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  1. Rufa’i AA, Yen SH, Wan Muda WAM
    MyJurnal
    Shift in the dispersion of breast cancer population continues to be a major health concern for women in the developing countries. However, prevalence and associated factors of physical activity among this population have not been explored in Malaysia. This study determined the profile and factors associated with physical activity in the breast cancer women. A multi-center cross-sectional survey was conducted among 399 breast cancer women. Socio-demographic questionnaire was used to generate socio-demographic and clinical data. Physical activity was assessed using the international physical activity questionnaire (IPAQ-SF). Sociodemographic variables were summarized by descriptive statistics. Factors associated with physical activity were identified using Logistic regression analyses. Majority of the participants were married (83.9%), had surgery (92.4%) and menopause (74.1%). The overall physical activity prevalence was 39.4%. Non formal education (Adjusted Odds Ratio [AOR] 5.80; 95%CI: 1.65, 52.15;p=0.017), having had surgery (AOR 0.18; 95%CI: 0.04, 0.79; p=0.023),
    Matched MeSH terms: Cross-Sectional Studies
  2. Abir T, Osuagwu UL, Kalimullah NA, Yazdani DMN, Husain T, Basak P, et al.
    Health Secur, 2021 08 03;19(5):468-478.
    PMID: 34348050 DOI: 10.1089/hs.2020.0205
    The COVID-19 pandemic has generated fear, panic, distress, anxiety, and depression among many people in Bangladesh. In this cross-sectional study, we examined factors associated with different levels of psychological impact as a result of COVID-19 in Bangladesh. From April 1 to 30, 2020, we used a self-administered online questionnaire to collect data from 10,609 respondents. Using the Impact of Event Scale-Revised to assess the psychological impact of the COVID-19 pandemic on respondents, we categorized the levels of impact as normal, mild, moderate, or severe. Ordinal logistic regression was used to examine the associated factors. The prevalence of mild, moderate, and severe psychological impact was 10.2%, 4.8%, and 45.5%, respectively. Multivariate analysis revealed that the odds of reporting normal vs mild, moderate, or severe psychological impact were 5.9 times higher for people living in the Chittagong Division, 1.7 times higher for women with lower education levels, 3.0 times higher among those who were divorced or separated, 1.8 times higher for those working full time, and 2.4 times higher for those living in shared apartments. The odds of reporting a psychological impact were also higher among people who did not enforce protective measures inside the home, those in self-quarantine, those who did not wear face masks, and those who did not comply with World Health Organization precautionary measures. Increased psychological health risks due to COVID-19 were significantly higher among people who experienced chills, headache, cough, breathing difficulties, dizziness, and sore throat before data collection. Our results showed that 1 in 2 respondents experienced a significant psychological impact as a result of the COVID-19 pandemic. Public health researchers should consider these factors when targeting interventions that would have a protective effect on the individual's psychological health during a pandemic or future disease outbreak.
    Matched MeSH terms: Cross-Sectional Studies
  3. Sahar NH, Badlishah-Sham SF, Ramli AS
    PMID: 34502011 DOI: 10.3390/ijerph18179405
    Self-management support is one of the most important components of the Chronic Care Model (CCM). The EMPOWER-SUSTAIN Global Cardiovascular Risks Self-Management Booklet© was developed for patients with Metabolic Syndrome (MetS), inspired by the CCM. Assessing usability of a self-management tool is important in chronic disease management. However, there was no available instrument to assess usability of a self-management booklet, as most instruments were developed to assess usability of mobile application. Therefore, this study aimed to adapt Skala Kebolehgunaan Aplikasi Mudah Alih (SKAMA) into the EMPOWER-SUSTAIN Usability Questionnaire (E-SUQ) and to determine its validity and reliability in assessing usability of a self-management booklet. A cross-sectional validation study was conducted among patients with MetS attending a university primary care clinic in Selangor, Malaysia. Content validation, adaptation and face validation of E-SUQ were performed according to recommended guidelines. It underwent two rounds of content validation as major revision was required for item 5. Subsequently, the revised E-SUQ was face-validated by 10 participants. Psychometric evaluation was conducted using principal component analysis with varimax rotation to determine the underlying structure of E-SUQ. Internal consistency reliability was assessed using Cronbach's α coefficient and the test-retest reliability was assessed using intraclass correlation coefficient (ICC (2,k)). A total of 205 patients participated in the study. The item-level content-validity-index (I-CVI) for item 5 improved from 0.57 to 1.0 after the second round of content validation. The final S-CVI/Ave value for ESUQ was >0.90. The item-level face-validity-index (I-FVI) ranged between 0.9 and 1.0. Kaiser-Meyer-Olkin value of 0.871 and Bartlett's test of sphericity p-value of <0.05 indicated good sample adequacy for factor analysis. Two factors with eigenvalues of >1 were extracted according to the Kaiser's Criteria. The two extracted factors explained 60.6% of the cumulative percentage of variance. The elbow of the scree plot occurred between the second and third component, suggesting two factors to be retained. The two factors were consistent with "Positive" and "Negative" tone model. The overall Cronbach's α coefficient was 0.77, indicating good internal reliability. The overall ICC was 0.85, indicating good reproducibility. The E-SUQ is shown to be valid, reliable and stable to measure the usability of a self-management booklet among patients with MetS in a university primary care clinic in Malaysia.
    Matched MeSH terms: Cross-Sectional Studies
  4. Lim HM, Dunn AG, Muhammad Firdaus Ooi S, Teo CH, Abdullah A, Woo WJ, et al.
    Fam Pract, 2021 06 17;38(3):210-217.
    PMID: 32968795 DOI: 10.1093/fampra/cmaa103
    BACKGROUND: mHealth apps potentially improve health care delivery and patient outcomes, but the uptake of mHealth in primary care is challenging, especially in low-middle-income countries.

