Head and Neck Cancer Survivors’ Perceptions of Cancer Treatment and Posttraumatic Growth

@#Introduction: Cancer patients’ perception on the treatment they received is vital to determine their adherence to cancer treatment, but important data on how this variable affects posttraumatic growth (PTG) experience by cancer patients is lacking. This cross-sectional study aimed to evaluate the degree of PTG among a cohort of head and neck cancer (HNC) survivors who were within first year of diagnosis and determined the association between perception of cancer treatment received (expectation and satisfaction with cancer treatment received and the feeling about the adverse effects) and PTG controlling for socio-demographic and clinical characteristics. Methods: HNC survivors were recruited from two oncology referral centres, and they were administered socio-demographic and clinical characteristics questionnaire, the Malay version of the Cancer Therapy Satisfaction Questionnaire (CTSQ) (to assess the satisfaction, expectation and feeling about the adverse effects of cancer treatment received) and the Malay version of the Posttraumatic Growth Inventory-Short Form (PTGi-SF) (to measure the degree of PTG). Results: A total of 200 HNC survivors participated in the study. The mean total PTGI-SF score was 39.5 (standard deviation [SD] = 9.3). Greater degree of positive expectation of cancer treatment and satisfaction with cancer treatment received significantly contributed to higher level of PTG, whereas feeling about side effects of treatment was not associated with PTG, after controlling for socio-demographic and clinical characteristics. Conclusion: Incorporating psychosocial interventions (such as education on cancer treatment and counselling) into the treatment regimen may facilitate development of PTG and hence, safeguard the mental well-being of HNC patients.

Prevalence Of Depressive Disorder And Its Association With Perceived Social Support Among Patients With Human Immunodeficiency Virus (Hiv) In Hospital Tuanku Jaafar, Seremban (Htjs), Malaysia

This study aimed to determine the prevalence of depressive disorder and its association with perceived social support among patients with HIV attending the Infectious Disease Clinic in HTJS. Methods: A cross-sectional study was conducted, and systematic random sampling method was employed for the selection of participants. Socio-demographic and clinical details were obtained through a self-rated questionnaire and participants’ medical records. Depressive disorder was screened and diagnosed using the Mini International Neuropsychiatric Interview (M.I.N.I.) and perceived social support was determined using the Multidimensional Scale of Perceived Social Support (MSPSS). Appropriate statistical analyses were used to determine the prevalence of depressive disorder and its association with perceived social support. Results: A total of 99 patients participated in this study. The mean age of participants was 38.16 ± 1.01 years, and the majority of participants were male (69.7%). Most of the participants were Malay (58.6%), followed by Indians (20.2%), Chinese (17.2%) and others (4.0%). The majority had completed secondary education (54%), and most were employed (79.8%). Most of the participants were single (45.5%) or married (45.5%). The lifetime and point prevalence of depressive disorder was 24.2% and 17.2%, respectively. About 64.7% of patients with depressive disorder were undiagnosed. Out of the 3 sources of perceived social support, perceived social support from a significant other (OR=0.53, p=0.042, Cl=0.29, 0.98) and perceived social support from friends (OR=0.49, p=0.015, Cl=0.27, 0.87) were found to be negative predictors for depressive disorder. Conclusion: This study reports that the prevalence disorder among patients with HIV in HTJS is higher than that of the general population. Patients without depressive disorder reported significantly higher perceived social support scores. Perceived social supports from significant others and friends were found to be important associated factors for lower depressive disorder vulnerability. Hence, physicians should routinely screen for depressive disorder in this vulnerable group and explore and mobilize their social support to reduce patients’ vulnerability to develop depressive disorder. ASEAN Journal of Psychiatry, Vol. 18 (1): January – June 2017: XX XX.

