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@#Introduction: Unintentional injuries among children are considered a major public health concern since they are one of the leading causes of child death and disability. Inadequate study has been done on whether and how parental influences are linked to childhood injury at home especially among the community with low-socioeconomic status. The study aims to determine the factors affecting unintentional home injury prevention practice among low socioeconomic status (B40) parents of under-five children in Selangor, Malaysia. Methods: This is a cross-sectional and quantitative study. A sample size of 453 parents will be sampled among B40 parents with under-five children in Selangor using a stratified random sampling method. For analysis, only complete questionnaires will be used. Data entry and statistical analysis will be carried out using IBM SPSS version 28.0. Chi-square/Fisher Exact test and simple logistic regression will be used for data analysis. Multiple logistic regression will be used to examine the predictors of poor home injury prevention practice. Discussion: Findings from the study will provide insight on challenges experienced by B40 parents of children under five in implementing preventive injury measures at home.
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@#Introduction: Increasing prevalence of dementia and the associated caregiving burden are expected due to longer life expectancy. This review aimed to critically assess dementia-driven caregiving burden and the associated factors in Malaysia. Methods: A systematic search using several combinations of keywords was conducted in Ovid Medline, PubMed, Science Direct, ProQuest, and Ebscohost databases. The primary outcome was the score or level of caregiver burden, while the secondary outcome was the factors associated with such burden. The quality of the individual articles was assessed using the Newcastle–Ottawa Scale and the Joanna Briggs Institute checklist. Results: The systematic search resulted in seven studies being reviewed, consisting of six cross-sectional studies and one quasi-experimental study. Using the Zarit Burden Interview, two studies reported moderate caregiver burden with mean scores of 35.4 (15.08) and 46.0 (17.0). High levels of burden or strain were reported using the Caregiver Strain Index in other studies. The three main associated factors with burden identified in these studies were the presence of behavioural and psychological symptoms of dementia (BPSD), higher education level, and lack of social support. Conclusion: Moderate to severe caregiving burden level were found to be experienced by dementia caregivers in this country. High education, lack of support, as well as taking care of patient with BPSD being the most prominent factors associated with burden. Therefore, burden should be regularly assessed among the dementia caregivers especially among those with lack of social support and manage family members with BPSD, as to prevent adverse outcome from dementia caregiving.
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@#Introduction: The universal truth surrounding the benefits of exclusive breastfeeding has seldom been disputed. However, the success of exclusive breastfeeding has not been guaranteed despite the availability of numerous interventions. The objective of this study is to review the effectiveness of various breastfeeding promotion education delivery methods in promoting exclusive breastfeeding. Design: A systematic search of leading databases was conducted for scholarly peer-reviewed randomized trials published between January 2014 and May 2019. Data sources: Eight articles were identified as relevant, all were published in English and assessed exclusive breastfeeding. Review Methods: Articles were analyzed for overall quality of evidence using the PEDro Scale. Results: A significant increase in the duration of exclusive breastfeeding was found in seven of the eight studies, with three interventions using combination verbal and written delivery methods and four interventions delivered verbally. Conclusion: Verbal delivery method was the most effective method and many studies use combination method of verbal and written to achieve the objective of their studies.
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@#The American College of Obstetricians and Gynaecologists (ACOG), US Department of Health and Human Services (HHS), and American College of Sports Medicine (ACSM) recommend that all pregnancies with medical clearance should engage in moderate-intensity physical activity (PA) at least 150 minutes per week. However, most of them are physically inactive. Thus, this article aims to identify predictors of physical inactivity among antenatal women. Four databases were used to search relevant articles using PICO strategy systematically. The screening began with examining titles, abstracts, and keywords, followed by scrutinizing and assessing full articles. Finally, a total of five studies were included for the data extraction, and the predictors are sociodemographic (trimesters, parity, marital status, and pre-pregnancy PA status), socioeconomic (household income), lifestyle (smoking and eating unhealthy diet) and health-related factors (multiple pregnancies, received fertility treatment, being unwell, musculoskeletal pain, symptom of early pregnancy and uterine contraction). All these predictors provide crucial information for the success of future physical activity intervention.
