The Reliability and Validity of the Malay Parent-Report Version of the Strengths and Difficulties Questionnaire.

[This retracts the article DOI: 10.21315/mjms2019.26.1.12.].

A Longitudinal Study of Emotional and Behavioral Problems among Malaysian School Children.

BACKGROUND: Emotional and behavioral problems (EBD) or mental health problems in children and adolescents are an important public health issue, but there has been no evaluation to date of the extent of such problems in near-developed countries. This study evaluated the prevalence and stability of EBD among children in Malaysia. METHODS: This research comprises a longitudinal population-based study that measured the prevalence and 6-month stability of EBD in children aged seven to eight years and thirteen to fourteen years attending public schools in Malaysia based on parents, teachers and children's (aged 13 to 14 years) report of the Strengths and Difficulties Questionnaire (SDQ) at baseline and 6 months later. FINDINGS: The prevalence of EBD in Malaysian school children was 9.3% for teacher-report, 8.5% for parent-report and 3.9% for child-report. There was no significance difference in the prevalence of emotional and behavioral problems over six-months for all informants, except for teacher-report Emotional and Conduct problems scores which increased significantly and child-report Total Difficulties and Emotional problems scores which decreased significantly (p < 0.05). CONCLUSIONS: This study shows that the prevalence of EBD among Malaysian children is almost similar to the Western countries and stable over a 6-month period. These findings suggest the need for policy makers in near-developed countries to provide services aimed at preventing EBD and treating children identified as having such problems.

The Reliability and Validity of the Malay Parent-Report Version of the Strengths and Difficulties Questionnaire.

BACKGROUND: The Strengths and Difficulties Questionnaire (SDQ) is a screening questionnaire that measures children's emotional and behavioural problems. This study examines the reliability and validity of the Malay parent-report version of the SDQ. METHODS: The Malay adult-report version of the SDQ was administered to 495 parents and 432 teachers, respectively. At the same time, a newly translated Malay child-report version of the SDQ was also administered to 150 children aged 13 to 14 years old in this community study. W e measured internal reliability using Cronbach's Alpha for all reported data. Construct validity of the parent-report data was assessed using factor analysis. Confirmatory Factor Analysis (CFA) was also subsequently perform on parent-report data to explain the model fit indices of this questionnaire. RESULT: Cronbach's Alpha was acceptable for all parent, teacher and child-report data with values of 0.74, 0.77 and 0.78, respectively. Factor analysis of the parent's report showed a five-factor solution, which was consistent with other psychometric evaluations of the SDQ in other languages. CFA showed good model fit of the original five factor model which consists of Emotional, Conduct, Hyperactivity, Peer problem and Pro-social scale. CONCLUSION: This study shows that the psychometric properties of the Malay parent-report version of the SDQ were similar to other parent-report version of the SDQ questionnaires in other languages, although cross-cultural differences may still exist.

'It's like taking a bit of masculinity away from you': towards a theoretical understanding of men's experiences of infertility.

In the UK, nearly half of all cases of infertility involve a 'male-factor'. Yet, little empirical work has explored how men as men negotiate this terrain. Three interrelated concepts; 'hegemonic masculinity', 'embodied masculinity' and the linkages between 'masculinities' and male help-seeking, provide the theoretical framework that guided a qualitative study conducted with 22 men experiencing infertility. The paper explores men's propensity to delay their help-seeking in relation to infertility despite their desire for children. It also demonstrates how, in the context of infertility, the male body can be defined as both a failed entity in itself (unable to father a child) and a subordinated social entity (unable to measure up to hegemonic ideals) that characterises men's masculine identities. The paper also illustrates how men appear willing to accept responsibility for their infertility and adopt aspects of hitherto subordinate masculine practice. This does not, however, constitute the total unravelling of well understood and accepted expressions of masculinity. Finally, the paper demonstrates how infertility is perceived as having the potential to fracture current and even future relationships. Moreover, regardless of how well men measured up to other hegemonic ideals, ultimately they can do little to counteract the threat of other (fertile) men.

Understanding the Relationship Between State Forgiveness and Psychological Wellbeing: A Qualitative Study.

Over the last 20 years, increasing attention has been given to associations between dispositional forgiveness and specific mental health problems. However, few studies have assessed whether forgiving real-life interpersonal hurts may be related to diverse psychological health outcomes. The present study addresses this gap by investigating, in depth, relationships between perceptions about state forgiveness and a variety of mental wellbeing outcomes as well as exploring perceptions about the factors that may modify such effects. Developing an understanding of a forgiveness wellbeing relationship is of relevance to healthcare workers, researchers and policy makers with an interest in improving public health. In-depth semi-structured interviews were conducted, and data were analysed using grounded theory methods. From England and Ireland, eleven adults who were affiliated with religious/spiritual and secular/atheist groups were recruited using purposive and convenience sampling methods. Key themes that appeared to be related to the effects of unforgiveness were: increases in negative affect; reduction in cognitive abilities and barriers to psychological and social growth. For the majority of participants, state forgiveness had strong ties to participants perceived sense of mental wellbeing, including reductions in negative affect, feeling positive emotions, positive relations with others, spiritual growth, a sense of meaning and purpose in life as well as a greater sense of empowerment. The data also revealed a number of factors that may positively or negatively influence a forgiveness-wellbeing link such as: viewing an offender as spiritually similar or different, responsibility/karma, blaming, wanting restitution/apology as well as practices such as meditation and prayer. The findings suggest that forgiving a range of real-life interpersonal offences may be an important determinant of psychological wellbeing, particularly among religious/spiritual populations. Further research is, however, needed.

