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The Community Follow-up Project (CFUP)

Mohd Sidik S, Azhar MZ, Mohd Yunus A, Azlan Hamzah SA

Med J Malaysia, 2005 Aug;60 Suppl D:54-7.
PMID: 16315625

The Community Follow-up Project (CFUP) is a project where medical students choose a hospital in-ward patient during their clinical ward-based attachments and follow-up this patient's progress after discharge from the hospital. The students do a series of home visits and also accompany their patients for some of their follow-ups at the hospital, government clinics, general practitioners' clinics and even to the palliative care or social welfare centres. The students assess the physical, psychological and social impact of the illness on the patient, family and community. By following their patients from the time their patients were in the hospital and back to their homes and community, the students are able to understand in depth the problems faced by patients, the importance of communication skills in educating patients on their illness and the importance of good communication between primary, secondary and tertiary care.
Fulltext Prevalence, associated factors and predictors of anxiety: a community survey in Selangor, Malaysia

Kader Maideen SF, Mohd Sidik S, Rampal L, Mukhtar F

BMC Psychiatry, 2015;15:262.
PMID: 26497745 DOI: 10.1186/s12888-015-0648-x

Anxiety is the most common mental health disorders in the general population. This study aimed to determine the prevalence of anxiety, its associated factors and the predictors of anxiety among adults in the community of Selangor, Malaysia.
Fulltext Diabetes-related distress, depression and distress-depression among adults with type 2 diabetes mellitus in Malaysia

Chew BH, Vos R, Mohd-Sidik S, Rutten GE

PLoS One, 2016;11(3):e0152095.
PMID: 27002728 DOI: 10.1371/journal.pone.0152095

Type 2 diabetes mellitus (T2DM) brings about an increasing psychosocial problem in adult patients. Prevalence data on and associated factors of diabetes related distress (DRD) and depression have been lacking in Asia. This study aimed to examine the prevalence of DRD and depression, and their associated factors in Asian adult T2DM patients. This study was conducted in three public health clinics measuring DRD (Diabetes Distress Scale, DDS), and depression (Patient Health Questionnaire, PHQ). Patients who were at least 30 years of age, had T2DM for more than one year, with regular follow-up and recent laboratory results (< 3 months) were consecutively recruited. Associations between DRD, depression and the combination DRD-depression with demographic and clinical characteristics were analysed using generalized linear models. From 752 invited people, 700 participated (mean age 56.9 years, 52.8% female, 52.9% Malay, 79.1% married). Prevalence of DRD and depression were 49.2% and 41.7%, respectively. Distress and depression were correlated, spearman's r = 0.50. Patients with higher DRD were younger (OR 0.995, 95% CI 0.996 to 0.991), Chinese (OR 1.2, 95% CI 1.04 to 1.29), attending Dengkil health clinic (OR 1.1, 95% CI 1.00 to 1.22) and had higher scores on the PHQ (OR 1.1, 95% CI 1.04 to 1.06). Depression was less likely in the unmarried compared to divorced/separately living and those attending Dengkil health clinic, but more likely in patients with microvascular complications (OR 1.4, 95% CI 1.06 to 1.73) and higher DDS (OR 1.03, 95% CI 1.02 to 1.03). For the combination of DRD and depression, unemployment (OR 4.7, 95% CI 1.02 to 21.20) had positive association, whereas those under medical care at the Salak health clinics (OR 0.28, 95% CI 0.12 to 0.63), and those with a blood pressure > 130/80 mmHg (OR 0.53, 95% CI 0.32 to 0.89) were less likely to experience both DRD and depression. DRD and depression were common and correlated in Asian adults with T2DM at primary care level. Socio-demographic more than clinical characteristics were related to DRD and depression.
The development of an intervention package to prevent children under five years old drowning in rural Bangladesh

