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@#Malnutrition is a common occurrence during cancer treatment among pediatric cancer patients and without proper care, it can bring negative implications. The purpose of this study was to develop a printed educational material titled “Penjagaan Pemakanan untuk Penjaga Kanser Kanak-Kanak” (Nutrition Care for Children with Cancer) to help the caregivers to manage their child in terms of nutrition. The objective of this study was to evaluate caregiver’s knowledge, attitude and practice (KAP) before and after receiving the printed educational material and to evaluate the acceptance of the printed educational material among caregiver. This quantitative study (Quasi-Experiment) was conducted among pediatric oncology caregivers in Institute of Pediatrics Hospital Kuala Lumpur (IPHKL)(n=34) and Universiti Kebangsaan Malaysia Medical Center (UKMMC)(n=34). IPHKL served as the experimental group where the caregivers received the developed booklet meanwhile UKMMC served as the control group where the caregivers received a pamphlet published by Institut Kanser Negara titled “Terapi Diet Pesakit Kanser – Kesan Sampingan Rawatan dan Cara Mengatasinya” (Nutrition Care for Cancer – How to Overcome the Side Effects of the Treatment). Results from this study showed that there was a significant increase (p<0.05) for KAP of the caregivers in both groups with a higher increase was seen in the experimental group. The score for KAP in the experimental group was (70 ± 8%) and after receiving the printed educational material, the score significantly increased to (92 ± 10%) which was higher compared to control group where their score before was (70 ± 11%) and increased to (77 ± 10%). For the evaluation of acceptance, there was a significant difference (p<0.05) for the mean score between experimental group (48.85 ± 4.931) and control (42.29 ± 6.834) with t= 4.538. In conclusion, the printed educational material developed from this study was well accepted and has the potential to effectively increase caregivers’ nutritional knowledge of managing the nutritional aspect of pediatric cancer patients during treatment. This could improve their nutritional status for a better clinical outcome.
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@#Introduction: The number of breast cancer survivors in developing Asian countries is still lacking compared to Western countries. Health-related quality of life (HRQoL) of cancer patients is one of the significant predictors of survival. Hence, this study was conducted to determine HRQoL status among breast cancer survivors of different diagnosis duration in East Coast of Peninsular Malaysia. Methods: Cross-sectional data were collected for 128 breast cancer survivors, aged 37 to 72 years who were recruited by using purposive sampling method at two main government hospitals in Kelantan (n=67) and Terengganu (n=61). The validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ–C30) and Breast Cancer Supplementary Measure (EORTC QLQ-BR23) which had been translated into the Malay language were used to measure HRQoL. Independent t-test was used to compare HRQoL status among short term (≤5 years duration since diagnosis) and long term (>5 years duration since diagnosis) breast cancer survivors. Results: Overall, our breast cancer survivors reported good HRQoL, with high scores for global health status, functional status and low symptoms scores. Long term breast cancer survivors had better social functioning compared to short term survivors (p=.038). Nevertheless, there was no significant difference found for other HRQoL status between short and long term breast cancer survivors. Conclusion: Breast cancer survivors in East Coast of Peninsular Malaysia generally experienced good HRQoL. The relatively similar HRQoL status between long-term and short-term survivors indicated a constant HRQoL profile among survivors throughout their survivorship.
