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Complementary and Alternative Medicine Use and Symptom Burden in Women Undergoing Chemotherapy for Breast Cancer in Malaysia

Chui PL, Abdullah KL, Wong LP, Taib NA

Cancer Nurs, 2017 7 21;41(3):189-199.
PMID: 28723722 DOI: 10.1097/NCC.0000000000000527

BACKGROUND: Complementary and alternative medicine (CAM) is commonly used for cancer- and chemotherapy-related symptoms. Nurses are likely to encounter many CAM users in their practice.
OBJECTIVE: The aims of this study were to assess CAM use and examine the symptom burden of CAM and non-CAM users among patients with breast cancer who are undergoing chemotherapy.
METHODS: A CAM use questionnaire and the Side-Effect Burden Scale were administered to 546 patients. Complementary and alternative medicine use was categorized as mind-body practices (MBPs), natural products (NPs), or traditional medicine (TM).
RESULTS: We identified 386 CAM users (70.7%) in this study. The CAM users reported a higher marginal mean total symptom burden score (40.39 ± 2.6) than non-CAM users (36.93 ± 3.21), although this difference was not statistically significant (P = .09). Triple-modality (MBP-NP-TM) CAM users had a significantly higher marginal mean total symptom burden score (47.44 ± 4.12) than single-modality (MBP) users (34.09 ± 4.43). The risk of having a high total symptom burden score was 12.9-fold higher among the MBP-NP-TM users than among the MBP users.
CONCLUSIONS: Complementary and alternative medicine use is common among Malaysian patients who are undergoing chemotherapy for breast cancer. However, CAM and non-CAM users reported similar symptom burdens, although single-modality use of MBP is likely associated with a lower symptom burden.
IMPLICATIONS FOR PRACTICE: Nurses should keep abreast of current developments and trends in CAM use. Understanding CAM use and the related symptom burden will allow nurses to initiate open discussion and guide their patients in seeking additional information or referrals for a particular therapy.

Matched MeSH terms: Women's Health
Fulltext The Third National Health and Morbidity Survey 2006 (NHMS III)

ISBN: 978-983-3887-27-9

Citation: National Health Morbidity Survey 2006. Kuala Lumpur: Ministry of Health, Malaysia, 2008
Study name: National Health and Morbidity Survey (NHMS-2006)

Matched MeSH terms: Women's Health
Fulltext Anthropometric and reproductive factors among newly- diagnosed breast cancer patients and healthy women: a case-control study

Zunura'in Z, Almardhiyah AR, Gan SH, Arifin WN, Sirajudeen K, Bhavaraju V, et al.

Asian Pac J Cancer Prev, 2016;17(9):4439-4444.
PMID: 27797258

The objective of this case-control study was to determine anthropometric and reproductive factors associated with the development of breast cancer among women. Fifty-six newly diagnosed breast cancer patients were recruited from the Oncology Clinic, Universiti Sains Malaysia (USM), and 56 healthy female hospital employees were recruited as controls. Socio-demographic and reproductive data were obtained using a standard questionnaire. Anthropometric factors (body weight, height, body fat percentage, visceral fat and waist and hip circumference) were assessed. A high waist circumference (adjusted OR= 1.04, [95% CI: 1.00, 1.09]) and being more than 30 years of age at rst full-term pregnancy (adjusted OR=3.77, [95% CI: 1.10, 12.90]) were predictors of breast cancer development. The results of this study indicate that weight and reproductive health management should be emphasized for breast cancer prevention in Malaysia.

Study site: Oncology clinic, Hospital Universiti Sains Malaysia (HUSM)

Matched MeSH terms: Women's Health
Fulltext Smokeless tobacco use among rural Kadazan women in Sabah, Malaysia

Gan CY

Southeast Asian J Trop Med Public Health, 1995 Jun;26(2):291-6.
PMID: 8629063

A survey was conducted to document and bring attention to the use of smokeless tobacco among rural Kadazan women in Sabah, East Malaysia. Of the 472 women interviewed, 59.5% had used tobacco among the ingredients that they habitually chewed. Women with low education were more likely to be chewers. The chewing habit was usually acquired during the teenage years and the practice was perceived mainly as a cultural norm. 73.3% of these smokeless tobacco users were unaware of any adverse health effect of this type of tobacco use as compared to 53.9% of the non-tobacco users. The high prevalence of smokeless tobacco use is easily maintained as tobacco is cheap, locally produced and its use is socially accepted. The low level educational status of the women compounds the problem and intervention programs to curb this form of tobacco use is warranted.

