ABSTRACT
INTRODUCTION: The Patient Assessment on Chronic Illness Care (PACIC) was developed to assess patients' perspectives on the alignment of primary care to the chronic care model. The Malay PACIC has been validated; however, Malaysia is a multicultural society, and English is spoken by many Malaysians and expatriates. We sought to validate the English version of the PACIC among patients with diabetes mellitus in Malaysia, as Malaysians may interpret a questionnaire that was originally developed for Americans in a different way. METHOD: This study was conducted between November and December 2016 at two primary care clinics that offered integrated diabetes care at the time. These sites were selected to assess the discriminative validity of the PACIC. Site 1 is a Malaysian Ministry of Health-run primary care clinic while site 2 is a university-run hospital-based primary care clinic. Only site 1 annually monitors patient performance and encourages them to achieve their HbA1c targets using a standard checklist. Patients with diabetes mellitus who understood English were recruited. Participants were asked to fill out the PACIC at baseline and two weeks later. RESULTS: A total of 200 out of the 212 invited agreed to participate (response rate=94.3%). Confirmatory factor analysis confirmed the 5-factor structure of the PACIC. The overall PACIC score and the score in two of the five domains were significantly higher at site 1 than at site 2. The overall Cronbach's alpha was 0.924. At test-retest, intra-class correlation coefficient values ranged from 0.641 to 0.882. CONCLUSION: The English version of the PACIC was found to be a valid and reliable instrument to assess the quality of care among patients with diabetes mellitus in Malaysia.
ABSTRACT
@#The objective of this study wasto determine the factorial validity of the Chinese version of the General Family Functioning subscale (GF-12) and to assess parents’ perceived family functioning of children with or without chronic respiratory disease in Malaysia. Thirty two parents of children with chronic respiratory disease and 30 parents of healthy children were recruited. The GF-12 was administered at baseline and 2 weeks later. Confirmatory factor analysis showed that our instrument was a 1-factor model assessing general family functioning. Cronbach’s α value was 0.950. Test-retest reliability coefficient ranged from 0.490-0.790. The overall mean (standard deviation) score was not significantly different between parent’s perceived family functioning of children with or without respiratory disease [1.83(0.63) versus 1.65(0.46), p=0.385]. The Chinese version of the GF-12 was found to be a valid and reliable instrument to assess family functioning in Malaysia. Parents in the present study showed healthy perceived family functioning (total score >2.00)
ABSTRACT
Bisphosphonates are pyrophosphate analogues, with a strong affinity for bones. They inhibit bone resorption and are currently the first choice of treatment for osteoporosis. Bisphosphonates should be taken in a specific manner and for at least one year to be effective in the maintenance and improvement of bone mineral density (BMD), as well as for protection against fractures. We report a case of a postmenospausal osteoporotic woman who lost BMD despite being on bisphosphonate therapy for eight years, highlighting issues that a primary care doctor needs to address before deciding on the next best option.