    OBJECTIVE: To measure factors associated with mHealth adoption among primary care physicians (PCPs) in Malaysia.

    METHODS: A cross-sectional study using a self-administered questionnaire was conducted among PCPs. The usage of mHealth apps by the PCPs has divided into the use of mHealth apps to support PCPs' clinical work and recommendation of mHealth apps for patient's use. Factors associated with mHealth adoption were analysed using multivariable logistic regression.

    RESULTS: Among 217 PCPs in the study, 77.0% used mHealth apps frequently for medical references, 78.3% medical calculation and 30.9% interacting with electronic health records (EHRs). Only 22.1% of PCPs frequently recommended mHealth apps to patients for tracking health information, 22.1% patient education and 14.3% use as a medical device. Performance expectancy and facilitating conditions were associated with mHealth use for medical references. Family medicine trainees, working in a government practice and performance expectancy were the facilitators for the use of mHealth apps for medical calculation. Internet connectivity, performance expectancy and use by colleagues were associated with the use of mHealth with EHR. Performance expectancy was associated with mHealth apps' recommendation to patients to track health information and provide patient education.

    CONCLUSIONS: PCPs often used mHealth apps to support their clinical work but seldom recommended mHealth apps to their patients. Training for PCPs is needed on the appraisal and knowledge of the mHealth apps for patient use.

    Matched MeSH terms: Cross-Sectional Studies
  5. Ahmad A, Zulaily N, Shahril MR, Wafa SW, Mohd Amin R, Piernas C, et al.
    BMC Pediatr, 2021 09 23;21(1):418.
    PMID: 34556071 DOI: 10.1186/s12887-021-02899-3
    BACKGROUND: Childhood obesity has been associated with increased odds of adult obesity and co-morbidities in later life. Finding the key determinants may help in designing the most appropriate and effective interventions to prevent obesity. This study aimed to identify the determinants of obesity among school adolescents in a sub-urban state of Malaysia.

    METHODS: This cross-sectional study involved 1,404 school adolescents aged 12 years (46% boys and 54% girls). Socio-demographic, dietary and physical activity data were collected using questionnaires whilst body weight and height were measured and body mass index was classified based on WHO BMI-for-age Z-scores cut-off.