'Men give in to chips and beer too easily': how working-class men make sense of gender differences in health.

This article, based on qualitative research with working-class men, explores men's perceptions and experiences regarding gender differences in health. It demonstrates how men put forward a range of behavioural/cultural, materialist/structural and psychosocial factors, which were believed to differently impact men's health compared to women. A common theme underpinning their explanations was the ways in which men and women were located within two distinct gender categories. These characterisations were used to explain why health-damaging beliefs and behaviours were more prevalent among men and also why men were better suited for certain kinds of jobs, albeit with potential costs to their health. Men also believed that women were protected from the damaging physical and emotional impact of manual employment because of their primary role within the home and because they were less emotionally robust, which required men to shield women from the stresses they experienced. However, men's emotional withdrawal can also be viewed as another example of how men use whatever resources are available to achieve and maintain dominance over women. Finally, the article demonstrates how a gender- and class-based approach can capture the impact of men's health-related practices alongside the broader cultural and structural influences on men's health.

Men, masculine identities and childbirth.

In recent years, fathers' experiences during childbirth have attracted much research and policy interest. However, little of this work has been grounded in the first-hand accounts of men and there is a lack of theory-based research to help understand men's thoughts and practices around childbirth. This paper is based on qualitative research undertaken with first-time fathers and healthcare professionals. It draws on Connell's (1995) conceptualisation of hegemonic masculinity to explore how men construct masculine identities within the context of pregnancy and childbirth and also how healthcare professionals construct masculinity. The paper demonstrates the ways in which men can find themselves marginalised within the context of pregnancy and childbirth, but are still able to draw on identifiable markers of masculine practice which enable them to enact a masculine form congruent with dominant masculinity. It also illustrates how healthcare professionals' constructions of masculinity enable them to predict how men will behave and allow them to position men in ways that involve minimum disruption to their own practice. The paper also highlights how men's marginal status is embedded in the dynamics of the social structure, which produce and reproduce dominant masculine identities within the context of childbirth.

'You can't ask for a Dubonnet and lemonade!': working class masculinity and men's health practices.

In recent years, much research concerning men's health has focused on men's health-related practices. While this body of research has often sought to contextualise men's health practice it has done so primarily in terms of gender not social class. The need remains therefore to link theories of masculinity and health to broader theories regarding social class and health which highlight the social and economic context of people's lives, in order to develop more complex understandings regarding the interactions between social class, gender and men's health practices. The aim of this article is to explore these interactions via a qualitative examination of the ways in which two groups of working class men living in two contrasting socio-economic areas construct masculinity and how this intertwines with their class position to impact on their health practices. This study highlights how men's conceptualisations of masculinity coupled with their class position informed their understanding of male roles and the expectations that flow from this. It shows how certain risky practices are firmly rooted in the material reality of men's lives, not simply in their gender, and how aspects of masculinity and class position intimately entwine to structure men's health seeking behaviour.

'That's just the cesspool where they dump all the trash': exploring working class men's perceptions and experiences of social capital and health.

This article explores issues relating to the concept of social capital which has been become an important explanation for inequalities in health. It is based on an analysis of in-depth interviews with working class men living in two contrasting socio-economic areas--one relatively disadvantaged and one advantaged. It highlights the role of different community contexts in the nature and extent of local social capital. In particular, it demonstrates how de-industrialization and economic change as well as material deprivation and a perceived dis-investment in local communities impacted on the men's levels of social capital. Analysis also shows the ways in which gender mediates the processes through which social capital is developed and accessed as a personal and social resource, and how the norms and values associated with working class masculinities appeared to preclude the men from building supportive health-enhancing relationships with others in their community. The prominence of social capital has focused attention on the subjective dimensions of community life as potential determinants of health. This article has, therefore, sought to contribute to this field by widening our understanding about the relationship between social capital, gender and health.

'Good luck to them if they can get it': exploring working class men's understandings and experiences of income inequality and material standards.