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@#A balanced dietary intake plays an important role in the prognosis of breast cancer and is one of the modifiable factors in preventing cancer recurrence. This study aims to determine the dietary intake among breast cancer survivors in East Coast of Peninsular Malaysia. A total of 125 breast cancer survivors, aged 37 to 72 years, with mean duration of survivorship of 6.1 ± 3.9 years were recruited from two main referral hospitals in Terengganu and Kelantan. Majority ofthe respondents were Malay (94.4%) with a mean BMI of 27.7 ± 5.07 kg/m², and were diagnosed with stage II cancer (66.0%). Dietary intake was estimated using a semi-quantitative food frequency questionnaire (FFQ). The results show that the mean daily intake of energy was 1764 ± 378 kcal/day, protein was 72.38 ± 33.6 g/day (16.5% of energy), carbohydrate was 243.0 ± 62.2 g/day (55% of energy) and fat was 55.8 ± 15.6 g/day (28% of energy). Overall, breast cancer survivors in this study had an adequate daily intake of vitamins and minerals according to Malaysian Recommended Nutrient Intakes (RNI) except for dietary fibre (10.6 ± 4.2 g/day), monounsaturated fatty acids (20.7 ± 5.7 g/day), polyunsaturated fatty acids (8.0 ± 2.2 g/day), calcium (561.0 ± 257.1 mg/day), iron (18.3 ± 7.2 mg/day) and potassium (1813.4 ± 531.1 mg/day) which was lower than the recommendation. Meanwhile, intake of sodium (2592 ± 1697 mg/day), protein (80.4 ± 33.6 g/day), saturated fatty acids (26.9 ± 14.2 g/day), vitamin B2 (1.9 ± 1.1 mg/day) and vitamin C (151.1 ± 149.3 mg/day) exceeded the recommendation by 135.0%, 139.0%, 166.9%, 154.6% and 152.0%, respectively. There was no significant difference in dietary intake between cancer survivors who were diagnosed in the past five years and those who were diagnosed more than five years ago (p>0.05) except for fat (p<0.001), saturated fatty acid (p=0.006), monounsaturated fatty acid (p=0.005) and polyunsaturated fatty acid (p=0.003). As a conclusion, breast cancer survivors in East Coast of Peninsular Malaysia had an adequate intake of most nutrients except for dietary fibre, monounsaturated fatty acids, polyunsaturated fatty acids, calcium, iron and potassium which was below the recommendation and sodium, protein, saturated fatty acids, vitamin B2, vitamin C which was above the recommendation. The intakes between long-term and short-term survivors were also comparable showing sustained dietary intake throughout survivorship.
Assuntos
Ingestão de Alimentos , Nutrientes , Neoplasias da Mama , SobreviventesRESUMO
A balanced dietary intake plays an important role in the prognosis of breast cancer and is one of the modifiable factors in preventing cancer recurrence. This study aims to determine the dietary intake among breast cancer survivors in East Coast of Peninsular Malaysia. A total of 125 breast cancer survivors, aged 37 to 72 years, with mean duration of survivorship of 6.1 ± 3.9 years were recruited from two main referral hospitals in Terengganu and Kelantan. Majority of the respondents were Malay (94.4%) with a mean BMI of 27.7 ± 5.07 kg/m², and were diagnosed with stage II cancer (66.0%). Dietary intake was estimated using a semi-quantitative food frequency questionnaire (FFQ). The results show that the mean daily intake of energy was 1764 ± 378 kcal/day, protein was 72.38 ± 33.6 g/day (16.5% of energy), carbohydrate was 243.0 ± 62.2 g/day (55% of energy) and fat was 55.8 ± 15.6 g/day (28% of energy). Overall, breast cancer survivors in this study had an adequate daily intake of vitamins and minerals according to Malaysian Recommended Nutrient Intakes (RNI) except for dietary fibre (10.6 ± 4.2 g/day), monounsaturated fatty acids (20.7 ± 5.7 g/day), polyunsaturated fatty acids (8.0 ± 2.2 g/day), calcium (561.0 ± 257.1 mg/day), iron (18.3 ± 7.2 mg/day) and potassium (1813.4 ± 531.1 mg/day) which was lower than the recommendation. Meanwhile, intake of sodium (2592 ± 1697 mg/day), protein (80.4 ± 33.6 g/day), saturated fatty acids (26.9 ± 14.2 g/day), vitamin B2 (1.9 ± 1.1 mg/day) and vitamin C (151.1 ± 149.3 mg/day) exceeded the recommendation by 135.0%, 139.0%, 166.9%, 154.6% and 152.0%, respectively. There was no significant difference in dietary intake between cancer survivors who were diagnosed in the past five years and those who were diagnosed more than five years ago (p>0.05) except for fat (p<0.001), saturated fatty acid (p=0.006), monounsaturated fatty acid (p=0.005) and polyunsaturated fatty acid (p=0.003). As a conclusion, breast cancer survivors in East Coast of Peninsular Malaysia had an adequate intake of most nutrients except for dietary fibre, monounsaturated fatty acids, polyunsaturated fatty acids, calcium, iron and potassium which was below the recommendation and sodium, protein, saturated fatty acids, vitamin B2, vitamin C which was above the recommendation. The intakes between long-term and short-term survivors were also comparable showing sustained dietary intake throughout survivorship.