    RESULTS: A multivariable linear regression model showed that BMI z-score was positively associated with parents' BMI (P<0.001), birth weight (P=0.003), and serving size of milk and dairy products (P=0.036) whilst inversely associated with household size (P=0.022). Overall, 13.1% of the variances in BMI Z-scores were explained by parents' BMI, birth weight, servings of milk and dairy products and household size.

    CONCLUSION: This study found important determinants of body weight status among adolescents mainly associated with family and home environmental factor. This evidence could help to form the effective and tailored strategies at the earliest stage to prevent obesity in this population.

    Matched MeSH terms: Cross-Sectional Studies
  6. Sim JH, Foong CC, Pallath V, Hong WH, Vadivelu J
    Int J Med Educ, 2021 May 27;12:86-93.
    PMID: 34049286 DOI: 10.5116/ijme.6082.7c41
    Objectives: This study aimed to validate a Malaysian version of a revised learning space questionnaire, as well as to test the utility of the revised questionnaire as a tool to investigate learning space preferences in a Malaysian medical school.

    Methods:   This is a cross-sectional survey. A convenient sample of 310 preclinical students of a public medical school in Malaysia were invited to participate. Validation data were collected using a revised 40-item, 5-point Likert scale learning space questionnaire.  The questionnaires were administered online via a student e-learning platform.  Data analysis was conducted using IBM SPSS version 24.  Exploratory factor analysis was conducted to examine the factor structure of the revised questionnaire to provide evidence for construct validity.  To assess the internal consistency of the revised questionnaire, Cronbach's alpha coefficients (α) were computed across all the items as well as for items within each of the factor.

    Results: A total of 223 (71.94%) preclinical students completed and returned the questionnaire. In the final analysis, exploratory factor analysis with principal axis factoring and an oblimin rotation identified a six-factor, 20-item factor solution. Reliability analysis reported good internal consistency for the revised questionnaire, with an overall Cronbach's alpha of 0.845, and Cronbach's alpha ranging from 0.800 to 0.925 for the six factors.

    Conclusions:   This study established evidence for the construct validity and internal consistency of the revised questionnaire.  The revised questionnaire appears to have utility as an instrument to investigate learning space preferences in Malaysian medical schools.

    Matched MeSH terms: Cross-Sectional Studies
  7. Chen HY, Ahmad CA, Abdullah KL
    Chin J Traumatol, 2021 Jul;24(4):237-248.
    PMID: 34112591 DOI: 10.1016/j.cjtee.2021.04.002
    PURPOSE: Malaysian disaster relief volunteers have a long and proud history of participating in relief missions within and outside the country. Despite of a plethora of researches into the various areas of disaster relief, there has been a little scholarly activity looking into the experiences of the medical volunteers worldwide and even less research on the experiences of the relief volunteers in Malaysia. Therefore, the purpose of this study is to identify the effect of disaster relief works on volunteers in Malaysia.

    METHODS: This is a non-experimental cross-sectional design study, which was conducted using survey questionnaire to examine the incidence of burnout, posttraumatic stress disorder (PTSD) symptoms and the quality of life (QOL) among the disaster relief volunteers. And the study also examined the socio-demographic variables of the participants. In addition, the association between the sociodemographic variable and the preferred coping strategies was also investigated through self-reporting checklist.

    RESULTS: The findings of this study revealed that 90.9% volunteers (n = 312) experienced some levels of recurring stress throughout their lives, which led to burnout. Also, 96.8% (n = 332) of the participants were categorized as having at least some symptoms of PTSD. However, self-reporting QOL measurements indicated that the participants are, in general, satisfied with their lives. Significant associations between the incidence of burnout, incidence of PTSD and QOL were identified. Both positive coping measures and behavioral or avoidant coping measures were also identified. Furthermore, a number of socio-demographic factors were also seen to interact significantly with burnout, PTSD and QOL.

    CONCLUSION: This study provides some insights into the psychological challenges of disaster relief volunteers in Malaysia, and this impact can last a long time after the volunteers return to their hometowns. Several recommendations including practice development, policy and research were discussed in the study.

