Displaying publications 1 - 20 of 23 in total

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  1. Noviani W, Chong MC, Tang LY
    Heliyon, 2023 Mar;9(3):e13433.
    PMID: 36895334 DOI: 10.1016/j.heliyon.2023.e13433
    BACKGROUND: Professional socialization could support competency achievement and assist the transition phase. It is rare to find quantitative studies examining the effects of professional socialization for nursing students (NS).

    OBJECTIVES: To investigate the effects of a socialization in professional reality integration for nursing student transition (SPRINT) to improve the professional competence of undergraduate NS in Indonesia.

    DESIGN: A quasi-experimental study non-equivalent control group pre-test post-test design was conducted using convenience sampling.

    PARTICIPANTS: One hundred twenty NS (60 participants in the experimental group and 60 participants in the control group) from two nursing departments in private universities in Indonesia.

    METHODS: The SPRINT educational intervention consisted of professional socialization training using several learning methods and activities. Meanwhile, the control group received conventional socialization. The Nurse Professional Competence short-form (NPC-SF) scale was evaluated prior to the participants' internship program, lasting from 6 to 12 weeks after clinical education in both groups.

    RESULTS: SPRINT intervention significantly increased overall professional competence scores of the experimental groups higher than the control group. By comparing the mean scores in three times measurement, the six competency areas mean score increased significantly for the experimental group while, for the control only three areas of competence increased in twelve week post-test.

    CONCLUSION: A "SPRINT" as an innovative educational program developed in collaboration with academia, clinical preceptors, could improve professional competence. It is recommended to implement SPRINT program to assist the smooth transition from academic into clinical education.

  2. Krishnasamy K, Tang LY, Chong MC, Lau PC, Chinna K
    Clin J Oncol Nurs, 2017 02 01;21(1):E23-E29.
    PMID: 28107326 DOI: 10.1188/17.CJON.E23-E29
    BACKGROUND: Malnutrition is common among patients with cancer, but little attention is given to its risks and consequences.
    OBJECTIVES: The aim of this study is to assess the nutritional status and identify the factors associated with malnutrition among newly diagnosed patients with cancer.
    METHODS: Patients admitted with newly diagnosed cancer at a teaching hospital in Malaysia were recruited from January to April 2015. Nutritional status was assessed before treatment initiation, and patients were classified into three categories.
    FINDINGS: A total of 132 pretreatment patients were recruited into the study. About half were severely malnourished. Patients with stage III cancer had the highest prevalence of severe malnourishment. Clinical parameters and disease characteristics were significantly associated with nutritional status. Demographic variables were also statistically significantly associated with severe nutritional status.
    KEYWORDS: malnutrition; nutrition status; nutritional assessment; risk factor
  3. Al-Amedy OS, Tang LY, Gulistan AS
    MyJurnal
    Diabetes is a chronic complicated disease. For that reason, self-care management and education are necessary to control blood glucose levels to decrease mortality and morbidity rate, the risk of complications and adverse medication related events. Lack of knowledge about a diabetic medication and non-adherence contribute to poor glycemic control among diabetes patients. Therefore, this study aims to assess relationship between medication knowledge and medication adherence among T2DM. A cross sectional study was carried out in outpatient's diabetic clinic in University Malaya Medical Centre via recruiting 250 participants. A set of questionnaires from earlier research were used to collect the data. Descriptive and inferential statistical analysis is used to analyze the data. The inclusive results indicated that, the mean age of the participants was 57.90 ±13.22 within 56years. More than half of patients (52.5%) had poor medication knowledge, and 47.5% had good knowledge. In terms of medication adherence, most of the participants (87.0%) had medium medication adherence; whereas, only 1.3% showed high medication adherence. However, there was no correlation between medication knowledge and medication adherence (p=0.743). The chi-square results indicated that medication knowledge was associated significantly with gender, educational level, employment status and monthly income (p value < 0.05). In conclusion it can be said that this study provides insight for healthcare professional about medication knowledge and adherence which are important for managing diabetes. Awareness of these factors will allow them to be more effective about medication counseling so that patients can become self-responsible and realize the benefits of prescribed therapies.
    Study site: Diabetic Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  4. Dinglasan JL, Tang LY, Chong MC, Al Raimi AM
    Saudi Med J, 2022 Jan;43(1):113-116.
    PMID: 35022293 DOI: 10.15537/smj.2022.43.1.20210211
    OBJECTIVES: To examine asthma prevalence and the relationship between the level of knowledge and quality of life (QoL) among asthmatic secondary school children aged 13-14 years old in Malaysia.