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@#Introduction: Hypertension treatment aims to reduce morbidity and mortality from cardiovascular and renal com- plications. In Malaysia, there is a high prevalence of uncontrolled hypertension among patients on treatment. This study aimed to identify the predictors of uncontrolled hypertension among patients receiving treatment from public primary care clinics in Pulau Pinang, Malaysia. Methods: An unmatched case-control study with 1:1 ratio was con- ducted among 334 hypertensive patients receiving treatment from selected public primary care clinics. Mean blood pressure measurements from the last two clinical visits were used to determine the hypertension status, and uncon- trolled hypertension was defined as 140/90 mm Hg or higher. The cases were those with uncontrolled hypertension, while the controls were those with controlled hypertension. Participants were recruited by simple random sampling. Independent variables were sociodemographic factors, clinical and psychosocial factors, medication adherence, lifestyle modification, and clinical inertia. Data were collected using validated questionnaires and review of medi- cal records. Multiple logistic regression analysis was performed by using IBM SPSS Statistics 25. Results: The mean age of respondents was 59 years (SD=11). Patients with medication non-adherence had 11.36 times higher odds of uncontrolled hypertension (aOR=11.36, 95% CI=6.59, 19.56, p<0.001). Clinical inertia increased 7.82 times the odds of uncontrolled hypertension (aOR=7.82, 95% CI=2.65, 23.09, p<0.001). Conclusion: Addressing medication adherence and clinical inertia are vital in reducing uncontrolled hypertension. The findings would help to prioritise interventions to improve the clinical management of hypertension and patient outcomes.
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@#Postpartum depression is a depressive episode that can start at any point during the first year after childbirth. There are several tools that can be used for PPD screening. The need to define a predictive tool that is clinically useful and has acceptable sensitivity and sensitivity is important especially to be used in the primary care setting. This systematic review investigates the evidence of the sensitivity and specificity of screening tools used for PPD screening. The Standard for Reporting of Diagnostic Accuracies (STARD) guidelines were used to conduct the review as a basis for our methodology. PubMed, ScienceDirect and Springerlink databases between 2007 until 2017 were comprehensively searched EPDS and BDI instrument has sensitivity of more than 80% but findings for specificity was inconclusive. The heterogeneity across studies could be the result of methodological differences in validation of the instruments. In addition, these studies were conducted across continents and settings with different cultures, languages and resources. We have identified 5 different instruments used to screen for postpartum depression. The EPDS was the most validated instrument in the review and we found that EPDS and BDI have higher accuracy to screen postpartum depression because the sensitivity reported were more than 80%.
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Abstract@#Women with gestational diabetes mellitus (GDM) during their pregnancy have a greater risk of developing overt diabetes mellitus and dysglycemia (prediabetes, impaired glucose tolerance or impaired fasting glucose) later in future, compared to mothers with normal pregnancy. Postpartum screening is crucial for early identification of type 2 diabetes (T2DM) in women with GDM. Nevertheless, despite various strategies, its rate remains low. A systematic review using databases of PubMed/Medline, Science Direct and CINAHL from 2008 to 2018, was conducted to identify the factors influencing the attendance of postpartum diabetes screening. Open access English articles, focusing on observational studies were reviewed. Primary screening of titles and abstracts of 91 articles were done, secondary screening of 31 articles resulted in 6 articles, included in this manuscript. Various factors identified to be associated with the attendance to postpartum diabetes screening, which are age, education, ethnicity, some obstetric factors like multiparty, and history of insulin usage previously. Many women fail to be screened for diabetes during the postpartum period, and this delays T2DM diagnosis, which in turn gives rise to various complications. Further research that considers these factors is necessary for developing interventions to improve postpartum T2DM screening for mothers with GDM during their pregnancy
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Abstract@#Introduction: Even though exclusive breastfeeding prevalence has increased from 19.3% in 2006 to 47.1% in 2016, this practice was slightly higher in urban areas (48.3%) compared to rural area (45.1%) in Malaysia. National Plan of Action for Nutrition of Malaysia III has set an indicator to achieve at least 70% exclusive breastfeeding by 2025. Therefore this study is to identify predictors that influenced exclusive breastfeeding practice in rural areas. Methods: This cross-sectional study was conducted in six rural health clinics in Hulu Langat District, Selangor among mothers with youngest child aged 6-48 months old. Respondents were selected through systematic random sampling. Validated self-administered questionnaire was used to assess sociodemographic factors, maternal factors, external factors and child’s factors. Mother’s height and weight was measured and body mass index was calculated. Data were analyzed using SPSS version 23. Multivariate logistic regression was used to determine the predictors for exclusive breastfeeding practice. Results: Response rate was 96% with a total of 311 mothers participated in this study. More than half of the mothers exclusively breastfed (52.4%). The predictors for exclusive breastfeeding were Malay ethnicity (AOR=3.951, 95% CI: 1.374-11.358), having tertiary education (AOR=2.401, 95% CI: 1.100-5.241) and positive attitude toward breastfeeding (AOR=7.755, 95% CI: 1.382-43.502). Conclusion: Prevalence of exclusive breastfeeding was higher in this study than the national level. Programme planners should pay special attention to Chinese and Indian ethnicities, mothers with lower level of education and negative attitude in order to improve breastfeeding practice among rural mothers.
