Study of Knowledge, Motivational Factors, and Potential Barriers Concerning Blood Donation Between Lapsed and Regular Blood Donors

@#Introduction: Many countries struggle to supply enough blood while maintaining their quality and safety. Increasing the number of regular donors is expected to increase the donor pool and blood safety. Thus, this study describes lapsed and regular blood donors’ characteristics, knowledge, motivation, and barriers concerning blood donation. Methods: This observational cross-sectional study has adopted an assisted self-administered questionnaire, which was distributed to blood donors at the Department of Transfusion Medicine, Hospital Sultanah Bahiyah, Kedah. A total of 328 participants consisting of 164 lapsed and 164 regular donors were selected. Logistic regression tests were used to determine the factors that predict lapsed donors. Results: Out of the selected 328 respondents, 54.3% were in the 25–39 age group, 66.2% were males, and 85.1% were Malays. Most of the respondents (88.4%) showed adequate blood donation knowledge, and 99.7% cited altruism as a motivator for blood donation. About 47.0% of the respondents claimed they lack enough time as their donation barrier. Donors who were younger in age, had a moderate blood donation knowledge (adjusted OR, 3.60; 95% CI, 1.34-9.64), didn’t know where to donate (adjusted OR, 2.79; 95% CI, 1.47-5.29), lack enough time (adjusted OR, 1.83; 95% CI, 1.04-3.24), and insufficient information about blood donation campaigns (adjusted OR, 2.19; 95% CI, 1.23-3.91) were more likely to lapse. Conclusion: Donor education, convenient time and location, and sufficient information about blood donation campaigns targeted at young donors are critical for preventing lapsed donors, which could subsequently increase the regular donor pool.

Impact of Transfusion Practice on the Occurrence of Acute Transfusion Reactions in a Malaysian Hospital: A Single-centre Retrospective Study

@#Introduction: Acute transfusion reactions (ATR) are commonly reported in clinical transfusion practice, which may result in significant morbidity and mortality. This study aims to explore the impact of transfusion practice on the prevalence, characteristics, and associated factors of ATR at Hospital Sultanah Bahiyah, Kedah, Malaysia. Methods: This was a retrospective study using records from haemovigilance forms of reported transfusion reactions, E-Delphyn (blood bank system), and E-His (hospital information system). A total of 118 cases of ATR from January 1, 2015 until December 31, 2017 were selected and analysed. For each case, a control was selected from a patient who did not develop ATR. Results: A total of 122,215 units of whole blood and blood component transfusions have been performed and 415 ATR were reported. The prevalence of ATR was 0.34% or one in 294 units transfused. There was a significant association between ATR and red cell concentrate (RCC) stored for more than 14 days (adj OR = 65.29, 95% CI 9.29-458.85). The most common ATR were allergic reactions with 63 cases (53.4%), followed by febrile non-haemolytic transfusion reactions (FNHTR) with 45 cases (38.1%). Allergic reactions were significantly associated with female patients (p = 0.038) and the paediatrics age group (p = 0.038). Multivariate analysis revealed a significant association between FNHTR and RCC stored more than 14 days (p = 0.002). Conclusion: The prevalence of ATR in this hospital was low and associated with RCC stored for more than 14 days. Implementation of pre-storage leucoreduction is recommended.

Factors Contributing to Non-Communicable Diseases in a Selected Low Socio-Economic Status Community in Kedah, Malaysia

@#Introduction: Non-communicable diseases (NCDs) are evolving as the leading cause of death worldwide, including in Malaysia. Changes in a socio-economic status have increased at-risk populations with NCDs. The objective of this study is to describe the prevalence of self-reported NCDs and its contributing factors in a selected low socio-economic status community in Kedah, Malaysia. Methods: A cross-sectional study with a self-administered questionnaire was done among convenience samples of 139 adults (age more than 18 years old) living in a selected low socio-economic status community in Kedah. Results: Among 139 respondents with a mean (SD) age 48.5 (13.1), there were 40.3% of respondents reported to have chronic illnesses with a prevalence of hypertension (25.9%), diabetes mellitus (21.6%), hypercholesterolemia (7.2%), chronic respiratory diseases (5.0%), heart disease (2.9%) and stroke (1.4%). The significant contributing factors of NCDs by multiple logistic regression were age, marital and working status. A person with an increase in 1 year of age has 1.05 times the odds to have NCDs (95% CI: 1.01 to 1.09, p-value=0.007). A divorcee has 3.55 times the odds compared to a married person to have NCDs (95% CI: 1.28 to 9.80, p-value=0.015). The non-working individual has 2.27 times the odds compared to working individuals to have NCDs (95% CI: 1.03 to 5.01, p-value=0.042). Conclusion: The prevalence of NCDs is high in this selected low socio-economic status community. The contributing factors are age, marital and working status.

