A Critical Appraisal of COVID-19 in Malaysia and Beyond

@#When the first report of COVID-19 appeared in December 2019 from Wuhan, China, the world unknowingly perceived this as another flu-like illness. Many were surprised at the extreme steps that China had subsequently taken to seal Wuhan from the rest of the world. However, by February 2020, the SARS-CoV-2 virus, which causes COVID-19, had spread so quickly across the globe that the World Health Organization officially declared COVID-19 a pandemic. COVID-19 is not the first pandemic the world has seen, so what makes it so unique in Malaysia, is discussed to avoid a future coronacoma.

The experiences of women with maternal near miss and their perception of quality of care in Kelantan, Malaysia: a qualitative study.

BACKGROUND: Maternal mortality has been the main way of ascertaining the outcome of maternal and obstetric care. However, maternal morbidities occur more frequently than maternal deaths; therefore, maternal near miss was suggested as a more useful indicator for the evaluation and improvement of maternal health services. Our study aimed to explore the experiences of women with maternal near miss and their perception of the quality of care in Kelantan, Malaysia. METHODS: A qualitative phenomenological approach with in-depth interview method was conducted in two tertiary hospitals in Kelantan, Malaysia. All women admitted to labour room, obstetrics and gynaecology wards and intensive care units in 2014 were screened for the presence of any vital organ dysfunction or failure based on the World Health Organization criteria for maternal near miss. Pregnancy irrespective of the gestational age was included. Women younger than 18 years old, with psychiatric disorder and beyond 42 days of childbirth were excluded. RESULTS: Thirty women who had experienced maternal near miss events were included in the analysis. All were Malays between the ages of 22 and 45. Almost all women (93.3%) had secondary and tertiary education and 63.3% were employed. The women's perceptions of the quality of their care were influenced by the competency and promptness in the provision of care, interpersonal communication, information-sharing and the quality of physical resources. The predisposition to seek healthcare was influenced by costs, self-attitude and beliefs. CONCLUSIONS: Self-appraisal of maternal near miss, their perception of the quality of care, their predisposition to seek healthcare and the social support received were the four major themes that emerged from the experiences and perceptions of women with maternal near miss. The women with maternal near miss viewed their experiences as frightening and that they experienced other negative emotions and a sense of imminent death. The factors influencing women's perceptions of quality of care should be of concern to those seeking to improve services at healthcare facilities. The addition of a maternal near miss case review programme, allows for understanding on the factors related to providing care or to the predisposition to seek care; if addressed, may improve future healthcare and patient outcomes.

The Effectiveness of A Cultural-Based Support Group For Malay Dementia Caregivers In Kelantan, Malaysia: A Pre-Post Intervention Study

: The psychological impact of care giving responsibility for dementia patients is significant regardless of the cultural background. Most of the current advanced caregivers’ interventions, originating from developed western countries, do not necessarily apply to local settings. Hence, there is a need for an effective culturally competent psychological intervention for these caregivers. The aim of the study is to assess the effectiveness of the cultural-based support group for Malay caregivers of dementia patients in Kelantan towards their burden, anxiety and depression level, and quality of life. Methods: This was an experimental study, without control, investigating pre and post support group intervention effectiveness in reducing caregiver burden, anxiety and depression, and improving the quality of life. Sixteen caregivers completed the program, which involved seven fortnightly support group sessions with duration of 2 hours each, conducted over twelve weeks. Caregivers’ burden was assessed using Caregiver Strain Index (CSI) while their psychological well-being was objectively assessed using Hospital Anxiety and Depression Scale (HADS). WHO Quality of Life questionnaire (WHOQOL-BREF) was used to measure the quality of life. The validated Malay versions of the questionnaires were used. Results: There was a statistically significant reduction in the level of caregiver burden (p = or < 0.001). Measurement of both scores of anxiety and depression comparing pre and post intervention also showed improvement, but statistically were not significant. Assessment of caregivers’ quality of life showed statistically significant improvement in the domains of social, psychological and physical (all with the p-value <0.05). Discussion: Our cultural-based support group is an effective intervention to improve burden, psychological well-being and quality of life among local caregivers of dementia patients. ASEAN Journal of Psychiatry, Vol. 18 (1): January – June 2017: XX XX.

Cultural Construction of Psychiatric Illness in Malaysia

The concept of the cultural construction of illness is important in terms of understanding people's behaviour. In this article, this idea is applied to psychiatric illness in Malaysia to explore how it is informed by sociocultural elements, a process that will help us understand the psychiatric expression and help-seeking behaviour of the country's population.

Severe Maternal Morbidity and Postpartum Depressive Symptomatology: A Prospective Double Cohort Comparison Study.

The adverse consequences to mothers of postpartum depression are well-documented, and risk factors are of interest. There is limited evidence on postpartum depression among women with severe maternal morbidity, defined as potentially life-threatening conditions during pregnancy, childbirth, or soon after termination of pregnancy. We compared postpartum depressive symptoms of postpartum women aged 18 and older who delivered in two tertiary referral hospitals in 2014 in Kelantan, Malaysia, and had (n = 145) or had not (n = 187) suffered severe maternal morbidity. A prospective double cohort study design was applied. Postpartum depressive symptoms were assessed at 1 and 6 months postpartum using the Malay version of the Edinburgh Postnatal Depression Scale. There was no significant difference in the mean Edinburgh Postnatal Depression Scale score changes (p = .803) between the two groups of women, after adjusting for age, social support, physical health, occupation, and education. Factors other than severe medical complications should be pursued as predictors of postpartum depressive symptomatology. © 2016 Wiley Periodicals, Inc.