatigue, emotion, and mastery domain of the CRQ are reliable and valid and can be used to assess quality of life in patients with severe airways obstruction. Items of the dyspnoea dimension are less reliable and should not be included in the overall score of the CRQ in comparative research.

Learning pathways during clinical placement of physiotherapy students: a Malaysian experience of using learning contracts and reflective diaries / 보건의료교육평가

PURPOSE: Learning contracts and reflective diaries are educational tools that have been recently introduced to physiotherapy students from Malaysia during clinical education. It is unclear how students perceive the experience of using a learning contract and reflective diary. This study explores the learning pathways of the students after using a learning contract and a reflective diary for the first time in their clinical placement. METHODS: A total of 26 final-year physiotherapy students completed a learning contract and a reflective diary during clinical placements. Two researchers explored the data qualitatively by the thematic content analysis method using NVivo. RESULTS: A total of four and six main learning themes were identified from the data of the students through a learning contract and reflective diary. CONCLUSION: These learning themes reflected the views of the students about what they have considered to be important learning pathways during their clinical placements. They give valuable insights into the experiences and opinions of students during their clinical education process, which should be useful for enhancing teaching and learning methods in physiotherapy education.

Perception Towards Teaching and Learning of Clinical Education Among Physiotherapy Students During Clinical Placements / Jurnal Sains Kesihatan Malaysia

This study aims to identify the perception of third year physiotherapy students on the teaching and learning during clinical placements. A sample of 154 third year undergraduate and diploma students from the Universiti Kebangsaan Malaysia, the Universiti Teknologi Mara and the Kolej Sains Kesihatan Bersekutu completed the questionnaire. High internal reliability of teaching and learning activities scale in the questionnaire was determined using Cronbach alpha (α = 0.94). Findings showed significant differences (p < 0.05) of perception among students in the clinical block between different levels of education, the ideal number of students in a group during clinical teaching session, and in the activity of ‘patient-centered activities,’ as well as 'feedback to the student.’ These findings demonstrated that the level of education does influence the students’ perceptions on their teaching and learning during clinical placements. In conclusion, the level of education is a contributory factor that influences the students’ rate of learning in clinical education.

Hospital-Based Pulmonary Rehabilitation was More Effective Than Home-Based Pulmonary Rehabilitation in Improving Quality of Life Among Chronic Obstructive Pulmonary Disease (COPD) / Jurnal Sains Kesihatan Malaysia

This study identified the effectiveness between home-based and hospital-based pulmonary rehabilitation program on the quality of life of chronic obstructive pulmonary disease (COPD) patients. Thirty five patients who met the inclusion criteria were referred by physicians and randomized to either hospital-based pulmonary rehabilitation (PRPH) or home-based pulmonary rehabilitation (PRPR). The PRPH program was scheduled twice a week for eight weeks at the Physiotherapy Department, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Whilst, the PRPR group was required to attend sessions at the Physiotherapy Department twice to learn the exercise regimens before carrying out the exercises themselves at home. Subjects were asked to record activitites in a diary and a telephone call was made once every two weeks to ensure compliance towards the exercise regimens. The SF-36 questionnaire and Geriatric Depression Scale were outcome measures used in assessing status of patients prior to treatment and after intervention at the 8th week Seventeen (48.6%) subjects completed the PRPH and 15 (43%), the PRPR. Results indicated that in the PRPH group there were significant improvements in some of the domains of SF-36, i.e., role physical (p = 0.012) body pain (p = 0.040), general health (p = 0.008) and role emotional (p = 0.012). In the PRPR group, the Geriatric Depression Scale mean score was 1.8 ± 0.41 at baseline compared to 1.69 ± 0.48 following intervention (p > 0.05). Whilst, among the PRPH group, the mean was 1.87 ± 0.35 at baseline and 1.53 ± 0.52 after eight week (p < 0.05). In conclusion, hospital-based pulmonary rehabilitation is more effective than the home-based pulmonary rehabilitation in improving the quality of life and reducing depression among patients with COPD.

A Comparison between Home Based and Hospital-Based Pulmonary Rehabilitation Programmes Among COPD Patients in Improving Lung Functional Status / Jurnal Sains Kesihatan Malaysia

This study was aimed at identifying the effectiveness of hospital-based pulmonary rehabilitation programme as compared to home-based pulmonary programme in improving the condition of the chronic obstructive pulmonary disease (COPD) patients of Universiti Kebangsaan Malaysia Hospital. A total of 35 patients aging between 17 to 78 years old were randomised either to hospital (48.6%, n = 20) or home (43%, n = 15) -based pulmonary rehabilitation by the Physiotherapists. For the hospital-based rehabilitation programme, the patients were scheduled to come to the hospital twice a week for eight weeks. For home-based rehabilitation programme, subjects were scheduled to come to the Physiotherapy Department twice to learn on the exercises that need to be carried out before they are allowed to do on their own at home. Each subject was given a diary to record the exercises that have been done. A telephone call is made once a week for monitoring purpose. Assessment of lung function, six-minute-walk test and Borg score were carried out before and after the eight-week rehabilitation is conducted. The Results showed that there was no significant change in lung function for both groups before and after rehabilitation. There is a significant different (p 0.05) for home-base pulmonary rehabilitation patients. The results also show that there exist no significant correlation between lung function and 6MWT even though there is an increase in walking distance at baseline or the eighth week. In conclusion, hospitalbased pulmonary rehabilitation is more effective than the home-based pulmonary rehabilitation in improving the exercise endurance which would helps in reduce dyspnoea among COPD patients.