Displaying publications 1 - 20 of 78 in total

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  1. Mohd Yusoff D, Awang S, Kueh YC
    J Taibah Univ Med Sci, 2019 Feb;14(1):39-46.
    PMID: 31435388 DOI: 10.1016/j.jtumed.2018.11.009
    Objectives: Urinary incontinence (UI) is common among pregnant women. This growing health problem affects physical, emotional, and social well-being. This study determined the prevalence of UI and associated factors, and evaluated screening needs.

    Methods: A total of 330 pregnant women visiting the antenatal clinic in Hospital Universiti Sains Malaysia (USM) were surveyed. Data were collected through a self-administered questionnaire and analysed with SPSS software version 22.0.

    Results: Overall, 84.5% (n = 279) of the pregnant women had experienced UI. Multiple logistic regression identified body mass index (BMI), presence of other illness, and consumption of coffee as major risk factors for UI. The majority of pregnant women preferred early screening for UI.

    Conclusion: A great majority of pregnant women in this study experienced UI. Higher BMI and the presence of other medical conditions are significant risk factors for UI and early screening is required. The need for universal education about UI and pelvic floor muscle exercise is warranted and can potentially prevent postnatal UI and UI later in life.

  2. Sabo A, Kueh YC, Kuan G
    PLoS One, 2019;14(5):e0215698.
    PMID: 31050664 DOI: 10.1371/journal.pone.0215698
    BACKGROUND: The present study was aimed at validating the Malay-language version of the Self-Efficacy for Exercise Scale (SEE-M) using confirmatory factor analysis (CFA).

    METHODS: Data were collected from undergraduate students at all campuses of the Universiti Sains Malaysia. A total of 1,605 students completed the SEE-M (female: 71.5%, male: 28.5%), with the mean age of 20.3 years (SD = 1.5). Perceived self-efficacy was assessed with the 18-item SEE-M. Standard forward-backward translation was performed to translate the English version of the Efficacy for Exercise Scale (SEE) into the Malay version (SEE-M).

    RESULTS: The 2 initial measurement models tested (1-factor and 3-factor models) did not result in a good fit to the data. Subsequent investigation of the CFA results recommended some modifications, including adding correlations between the item residuals within the same latent variable. These modifications resulted in good fit indices for the 1-factor model (RMSEA = .059, CFI = .939, TLI = .922, SRMR = .049) and the 3-factor model (RMSEA = .066, CFI = .924, TLI = .903, SRMR = .051). The final measurement models comprised all 18 SEE-M items, which had significant factor loadings of more than .40. The test-retest results indicated that the SEE-M was stable, with an intra-class correlation of .99. The composite reliability was .886 for the 1-factor model and .670-.854 for the 3-factor model.

    CONCLUSIONS: The translated version of the SEE-M was valid and reliable for assessing the level of self-efficacy for exercise among university students in Malaysia.

    PERSPECTIVE: This study examining the psychometric properties of the SEE scale based on CFA was the first to assess 2 proposed models (1-factor and 3-factor models) simultaneously and to translate the original, English-language SEE into Malay.

  3. Konter E, Kueh YC, Kuan G
    PMID: 32635576 DOI: 10.3390/ijerph17134834
    While courage is widely attributed to athletic pursuits, it has received little scientific attention from both researchers and applied practitioners. A reliable measurement is required to examine courage in sports and competitive activities. Therefore, this research aimed to adapt the original Turkish Sports Courage Scale-31 into American English (SCS-AE). The SCS-31 measure was translated from Turkish into the American English language by the Brislin forward and backward translation technique and language validity. Then, the translated SCS-AE was administered to 548 American university college students (Mean age = 19.02, SD = 1.21). All participants played a sport (e.g., football, soccer, basketball, gymnastics). Based on confirmatory factor analyses (CFA), 31 items of SCS-AE were reduced to 24 items with four factors (i.e., assertiveness, determination, mastery, and venturesome). The fit indices were satisfactory (RMSEA = 0.06, CFI = 0.97, SRMR = 0.06, NFI = 0.96 and NNFI = 0.97). The internal consistency measured by Cronbach alpha, ranging from 0.73 to 0.78, were considered acceptable. The convergent validity and discriminant validity of SCS-AE were also achieved. Our findings indicate strong support for research using the four-factor model of the SCS-AE and adequate support for the five-factor model with sufficient caution regarding the internal consistency of the self-sacrifice factor. While cultural differences in courage perception might exist between these countries, the findings showed more similarities than differences in courage. Results indicated that the SCS-AE is usable for research purposes in the suggested format. Future directions are discussed using the SCS-31 and SCS-AE for research.
  4. Chew KS, Kueh YC, Abdul Aziz A
    BMC Med Educ, 2017 Mar 21;17(1):58.
    PMID: 28320367 DOI: 10.1186/s12909-017-0897-0
    BACKGROUND: Despite their importance on diagnostic accuracy, there is a paucity of literature on questionnaire tools to assess clinicians' awareness toward cognitive errors. A validation study was conducted to develop a questionnaire tool to evaluate the Clinician's Awareness Towards Cognitive Errors (CATChES) in clinical decision making.