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Increasing physical activity level during and after treatment is recommended by the American Cancer Society because of the many benefits namely reducing fatigue and improves psychological distress which leads to an improvement in the quality of life. This study is aimed to compare physical activity level and body composition between oncology patients who are still undergoing treatment and those on medical follow-up. Patients were recruited based on convenience sampling from the Oncology Outpatient Clinics of Universiti Kebangsaan Malaysia Medical Center (UKMMC). Anthropometric measurements and body compositions were measured using calibrated tools while physical activity level were assessed using Global Physical Activity Questionnaire (GPAQ). Medical treatment history was obtained from patients medical records. A total of 53 patients (n=38 were undergoing treatment and n=15 was on follow-up) consisting of Malays (54.7%) and Chinese (45.3%) and with mean age of 55.3 ± 9.3 years. Most patients were previously diagnosed with ovarian cancer (39.6%) and colon cancer (18.9%) patients and they were at cancer stage III (18.8%). Body mass index (BMI) and percent fat mass were significantly different (p<0.05) between patients undergoing treatment (22.8 ± 2.7 kg/m2, 28.7 ± 7.2%) and on follow-up (26.2 ± 5.5 kg/m2, 37.1 ± 11.9%). Majority of the patients undergoing treatment were categorized under low physical activity compared to those on follow-up (p<0.05). Physical activity level measured as METS-minutes/week is also found to be significantly different (p<0.05) between patients on treatment and follow-up. As a conclusion, cancer patients undergoing treatment have low physical activity, with lower BMI and fat mass compared to those on follow-up. This is consistent with their nature of living where during treatment the patients will resting while coping with side effects of treatments.
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Food frequency questionnaire (FFQ) is a practical tool for the measurement of usual food intake in large surveys because it gives a quick approximation to ‘true’ dietary intake. This study was carried out to compare the semiquantitative FFQ with three day 24-hour diet recalls (24-hr DR) in assessing intake of energy, total fat, fatty acids and vitamin A, C and E among Malaysian women. This semi-quantitative FFQ which was developed specifically for the Malay and Indian ethnicities has 200 food items and categorized according to three mealtimes namely breakfast, lunch or dinner and morning or afternoon snacks. A total of 51 Malay and 28 Indian women aged between 30 to 60 years were selected as study subjects. The result of the study shows that majority of study subjects were within the normal EI/BMR ratio when their energy intake was assessed by semi-quantitative FFQ (70%) and 24-hr DR (74%). However, 10% of study subjects became over-reporters when their intakes were assessed using the semi-quantitative FFQ. Analysis of t-test shows there is no significant difference (p > 0.05) on the mean intake of energy, total fats, saturated, monounsaturated and polyunsaturated fatty acids and vitamin A, C and E between semi-quantitative FFQ and 24-hr DR. Percent mean differences were also less than 10% for all nutrients included in this study. This indicates that the semi-quantitative FFQ can produce comparable results with 24-hr DR. Energy adjusted correlation coefficient values for all studied nutrients were total fat (r = 0.64, p = 0.02), saturated fatty acids (r = 0.59, p = 0.01), monounsaturated fatty acids (r = 0.52, p = 0.03), polyunsaturated fatty acids (r = 0.57, p = 0.02), vitamin A (r = 0.69, p = 0.01), retinol (r = 0.55, p = 0.01), beta carotene (r = 0.74, p = 0.01), vitamin C (r = 0.64, p = 0.02) and vitamin E (r = 0.69, p = 0.01). Cross-classification for both methods into quartiles of intake resulted in correct classification into the same or adjacent quartile from 82% to 96% of the study subjects. Only 3% of the subjects were grossly misclassified. As a conclusion, this semi-quantitative FFQ gives estimation as good as 24-hr DR for intakes of energy, total fat, fatty acids and vitamin A, C and E among Malaysian women specifically for the Malay and Indian ethnicities. This semi-quantitative FFQ is a useful tool in dietary intake assessment for research use especially for epidemiological study on diet and disease relationship such as cardiovascular, cancer and diabetes.