Matched MeSH terms: Women's Health
Development and validation of the osteoporosis patient satisfaction questionnaire (OPSQ)

Lai PS, Chua SS, Chan SP, Low WY, Wong IC

Maturitas, 2010 Jan;65(1):55-63.
PMID: 19962839 DOI: 10.1016/j.maturitas.2009.10.006

OBJECTIVES: To develop and validate the Osteoporosis Patient Satisfaction Questionnaire (OPSQ) and to assess the opinion of postmenopausal osteoporotic women towards pharmaceutical care.
METHODS: A 16-item instrument was designed. Each response consists of a five-point Likert-like scale with higher scores indicating greater satisfaction. The face and content validity was established via consultation with an endocrinologist and three pharmacists as well as feedback from participants in a preliminary study. Postmenopausal osteoporotic women taking bisphosphonates were recruited and randomly allocated to the intervention (n=90) and control groups (n=90). Pharmaceutical care was provided at month 2 to the intervention group while the control group received standard pharmacy services. The OPSQ was administered at month 6 (end of the intervention period), to assess patients' satisfaction. Factor analysis was performed using varimax rotation. Internal reliability was established using Cronbach's alpha. Construct validity was performed by using the Mann-Whitney U test.
RESULTS: The internal reliability of the OPSQ produced a Cronbach's alpha of 0.86. Factor analysis identified one component in the OPSQ, which measured patient satisfaction. The intervention group showed significantly better overall OPSQ score than the control group (91.89+/-7.22% versus 84.32+/-7.48%, p<0.001). This indicates that the OPSQ was able to differentiate between participants who received pharmaceutical care from those who did not.
CONCLUSIONS: The 16-item OPSQ developed in this study has high internal reliability and is a valid instrument for assessing osteoporotic women's satisfaction with pharmaceutical care service in Malaysia.

Matched MeSH terms: Women's Health
Fulltext The syndemic of HIV, HIV-related risk and multiple co-morbidities among women who use drugs in Malaysia: Important targets for intervention

Loeliger KB, Marcus R, Wickersham JA, Pillai V, Kamarulzaman A, Altice FL

Addict Behav, 2016 Feb;53:31-9.
PMID: 26436520 DOI: 10.1016/j.addbeh.2015.09.013

Substance use and HIV are syndemic public health problems in Malaysia. Harm reduction efforts to reduce HIV transmission have primarily focused on men with substance use disorders.

Matched MeSH terms: Women's Health
Fulltext Validity and Reliability of Health Belief Model Questionnaire for Promoting Breast Self-examination and Screening Mammogram for Early Cancer Detection

Che Mohamed N, Moey SF, Lim BC

Asian Pac J Cancer Prev, 2019 09 01;20(9):2865-2873.
PMID: 31554389 DOI: 10.31557/APJCP.2019.20.9.2865

Background: Early detection of breast cancer is essential in improving overall women’s health. The researchers
sought to develop a comprehensive measure that combined the basic components of the health belief model (HBM)
with a focus on breast self-examination (BSE) and screening mammogram amongst women. Methods: Questionnaire
items were developed following a review of relevant literature of HBM on BSE and screening mammogram. The
sampling frame for the study was Malaysian women aged 35 to 70 years old, living in Kuantan, Pahang and able to
read or write in Bahasa Malaysia or English. As such, 103 women were randomly selected to participate in the study.
Tests of validity using exploratory factor analysis (EFA) and reliability were subsequently performed to determine the
psychometric properties of the questionnaire. Results: The EFA revealed nine factors (self-efficacy of mammogram,
perceived barriers of BSE and mammogram, perceived susceptibility of breast cancer, perceived severity of breast
cancer, cues to action for mammogram screening, perceived benefits of BSE, health motivation, perceived benefits
of mammogram and self-efficacy of BSE) containing 54 items that jointly accounted for 74.2% of the observed
variance. All nine factors have good internal consistency with Cronbach’s alpha ≥ 0.8. Fifty-four items remained in
the final questionnaire after deleting 13 problematic items. The scale also showed good convergent and discriminant
validity. Conclusion: The findings showed that the designed questionnaire was a valid and reliable instrument for the
study involving women in Kuantan, Pahang. The instrument can help to assess women’s beliefs on BSE adoption and
mammogram screening in health care practice and research.