    Matched MeSH terms: Cross-Sectional Studies
  8. Eskin M, Baydar N, Harlak H, Hamdan M, Mechri A, Isayeva U, et al.
    J Affect Disord, 2021 11 01;294:366-374.
    PMID: 34315098 DOI: 10.1016/j.jad.2021.07.050
    BACKGROUND: Research on suicidality in low to middle-income countries is scarce. We addressed this issue by investigating suicidality in a cross-national college student samples from 11 predominantly low to middle-income majority Muslim countries.

    METHODS: The sample consisted of 7427 college students (56% female) who reported to be affiliated with Islam. Data on self-construal, social support, negative life-events, acceptability of suicide, suicidal ideation, and suicide attempts were collected with self-administered questionnaires.

    RESULTS: Acceptability of suicide and the experience of negative life-events were positively, and perceived social support was negatively associated with suicidal ideation. Interdependent self-construal was negatively related to the acceptability of suicide and positively associated with perceived social support, implying a negative indirect effect on suicidal ideation although its direct effect was positive. The number of negative life-events was the strongest positive predictor of ever attempting suicide. The interdependent self-construal moderated the association of negative life-events with suicide attempts.

    LIMITATIONS: Cross-sectional and self-report nature of the study were its major limitations. Participants may have suppressed their responses about suicide because of religious and legal reasons.

    CONCLUSION: Remarkable similarities across 11 country samples emerged in the linkages between cultural and interpersonal factors with suicidality. Our findings highlight the value of a nuanced approach to suicidality, that can recognize the differences in the processes associated with suicidal ideation and suicide attempts, as well as the need to consider the interplay of a broad range of personal, interpersonal, and cultural influences.

