Translation and validation of the Malay version of modified orthotics and prosthetics users' survey.

BACKGROUND: An excellent validated and reliable instrument is paramount in holistically evaluating the prosthetic and orthotic (P&O) service, encompassing functional outcomes, health-related quality of life (HRQoL), and patient satisfaction with devices and service. OBJECTIVE: To perform a translation and cross-cultural adaptation of 3 modules of the Orthotics and Prosthetics Users' Survey (OPUS): (1) lower-extremity functional status (LEFS), (2) client satisfaction with device and services (CSDS), and (3) HRQoL in Malay language, and analyze its psychometric properties. STUDY DESIGN: Translation and validation study. METHODS: This translation process consisted of 4 phases: (1) a forward-backward translation, (2) content and face validity by utilizing content and face validity indices, (3) pilot testing and psychometric analysis using exploratory factor analysis, and (4) test-retest reliability. RESULTS: One item from OPUS Health Quality of Life Index-Malay pilot version, 5 items from OPUS LEFS-Malay pilot version, and 4 items of OPUS Satisfaction with Device and Services-Malay pilot version were deleted because of poor factor loading of <0.6. The final version of Modified OPUS HRQoL-M, Modified OPUS LEFS-M, and Modified OPUS CSDS-M consisted of 22 items, 15 items, and 17 items, respectively. The final versions of all 3 Modified OPUS Malay version possess good internal consistency of 0.854, 0.927, and 0.98, and intraclass correlation of 0.773, 0.871, and 0.821, respectively . CONCLUSION: Modified OPUS HRQoL-M, Modified OPUS LEFS-M, and Modified OPUS CSDS-M are valid and reliable instruments to be adopted into the local Malaysia population.

The impact of a pressure ulcer prevention educational program based on the health belief model for persons with spinal cord injury.

STUDY DESIGN: Pre- and post- trial. OBJECTIVES: To determine the changes of health belief levels after a pressure ulcer (PrU) prevention educational program based on the Health Belief Model (HBM). SETTING: Department of Rehabilitation Medicine, University Medical Centre, Malaysia. METHODS: This study was conducted between May 2016 and May 2018. We created a multidisciplinary structured PrU prevention education program based on the HBM, consisting of didactic lectures, open discussions and a practical session. The content of the program was based on several PrU prevention guidelines. The education program focused on a group of 6-10 participants, and was conducted by a multidisciplinary team; i.e. doctor, physiotherapist, occupational therapist and a nurse. The skin care belief scales (SCBS) questionnaire was administered pre, post and 8-week post intervention, which measured the 9 domains of HBM. The data from the study was analyzed using repeated measures ANOVA to assess the effectiveness of the program. RESULTS: Thirty spinal cord injured participants who fulfilled the inclusion and exclusion criteria completed this study. The results of the education program show statistically significant effects on Susceptibility; F (2,58) = 12.53, P < 0.05, Barriers to Skin Check Belief; F(2,58) = 5.74, P > 0.05, Benefits to Wheelchair Pressure Relief Belief; F(1.65,47.8) = 3.97, P < 0.05, Barriers to Turning and Positioning Belief; F(2,58) = 3.92, P < 0.05 and Self-Efficacy; F(1.7,49.11) = 4.7, P < 0.05. CONCLUSIONS: A structured HBM based education program is shown to improve health beliefs level in five SCBS domains. This education program is recommended for PrU prevention within the spinal cord injured population. IMPLICATIONS: A multidisciplinary structured HBM based education program may improve the current method of PrU prevention education.

Incomplete paraplegia caused by extramedullary hematopoiesis in a patient with thalassemia intermedia.

INTRODUCTION: Extramedullary hematopoiesis (EMH) is the production of blood cell precursors outside the bone marrow that occur in various hematological diseases. In patients with thalassemia intermedia, ineffective erythropoiesis drives compensatory EMH in the liver, pancreas, pleura, spleen, ribs and spine. CASE PRESENTATION: We describe a patient with thalassemia intermedia who presented with acute neurological symptoms caused by paraspinal EMH, which responded well to combination therapy of steroid, hypertransfusion, laminectomy and excision of pseudotumor and hydroxyurea therapy to boost the formation of fetal haemoglobin. DISCUSSION: Prompt recognition of EMH based on clinical presentation and typical radiological findings should be made. Early treatment is recommended to prevent irreversible damage to the spinal cord.