    METHODS: This questionnaire is divided into two parts. Part A is to evaluate the clinicians' awareness towards cognitive errors in clinical decision making while Part B is to evaluate their perception towards specific cognitive errors. Content validation for both parts was first determined followed by construct validation for Part A. Construct validation for Part B was not determined as the responses were set in a dichotomous format.

    RESULTS: For content validation, all items in both Part A and Part B were rated as "excellent" in terms of their relevance in clinical settings. For construct validation using exploratory factor analysis (EFA) for Part A, a two-factor model with total variance extraction of 60% was determined. Two items were deleted. Then, the EFA was repeated showing that all factor loadings are above the cut-off value of >0.5. The Cronbach's alpha for both factors are above 0.6.

    CONCLUSION: The CATChES questionnaire tool is a valid questionnaire tool aimed to evaluate the awareness among clinicians toward cognitive errors in clinical decision making.

  5. Tai ELM, Kueh YC, Abdullah B
    PMID: 32046207 DOI: 10.3390/ijerph17031067
    Nasolacrimal duct obstruction (NLDO) is the most common cause of childhood epiphora. It is managed conservatively in the first year of life, after which surgical treatment is classically based on a stepwise paradigm of probing, intubation, and dacryocystorhinostomy. This systematic review aims to present the current role of intubation in the management of children with NLDO requiring surgical intervention. A search for English-language articles from the electronic databases PubMed, SCOPUS, and the COCHRANE library was conducted over a period of five months in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook. The following keywords were used to aid retrieval: stents, children, lacrimal intubation, endoscopic dacryocystorhinostomy, external dacryocystorhinostomy, NLDO, dacryocystitis, congenital, acquired. The primary outcome was defined as the success of the intervention, determined by resolution of symptoms and patency of the lacrimal anatomy confirmed by the fluorescein dye disappearance test or syringing. Secondary outcomes included the presence of complications. A total of 144 articles were identified; of these, 35 fulfilled the study criteria. The majority of the included studies involved lacrimal intubation alone, followed by intubation as an adjunctive procedure to balloon dacryoplasty and dacryocystorhinostomy. The overall success rate of these procedures ranged from 41.1% to 100%. Post-operative complications were reported in 65.7% of the included studies. Lacrimal intubation was most commonly performed as a primary procedure in children with NLDO, with high success rates. The main complication was stent dislodgement. There is lack of evidence regarding the benefit of intubation over probing as primary treatment of congenital NLDO. In the absence of high-quality evidence, the decision of whether to perform lacrimal intubation in children with NLDO requiring surgical intervention depends on clinical judgement and other low-level evidence, such as observational non-randomised trials.
  6. Kueh YC, Morris T, Ismail AA
    Psychol Health Med, 2017 02;22(2):138-144.
    PMID: 26851120 DOI: 10.1080/13548506.2016.1147055
    We examined the effect of diabetes knowledge and attitudes on self-management and quality of life (QoL) of people with type 2 diabetes mellitus (T2DM). We employed a cross-sectional study design. A total of 137 female and 129 male participants with T2DM completed the diabetes knowledge scale (DKN), Diabetes Integration Scale-19 (ATT19), Summary of Diabetes Self-care Activities (SDSCA) scale, and Diabetes Quality of Life (DQoL) scale, measuring diabetes knowledge, attitudes, self-management, and QoL respectively. The SDSCA scale measures diet, exercise, blood glucose monitoring, and foot care. The DQoL scale measures satisfaction and impact of QoL. An initial path model that tested the inter-relationships of the study variables was first identified based on previous research. Then, the path model was tested using Mplus 7.3. In the final model, diabetes knowledge was a significant predictor of attitudes and self-management in terms of blood glucose monitoring and foot care. Attitudes was a significant predictor of impact of QoL. Self-management in terms of blood glucose monitoring was a significant predictor of impact of QoL and diet was a significant predictor of satisfaction and impact of QoL. Exercise and foot care aspects of Self-management were significant predictors of satisfaction and impact of QoL respectively. The final model showed a good fit to the data: RMSEA = .045 (90% CI: .009, .071; Clfit = .601), CFI = .950, SRMR = .058. The findings suggest a theoretical basis to direct the development of appropriate health programs and interventions for improving QoL in people with T2DM and warrant replication in diverse samples.
    Study site: Diabetes Clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
  7. Kueh YC, Morris T, Ismail AAS
    MyJurnal
    The present study aimed to examine the levels of diabetes knowledge, attitudes, self-management and quality of life (QoL) between two countries with different cultural and language backgrounds. Data collection was conducted in two hospitals in Melbourne, Australia, and a hospital in Kelantan, Malaysia. Participants with type 2 diabetes mellitus (T2DM) were asked to complete four questionnaires, measuring diabetes knowledge, attitudes, self-management, and QoL. The differences between the samples were