    METHODS: A cross-sectional design was employed. Data was collected through a self-administered questionnaire containing demographic characteristics, asthma symptoms, knowledge on asthma, and QoL.

    RESULTS: Data from 2891 asthmatic schoolchildren aged 13-14 years old from secondary schools in Petaling Jaya, Malaysia, were analyzed. According to the International Study of Asthma and Allergies in Childhood (ISAAC) scoring for asthma prevalence, the number of children who exhibited signs and symptoms of asthma was 9% (n=260). The mean score for total knowledge indicated a low knowledge level (82.7%). No significant relationship was found between knowledge level and QoL. Only the race factor was associated with asthma knowledge.

    CONCLUSION: This study has provided valuable information on asthma prevalence among Malaysian adolescents and their knowledge on asthma condition. Further research should explore the correlation factors of asthma knowledge and QoL.

  5. Huang WX, Chong MC, Tang LY, Liu XX
    J Pediatr Nurs, 2024 Nov 07.
    PMID: 39516056 DOI: 10.1016/j.pedn.2024.10.035
    OBJECTIVE: This study aims to analyze the concept of Child-friendly Healthcare (CFH) using Walker and Avant's conceptual analysis framework to clarify its meaning, attributes, and implications for clinical practice.

    METHOD: The study employed Walker and Avant's conceptual analysis method, which involves a systematic process comprising concept selection, setting objectives, exploring potential uses, defining attributes, constructing a model case, identifying contrary cases, determining antecedents and consequences, and examining empirical referents. A scoping review was conducted across multiple sources, including online dictionaries, scientific databases, and grey literature, with a focus on literature relevant to CFH.

    RESULT: A total of 37 articles were reviewed, revealing diverse definitions and interpretations of CFH across various contexts. The concept was defined by five key attributes: (1) child interests-prioritized quality services, (2) child-friendly environments and spaces, (3) social interaction, (4) child participation, and (5) development facilitation. The study also identified the antecedents and consequences of CFH, developed model and contrary cases, and examined empirical referents to offer a comprehensive understanding of the concept.

    CONCLUSION: This analysis effectively clarified the concept of CFH, highlighting its core attributes and providing valuable insights for clinical nursing practice. The findings suggest that CFH can be used as a framework to guide child-centered healthcare practices, thereby enhancing the quality of care provided to pediatric patients.

    IMPLICATIONS: Conducting a concept analysis of CFH can significantly contribute to improving patient health outcomes, supporting institutional development, and fostering future research and practical applications in child healthcare settings.