Stress among first and third year medical Studentsat University Kebangsaan Malaysia

To identify the stress-prevalence and coping-strategies among University Kebangsaan Malaysia [UKM] medical students. This was an observational study conducted among 234 UKM first and third year medical students. Standardized questionnaire on stress and coping strategies was used. Stress data was related to subjective experiences on some positive and negative adjectives such as tense, relaxed etc. Positive adjectives were measured by sign "++" and "+" scoring "1" while stress-negative adjectives were measured by sign "?" and "-" scoring "0". Forty-eight coping items under task, emotion and avoidance strategies were measured using 5-point Likert-scale. Overall stress-prevalence was 49%. Female and Malay respondents were more stressed. Significant differences of stress-level was observed between Malays and non Malays in first year [p=0.04] and in third year [p=0.01]. Most common strategies used to cope stress was task-oriented while emotion oriented was least. Stress-prevalence and stress-level in UKM medical students was high. Most of the respondents coped stress using task-oriented strategies. Stressor and its effective management must be ensured. Educational institutions should act as a creative designer of learning environment to get relieve from educational stressor

Carers As Teachers

Objectives: This paper reports the outcome of Session With Carer, one of the activities in the Year 4 Personal and Professional Development (PPD) module in the new integrated curriculum of the Undergraduate Medical Programme at the Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM). Methods: This activity involves groups of 14 – 15 students sitting in with family members of individuals with mental illness. The session starts with the carer giving his or her perspective of patient’s care and the challenges involved. This is followed by a question and answer session. Finally, the carer provides a written feedback by way of scoring certain items as well as brief comments. After the session, each student is required to prepare an individual report in the form of reflective writing. Results: Out of a total of 224 students, the reflections of 126 students were reviewed to assess what they had learnt from the Session With Carer. Among the more significant findings were: 100% learnt about the various challenges faced by carers. 31.7% learnt the importance of faith/spirituality of the carer in caring for a mentally ill family member. 29.4% learnt the importance of family and others’ support. An equal number, that is, 26.2% learnt that it helps for the carer to have good mental health and a positive attitude, as well as good knowledge of the illness. Those who became aware of the benefits of the carer having patience and determination made up 23.8% of the total reflections reviewed. Conclusion: The findings show that the Session With Carer is very educational, and helps create more awareness of the importance of the carer’s role in patient management and support. In other words, carers can act as teachers in creating more public awareness about mental illness and ultimately, help in gradually removing the stigma associated with mental illness. Therefore, carers should be utilized for this purpose.

Post Traumatic Stress Disorder (PTSD) Symptoms, Coping Styles And Social Support Among Survivors Of The December 26th 2004 Malaysian Tsunami Disaster

Objective: This study examined the symptoms of PTSD among survivors of the December 26th 2004 Malaysian tsunami disaster, as well as differences among sexes in terms of coping styles and availability of social support. Methods: A total of 64 (28 males and 36 females) respondents from several affected districts of Kuala Muda and Langkawi in Kedah and Batu Maung, Pulau Pinang were recruited through purposive sampling. The Detailed Assessment of Posttraumatic Stress (DAPS) was used to measure the posttraumatic stress disorder/symptoms, while the Social Support Questionnaire and Significant Others Scale (Form A) were used to measure the quality and quantity of social support. The COPE Questionnaire was used to measure two coping styles; adaptive and maladaptive coping. Results: Fifty two (81%) respondents did not fulfill the DAPS-PTSD criteria while only 12 (19%) fulfilled the criteria. There was no significant difference between men and women in terms of posttraumatic stress-total, and the quantity and quality of social support. However, there is a significant difference in adaptive and maladaptive coping styles among victims who fulfill the PTSD diagnosis and those who did not. It was also found that there is no relationship between PTSD symptoms and emotional support, whereas there is a significant relationship between PTSD symptoms and practical support. Conclusion: This research showed that only a small number of respondents fulfilled the diagnosis of PTSD following their experience of a disaster. There were no difference between genders in terms of PTSD symptoms and social support. Among victims who fulfill the PTSD diagnosis and those who do not, there is a significant difference in the adaptive and maladaptive coping styles. As for the relationship between PTSD symptoms and social support, there is a significant relationship between PTSD symptoms and practical support but not with emotional support.