    examined using chi-square and independent samples t-tests. The variables of gender and type of treatment (using insulin or not using insulin for treatment) based on groups were analysed using one-way ANOVA. All analyses were conducted using SPSS 22.0. The results highlighted some similarities and differences between the Australia-based sample and the Malaysia-based sample. In general, the Australia-based participants scored significantly higher in diabetes knowledge and reported more regular self-management of T2DM in exercise, blood glucose testing and foot care. The Australia-based sample also scored higher on attitudes compared to the Malaysia-based participants. On the other hand, Malaysia-based participants reported a lower level of impacts of T2DM on QoL. There was no significant difference between self-management of T2DM in terms of diet and satisfaction as an aspect of QoL related to living with diabetes between the two samples. The present study highlighted the levels of diabetes knowledge, attitudes, self-management, and QoL among Australia-based and Malaysia-based people with T2DM.
    Study site: Alfred Hospital and Western Hospital, Australia; Diabetes Health Clinic, Hospital
    Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
  8. Zamaili AM, Kueh YC, Mohamad S, Abdullah B
    PMID: 38521652 DOI: 10.1016/j.anorl.2024.02.014
    Endoscopic sinus surgery (ESS) has become an established surgical option in refractory chronic rhinosinusitis (CRS). The goal of this review is to assess the impact of steroid-eluting middle meatal implants after ESS. Cochrane Central Register of Controlled Trials (CENTRAL), SCOPUS, PUBMED, and GOOGLE SCHOLAR were searched from inception to November 2022. All randomised controlled trials (RCTs) involving adult patients receiving ESS for CRS utilising a steroid-eluting middle meatal implants were eligible. The primary outcome was adhesion or synechiae. The secondary outcomes were mucosal inflammation, polyp reformation, the need for oral steroids and additional surgery, postoperative bleeding, sinus pain and discomfort, postoperative sinus-related infection, and change in intraocular pressure. Fourteen full articles were examined out of 496 potential abstracts. Seven RCTs satisfied the criteria. At 30days, steroid-eluting implants reduced adhesion (OR: 0.28, 95% CI: 0.14 to 0.56; P<0.001), mucosal inflammation (MD: -13.09, 95% CI: -18.22 to -7.97; P<0.001), polyp reformation (OR: 0.31; 95% CI: 0.22 to 0.44; P<0.001), and requirement of additional oral steroid (OR: 0.44; 95% CI: 0.25 to 0.78; P=0.005) or surgery (OR: 0.25; 95% CI: 0.12 to 0.50; P<0.001). While their use for adhesion (OR: 0.24; 95% CI: 0.11 to 0.54; P<0.001) and polyp reformation (OR: 0.24; 95% CI: 0.12 to 0.51; P<0.001) were favourable, there was no difference in mucosal inflammation (MD: -5.68, 95% CI: -12.39 to 1.03; P=0.100) or the need for surgery (OR: 0.96; 95% CI: 0.07 to 12.37; P=0.980) when evaluated after 30days. Overall, the findings suggest that steroid-eluting middle meatal implants improve ESS outcomes by lowering rates of adhesion formation, postoperative medical and surgical interventions, recurrent polyposis, and inflammation, while having no significant negative impact in the immediate postoperative period. More research is needed into the long-term impacts.
  9. Sabo A, Kuan G, Kueh YC
    BMC Psychol, 2024 Jul 31;12(1):419.
    PMID: 39085962 DOI: 10.1186/s40359-024-01825-3
    The present study examines the mediating effect of psychological factors in the structural relationships between social and physical environmental factors and the amount of physical activity among undergraduate students at Universiti Sains Malaysia. The sample consisted of 422 students with a mean age of 20.2 years (SD = 1.27). The majority of the students were female (69.7%) and Malay (81.3%). Standardized scales were used to measure the total amount of physical activity and all the study variables. The final SEM had a good fit to the data: CFI = 0.968, TLI = 0.948, SRMR = 0.036, RMSEA (90%CI) = 0.046 (0.025, 0.065), RMSEA p-value = 0.609 with 11 paths relationships. Family support had a significant effect on perceived benefits and perceived barriers. The effect of friend support on physical activity was significantly mediated by perceived benefits, self-efficacy, and psychological needs satisfaction. The effect of the availability of exercise facilities on physical activity was significantly mediated by perceived benefits and psychological needs satisfaction. Furthermore, psychological needs satisfaction mediated the effect of perceived benefits, perceived barriers, and self-efficacy on physical activity. The study findings illustrated that the application of the social-ecological model and psychological factors is important in order to understand and promote positive physical activity behaviour.
  10. Konter E, Kueh YC, Kuan G
    Malays J Med Sci, 2020 Jul;27(4):85-96.
    PMID: 32863748 MyJurnal DOI: 10.21315/mjms2020.27.4.8
    Background: The nature of the relationship between passion and courage and its influence on soccer performance has yet to be revealed. Thus, the purpose of this study was to examine passion attributes (i.e. harmonious and obsessive inclinations) among male soccer players in relation to the level of courageous characteristics (i.e. mastery, determination, assertiveness, venturesome and sacrificial behaviour), other demographic and player characteristics.