  6. Tumin M, Tafran K, Tang LY, Chong MC, Mohd Jaafar NI, Mohd Satar N, et al.
    Medicine (Baltimore), 2016 Mar;95(12):e3178.
    PMID: 27015207 DOI: 10.1097/MD.0000000000003178
    Malaysia suffers from a chronic shortage of human organs for transplantation. Medical and nursing students (MaNS) are future health professionals and thus their attitude toward organ donation is vital for driving national donation rates. This study investigates MaNS' willingness to donate organs upon death and the factors influencing their willingness. A cross-sectional design was used with a sample of 500 students (264 medical and 236 nursing) at the University of Malaya. A self-administrated questionnaire was used. The responses were analyzed by using descriptive statistics and multiple logistic regression. Of all respondents, 278 (55.6%) were willing to donate organs upon death, while the remaining 222 (44.4%) were unwilling to donate. Only 44 (8.8%) had donor cards. The multiple logistic regression revealed that the minorities ethnic group was more willing to donate organs than Malay respondents (adjusted odds ratio [aOR] = 1.98, P = 0.010). In addition, medical students were more willing to donate than nursing students (aOR = 2.53, P = 0.000). Respondents who have a family member with a donor card were more willing to donate than respondents who do not (aOR = 3.48, P = 0.006). MaNS who believed that their religion permits deceased donation were more willing to donate than their counterparts (aOR = 4.96, P = 0.000). Household income and sex were not significant predictors of MaNS' willingness to donate organs upon death. MaNS have moderate willingness, but low commitment toward deceased organ donation. Strategies for improving MaNS' attitude should better educate them on organ donation, targeting the most the Malay and nursing students, and should consider the influence of family attitude and religious permissibility on MaNS' willingness.
    Study site: University of Malaya, Kuala Lumpur, Malaysia
  7. Ramoo V, Abdullah KL, Tan PS, Wong LP, Chua YP, Tang LY
    Nurs Crit Care, 2017 May;22(3):141-149.
    PMID: 25913373 DOI: 10.1111/nicc.12180
    BACKGROUND: Inappropriate sedation assessment can jeopardize patient comfort and safety. Therefore, nurses' abilities in assessing and managing sedation are vital for effective care of mechanically ventilated patients.

    AIMS AND OBJECTIVES: This study assessed nurses' sedation scoring and management abilities as primary outcomes following educational interventions. Nurses' perceived self-confidence and barriers to effective sedation management were assessed as secondary outcomes.

    DESIGN: A post-test-only quasi-experimental design was used. Data were collected at 3 and 9 months post-intervention.

    METHODS: A total of 66 nurses from a 14-bed intensive care unit of a Malaysian teaching hospital participated. The educational interventions included theoretical sessions, hands-on sedation assessment practice using the Richmond Agitation Sedation Scale, and a brief sedation assessment tool. Nurses' sedation scoring and management abilities and perceived self-confidence level were assessed at both time points using self-administered questionnaires with case scenarios. Sedation assessment and management barriers were assessed once at 9 months post-intervention.

    RESULTS: Median scores for overall accurate sedation scoring (9 months: 4·00; 3 months: 2·00, p = 0·0001) and overall sedation management (9 months: 14·0; 3 months: 7·0, p = 0·0001) were significantly higher at 9 months compared to 3 months post-intervention. There were no significant differences in the perceived self-confidence level for rating sedation level. Overall perceived barrier scores were low (M = 27·78, SD = 6·26, possible range = 11·0-55·0). Patient conditions (M = 3·68, SD = 1·13) and nurses' workload (M = 3·54, SD = 0·95) were the greatest barriers to effective sedation assessment and management. Demographic variables did not affect sedation scoring or management abilities.

    CONCLUSIONS: Positive changes in nurses' sedation assessment and management abilities were observed, indicating that adequate hands-on clinical practice following educational interventions can improve nurses' knowledge and skills.

    RELEVANCE TO CLINICAL PRACTICE: Educational initiatives are necessary to improve ICU practice, particularly in ICUs with inexperienced nurses.

  8. Alhadidi M, Abdullah KL, Tang LY, Danaee M, Al Hadid LAR
    Perspect Psychiatr Care, 2021 Jan;57(1):225-234.
    PMID: 32502330 DOI: 10.1111/ppc.12553
    PURPOSE: This study assessed the level of knowledge about schizophrenia, insight into illness, and internalized stigma and their associated factors among patients with schizophrenia in Jordan.

    DESIGN AND METHODS: A cross-sectional survey was conducted on 135 patients diagnosed with schizophrenia, who had been admitted to the largest psychiatric hospital in Jordan.

    FINDINGS: The participants had a low level of knowledge, insight, and a high level of internalized stigma. No correlation was found between these variables. Meanwhile, the educational level and vacation were found to be predictors of knowledge.

    PRACTICE IMPLICATIONS: This can help psychiatric nurses to identify which area needs to be improved to ensure the best service and care is provided to patients diagnosed with schizophrenia.

