Factors Contributing to Non-Communicable Diseases in a Selected Low Socio-Economic Status Community in Kedah, Malaysia

@#Introduction: Non-communicable diseases (NCDs) are evolving as the leading cause of death worldwide, including in Malaysia. Changes in a socio-economic status have increased at-risk populations with NCDs. The objective of this study is to describe the prevalence of self-reported NCDs and its contributing factors in a selected low socio-economic status community in Kedah, Malaysia. Methods: A cross-sectional study with a self-administered questionnaire was done among convenience samples of 139 adults (age more than 18 years old) living in a selected low socio-economic status community in Kedah. Results: Among 139 respondents with a mean (SD) age 48.5 (13.1), there were 40.3% of respondents reported to have chronic illnesses with a prevalence of hypertension (25.9%), diabetes mellitus (21.6%), hypercholesterolemia (7.2%), chronic respiratory diseases (5.0%), heart disease (2.9%) and stroke (1.4%). The significant contributing factors of NCDs by multiple logistic regression were age, marital and working status. A person with an increase in 1 year of age has 1.05 times the odds to have NCDs (95% CI: 1.01 to 1.09, p-value=0.007). A divorcee has 3.55 times the odds compared to a married person to have NCDs (95% CI: 1.28 to 9.80, p-value=0.015). The non-working individual has 2.27 times the odds compared to working individuals to have NCDs (95% CI: 1.03 to 5.01, p-value=0.042). Conclusion: The prevalence of NCDs is high in this selected low socio-economic status community. The contributing factors are age, marital and working status.

Improvement of Urgent Tests Laboratory Turnaround Time Through Laboratory Lean Management

@#Introduction: Laboratory turnaround time (LTAT) is considered a reliable indicator of the quality and efficiency of a laboratory’s service. LTAT achievement, particularly of urgent tests, remains unsatisfactory and challenging in many clinical laboratories especially in tertiary health care centres with high workload and restricted resources. The unresolved issue of unsatisfactory urgent renal profile (RP) LTAT below the standard performance goal prompted our interest to improve laboratory’s handling of urgent test request. We thus implemented the Lean principle in the management of urgent test requests using urgent RP as the test model. Methods: The implementation of laboratory Lean involved 4 steps process; (1) Development of burning platform for change (2) Identification of waste (3) Planning and implementation of control measures (4) Measuring, monitoring, and sustaining the improvement. Urgent RP LTAT and the percentage of the request met the time requirement determined based on the data extracted from laboratory information system (LIS) before and after the implementation of Lean was compared to assess the effectiveness. Results: Urgent RP LTAT after the implementation of Lean was reduced i.e 35 min (before) vs 31 min (after), with the percentage of LTAT met the time requirement was significantly increased above the set target i.e 82.8% (before) to 93.5% (after) with P-value = 0.001. Conclusion: Implementation of innovation using Lean management has significantly improved urgent RP LTAT achievement, thus optimised urgent test management in our Chemical Pathology laboratory. Lean is a strongly recommended strategy to improve urgent test LTAT especially in laboratories with restricted resources.

Prevalence of Geriatric Giants Among Older People in Kelantan Malaysia

@#Introduction: Geriatric Giants are the impairment that appear in older people. It comprises of impaired cognition, urinary incontinence, instability, fall and immobility. The aim of this study is to determine the prevalence of Geriatric Giants among older people living in three different living environment; own home, pondok and old folks home. Methods: This comparative study involved 471 respondents from Kelantan. There were 157 participants each from own home, pondok and old folks home. The prevalence of Geriatric Giants were determine by 10 minutes comprehensive screening which was developed to diagnose and manage the Geriatric Giants (WHO, 2007) and prevalence were compared using chi-square tests or Fisher exact test. Results: Prevalence of dementia among respondents of old folks home (11.5%), pondok (6.4%) and own home (0.6%). Prevalence of urinary incontinence among respondents of own home (22.3%), old folks home (16.6%) and pondok (14.0%). Prevalence of instability among respondents of old folk home (31.2%), pondok (27.4%) and own home (14.0%). Prevalence of fall among respondents of pondok (33.1%), old folks home (24.25) and own home (19.7%). Old folk home respondents had the highest prevalence of moderate and severe immobility There were significant difference in prevalence of dementia ((Fisher exact p value <0.001), instability (χ2(2)=13.957,p=0.001), fall (χ2(2)=7.629,p=0.022) and mild and moderate immobility. Conclusion: Old folks home respondents had more prevalence of Geriatric Giants compared to their other counter parts.