Hossain M, Mani KK, Mohd Sidik S, Kadir Shahar H

Acta Paediatr, 2016 Aug;105(8):e373-8.
PMID: 27111395 DOI: 10.1111/apa.13447

AIM: There are an estimated 372 000 worldwide deaths by drowning every year, and it has been described as a secret epidemic in Bangladesh. The aim of this study was to develop an intervention package to prevent children under the age of five from drowning in rural Bangladesh.
METHODS: This was a qualitative study using focus group discussions in three villages in rural Bangladesh. The 45 participants were mothers and fathers with children under five, the parents of children who had drowned and community leaders.
RESULTS: The majority of the participants (71%) were male. The focus groups revealed that most drowning's occurred between 11am and 2pm and that risk factors included the following: children not being able to swim, ditches that were not filled in, lack of medical facilities, parents who were not aware of childhood drowning and lack of information through the media about how to prevent of childhood drowning. Suggestions included using a mobile-based short messaging service or voice calls to parents, especially mothers, could increase awareness and reduce the risk of childhood drowning.
CONCLUSION: A safety education programme could be effective in increasing knowledge and changing attitudes, which could prevent drowning among children in Bangladesh.
From the MJM Editors' Desk: Common errors authors make in submission to the Medical Journal of Malaysia

Rampal L, Liew BS, Oothuman P, Philip R, Mohd Sidik S, Hoe VC, et al.

Med J Malaysia, 2020 07;75(4):323-324.
PMID: 32728008

Proper understanding the 'Instructions to authors' for a particular journal is the key towards successful submission of a manuscript which will lead to it being published. Common errors that are frequently made by authors in their submission to the Malaysia Journal of Malaysia (MJM) that lead to rejection of their submission or requiring major revisions or minor revisions are listed and discussed in this article. Outright rejection prior to even a peer review process may be made for an article due to: it is poorly written or when there is suspicion on the authenticity of the submission, which contains elements that are suspected to be plagiarised, it is a duplicate submission or not in the format required by the MJM. The editor in charge of the issue makes a recommendation to the Editor in Chief for the final decision.
Fulltext The association of nutritional risk with physical and mental health problems among elderly in a semi-urban area of Mukim Kajang, Selangor, Malaysia

Mohd Sidik S, Rozali A, Shiran MS, Sam AA

Malays J Nutr, 2004 Sep;10(2):149-58.
PMID: 22691736 MyJurnal

Imbalances and deficiencies of nutrients are particularly prevalent among the elderly, resulting in increased risk of illness and impaired outcome, as well as reduced quality of life. A cross-sectional study was conducted to assess the nutritional risk and to determine its association with physical and mental health problems among the elderly in a semiurban community in the District of Hulu Langat, Selangor. Elderly people aged 60 years and above were included in the study, conducted from 11th March to 10th May 2004. Data were collected using a questionnaire-guided interview method. The Nutrition Screening Initiative Checklist (NSI-13) was used to assess the level (low, moderate, high) of nutritional risk of the subjects. The questionnaire also included the Barthel Index, Geriatric Depression Scale (GDS-30) and Elderly Cognitive Assessment Questionnaire (ECAQ) to identify functional status, depressive symptoms and cognitive impairment respectively, among the respondents. Out of 316 elderly residents, 300 agreed to participate in the study (response rate 94.9%). Respondents aged from 60 to 93 years old and the mean age was 67.08±6.6. Prevalence of moderate and high nutritional risks were 25.3% and 36.3% respectively. Nutritional risks were found to be significantly associated with age (p=0.015), marital status (p=0.00), chronic illness (p=0.000), functional disability (p=0.000) and depressive symptoms (p=0.010). In conclusion, the health status of the elderly strongly depends on their nutritional risk. Age, marital status, chronic illness, functional disability and depressive symptoms are factors to be emphasised when assessing the nutritional risk of the elderly.
Study site: Hulu Langat District, Selangor, Malaysia
Device, Questionnaire & Scale: Nutrition Screening Initiative Checklist (NSI-13); Barthel Index; Geriatric Depression Scale (GDS-30); Elderly Cognitive Assessment Questionnaire (ECAQ)
Prevalence data: Depression 6.3%, cognitive impairment 8.3%
Fulltext Prevalence of cardiovascular risk factors in a rural community in mukim dengkil, selangor