    Matched MeSH terms: Cross-Sectional Studies
  9. Yahya NFS, Teng NIMF, Shafiee N, Juliana N
    PMID: 34682652 DOI: 10.3390/ijerph182010915
    Breastfeeding is the best form of feeding for premature infants. However, mothers with premature delivery are frequently reported to be depressed, and this has been especially the case during the Coronavirus Disease-2019 (COVID-19) pandemic. We aimed to measure the level of breastfeeding attitude and its association with postpartum depression among mothers with premature infants in the Neonatal Intensive Care Unit (NICU) during the COVID-19 pandemic. A total of 248 mothers with a premature infant were observed in this cross-sectional study from the chosen NICUs of government hospitals in Selangor, Malaysia. The Iowa Infant Feeding Attitude Score (IIFAS) and the Edinburgh Postnatal Depression Scale, along with sociodemographic questionnaires, were used to obtain information on the mothers' attitudes towards breastfeeding and the risk of postpartum depression. A higher percentage of mothers had a positive attitude towards breastfeeding (64.9%), with a mean IIFAS score of 66.30 ± 6.92. Meanwhile, about 27% of mothers with premature infants were reported to have high risk of depressive symptoms. Mothers with a high risk of depression were less likely to have a positive attitude towards breastfeeding (OR 0.37, 95% CI 0.199, 0.675) as compared to mothers with a low risk of depression (p < 0.01). We found that there is an association between the risk of depression and the attitude towards breastfeeding. Early identification of maternal mental health problems should be addressed to ensure the willingness of mothers to continue breastfeeding.
    Matched MeSH terms: Cross-Sectional Studies
  10. Abir T, Osuagwu UL, Nur-A Yazdani DM, Mamun AA, Kakon K, Salamah AA, et al.
    PMID: 34682502 DOI: 10.3390/ijerph182010728
    Previous studies on internet use frequency were focused on mental health impact, with little known about the impact on physical health during the COVID-19 lockdown. This study examined the impact of internet use frequency on self-reported physical health during the COVID-19 lockdown in Bangladesh. A web-based cross-sectional study on 3242 individuals was conducted from 2 August-1 October 2020. The survey covered demographics, internet use frequency and self-reported physical health questions. Linear regression analyses were used to examine the impact of internet use frequency on physical health. 72.5%, 69.9%, 65.1% and 55.3% respondents reported headache, back pain, numbness of the fingers and neck pain, respectively. The analyses showed increased physical health impact among regular (coefficient β = 0.52, 95% confidence interval [CI]: 0.18-0.85, p = 0.003), frequent (β = 1.21, 95% CI: 0.88-1.54, p < 0.001) and intense (β = 2.24, 95% CI: 1.91-2.57, p < 0.001) internet users. Other important predictors were gender, income, occupation, regions, and working status. Frequent and extensive uses of the internet were strong predictors of physical health problems, and our findings suggest the need for increased awareness about the physical health problems that can be triggered by excessive internet usage.
    Matched MeSH terms: Cross-Sectional Studies
  11. Abdullah N, Al-Junid SH, Looi ML, Chin SF, Mohd Haniff EA, Syed Zakaria SZ, et al.
    Background: Validation of self-reported questionnaire is very crucial in ensuring the quality and reliability of data collection.
    Objective: The aim of this study were i) to validate the questionnaire on tobacco smoke intake and second hand smoke exposure among The Malaysian Cohort (TMC) subjects through the determination of urinary cotinine levels, ii) to determine the optimal cut-off point of urine cotinine that discriminates smokers from non-smokers and iii) to estimate misclassification rate between self-reported smoking and urinary cotinine level.
    Methods: Urine samples from a total of 775 The Malaysian Cohort subjects (104 smokers, 102 former smokers and 569 non-smokers) were obtained and urinary cotinine levels were determined by high-performance liquid chromatography (HPLC). Differences between groups were compared using Kruskal Wallis and Mann-Whitney tests. The Receiver Operating Characteristic (ROC) curved was performed to define the optimal urinary cotinine cut-off point.
    Results: Urinary cotinine concentration significantly (p<0.001) correlated with smoking status (r=0.46), the average number of cigarettes smoked per day (r=0.53), duration of smoking (r=0.33) and number of cigarettes packed per year (r=0.47). Smokers and second hand smokers have significantly higher median cotinine levels (978.40 and 21.31 respectively) compared to non-smokers (15.52) and non-exposed (13.60) subjects. Cotinine level at cut-off value of 1.51 ng/mg creatinine is able to distinguish smokers and non-smokers with a sensitivity of 84.62% and specificity of 81.97%.
    Conclusion: The Malaysian Cohort self-reported smoking questionnaire is a reliable tool in assessing the use of tobacco and second hand smoke exposure among the subjects.
    Study name: The Malaysian Cohort (TMC) project
    Matched MeSH terms: Cross-Sectional Studies
  12. Badri SKZ, Kong MY, Wan Mohd Yunus WMA, Nordin NA, Yap WM
    PMID: 34682544 DOI: 10.3390/ijerph182010800