    Methods: Data were collected from 278 male soccer players aged 13-38 years (mean [M] = 17.42 ± 4.36) with the number of competitive soccer experiences ranging from 1-28 years (M = 7.51 ± 4.23 years). Participants had at least a year of experience in the sport of soccer completed the validated passion scale, sports courage scale and demographic form.

    Results: Analyses revealed that soccer players with higher levels of total courage (P < 0.001), have more experience in soccer (P = 0.011), and their soccer level being professional (P < 0.001) had a significantly higher score in harmonious passion. There was no significant difference in obsessive passion among different level of total courage (P = 0.154). However, soccer players with more experience (P = 0.011) and higher soccer level being professional (P < 0.001) demonstrated a significant higher score in obsessive passion.

    Conclusion: In conclusion, soccer players with higher harmonious and obsessive passionate attributes had higher courage (except for mastery). In addition, the courageous and passionate traits of the soccer players played meaningful roles in indicating individual and performance variables.

  11. Kuan G, Kueh YC, Abdullah N, Tai ELM
    BMC Public Health, 2019 Jun 13;19(1):751.
    PMID: 31196195 DOI: 10.1186/s12889-019-7109-2
    BACKGROUND: Health-promoting behaviour is an important concept for health education. Unfortunately, there is a dearth of validated instruments to measure levels of health-promoting behaviour in the Malaysian context. The purpose of this study was to validate a Malay-language version of the Health-Promoting Lifestyle Profile II (HPLP-II) using a confirmatory approach.