Yunus AM, Mohd Sidik S, Nor Afiah M, Rampal L, Tiew Kh

Malays J Nutr, 2004 Mar;10(1):5-11.
PMID: 22691743 MyJurnal

Hypertension and obesity are established and independent risk factors for cardiovascular diseases. There are important inter-relationships between these two factors that may explain the aetiology of coronary heart disease. To determine the prevalence of hypertension and obesity in a rural community setting in Malaysia, and to identify their associated factors, a cross-sectional study was conducted among residents aged 15 years and above in Mukim Dengkil, Selangor from June to October 1999. Sample size was 570, giving a response rate of 86.7%. Prevalence of hypertension was 26.8%, with the highest prevalence among those aged 60 years and above (57.3%), and 50 to 59 years old (53.3%). Factors found to be significantly associated with hypertension were male (χ²=4.71, df=1, p<0.05) and age (t=10.7, df=568, p<0.01). Prevalence of obesity was 11.4%, with the highest prevalence among those aged 40 to 49 years (22.7%) and 30 to 39 years (14.4%). The factors associated with obesity were age (p<0.01), female (χ²=12.45, df=1, p<0.05) and ethnicity (Fisher's Exact probability, p<0.05) with Chinese and Malays having a higher prevalence compared to other ethnic groups. However, there was no significant association between hypertension and obesity (OR=1.14, 95% CI=0.65, 2.02). The prevalence of hypertension and obesity in this study is high. There is a need for prevention programs for these risk factors in rural communities in Malaysia.
Fulltext Factors associated with depression among elderly patients in a primary health care clinic in Malaysia

Mohd Sidik S, Mohd Zulkefli NA, Shah SA

Asia Pac Fam Med, 2003;2(3):148-152.

Aim: To identify the factors associated with depression among elderly patients attending a primary health care clinic in Malaysia. Methods: A cross sectional study was conducted on patients aged 60 years and above in Klinik Kesihatan Butterworth, Seberang Perai Utara, Pulau Pinang, Malaysia from April to September 1999. The Geriatric Depression Scale questionnaire was used as a screening instrument. Results: The response rate was 99.0%. A total of 18% of the patients were found to have depression. The associated factors were females (odds ratio (OR) = 2.87, 95% confidence interval (CI) = 1.37-6.02), those who were unmarried (OR = 3.46, 95% CI = 1.66-7.21), without formal education (OR = 8.0, 95% CI = 2.97-21.48), low total family income (OR = 7.97, 95% CI = 2.71-23.46) and urban residence (OR = 2.23, 95% CI = 1.09-4.58). Conclusion: Depression is very common among the elderly. As this is an important problem in primary care practice, primary care doctors should be aware of this problem so that early detection and management can be implemented., (C) 2003 Blackwell Science Ltd
Fulltext Prevalence of depression among women attending a primary urban care clinic in Malaysia

Mohd Sidik S, Arroll B, Goodyear-Smith F, Ahmad R

Singapore Med J, 2012 Jul;53(7):468-73.
PMID: 22815016

Depression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic.
Psychometric Properties of the Catastrophic Cognitions Questionnaire-Modified (CCQ-Modified) Among Community Samples in Malaysia