    Perfectionism or a tendency to aim for an unrealistic standard can impair happiness. However, the potential mechanisms of perfectionism to explain the association between trait emotional intelligence (EI) and happiness are still understudied. This study explores the mediating role of perfectionism in the relationship between trait emotional intelligence (EI) and happiness among young adults. A cross-sectional sample of 259 young adults aged between 18 to 35 years old was recruited. All analyses were conducted using SPSS and AMOS Structural Equation Modeling. High trait EI was linked to low perfectionism and high happiness levels. Furthermore, perfectionism mediated the relationship between trait EI and happiness. Although high trait EI lowered maladaptive perfectionism, the negative impact of maladaptive perfectionism remained and subsequently led to decreasing happiness levels of young adults. This study offers an enhanced understanding of the role of perfectionism in explaining the happiness state of young adults. Moreover, it provides practical implications for using trait EI and managing perfectionism tendency to manage the happiness and wellbeing of the young adult population.
    Matched MeSH terms: Cross-Sectional Studies
  13. Abdul Manaf MR, Mohammed Nawi A, Mohd Tauhid N, Othman H, Abdul Rahman MR, Mohd Yusoff H, et al.
    PMID: 34682645 DOI: 10.3390/ijerph182010903
    The current academic landscape has overwhelmed faculties and with demands to adopt tech-savvy teaching modes and accelerate scholarly works, administrative duties, and outreach programs. Such demands have deteriorated the health-related quality of life (HRQoL) among university employees. This study aimed to determine the factors associated with HRQoL among university employees in a Malaysian public university. This cross-sectional study was conducted among 397 employees from the Universiti Kebangsaan Malaysia (UKM) between April and June 2019. A self-administered questionnaire that consisted of socio-demographic items, risky health behaviors, health-related information, and validated scales for measuring employees' physical inactivity, psychological states, and HRQoL was utilized. Descriptive and inferential statistics were calculated using SPSS version 23.0. Hierarchical multiple linear regression models were yielded to determine the factors associated with different domains of HRQoL. Mediation analysis was conducted using PROCESS MACRO (Model 4). Statistical significance was set to p < 0.05. Physical HRQoL scored the highest, while environmental HRQoL had the lowest score among the employees. Physical HRQoL was influenced by age, service duration, comorbid conditions, BMI, chronic diseases, and anxiety. Factors associated with psychological HRQoL were age, service duration, depression, and stress. Age, service duration, and chronic diseases affected employees' social relationship HRQoL, while environmental HRQoL was associated with age, occupation type, chronic diseases, and depression. Socio-demographics, risky health behaviors, health profiles, and psychological attributes were significantly associated with employees' HRQoL. Age was the only positively correlated factor across all HRQoL domains, while other factors deteriorated employees' HRQoL.
    Matched MeSH terms: Cross-Sectional Studies
  14. Lee PM, Chang CT, Yusoff ZM
    Int J Clin Pharm, 2021 Feb;43(1):46-54.
    PMID: 32524510 DOI: 10.1007/s11096-020-01070-9
    Background Tyrosine kinase inhibitors have been demonstrated to improve the survival of patients with chronic myeloid leukaemia. However, medication adherence is vital for patients on chronic treatment. Objective The objective of the current study was to evaluate response to treatment, adherence by patients to tyrosine kinase inhibitors and factors associated with adherence and response. Setting A haematology clinic in a regional referral hospital in Malaysia. Method Patients aged ≥ 13 years who had been on imatinib or nilotinib for ≥ 12 months were included in this cross-sectional study. An optimal response was defined as the achievement of major molecular response at 12 months of treatment. Patient medication adherence was determined using the average medication possession ratio based on the dispensing records. The patients were considered adherent if the medication possession ratio was > 90%. Multiple logistic regression was performed to evaluate the factors associated with adherence. The association of adherence with molecular response was analysed by univariate logistic regression. Main outcome measure The primary outcome measures were the proportion of patients who achieved optimal response and the medication possession ratio. Results A total of 151 patients were screened, and 71 patients were included. Twenty-eight patients (39%) achieved major molecular response at 12 months of treatment. The median time to achieve this was 15.5 months (an interquartile range of 15). The mean medication possession ratio for imatinib and nilotinib was 0.94 (± 0.14) and 0.96 (± 0.10), respectively, but this difference was without statistical significance (t  =  - 0.517, p  =  0.610). Nausea and vomiting (odds ratio [OR] of 0.25, 95% confidence interval [CI]: 0.07-0.83, p  =  0.023) and disease phase at diagnosis (OR of 0.20, 95% CI 0.04-1.06, p  =  0.059) were associated with patient adherence. An association was not found between patient adherence and molecular response (OR of 1.03, 95% CI 0.35-3.09, p  =  0.956). Conclusion The patients in this study demonstrated a relatively deep molecular response and optimal adherence. Nevertheless, one fourth of them were noncompliant with imatinib. Therefore, active interventions are warranted to prevent treatment-associated adverse events and improve adherence.
    Matched MeSH terms: Cross-Sectional Studies
  15. Chow MISP, Hashim AH, Guan NC
    Int J Soc Psychiatry, 2021 Jun;67(4):376-385.
    PMID: 32924726 DOI: 10.1177/0020764020957362
    BACKGROUND: Until now, there is scarcity of information regarding resilience, religiosity and religious coping among adolescent refugees. Currently, most researches emphasize on the physical, psychological and social distresses experienced by refugees while overlooking these crucial aspects, that is, resilience and coping.