    METHODS: Participants were 997 university undergraduate students, with a mean age of 21 years (SD = 1.58). The majority of the participants (80.4%) were female. Health-promoting behaviour was assessed using the 52-item HPLP-II, which measures six components of health-promoting behaviour outcomes. HPLP-II was translated into the Malay language using standard forward and backward translation procedures. Participants then completed the HPLP-II Malay version (HPLP-II-M). Confirmatory factor analysis (CFA) was conducted using Mplus 8.0 software on the six domains of HPLP-II-M model.

    RESULTS: The CFA result based on the hypothesised measurement model of six factors was aligned with the original HPLP-II, except for two low loading items which were subsequently removed from the CFA analysis. The final CFA measurement model with 50 items resulted in a good fit to the data based on RMSEA and SRMR fit indices (RMSEA = 0.046, 90%CI = 0.045, 0.048, SRMR = 0.062). The construct reliabilities for the HPLP-II-M subscales were acceptable, ranging from 0.737 to 0.878.

    CONCLUSION: The HPLP-II-M with six components of health-promoting behaviour outcomes and 50 items was considered valid and reliable for the present Malaysian sample.

  12. Sabo A, Kueh YC, Arifin WN, Kim Y, Kuan G
    PLoS One, 2020;15(9):e0239725.
    PMID: 32986724 DOI: 10.1371/journal.pone.0239725
    BACKGROUND: This study aimed to determine the validity of the Malay-translated version scales for assessing the social support and physical environment for exercise activities.

    METHOD: The study was a cross-sectional design in nature, using self-reported questionnaires among the university students in Malaysia. Participants were selected using a convenience sampling approach. Perceptions regarding social support and physical environment were assessed using the Malay-translated version scales. The standard forward-backwards translation was conducted to translate the English version of the scales to the Malay version. Confirmatory factor analysis (CFA) was used to validate the translated version scales; composite reliability (CR) and average variance extracted (AVE) were computed.

    RESULTS: A total of 857 students participated in this study (female: 49.1%, male: 50.9%). The mean age of the participants was 20.2 (SD = 1.6). The fit indices of the initial hypothesized measurement models (social support and physical environment) were not satisfactory. Further improvements were made by adding covariances between residuals' items within the same factor for each hypothesized model. The final re-specified measurement models demonstrated adequate factor structure for the social support scale with 24 items (CFI = .932, TLI = .920, SRMR = .054, RMSEA = .061), and the physical environment scale with five items (CFI = .994, TLI = .981, SRMR = .013, RMSEA = .054). The CR was .918 for family support, .919 for friend support, .813 for perceived availability, and .771 for perceived quality. The AVEs were .560 for family support, .547 for friend support, .554 for perceived availability, and .628 for perceived quality. The intra-class correlation (ICC) based on test-retest was .920 for family support, .984 for friend support, .895 for availability of facilities, and .774 for quality of facilities.

    CONCLUSION: The Malay version of the social support scale for exercise and the physical environment scale for physical activity were shown to have adequate psychometric properties for assessing perceived social support and physical environment among the university students in Malaysia.

    PERSPECTIVE: This study presented the psychometric properties of the social support and physical environment scales based on CFA and was the first to translate these scales from the original English version to the Malay version.

  13. Lim BC, Kueh YC, Arifin WN, Ng KH
    PLoS One, 2021;16(4):e0250627.
    PMID: 33909664 DOI: 10.1371/journal.pone.0250627
    BACKGROUND: Healthy lifestyle habits formed during young adulthood may have a sustaining impact on health across later life. The current study aimed to test the theoretical model of factors (selected demographic variables, knowledge of heart disease, health belief related to cardiovascular disease (CVD), self-efficacy, cues to action, and screening intention) influencing health-promoting behaviours among Malaysian university students.