This paper seeks to contribute to the recent debate within the field of inequalities in health that has focused on the relationship between income distribution and health. This has contested the extent to which the main effects of income on health are not directly related to material standards but operate through psychosocial mechanisms, linked to how people experience and perceive their relative position. However, whilst this has focused attention on the qualitative dimensions of income inequality as a potential determinant of health inequality, very little empirical work has directly examined lay perspectives. In this study I attempted to address this gap by exploring how two groups of working class men living in contrasting socio-economic areas understood and experienced differences in income and material circumstances and how these were perceived to impact on their health. This study shows that the anger and resentment felt by these men had their roots largely in the perceptions of others and the way others treated them, rather than in income differentials per se. There was little evidence of feelings of shame or inferiority. For men at the bottom of the social ladder, financial hardship was additionally perceived as having the greatest impact on their health and well-being.

'You ain't going to say...I've got a problem down there': workplace-based prostate health promotion with men.

Prostate health has emerged as a key health issue for men. Nearly 10,000 men die from prostate cancer each year and many more live with non-cancerous, but debilitating, prostate conditions. Despite the widespread prevalence, evidence suggests that men lack knowledge about male cancers and conditions, and are more likely to ignore signs and delay seeking help. Health promotion with men in the workplace is, therefore, increasingly being advocated as an important way of providing men with health information and encouraging them to see a health professional where appropriate. However, there has not been a developed account of men's views on health promotion within the workplace. This paper presents the findings of a small-scale qualitative study that explored men's perceptions and experiences of three different workplace-based health promotion interventions to improve prostate health awareness and their attitudes towards the workplace as an appropriate setting for promoting men's health. This paper shows that men generally welcomed a workplace-based health promotion campaign targeted specifically at them. However, the masculine 'culture' of the workplace, where concerns about health were likely to be met with ridicule rather than concern, was one important factor in understanding these men's views of different health promotion interventions.

Smoking behaviour change among fathers of new infants.

Protecting infants from exposure to parental tobacco smoke is key to positive health outcomes in childhood and later life. While mothers' smoking has been well researched, fathers' smoking has received little attention. This paper reports data from a cross-sectional survey of 286 smoking fathers in the English Midlands, interviewed when their infants were 8-14 weeks old. It examines whether fathers attempt and successfully achieve two smoking behaviours positively associated with infant health: quitting and not smoking in the home. The birth of a new baby was not associated with attempting or successfully quitting smoking for the majority of fathers. Less than 20% had tried to quit and only 4% had successfully quit smoking since the birth of their baby. Half of the participants reported that they had not changed their cigarette consumption since their baby's birth. Not smoking in the home appeared to be a more achievable behaviour for many fathers; 78.0% had attempted and 60% had successfully achieved not smoking in home. Independent predictors of attempting to quit were fathers' own cigarette consumption and level of knowledge about infant exposure to tobacco smoke. Attempting to abstain from smoking in the home and being successful in the attempt were both independently associated with partner's smoking status, number of financially dependent children and father's social class. Findings suggest that promoting reductions in cigarette consumption and improving knowledge levels among fathers about passive smoking in infants may encourage more quit attempts. Not smoking in the home is a more achievable behaviour and is linked to fathers' caring and economic circumstances and their partner's smoking status. Influences on fathers' smoking behaviour appear to be multi-factorial. Understanding father's smoking and developing health promotion strategies to protect infants from passive smoking is likely to depend on research which can bridge the caring and economic spheres of their lives.

Effect of strategies to reduce exposure of infants to environmental tobacco smoke in the home: cross sectional survey.

OBJECTIVE: To examine parents' reported knowledge and use of harm reduction strategies to protect their infants from exposure to tobacco smoke in the home, and the relation between reported use of strategies and urinary cotinine to creatinine ratios in the infants. DESIGN: Cross sectional survey. SETTINGS: Coventry and Birmingham. MAIN OUTCOME MEASURES: Parents' reported knowledge and use of harm reduction strategies and urinary cotinine to creatinine ratios in their infants. PARTICIPANTS: 314 smoking households with infants. RESULTS: 86% of parents (264/307) believed that environmental tobacco smoke is harmful, 90% (281/314) believed that infants can be protected from it in the home, and 10% (32/314) were either unaware of measures or reported using none. 65% of parents (205/314) reported using two or more measures, but only 18% (58/314) reported not allowing smoking in the home. No difference was found in mean log e transformed urinary cotinine to creatinine ratio in infants from households that used no measures compared with households that used less strict measures. Mean log cotinine to creatinine ratios were significantly different in households banning smoking in the home compared with those using less strict or no measures. Banning smoking in the home was independently associated with a significant reduction in urinary cotinine to creatinine ratio by a factor of 2.6 (1.6 to 4.2) after adjustment for average household cigarette consumption, tenure, and overcrowding. CONCLUSIONS: Less than a fifth of parents in smoking households ban smoking in the home. Banning smoking was associated with a small but significant reduction in urinary cotinine to creatinine ratio in infants, whereas less strict measures compared with no measures had no effect on the infants' exposure to environmental tobacco smoke.