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@#Background: Lack of awareness, poor knowledge and attitude regarding cancer have been identified as possible reasons accounting for the late presentation which lead to the poor survival of cancer patients in Malaysia. Method:A cross sectional study was conducted in three traditional Malay villages in Negeri Sembilan among adult males. Those who were already diagnosed with prostate cancer or Non malaysians were excluded from the study. Data was collected using self-administered questionnaires which consist of several sections namely socio-demographic, awareness about prostate cancer, sources of information, family history of prostate cancer, lifestyle associated with risk of cancer, knowledge and attitude towards prostate cancer. Data was analysed using SPSS version 22.0. Chi-square test was used to determine associations. Level of significance was set at p<0.05. The knowledge and attitude scores were then categorized into 2 levels (50% or more of total score equals to ‘good’ and less than 50 % equals to ‘poor’). Results: A total of 168 respondents participated in this study and 62.1% of them had heard about prostate cancer and it is associated with level of education, monthly income and age (p= 0.023, 0.007 and 0.022). Most common sources of information are television, newspaper and friends (52.8%, 43.4% and 39.6% respectively). Among those who had heard about prostate cancer, 58.5% had good knowledge and this was significantly associated with smoking status (p =0.022). Conclusion: The percentage of awareness, knowledge and attitude regarding prostate cancer among the study population are still low. More effort should be carried out especially among men in rural communities to improve the situation.
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Introduction: Automotive workers are exposed to high level of noise as part of their daily work routine. Determining the predictors of knowledge, attitude and practice of noise induced hearing loss (NIHL) among automotive is important because it may help prevent a serious irreversible disease known as noise induced hearing loss. Methods: A cross sectional study in an automotive plant in Shah Alam, Selangor was conducted from January 2015 to May 2015 among 550 workers with response rate of 83%. Respondents were workers from the operational divisions, selected based on simple random sampling using validated, published (1) and reliable self-administered questionnaire that focused on knowledge, attitude and practice towards NIHL. Results: Logistic Regression was used to determine predictors and the predictors for satisfactory knowledge on noise induced hearing loss were perceived noise exposure as harmful noise (AOR=0.54, 95%CI = 1.02 - 3.41), years in service for more than 10 years (AOR=2.79, 95%CI = 1.71 – 4.56) and had received training on safety (AOR=1.94, 95%CI = 1.12 – 3.36). For satisfactory attitude the predictors were perceived noise exposure as harmful noise (AOR=3.79, 95%CI = 2.36 – 6.10), years in service for more than 10 years (AOR=0.56, 95%CI = 0.34 – 0.83) and tertiary level of education (AOR=3.61, 95%CI = 1.67 - 7.81). As for satisfactory practice the predictors were more than 10 years in service (AOR=2.16, 95%CI = 1.24 – 3.75) and had received training on safety (AOR=1.94, 95%CI = 1.26 – 2.99). Conclusions: The results from this study may be used to set appropriate measures and identify workers who are at risk of developing noise induced hearing loss.