    AIM: The study aimed to examine resilience and its association with religiosity and religious coping among adolescent refugees living in Malaysia.

    METHODS: This is a cross-sectional study conducted in five community-based learning centres in Malaysia from July 2019 till December 2019. A total of 152 refugees, aged 13 to 19-years-old, were recruited. The study gauged resilience using the 14-Item Resilience Scale (RS-14), the Duke University Religion Index (DUREL) for religiosity and the Brief Religious Coping Scale (Brief RCOPE) for religious coping.

    RESULTS: The majority of adolescent refugees portrayed moderate levels of resilience (43.5%). The study highlighted the interconnectedness between resilience and intrinsic religiosity (IR) (p 

    Matched MeSH terms: Cross-Sectional Studies
  16. Shariff Ghazali S, Seman Z, Zainuddin NH, Omar MA, Sooryanarayana R, Ariaratnam S, et al.
    BMJ Open, 2021 10 20;11(10):e052126.
    PMID: 34670764 DOI: 10.1136/bmjopen-2021-052126
    OBJECTIVES: To determine the prevalence and factors associated with multimorbidity among community-dwelling older adults in Malaysia.

    DESIGN: A population-based cross-sectional study.

    SETTING: 13 states and 3 Federal Territories in Malaysia.

    PARTICIPANTS: A total of 3966 adults aged 60 years and above were extracted from the nationwide National Health and Morbidity Survey (NHMS) 2018 data set.

    PRIMARY OUTCOME MEASURES: Multimorbidity was defined as co-occurrence of at least two known chronic non-communicable diseases in the same individual. The chronic diseases included hypertension, type 2 diabetes mellitus, dyslipidaemia and cancer.

    RESULTS: The prevalence of multimorbidity among Malaysian older adults was 40.6% (95% CI: 37.9 to 43.3). The factors associated with multimorbidity were those aged 70-79 years (adjusted OR (AOR)=1.30; 95% CI=1.04 to 1.63; p=0.019), of Indian (AOR=1.69; 95% CI=1.14 to 2.52; p=0.010) and Bumiputera Sarawak ethnicities (AOR=1.81; 95% CI=1.14 to 2.89; p=0.013), unemployed (AOR=1.53; 95% CI=1.20 to 1.95; p=0.001), with functional limitation from activities of daily livings (AOR=1.66; 95% CI=1.17 to 2.37; p=0.005), physically inactive (AOR=1.28; 95% CI=1.03 to 1.60; p=0.026), being overweight (AOR=1.62; 95% CI=1.11 to 2.36; p=0.014), obese (AOR=1.88; 95% CI=1.27 to 2.77; p=0.002) and with abdominal obesity (AOR=1.52; 95% CI=1.11 to 2.07; p=0.009).

    CONCLUSION: This study highlighted that multimorbidity was prevalent among older adults in the community. Thus, there is a need for future studies to evaluate preventive strategies to prevent or delay multimorbidity among older adults in order to promote healthy and productive ageing.

    Matched MeSH terms: Cross-Sectional Studies
  17. Das G, Ahmed S, Ahmed AR, Tirth V, Jamil S, Muhammad AA, et al.
    Work, 2021;70(2):387-393.
    PMID: 34657847 DOI: 10.3233/WOR-213602
    BACKGROUND: Medical professionals, especially dental professionals, have been adversely affected by the pandemic of COVID-19 due to an increased chance of exposure to patients because of close contact during treatments.

    OBJECTIVES: This study aimed to evaluate knowledge about the disease and assess ways of precautions to be taken during the pandemic.

