Mindfulness: A New Paradigm of Psychosocial Care in the Palliative Care Setting in Southeast Asia

Alleviation of suffering in palliative care needs a combination of good symptom control and psychosocial care. The capacity of mindfulness to promote psychological flexibility opens up possibilities of creating a paradigm shift that can potentially change the landscape of psychosocial care. In this review, we attempt to introduce 4 methods to establish mindfulness based on 'The Discourse on the Foundations of Mindfulness', a core text of Theravada Buddhism, followed by a brief comparison of the concepts and practices of mindfulness in different cultures and religions in Southeast Asia. Next, 2 mindfulness-based interventions specifically designed for palliative psychosocial care - mindfulness-based supportive therapy (MBST) and mini-mindfulness meditation (MMM) are introduced. We hypothesise that mindful practices, tailored to the palliative setting, can promote positive psychosocial outcomes.

Factor Structure Of Type D Scale In Malaysian Patients With Coronary Artery Disease

Objective: Type D personality, tendency trait to experience increased NA (Negative Affect) and SI (Social Inhibition) has been associated with negative psychological conditions linked to heart disease. This study aimed to examine the psychometric properties of the Malay version of Type D personality scale (DS14) among Malaysian patients with coronary artery disease (CAD). Methods: In this cross-sectional study 195 patients diagnosed with CAD were selected from National Heart Institute, Kuala Lumpur. They completed the questionnaire including demographic information and the Malay version of DS14 and Hospital Anxiety and Depression Scale (HADS). Results: The structural validity, as demonstrated by exploratory factor analysis of the DS14 was acceptable. The Cronbach's α coefficient for the NA and SI subscales were 0.876 and 0.732, respectively. With the standardized cut-off of NA ≥ 10 and SI ≥ 10, 28.2% of the patients with CAD were defined as having a Type D personality. Anxiety was significantly higher among patients with Type D personality. Conclusion: The results indicate that the Type D personality (DS14) questionnaire is a valid and reliable tool in the Malaysian population. The prevalence of Type D personality in Malaysia falls close to what has been found in Western countries, at least for CAD patients. This study indicates also that it is possible to use the DS14 among the Malaysian population in future cross-cultural studies.

Schizophrenia, substance use and aggressions: What are the relationships?

Objectives: The objective of the study is to determine the prevalence of substance abuse for alcohol, cannabis, opiates, stimulants, solvent and other substances among patients with schizophrenia in Hospital Bahagia Ulu Kinta (HBUK), Perak , Central Peninsular of Malaysia. This study also aims to determine the association of substance abuse with aggression, the demographic characteristics and total duration of hospitalization. Methods: This was a retrospective cross-sectional study whereby the first 194 subjects diagnosed to have schizophrenia based on International Classification of Disease, 10th edition (ICD-10) criteria were taken from data registry of patients admitted to HBUK from January until February 2004. The subjects’ medical files were examined for documentation of substances abuse, aggression and accumulative duration of hospitalization. Results: The results showed the prevalence of substances misuse among patients with schizophrenia in general (including alcohol) was 24.7%. Cannabis 16.7%, alcohol 13.4%, opiates(heroin) 6.7%, Amphetamine type stimulants (amphetamine, metamphetamine, ecstacy) 5.7%, and other substances (benzodiazepine, solvents) 1.5%. Conclusion: There is higher prevalence of substance misuse in patients with schizophrenia as compared to general population. Male patients with history of substance misuse are more likely to have aggression than female. This group needs special precaution and probably in need of specialist help.