Long-term Survivorship of Breast Cancer Patients and Its Prognostic Factors: A Tertiary Oncological Center Experience in Penang

@#Introduction: Breast cancer is the most common cause of cancer death among women. The purpose of this study is to determine the 5-years survival rate and prognostic factors among breast cancer patients in a tertiary oncological centre in Penang, Malaysia. Methods: A retrospective cohort study was conducted at the Advanced Medical and Dental Institute, Universiti Sains Malaysia. All 214 cases of breast cancer diagnosed from 1st January 2008 until 31st December 2012 were selected and retrospectively followed-up until 31st December 2017. The survival status for this study was referring to the record of the National Registration of Malaysia. Kaplan-Meier with Log-rank test and Cox regression were used for the univariable and multivariable analysis, respectively. Results: The mean (SD) age at diagnosis was 50.98 (±10.75) years. The majority of the patients were Malay (55.7%) and married (96.5%). After controlling for the effect of underlying comorbidities, lymph nodes involvement, marital status, vascular involvement and adjuvant therapy; it was found that marital status (adj HR= 3.63, 95% CI 1.17-11.24) and lymph nodes involvement (adj HR=2.36, 95% CI 1.17-4.76) were the significant prognostic factors. Conclusion: This study re-emphasizes the role of marital status and lymph nodes involvement as independent predictors of the long-term survival of breast cancer patients. Further studies are needed to assess the promising benefit of personalized treatment and specific supportive care given to the patients with these risk factors for better cancer experience and survival.

Validation of the Malay Version of the Snyder Hope Scale Among Malaysian Cancer Patients / Jurnal Sains Kesihatan Malaysia

@#Hope leads to lower depression and anxiety and is associated with improved quality of life of cancer patients. In thisstudy, Hope Scale (HS) was translated into Malay, and the psychometric properties of the Malay version of the HopeScale were investigated among Malaysian cancer patients. Concurrent translation and back translation of the originalEnglish version of the Hope Scale were performed, and the Malay version was administered to 195 cancer patientswith different cancer diagnoses at baseline assessment and 2 months later at follow-up. The Hope Scale (Malay) totalscore (Cronbach’s α = 0.72; intraclass correlation coefficient (ICC) = 0.67) and its domains (Cronbach’s α [pathway] =0.7; Cronbach’s α [agency] = 0.7; ICC[Pathway] = 0.64; ICC[Agency] = 0.70) demonstrated acceptable internal consistencies andtest-retest reliability. Convergent and discriminant validities were also achieved by the Hope Scale (Malay). The HopeScale (Malay) demonstrated construct validity, as confirmatory factor analysis demonstrated that the items in the HopeScale (Malay) best fit into two domains, which was true for the original English version. The Hope Scale (Malay) hadacceptable psychometric properties and thus is suitable for assessing hope in Malaysian cancer patients.

Validation Of The Malay Version Of The Sources Of Social Support Scale Among Malaysian Cancer Patients

Objective: It is important to investigate the association between spousal support and psychology of cancer patients, thus a validated instrument to measure the degree of perceived spousal support is required. We translated and evaluated the psychometric properties of the Sources of Social Support Scale-Malay version (SSSS-Malay) among Malaysian cancer patients. Methods: In this study, the SSSS-Malay and Hope Scale-Malay [used to compare with the SSSS-Malay to assess discriminant validity] were administered to 195 Malaysian cancer patients during baseline assessment. The SSSS-Malay was re-administered 2 months after the baseline assessment during follow-up. Results: The SSSS-Malay total score (Cronbach’s α = 0.70, intraclass correlation coefficient (ICC) = 0.72) and its domains (Cronbach’s α ranging from 0.70 to 0.83, intraclass correlation coefficient ranging from 0.6 to 0.76) exhibited good internal consistencies and good test-retest reliability. The SSSS-Malay also demonstrated good convergent and discriminant validities. However, confirmatory factor analysis of the SSSSMalay showed that it was best fit into a 3-factor model instead of the 4-factor model of the original English version. Conclusion: The SSSS-Malay demonstrated good psychometric properties for use in Malaysian cancer patients.

Validation Of The Malay Version Of The Posttraumatic Growth Inventoryshort Form (Ptgi-Sf) Among Malaysian Cancer Patients

Introduction: Posttraumatic growth (PTG) is a positive psychological change in life that occurs as a result of struggle with highly challenging life crises. There is a growing need to explore posttraumatic growth (PTG) in cancer patients, as higher PTG may enhance well-being of patients. Objectives: The aim of this study was to translate the Posttraumatic Growth Inventory-Short Form (PTGISF) into the Malay language and evaluate its psychometric properties for assessing Malaysian cancer patients in future studies. Methods: Two parallels forward and backward translations of the PTGI-SF into the Malay language were conducted. The test was administered to 195 cancer patients. Reliability was evaluated by testing internal consistency (Cronbach’s α) and calculating the test-retest intra-class correlation coefficient, and validity was examined by determining face, convergent, and discriminant validities and using confirmatory factor analysis (CFA). Results: The Malay version of the PTGI-SF and its five domains demonstrated good internal consistencies and acceptable test-retest reliability. All 10 items of this version were highly correlated with their own domains and thus exhibited convergent validity. Discriminant validity was achieved, as all domains of the Malay PTGI-SF was not highly correlated with the domains of the Source of Social Support Scale. CFA resulted in a bestfitting 5-factor model. Conclusion: The Malay version of the PTGI-SF is a suitable tool for measuring PTG in Malaysian cancer patients.