    METHODS: In a cross-sectional survey, the undergraduate students in Universiti Sains Malaysia were invited to complete the self-administered questionnaires. Participants were selected using a purposive sampling method. The proposed hypothesised model was analysed using a structural equation modelling with Mplus 7.3 program. A total of 788 (70.7% female) undergraduate students with a mean age of 20.2 (SD = 1.02) participated in the study. The primary outcome of knowledge, health beliefs, and health-promoting behaviours related to CVD were measured by questionnaires namely: Knowledge of Heart Disease, Health Beliefs Related to CVD, and Health Promoting Lifestyle Profiles-II.

    RESULTS: The final hypothetical structural model showed a good fit to the data based on several fit indices: with comparative fit index (CFI) at .921, standardised root mean square residual (SRMR) at .037, and root mean square error of approximation (RMSEA) at .044 (90% CI: .032, .054). The final structural model supported 13 significant path estimates. These variables explained 12% of the total variance in health-promoting behaviours. Through perceived benefits, total knowledge had an indirect effect on health-promoting behaviours.

    CONCLUSION: The results suggest that perceived barriers, perceived benefits, family history of CVD, and screening intention enable young adults to engage in health-promoting behaviours.

  14. Lim BC, Kueh YC, Arifin WN, Ng KH
    MyJurnal
    Objective: To determine the factor structure of the Health Promoting Behaviours (HPB) component of Health Promoting Lifestyle Profile-II among undergraduate students in Universiti Sains Malaysia (USM) by confirmatory factor analysis (CFA).
    Methods: A cross sectional study was conducted among undergraduate students. The data was collected in the USM campus using a proportionate cluster sampling method. The HPB questionnaire was handed to students in the lecture hall and collected immediately when the lecture finished. CFA was conducted using robust maximum likelihood estimation due to violation of multivariate normality assumption. A three-factor model was tested for measurement model validity and construct validity.
    Results: A total of 788 students participated in the study. CFA of a 21-item, three-factor model yielded an adequate goodness-of-fit values. The measurement model also showed a good convergent and discriminant validity after model re-specification.
    Conclusion: The health promoting behaviours scale was proven to have a valid measurement model and reliable constructs. It was deemed suitable for use to measure the health promoting behaviours components of a healthy lifestyle among Malaysian undergraduate students. It was recommended to further conduct cross-validation studies in other Malaysian public universities to provide additional empirical evidence to support its use.
  15. Hidrus A, Kueh YC, Norsa'adah B, Kuan G
    PMID: 32024257 DOI: 10.3390/ijerph17030922
    Exercise self-efficacy (ESE) is one of the psychological constructs in the Transtheoretical Model (TTM). The objective of the present study is to assess the validity and reliability of the Malay version of Exercise self-efficacy scale (ESE-M) among Malaysians with type 2 diabetes mellitus (T2DM). A cross-sectional study design with convenience sampling method using a self-administered questionnaire was carried out. Participants were invited to complete the ESE-M with 18 items. Confirmatory factor analysis (CFA) was conducted and composite reliability (CR) was computed using Mplus 8. A total of 331 Malaysians with T2DM with a mean age of 63 years old (Standard Deviation = 0.57) completed the questionnaire. Most of the participants were male (52%) and Malay (89.4%). Two initial CFA models (single factor and three factors) of ESE-M scale were tested and they did not fit to the data well. Several re-specifications of the models were conducted. The final model for the ESE-M showed improvement on the value of model fit indices for the single factor model (comparative fit index (CFI) = 0.952, Tucker and Lewis index (TLI) = 0.938, standardised root mean square (SRMR) = 0.044, root mean square error of approximation (RMSEA) = 0.054) and three factors model (CFI = 0.891, TLI = 0.863, SRMR = 0.049, RMSEA = 0.081). The CR for the self-efficacy factor was 0.921 (single factor), while CR for internal feelings, competing demands and situational (three factors) were 0.762, 0.818 and 0.864, respectively. The final model of single factor ESE-M showed better fit to the data compared to the three factors ESE-M. This indicated that the single factor ESE-M is more suitable to be adopted for future study among Malaysians with T2DM.
  16. Kuan G, Sabo A, Sawang S, Kueh YC
    PLoS One, 2020;15(3):e0230644.
    PMID: 32187222 DOI: 10.1371/journal.pone.0230644
    BACKGROUND: This study examined the psychometric properties of the Malay version of the decisional balance (DB-M) for exercise (i.e. perceived benefits and perceived barriers) using a cross-sectional design. Also, this study assessed the measurement and structural invariance of the DB-M across gender.

