Résumé
Introduction: Cancer pain is a complex experience and is one of the most common and distressing symptom of breast cancer which affects patients’ functioning in daily activities, their quality of life (QOL), and mood. Yet, there is a great lack of data on breast cancer and pain in Malaysia. Methods: A cross-sectional study using the Breast Cancer Patient Version of Quality of Life (QOL) Instrument (translated into Malay) and Depression Anxiety and Stress Scale (DASS) were conducted on 87 female breast cancer patients to investigate the impact of pain interference level on their quality of life and depressive level. Results: The patients were divided into 4 groups based on their rating of how pain and aches have been a problem to them (i.e not a problem [n=18 (20.7%)], mild[n=29 (33.3%)], moderate [n=18 (20.7%)] and severe [n=22(25.3%). Pain and aches ware reported to be the most severe interference problems in QOL physical domain by patients (mean=5.8, SD=2.8), followed by fatigue (mean=6.0, SD=3.1) and sleep changes (mean=6.2, SD=3.5). Patients who reported that pain and aches had severely affected them showed significantly lower score on many aspects of quality of life (Fs > 5, p < 0.005; p < 0.0001) and patients reported pain was not a problem at all demonstrated highest score on all aspects of QOL. Patients with most severe pain interference level showed highest depressive score [F (3, 84) =3, p < 0.05]. Conclusion: The study underscores the impact of pain interference on patients’ quality of life and depressive level. The pain assessment deserves significant attention and therefore a comprehensive biopsychosocial assessment of pain to rule out any related underlying issues is warranted in the management of breast cancer to ensure appropriate intervention given to the patients.
Résumé
The objectives of this study were to determine the prevalence of the urban poor and its health related factors in Selangor. This cross-sectional study was conducted in the community of Selangor. Data was collected from January 2006 to June 2006. Three out of nine districts were selected to be involved in the study, which were Klang, Kuala Langat and Petaling. A Multistage Stratified Proportionate Systematic Random Sampling was used for this study. The sampling was carried out by the Statistics Department of Malaysia. The survey frame was based on the information gathered from the Population and Housing Census in year 2000. The respondents were interviewed by trained research assistants using a structured pre-tested standardized questionnaire prepared in Malay and English languages. A monthly income of RM706 and less was used to define urban poor based on the guidelines given by the Economy Planning Unit of Malaysia (2004). SPSS 16.0 version was used to analyze the data. Out of 2535 respondents interviewed in this study, 2491 respondents answered the questionnaire completely (response rate 98.3%). Out of 2491 respondents, 202 (8.1%) had a monthly income of RM706 and less. Analysis of the urban poor respondents found that majority were aged between 18 to 40 years old (55.9%), and 29.7% had diagnosed medical illnesses, where hypertension, diabetes and asthma were the most common illnesses at 12.4%, 10.9% and 5.0% respectively. About 10% of the urban poor respondents had physical disabilities such as blurring of vision (7.9%), hearing problems (1.0%) and other disabilities (1.0%).
Résumé
Objectives: There is a lack of current published information on health and nutritional status of Orang Asli children. A study was conducted to assess breastfeeding practices, dietary intake and growth status of Orang Asli children in Sepang and Carey Island, Selangor.Methods: A total of 173 children(88 Temuan and 85 Mah Meri) from 137 households were measured for body weight and height. Information on breastfeeding practices and dietary intake was obtained from their mothers. Results:Most of the mothers (98.9%) breastfed their infants with a high proportion (86.8%) initiating breastfeeding within one hour after delivery.About 53% of the mothers reported discarding colostrum due to various reasons including the perception that colostrum in undesirable and can produce ill-health. Although many of these mothers (58.3%) discarded colostrum on their own initiative, about 25% of them reported that they were advised by health professionals. Among mothers who had stopped breastfeeding at the time of the study (n=48), the mean duration of breastfeeding was 12.1 ± 8.9 months. About 33% of the mothers stopped breastfeeding before their infants were 6 months old and only 31% breastfed their children for more than 1 year. The percentages of significantly underweight, stunted and wasted were 48.9%, 5.2.2% and 4.3% respectively for children aged 1-3 years, whereas among children aged 4-6 years old, 35.8%, 50.6% and 1.3% were underweight, stunted and wasted, respectively. A higher proportion of Mah Meri than Temuan children in both age groups were significantly underweight, stunted and wasted. Despite the adequate intake of energy and most nutrients,the Orang Asli children had insufficient mean number of servings for all food groups-grain and cereals, fruits, vegetables, meat and fish, and milk and dairy products. Conclusion: In this study, undernutrition is a major health and nutrition problem among the Orang Asli children. The problem could be due to many factors that include poor infant and child feeding practices. Concerted efforts by various government and non government agencies are essential to improve the health and nutrition of Orang Asli.