Abdul Khaiyom JH, Mukhtar F, Ibrahim N, Mohd Sidik S, Oei TP

Stress Health, 2016 Dec;32(5):543-550.
PMID: 26620359 DOI: 10.1002/smi.2660

The Catastrophic Cognitions Questionnaire-Modified (CCQ-M) is a common instrument for measuring catastrophic thoughts. In some countries, however, CCQ-M still poses concerns following the lack of appropriate validation among their populations. The current study aimed to examine the factor structure of the CCQ-M, the reliability, and the validity in community samples in Malaysia. The Malay version of CCQ-M and additional measures assessing the symptoms and cognitions relevant to anxiety disorders were completed by 682 university students and general community. Exploratory factor analysis revealed a two-factor structure accounting for 62.2% of the total variance. Confirmatory factor analysis confirmed the two-factor model by deleting four items. The Cronbach's alpha coefficients for the total and the two subscales were .94, .90, and .92, respectively. Test-retest reliability analysis was conducted on 82 university students in the interval period of 14 days, and the result was r = .58. Evidence supported the concurrent, convergent, and discriminant validity. In conclusion, the 17-item CCQ-M-Malaysia is a valid and reliable instrument for assessing catastrophic cognitions among Malaysian populations. Copyright © 2015 John Wiley & Sons, Ltd.
Effects of a brief mindfulness-based intervention program for stress management among medical students: the Mindful-Gym randomized controlled study

Phang CK, Mukhtar F, Ibrahim N, Keng SL, Mohd Sidik S

Adv Health Sci Educ Theory Pract, 2015 Dec;20(5):1115-34.
PMID: 25697124 DOI: 10.1007/s10459-015-9591-3

Pursuing undergraduate medical training can be very stressful and academically challenging experience. A 5-week mindfulness-based stress management (MBSM/Mindful-Gym) program was developed to help medical students cope with stress. The aim of this study was to evaluate the effectiveness of the intervention in reducing stress among students in a medical school in Malaysia. Seventy-five medical students participated in the program. They were stratified according to years of studies and randomly allocated to intervention (N = 37) and control groups (N = 38). The following outcome variables were measured at pre- and post-intervention: mindfulness (with Mindful Awareness Attention Scale); perceived stress (with Perceived Stress Scale); mental distress (with General Health Questionnaire), and self-efficacy (with General Self-efficacy Scale). Hierarchical multiple regressions were used to analyse the effect of group (intervention vs. control) on changes in the outcome variables. There were significant improvements at one week post-intervention in all outcome variables: mindfulness (β = 0.19, ΔR2 = 0.04, p = .040, f (2) = 0.05), perceived stress (β = -0.26, ΔR2 = 0.07, p = .009, f (2) = 0.10); mental distress (β = -0.28, ΔR2 = 0.10, p = .003, f (2) = 0.15); and self-efficacy (β = 0.30, ΔR2 = 0.09, p < .001, f (2) = 0.21). Six months after the intervention, those who had joined the program reported higher self-efficacy compared to those in the control group (β = 0.24, ΔR2 = 0.06, p = .020, f (2) = 0.08); but there was no difference in other outcome measures. More than 90% of the participants found the program applicable in helping patients and all reported that they would recommend it to others. This study indicates that the program is potentially an effective stress management program for medical students in Malaysia.
Fulltext Knowledge and awareness about STDs among women in Bangladesh

Hossain M, Mani KK, Mohd Sidik S, Shahar HK, Islam R

BMC Public Health, 2014;14:775.
PMID: 25081860 DOI: 10.1186/1471-2458-14-775

BACKGROUND:
Knowledge and awareness concerning sexually transmitted diseases (STDs) has become the burning issue of the day. Although STDs pose serious risks to health security, there is very little literature quantifying the knowledge and awareness of these diseases and their principal socioeconomic determinants. The aim of this study is to determine the effect of different socio-economic and demographic factors on knowledge and awareness about STDs among women in Bangladesh.

METHODS:
This is a cross-sectional study using data from the Bangladesh Demographic and Health Survey (BDHS) 2011. It involves 10,996 women in six divisions of Bangladesh - Dhaka, Rajshahi, Chittagong, Barisal, Khulna and Sylhet. In this study, the percentage distribution and logistic regression model are used to identify which factors are associated with knowledge and awareness among women in Bangladesh about STDs.

RESULTS:
There is a significant association between geographic division (Dhaka: OR = 1.669, 95% CI = 0.89-2.10, Khulna: OR = 2.234, 95% CI = 1.2-3.2); places of residence (Rural: OR = 0.363, 95% CI = 0.20-1.08), respondent's age (20-29 years: OR = 1.331; 95% CI = 0.98-2.31); education (Primary: OR = 2.366, 95% CI = 1.98-3.1, secondary: OR = 10.089, 95% CI = 8.98-12.77, higher: OR = 20.241, 95% CI = 18.33-22.65); listening to radio (OR = 1.189, 95% CI = 1.29-3.12) and watching TV (OR = 2.498, 95% CI = 2.22-4.09) with knowledge and awareness among women in Bangladesh about STDs.