    METHODS: The study sample consisted of 750 students (female: 51.7%, male: 48.3%), with a mean age of 20.2 years (SD = 1.2). Decision balance (DB) scale was assessed with the 10-item DB-M. Standard forward-backward translation was performed to translate the English version of the DB into Malay version (DB-M).

    RESULTS: The confirmatory factor analysis (CFA) results based on the hypothesised measurement model of two factors and ten items demonstrated adequate factor structure after the addition of some correlated item residuals (comparative fit index (CFI) = .979, Tucker and Lewis index (TLI) = .969, standardised root mean square residual (SRMR) = .037, root mean square error of approximation (RMSEA) = .047). The construct reliability and average variance extracted values were .850 and .839, and .542 and .538, for perceived benefits and perceived barriers, respectively. Meanwhile, the Cronbach's alpha was .857 and .859, and the intraclass correlation coefficient for test-retest reliability was .979 and .960 for perceived benefits and perceived barriers respectively. The findings provided evidence for measurement invariance of DB-M for the male and female samples. The final CFA model fit the data well for both male sample (CFI = .975, TLI = .964, SRMR = .040, RMSEA = .052) and female sample (CFI = .965, TLI = .949, SRMR = .044, RMSEA = .058).

    CONCLUSIONS: The translated version of the DB-M was valid and reliable for assessing the level of perceived benefits and perceived barriers in exercise among university students in Malaysia.

  17. Hidrus A, Kueh YC, Norsa'adah B, Chang YK, Kuan G
    PMID: 34501562 DOI: 10.3390/ijerph18178972
    Brain Breaks® are structured physical activity (PA) web-based videos designed to promote an interest in learning and health promotion. The objective of this study was to examine its effects on decision balance (DB) which consists of the perceived benefits (Pros) and perceived barriers (Cons) of exercise in people with type 2 diabetes mellitus (T2DM). A randomised controlled trial was conducted among people with T2DM at Hospital Universiti Sains Malaysia. The intervention group received Brain Breaks videos for a period of four months. The intervention and control groups completed the validated Malay version of DB questionnaire for five times, at pre-intervention, the first month, the second month, the third month, and post-intervention. Multivariate Repeated Measures Analysis of Variance was performed for data analysis. A total of 70 participants were included (male = 39; female = 31) with a mean age of 57.6 years (SD = 8.5). The intervention group showed a significant change in the Pros and Cons factors of DB scores over time. The intervention group showed significantly higher scores for the Pros (p-value < 0.001) and lower scores for the Cons (p-value = 0.008) factors than the control group. In conclusion, the Brain Breaks video is an effective intervention to improve decisional balance in patients with T2DM to help them in deciding on behaviour change to be more physically active.
  18. Saman ZM, Siti-Azrin AH, Othman A, Kueh YC
    PMID: 34770183 DOI: 10.3390/ijerph182111669
    The effect of cyberbullying among adolescents in Malaysia is not much studied. The Cyberbullying Scale (CBS) has been validated to be used among English speaking adolescents to measure cyberbullying but not in Malay language. Therefore, its validity should be established before use in the Malaysian context. Thus, the study aimed to evaluate the validity and reliability of the Malay version of the CBS (CBS-M) among secondary school students. The study was cross-sectional and involved a self-administered questionnaire with 16 items from CBS-M, and 21 items from the Depression, Anxiety, and Stress Scale (DASS-21). Participants were recruited using a multi-stage sampling method. The validity of the CBS-M was tested in two phases, namely, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Spearman's correlation was used to examine the strength of the relationship between the CBS and subscales from DASS-21 to further support the validity of CBS-M. A total of 401 respondents from Muar, Johor, participated. The mean age was 14.6 years (SD = 1.25). EFA results indicated a one-factor model of CBS-M with a total variance extracted of 33.9%. Internal consistency measured by Cronbach's alpha reached 0.87. The model was then tested using CFA. The initial model did not fit the data well. Thus, several model re-specifications were conducted on the initial model. The final measurement model of CBS-M fit the data well with acceptable fit indices (CFI = 0.946, TLI = 0.932, SRMR = 0.055, RMSEA = 0.049). The composite reliability for CBS-M was satisfactory with a value of 0.832. The CBS-M questionnaire is a valid and reliable tool for measuring cyberbullying among young adolescents in Malaysia.
  19. Kueh YC, Sabo A, Kim Y, Kuan G
    PLoS One, 2021;16(9):e0257511.
    PMID: 34591879 DOI: 10.1371/journal.pone.0257511
    BACKGROUND: This study examined the psychometric properties of the Korean and Malay version of the decisional balance (DB) for exercise (i.e. perceived benefits and perceived barriers) using a cross-sectional design. Also, this study assessed the measurement and structural invariance of the DB scale across countries.