Long-term Survivorship of Breast Cancer Patients and Its Prognostic Factors: A Tertiary Oncological Center Experience in Penang

@#Introduction: Breast cancer is the most common cause of cancer death among women. The purpose of this study is to determine the 5-years survival rate and prognostic factors among breast cancer patients in a tertiary oncological centre in Penang, Malaysia. Methods: A retrospective cohort study was conducted at the Advanced Medical and Dental Institute, Universiti Sains Malaysia. All 214 cases of breast cancer diagnosed from 1st January 2008 until 31st December 2012 were selected and retrospectively followed-up until 31st December 2017. The survival status for this study was referring to the record of the National Registration of Malaysia. Kaplan-Meier with Log-rank test and Cox regression were used for the univariable and multivariable analysis, respectively. Results: The mean (SD) age at diagnosis was 50.98 (±10.75) years. The majority of the patients were Malay (55.7%) and married (96.5%). After controlling for the effect of underlying comorbidities, lymph nodes involvement, marital status, vascular involvement and adjuvant therapy; it was found that marital status (adj HR= 3.63, 95% CI 1.17-11.24) and lymph nodes involvement (adj HR=2.36, 95% CI 1.17-4.76) were the significant prognostic factors. Conclusion: This study re-emphasizes the role of marital status and lymph nodes involvement as independent predictors of the long-term survival of breast cancer patients. Further studies are needed to assess the promising benefit of personalized treatment and specific supportive care given to the patients with these risk factors for better cancer experience and survival.

Validation of the Malay Version of the Snyder Hope Scale Among Malaysian Cancer Patients / Jurnal Sains Kesihatan Malaysia

@#Hope leads to lower depression and anxiety and is associated with improved quality of life of cancer patients. In thisstudy, Hope Scale (HS) was translated into Malay, and the psychometric properties of the Malay version of the HopeScale were investigated among Malaysian cancer patients. Concurrent translation and back translation of the originalEnglish version of the Hope Scale were performed, and the Malay version was administered to 195 cancer patientswith different cancer diagnoses at baseline assessment and 2 months later at follow-up. The Hope Scale (Malay) totalscore (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 andtest-retest reliability. Convergent and discriminant validities were also achieved by the Hope Scale (Malay). The HopeScale (Malay) demonstrated construct validity, as confirmatory factor analysis demonstrated that the items in the HopeScale (Malay) best fit into two domains, which was true for the original English version. The Hope Scale (Malay) hadacceptable psychometric properties and thus is suitable for assessing hope in Malaysian cancer patients.

Influence of Breastfeeding Pattern on Cardiovascular Disease Risks During Adulthood: A Review

@#Infant feeding is thought to modulate cardiovascular risk factors such as obesity, hypertension, hyperglycemia, and dyslipidemia. This possible association between patterns of feeding with development of cardiovascular disease later in life provides the opportunity for early intervention and prevention strategies. Among all the feeding methods applied, breastfeeding is thought to be the best method and is said to be attributable to future health benefits. However, current evidence from the literature is weak and inconsistent to advocate risk factors management. Therefore, this narrative review aims to provide current findings in assessing the association of breastfeeding pattern and risk of developing cardiovascular diseases later in life. We searched three databases (MEDLINE, PubMed and Google Scholar) from year 2000 to 11 July 2018. Findings on the association between breastfeeding and cardiovascular risk factors are equivocal, although positive trend of beneficial effects of breastfeeding in reducing risk of cardiovascular diseases in adulthood was reported in majority of the studies. Future research should address all limitations that were identified by previous studies such as bias of study design and heterogeneity of samples to establish the association between breastfeeding pattern and cardiovascular disease in later life.

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 Posttraumatic Growth Inventoryshort Form (Ptgi-Sf) Among Malaysian Cancer Patients

Introduction: Posttraumatic growth (PTG) is a positive psychological change in life that occurs as a result of struggle with highly challenging life crises. There is a growing need to explore posttraumatic growth (PTG) in cancer patients, as higher PTG may enhance well-being of patients. Objectives: The aim of this study was to translate the Posttraumatic Growth Inventory-Short Form (PTGISF) into the Malay language and evaluate its psychometric properties for assessing Malaysian cancer patients in future studies. Methods: Two parallels forward and backward translations of the PTGI-SF into the Malay language were conducted. The test was administered to 195 cancer patients. Reliability was evaluated by testing internal consistency (Cronbach’s α) and calculating the test-retest intra-class correlation coefficient, and validity was examined by determining face, convergent, and discriminant validities and using confirmatory factor analysis (CFA). Results: The Malay version of the PTGI-SF and its five domains demonstrated good internal consistencies and acceptable test-retest reliability. All 10 items of this version were highly correlated with their own domains and thus exhibited convergent validity. Discriminant validity was achieved, as all domains of the Malay PTGI-SF was not highly correlated with the domains of the Source of Social Support Scale. CFA resulted in a bestfitting 5-factor model. Conclusion: The Malay version of the PTGI-SF is a suitable tool for measuring PTG in Malaysian cancer patients.

Barriers and Motivation Factors towards Treatment Compliance from the Perspective of Defaulted Tuberculosis Patients in Kuala Lumpur / Jurnal Sains Kesihatan Malaysia

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.

Previous treatment, sputum-smear nonconversion, and suburban living: the risk factors of multidrug-resistant 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 1.086.19], 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 2[nd] [odds ratio 7.00, 95% confidence interval 2.46-19.89] and 6[th] months of treatment [odds ratio 17.96, 95% confidence interval 3.51-91.99]. Living in suburban areas, positive sputum smears in the 2[nd] 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

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