Matched MeSH terms: Women's Health
Prevalence, risk factors, and complications of violence against pregnant women in a hospital in Peninsular Malaysia

Khaironisak H, Zaridah S, Hasanain FG, Zaleha MI

Women Health, 2017 09;57(8):919-941.
PMID: 27636717 DOI: 10.1080/03630242.2016.1222329

Violence against women is a worldwide public health problem and becomes more crucial when it involves pregnant women. The primary aim of this study was to determine the prevalence of violence against pregnant women (VAPW), while the secondary aim was to identify the factors associated with violence and complications of violence during pregnancy. This was a cross-sectional study conducted in 1,200 postnatal women from March 1, 2015 through August 31, 2015 using a validated Malay Version of the WHO Women's Health and Life Experiences Questionnaire. Data on pregnancy complications were obtained from antenatal records and discharge summaries. The prevalence of any form of VAPW was 35.9%, consisting of: any psychological (29.8%); any physical (12.9%); and any sexual (9.8%) violence. VAPW was significantly associated with: (1) women's use of drugs, having had exposure to violence during childhood, having a violence-supporting attitude, having two or more children; and (2) having partners who were smokers, alcohol drinkers, or had controlling behavior. VAPW was significantly associated with anemia, urinary tract infection, premature rupture of membranes, antepartum hemorrhage, poor weight gain during pregnancy, low birth weight, and prematurity. In conclusion, the high prevalence of violence requires further research on preventive strategies for VAPW.

Matched MeSH terms: Women's Health
Genitourinary syndrome of menopause in five Asian countries: results from the Pan-Asian REVIVE survey

Chua Y, Limpaphayom KK, Cheng B, Ho CM, Sumapradja K, Altomare C, et al.

Climacteric, 2017 Aug;20(4):367-373.
PMID: 28453308 DOI: 10.1080/13697137.2017.1315091

OBJECTIVES: The Pan-Asian REVIVE survey aimed to examine women's experiences with genitourinary syndrome of menopause (GSM) and their interactions with health-care professionals (HCPs).
METHODS: Self-completed surveys were administered face-to-face to 5992 women (aged 45-75 years) in Indonesia, Malaysia, Singapore, Taiwan, and Thailand.
RESULTS: Of 638 postmenopausal women with GSM symptoms, only 35% were aware of the GSM condition, most of whom first heard of GSM through their physician (32%). The most common symptoms were vaginal dryness (57%) and irritation (43%). GSM had the greatest impact on sexual enjoyment (65%) and intimacy (61%). Only 25% had discussed their GSM symptoms with a HCP, and such discussions were mostly patient-initiated (64%) rather than HCP-initiated (24%). Only 21% had been clinically diagnosed with GSM and only 24% had ever used treatment for their symptoms. Three-quarters of those who had used treatment for GSM had discussed their symptoms with a HCP compared to only 9% of those who were treatment-naïve.
CONCLUSION: GSM is underdiagnosed and undertreated in Asia. As discussion of GSM with HCPs appears to be a factor influencing women's awareness and treatment status, a more active role by HCPs to facilitate early discussions on GSM and its treatment options is needed.

Matched MeSH terms: Women's Health
Early detection and prevention of domestic violence using the Women Abuse Screening Tool (WAST) in primary health care clinics in Malaysia

Wong YL, Othman S

Asia Pac J Public Health, 2008;20(2):102-16.
PMID: 19124304 DOI: 10.1177/1010539507311899

Despite being an emergent major public health problem, little research has been done on domestic violence from the perspectives of early detection and prevention. Thus, this cross-sectional study was conducted to identify domestic violence among female adult patients attending health centers at the primary care level and to determine the relationship between social correlates of adult patients and domestic violence screening and subsequent help/health-seeking behavior if abused. Face-to-face interviews were conducted with 710 female adult patients from 8 health centers in Selangor who matched the inclusion criteria and consented to participate in the study, using a structured questionnaire that included adaptation of a validated 8-item Women Abuse Screening Tool (WAST). Statistical tests showed significant differences in ethnicity, income, and education between those screened positive and those screened negative for domestic violence. Of the participants, 92.4% reported that during consultations, doctors had never asked them whether they were abused by their husband/partner. Yet, 67.3% said they would voluntarily tell the doctor if they were abused by their husband/partner. The findings indicate that primary care has an important role in identifying domestic violence by applying the WAST screening tool, or an appropriate adaptation, with women patients during routine visits to the various health centers. Such assessment for abuse could be secondary prevention for the abused women, but more important, it will serve as primary prevention for nonabused women. This approach not only will complement the existing 1-stop crisis center policy by the Ministry of Health that copes with crisis intervention but also will spearhead efforts toward prevention of domestic violence in Malaysia.

Matched MeSH terms: Women's Health