CONCLUSION:
There is a need to improve the education in Bangladesh about STDs particularly among those in the rural areas and older ages of women (30-49 years). Formal, informal and special educational knowledge and awareness programmes may be implemented to educate people concerning STDs in Rajshahi, Sylhet and Chittangong division. Campaigns and mass media can be used to increase the knowledge and awareness among the community, especially among women. Policies concerning the issue of STDs need to be improved and can be emphasized in collaboration with government agencies to ensure the success of these campaigns.
Fulltext Myeloid sarcoma of the urinary bladder with cutaneous tumour seeding after percutaneous suprapubic catheterization

Geok Chin T, Masir N, Noor Hussin H, Mohd Sidik S, Boon Cheok L, Yean T

Malays J Pathol, 2011 Jun;33(1):47-51.
PMID: 21874752 MyJurnal

Myeloid sarcoma (MS) is a rare extramedullary myeloid tumour. It has been reported in various sites, including lymph node, bone, skin, soft tissue, various organs and the CNS. It may precede or occur concurrently with acute myeloid leukemia. Urinary bladder involvement is extremely uncommon. We report a 70-year-old female who had MS of the urinary bladder, presented with frank and persistent hematuria associated with lower abdominal pain. She subsequently had tumour seeding in the abdominal skin via percutaneous suprapubic catheter. Tumours from both the urinary bladder and skin showed immature cells that were immunoreactive toward LCA (focal), MPO (strong), CD99 (weak) and CD117 (weak). Summary of cases in the literature is presented. The potential of its misdiagnosis and the useful markers for the diagnosis of MS are discussed.
Fulltext Low back pain and association with whole body vibration among military armoured vehicle drivers in Malaysia

Rozali A, Rampal KG, Shamsul Bahri MT, Mohd Sidik S, Shamsul Azhar S, Khairuddin H, et al.

Med J Malaysia, 2009 Sep;64(3):197-204.
PMID: 20527267 MyJurnal

A cross sectional study was conducted among military armoured vehicle drivers in the two largest mechanized battalions with the objective to determine the prevalence of low back pain (LBP), and its association with whole body vibration (WBV) and other associated factors. A self-administered questionnaire and Human Vibration Meter were used in this study. A total of 159 respondents participated in this study and 102 (64.2%) of them were subjected to WBV measurement. One-hundred-and-seventeen respondents complained of LBP for the past 12 months giving a prevalence of 73.6%. The prevalence of LBP among tracked armoured vehicle drivers was higher (81.7%) as compared to wheeled armoured vehicle drivers (67.0%). The mean acceleration at Z-axis in tracked armoured vehicles (1.09 +/- 0.26 ms(-2)) and wheeled armoured vehicles (0.33 +/- 0.07 ms) were the dominant vibration directions. The mean estimated vibration dose value (eVDV) for eight-hour daily exposure at Z-axis (19.86 +/- 4.72 ms(-1.75)) in tracked armoured vehicles showed the highest estimation. Based on the European Vibration Directive (2002), the mean eVDV at Z-axis in tracked armoured vehicles exceeded exposure action value (EAV) (> 9.1 ms(-1.75), but did not exceed exposure limit value (ELV) (<21.0 ms(-1.75)). Logistic regression analysis revealed that only driving in forward bending sitting posture (OR = 3.63, 95% CI 1.06-12.42) and WBV exposure at X-axis (OR = 1.94, 95% CI 1.02-3.69) were significant risk factors to LBP. Preventive measures should be implemented to minimize risk of WBV and to improve ergonomic postures among drivers.
Fulltext Self-esteem and its associated factors among secondary school students in Klang District, Selangor