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Hearing Loss , Noise, OccupationalABSTRACT
Introduction: Outbreak of vaccine preventable disease still persists despite good coverage of immunization in Malaysia. Health literacy on childhood immunization is one of essential factor for the outbreak to happen. Thus, this study determined the predictors of health literacy on childhood immunization among antenatal mother in Seremban, Negeri Sembilan. Methodology: A cross sectional study was conducted among 424 antenatal women using a cluster sampling approach. Antenatal women who were Malaysian and not illiterate were chosen in this study. A self-administered, validated and pretested questionnaire was used to collect data on sociodemographic, socio economic, awareness on immunization, utilization of health care services and health literacy on childhood immunization. The data was analyzed using SPSS version 22.0. Chi Square test was used in bivariate analysis and multiple logistic regression was used to determine the predictors of inadequate health literacy on childhood immunization. Result: Out of 362 respondents, 81.2% were inadequate health literacy. The predictors were maternal education (AOR= 2.608, 95% CI 1.477-4.604), parity (AOR= 1.067, 95% CI 1.103-3.876), residential area (AOR= 2.344, 95% CI 1.184-4.641) and utilization of government hospital (AOR= 2.344, 95% CI 1.184-4.641). Conclusion: Accessibility of health education with regard to immunization need to be strengthen among primigravida, low education and those staying in rural area. In addition, health education also needs to emphasize on the individual that is employed and low economic status with underutilization of government hospital. A simplified education material with interesting pictures and using visual aids help illiterate people for better understanding.
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Introduction: During which HFMD epidemic has kept on recurring worldwide, effective vaccine and specific treatment for HFMD are still not available, calling attention to on preventive practices as the mainstay of the management. Therefore, it is timely to renew the assessment on maternal preventive practices and its predictors in Klang District, Selangor wherein the endemicity and upsurge of HFMD cases has been demonstrated. Methods: A cross-sectional study was conducted from 1st April 2017 until 15th May 2015 among mothers of Community Development Department (KEMAS) preschool children in Klang District. Respondents were selected based on probability proportional to size sampling, whereas data collection was facilitated by validated, and reliable self-administered questionnaire, that examine on the preventive practices towards HFMD. Results: A total of 353 mothers responded to questionnaire, resulting response rate of 80.2%. Most of the respondent were housewife, married and obtained educational level up to secondary school. Insufficient knowledge score (13.61 ± 4.04) was demonstrated, with health belief highlighted on low mean score for perceived severity and perceived barrier, which was 8.30(SD=1.36) and 7.80(SD=2.14) respectively. Simple linear regression revealed significant linear relationship between preventive practices with knowledge and all health belief subscales. Hierarchical multiple linear regression reported predictors of preventive practices towards HFMD, which include knowledge, (perceived susceptibility)2, perceived severity, and perceived barrier, with the group of variables was significantly predicting the (preventive practice)3 and accounted for 13.1% variance in the (preventive practices)3 (F[5,347]=11.588, p value=<0.001, adjusted R2=0.131). Conclusion: The four predictors derived from this study should be given further attention in planning for future HFMD intervention
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Introduction: Childhood obesity becomes a global epidemic with the majority are living in developing countries. Obese children are at risk of becoming obese adults with non-communicable diseases, which may further lead to huge economic burden for the affected countries. The study objectives were to determine the biosocial background contributing overweight and obesity among preschoolers in Putrajaya (2017) - sociodemographic, pre-and perinatal factors, feeding and weaning practices. Methods: Cross-sectional study was performed using cluster random sampling among 897 preschoolers, whose anthropometric body weights and heights were measured. The calculated BMI was used to determine their obese status based on WHO Growth Standards 2006 and Reference 2007. Their mothers were distributed with self-administered, validated, and pre-tested questionnaires regarding their children’s first two-years-of-life experience. Chi Square test was used for bivariate categorical analysis, Independent T-test and Mann Whitney U test for continuous data analysis. Multivariate binary logistic regression was executed to determine predictors of child obesity. Results: The prevalence of obese children was 7.4%, which can be predicted by the increase in child’s age (Adjusted Odd Ratio: 2.619; 95%CI: 1.435 – 4.780), mothers with higher level of education (AOR: 3.896; 95%CI: 1.127 – 13.470), and higher maternal BMI (AOR: 1.132; 95%CI: 1.057 – 1.213). Conclusion: Three predictors of child obesity can be derived from sociodemographic and pre-and perinatal factors. Further application on these predictors in more targeted interventions and policies need to be considered to reduce the prevalence of obesity and related non-communicable diseases in the country.