    METHODS: A questionnaire was developed and registered at Google Forms. The study population included dental practitioners, working in hospitals and clinics. A total of 495 dental practitioners from 14 different countries across the world responded. Most dentists were aware of the required modifications in the management of patients. The points allotted for each correct/best answer by participants for a group of questions regarding each component (Knowledge, Perceptions, and Practices) were added/summed to generate an overall score for each of the three components.

    RESULTS: Both univariate and multivariate analysis employed for the evaluation of results. Moreover, the total practice score was significantly associated with gender and sector of practice. Multivariable analysis model using multiple linear regressions was formulated by including those variables which were significant at the univariate stage. Hence, the practice sector was the only variable found to be significantly associated with the total knowledge score (p-value 

    Matched MeSH terms: Cross-Sectional Studies
  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.
    Matched MeSH terms: Cross-Sectional Studies
  19. Wahab S, Shah NE, Sivachandran S, Shahruddin I, Ismail NNS, Mohan LD, et al.
    Acad Psychiatry, 2021 Dec;45(6):672-680.
    PMID: 34342844 DOI: 10.1007/s40596-021-01513-z
    OBJECTIVE: The attitude of medical personnel towards suicide may influence the outcome of suicidal-patients management. This study aimed to determine the attitudes of medical undergraduates towards suicide and its association with their help-seeking behavior.

    METHODS: A cross-sectional study involving 290 medical undergraduates was conducted in a Malaysian university. The questionnaires on the attitude towards suicide and general help-seeking behavior were used as research instruments.

    RESULTS: The mean age of the participants was 22.4 years. Participants who did psychiatry posting indicated a greater tendency to agree on suicide as a way of communication (p = 0.008) than those who did not. Participants previously diagnosed with a psychiatric illness indicated a greater ability to understand and accept suicide (p < 0.001) as well as a greater tendency to agree on the normality of suicide (p = 0.019) than those without a previous diagnosis. Those who attended a suicide prevention program also indicated a greater tendency to agree that loneliness and avoidance could be triggers to suicide (p = 0.037) than those who did not. No correlation was found between the "attitude towards suicide" and "general help-seeking behavior" variable.

    CONCLUSION: Education programs in suicide prevention and management need to be incorporated early into the undergraduate medical curriculum to cultivate a more positive attitude towards suicide and help-seeking behavior.

    Matched MeSH terms: Cross-Sectional Studies
  20. Munawar K, Mukhtar F, Choudhry FR, Ng ALO
    Asia Pac Psychiatry, 2022 Mar;14(1):e12475.
    PMID: 33963816 DOI: 10.1111/appy.12475
    BACKGROUND: Mental health problems in Malaysia are on a rise. This study aimed at performing a systematic review of mental health literacy (MHL) in Malaysia.

    METHODS: Medline, Embase, ERIC/Proquest, ScienceDirect, Pubmed, PsycINFO, CINAHL, Scopus, EBM Reviews - Cochrane Central Register of Controlled Trials, Ovid Emcare and reference lists of included studies were searched in February 2020. Studies that evaluated at least one of the main components of MHL, including (1) knowledge related to mental health issues, and (2) stigma, were included irrespective of study design. As secondary findings, the review also synthesized results related to facilitators and barriers to seeking mental health services. Depending on the research design, the quality of each study was assessed through checklists.

    RESULTS: Forty six studies published between 1995 to 2019 were included. Most studies used cross-sectional designs to investigate MHL. Findings indicate that most Malaysians have stigmatizing attitudes towards mental health problems. Participants in the included studies endorsed multifactorial explanations of mental health issues with a dominance of supernatural and religious aetiologies. Likewise, the commonest barrier was considering sources other than professional sources of mental-health services. Presence of adequate knowledge and considering providers as competent facilitated help-seeking. Additionally, there was considerable heterogeneity in studies and a lack of standardized measures assessing MHL.

    CONCLUSIONS: There is an increase in studies on MHL in Malaysia. A few of these studies, based on experimental design, have shown positive effects. Researchers, practitioners, and policymakers should develop standardized measures and interventional studies based on all the components of MHL.

    Matched MeSH terms: Cross-Sectional Studies
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