Mohd Sidik S, Rampal L, Loh JW, Chan CL, Teh PC, Tan PO

Med J Malaysia, 2008 Mar;63(1):26-30.
PMID: 18935727

Self-esteem is an important determinant of psychological well-being that is particularly problematic during adolescent life stage. There is a correlation between low self-esteem and other social problems among today's adolescents. This study was conducted to determine the mean self-esteem score, and to determine the association between self-esteem and age, sex, race, religion, number of siblings, ranking among siblings, family function, parental marital status and smoking among adolescents aged 12 to 20-years-old. A cross sectional study design using random cluster sampling method was done. Four out of a total of 35 secondary schools in Klang District, Selangor were selected. Respondents consisted of individual students in selected classes from the four selected schools. Data was collected using a self-administered, structured, pre-tested questionnaire and was analyzed using the SPSS version 12.0. Out of 1089 respondents, 793 completed the questionnaire (response rate 73.82%). The overall mean self-esteem score was 27.65. The mean self-esteem score for males (27.99) was slightly higher than females (27.31). The differences in the mean scores by race were statistically significant. There was a statistically significant relationship between mean self-esteem scores and sex, age, race, religion, number of siblings, smoking and family function. There was no statistically significant difference between mean self-esteem score with parental marital status and with ranking among siblings. The overall mean self-esteem score was 27.65. Self-esteem was associated with sex, age, race, religion, number of siblings, smoking and family function.
Fulltext The utility of hepatocyte paraffin 1 antibody in the immunohistological distinction of hepatocellular carcinoma from cholangiocarcinoma and metastatic carcinoma

Shiran MS, Isa MR, Mohd Sidik S, Rampal L, Hairuszah I, Sabariah AR

Malays J Pathol, 2006 Dec;28(2):87-92.
PMID: 18376797 MyJurnal

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and its diagnosis on routine stains is usually straightforward, except in some cases where there may be difficulty in distinguishing HCCs from metastatic carcinomas (MC) and cholangiocarcinomas (CC). Hepatocyte Paraffin 1 antibody (Hep Par 1) is a new monoclonal antibody which reacts with normal and neoplastic hepatocytes, and this study aims to determine its specificity and sensitivity in distinguishing hepatocellular carcinoma (HCC) from cholangiocarcinoma (CC) and metastatic carcinomas (MC). Hep Par 1 antibody was applied to 28 cases of HCC, 22 cases of MC from varying sites and 8 CCs, and produced a strong, diffuse, granular, cytoplasmic staining of all benign hepatocytes. 23 out of 28 cases of HCC showed heterogeneously positive staining for Hep Par 1 irrespective of their degree of differentiation, while 2 out of 8 cases of cholangiocarcinoma were positive for Hep Par 1, and all 22 cases of metastatic carcinoma were negative. The sensitivity and specificity of Hep Par 1 for HCC was 82.1% and 93.3% respectively; whereby the antibody was noted to show occasional false positivity in cases of cholangiocarcinoma and non-neoplastic bowel mucosa, while its variable staining in HCC produced false negative results in some small biopsies. Thus, Hep Par 1 should be used in a panel with other antibodies to obtain useful information in distinguishing HCC from CC and MC.
Fulltext Development of underwater and hyperbaric medicine in Malaysia

Rozali A, Rampal KG, Zin BM, Mohd Sidik S, Khairuddin H, Abd Halim M, et al.

Med J Malaysia, 2006 Dec;61(5):647-50.
PMID: 17623973 MyJurnal

Underwater and Hyperbaric Medicine is a treatment modality gaining recognition in Malaysia. It uses the hyperbaric oxygen therapy (HBOT) approach where patients are placed in recompression chambers and subjected to oxygen therapy under pressure. In Malaysia it was introduced as early as the 1960's by the Royal Malaysian Navy to treat their divers for decompression illness (DCI), arterial gas embolism (AGE) and barotraumas. Other sectors in the armed forces, universities and private health centres began developing this approach too in the late 1990's, for similar purposes. In 1996, Underwater and Hyperbaric Medicine began gaining its popularity when the Institute of Underwater and Hyperbaric Medicine at the Armed Forces Hospital in Lumut started treating specific clinical diseases such as diabetic foot ulcers, osteomyelitis, and carbon monoxide poisoning and other diseases using HBOT. This paper discusses the development of this interesting treatment modality, giving a brief historical overview to its current development, as well as provides some thought for its future development in Malaysia.
Fulltext Erratum: Randomized controlled trial on drowning prevention for parents with children aged below five years in Bangladesh: a study protocol