    METHODS: A cross sectional study was conducted in Malaysia and Korea. The study sample consisted of 574 Korean participants and 562 Malaysian participants. The mean age of the participants was 19.8 (SD = 1.29) for the Korean sample and 19.8 (SD = 1.22) for the Malaysian sample. Participants were invited to complete the DB scale with the 10-item and two factors (i.e., perceived benefit and perceived barriers). Confirmatory factor analysis (CFA) and invariance test were conducted on the data by using Mplus 8.3.

    RESULTS: The CFA results based on the hypothesised measurement model of two factors and ten items showed sufficient construct validity after adding residual covariance between items within the same factor: CFI = 0.979, TLI = 0.970, SRMR = 0.036, RMSEA = 0.036 for the Korea sample, and CFI = 0.964, TLI = 0.949, SRMR = 0.055, RMSEA = 0.066 for the Malay sample. For the Korea sample, the construct reliability was 0.62 and 0.74 for perceived benefits and perceived barriers respectively. For the Malay sample, the construct reliability was 0.75 and 0.77 for perceived benefits and perceived barriers respectively. The findings presented evidence for measurement and structural invariance of the DB scale for the Korea and Malaysia samples.

    CONCLUSION: The DB scale was a valid and reliable measure for assessing exercise behaviour and for making comparisons between Korean and Malaysian samples.

  20. Kuan G, Morris T, Kueh YC, Terry PC
    Front Psychol, 2018;9:14.
    PMID: 29459837 DOI: 10.3389/fpsyg.2018.00014
    Music that is carefully selected to match the requirements of activities and the characteristics of individuals has been shown to produce significant impacts on performance enhancement (Priest et al., 2004). There is also evidence that music can enhance imagery (Grocke and Wigram, 2007), although few studies have investigated the effects of music on imagery in the context of sport skills. In the present study, the effects of relaxing and arousing music during imagery on dart-throwing performance, physiological arousal indices, and competitive state anxiety, were investigated among 63 novice dart throwers. Participants had moderate-to-high imagery ability and were randomly assigned to unfamiliar relaxing music (URM), unfamiliar arousing music (UAM), or no music (NM) groups. Performance was assessed by 40 dart throws at a concentric circles dartboard before and after 12 imagery sessions over 4 weeks. Measures of galvanic skin response (GSR), peripheral temperature (PT), and heart rate (HR) were taken during imagery sessions 1 and 12, and the Competitive State Anxiety Inventory-2 Revised (CSAI-2R) was administered prior to the pre- and post-intervention performance task. Dart-throwing gain scores were significantly higher for URM than for UAM and NM, with no significant difference between UAM and NM (URM = 37.24 ± 5.66, UAM = 17.57 ± 5.30, and NM = 13.19 ± 6.14,F2,62= 5.03,p= 0.01, η2= 0.14). GSR, PT, and HR reflected lower arousal for URM than for UAM or NM. Significant decreases in somatic anxiety were evident for URM and UAM but not NM. Significant decreases in cognitive anxiety were evident for URM and NM but not UAM. Significant increases in self-confidence were evident for URM but not UAM or NM. Performance improved in all three conditions but URM was associated with the largest performance gain, the lowest physiological indices of arousal, and the most positive CSAI-2R profiles. Listening to relaxing music during imagery may have benefits for performance in other fine motor skills.
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