Hossain M, Mani KK, Mohd Sidik S, Hayati KS, Rahman AF

BMC Public Health, 2015;15:898.
PMID: 26374101 DOI: 10.1186/s12889-015-2169-4
Fulltext Randomized controlled trial on drowning prevention for parents with children aged below five years in Bangladesh: a study protocol

Hossain M, Mani KK, Mohd Sidik S, Hayati KS, Rahman AK

BMC Public Health, 2015;15:484.
PMID: 25957574 DOI: 10.1186/s12889-015-1823-1

Drowning is the third leading cause of death for children aged 0-4 years in many Asian countries, and is a serious but neglected health problem in low and middle-income countries like Bangladesh. The aim of the study is to outline the study protocol of a trial to test the efficacy of a mobile coach based intervention for the prevention of childhood drowning.
Fulltext Malay Version of the mHealth App Usability Questionnaire (M-MAUQ): Translation, Adaptation, and Validation Study

Mustafa N, Safii NS, Jaffar A, Sani NS, Mohamad MI, Abd Rahman AH, et al.

JMIR Mhealth Uhealth, 2021 02 04;9(2):e24457.
PMID: 33538704 DOI: 10.2196/24457

BACKGROUND: Mobile health (mHealth) apps play an important role in delivering education, providing advice on treatment, and monitoring patients' health. Good usability of mHealth apps is essential to achieve the objectives of mHealth apps efficiently. To date, there are questionnaires available to assess the general system usability but not explicitly tailored to precisely assess the usability of mHealth apps. Hence, the mHealth App Usability Questionnaire (MAUQ) was developed with 4 versions according to the type of app (interactive or standalone) and according to the target user (patient or provider). Standalone MAUQ for patients comprises 3 subscales, which are ease of use, interface and satisfaction, and usefulness.
OBJECTIVE: This study aimed to translate and validate the English version of MAUQ (standalone for patients) into a Malay version of MAUQ (M-MAUQ) for mHealth app research and usage in future in Malaysia.
METHODS: Forward and backward translation and harmonization of M-MAUQ were conducted by Malay native speakers who also spoke English as their second language. The process began with a forward translation by 2 independent translators followed by harmonization to produce an initial translated version of M-MAUQ. Next, the forward translation was continued by another 2 translators who had never seen the original MAUQ. Lastly, harmonization was conducted among the committee members to resolve any ambiguity and inconsistency in the words and sentences of the items derived with the prefinal adapted questionnaire. Subsequently, content and face validations were performed with 10 experts and 10 target users, respectively. Modified kappa statistic was used to determine the interrater agreement among the raters. The reliability of the M-MAUQ was assessed by 51 healthy young adult mobile phone users. Participants needed to install the MyFitnessPal app and use it for 2 days for familiarization before completing the designated task and answer the M-MAUQ. The MyFitnessPal app was selected because it is one among the most popular installed mHealth apps globally available for iPhone and Android users and represents a standalone mHealth app.
RESULTS: The content validity index for the relevancy and clarity of M-MAUQ were determined to be 0.983 and 0.944, respectively, which indicated good relevancy and clarity. The face validity index for understandability was 0.961, which indicated that users understood the M-MAUQ. The kappa statistic for every item in M-MAUQ indicated excellent agreement between the raters (κ ranging from 0.76 to 1.09). The Cronbach α for 18 items was .946, which also indicated good reliability in assessing the usability of the mHealth app.
CONCLUSIONS: The M-MAUQ fulfilled the validation criteria as it revealed good reliability and validity similar to the original version. M-MAUQ can be used to assess the usability of mHealth apps in Malay in the future.

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