  9. Koo HC, Lim GP, Kaur S, Chan KQ, Florence Tan YX, Pang XJ, et al.
    Nutr J, 2020 07 16;19(1):73.
    PMID: 32677967 DOI: 10.1186/s12937-020-00588-y
    BACKGROUND: To date, there is no validated whole grain assessment tool for children in any Southeast Asian countries. Hence, there is a need for a valid tool to assess whole grain intake among Malaysian children. This study aimed to develop, validate and test the reproducibility of a food frequency questionnaire (FFQ) in estimating whole grain intake among Malaysian children.

    METHODS: A total of 392 children participated in the FFQ development and 112 children aged 9-12 years participated in the validation phase; with a subsample of 50 children participating in the reproducibility phase. Three-day diet record (3DR) as the reference method in validation phase. Spearman correlations, mean difference, Bland-Altman plot and cross-classification analyses were used to assess validity. The reproducibility was tested through a repeat administration of the FFQ, with 1 month time interval. Reproducibility analyses involved intra-class correlation coefficient (ICC), Cronbach's alpha and cross-classification analyses.

    RESULTS: The FFQ consisted of 156 whole grain food items from six food groups. Mean intake of whole grain in FFQ1 and 3DR were correlated well (r = 0.732), demonstrated good acceptance of the FFQ. Bland Altman plots showed relatively good agreement for both the dietary methods. Cross-classification of whole grain intake between the two methods showed that

  10. Foo ML, Tang LY, Vimala R, Chui PL, Chong MC
    J Contin Educ Nurs, 2017 Aug 01;48(8):347-352.
    PMID: 28759691 DOI: 10.3928/00220124-20170712-05
    BACKGROUND: Because nurses need to handle a broad range of issues related to patients' health status, it is necessary to make reliable and sound clinical judgments for professional accountability and the patients' safety.

    METHOD: A quasi-experimental pre- and posttest design with a control group was used to study the effectiveness of an educational intervention on the clinical judgment skills of 80 RNs from two district hospitals. The change in clinical judgment skills during a 6-week period was evaluated using a complex case-based scenario after the completion of the educational intervention.

    RESULTS: The mean scores of clinical judgment skills of the experimental group had significantly improved from 24.15 ± 6.92 to 47.38 ± 7.20. (p < .001). However, only a slight change was seen in mean scores for the control group (23.80 ± 5.77 to 26.50 ± 6.53).

    CONCLUSION: The educational intervention was effective postintervention. Continuing nursing education using a traditional and case-based method is recommended to improve clinical judgment skills in clinical settings. J Contin Educ Nurs. 2017;48(8):347-352.

  11. Tang YH, Chong MC, Chua YP, Chui PL, Tang LY, Rahmat N
    J Clin Nurs, 2018 Dec;27(23-24):4311-4320.
    PMID: 29777560 DOI: 10.1111/jocn.14538
    AIMS: To determine the effect mobile messaging apps on coronary artery disease patient knowledge of and adherence to a healthy lifestyle.

    BACKGROUND: Due to the increasing incidence of coronary artery disease in recent years, interventions targeting coronary artery disease risk factors are urgent public priorities. The use of mobile technology in healthcare services and medical education is relatively new with promising future prospects.

    DESIGN: This study used a quasiexperimental design that included pre- and posttest for intervention and control groups.

    METHODS: The study was conducted from January-April 2017 with both intervention and control groups, in a teaching hospital in Klang Valley. Convenience sampling was used with inclusive criteria in choosing the 94 patients with coronary artery disease (intervention group: 47 patients; control group: 47 patients). The pretest was conducted as a baseline measurement for both groups before they were given standard care from a hospital. However, only the intervention group was given a daily information update via WhatsApp for 1 month. After 1 month, both groups were assessed with a posttest.

    RESULTS: The split-plot ANOVA analysis indicates that there is a significant and positive effect of the intervention on coronary artery disease patients' knowledge on coronary artery disease risk factors [F(1, 92) = 168.15, p 

  12. Chong LT, Chong MC, Tang LY, Ramoo V, Chui PL, Hmwe NTT
    J Pediatr Nurs, 2019 06 15;48:e15-e20.
    PMID: 31213340 DOI: 10.1016/j.pedn.2019.05.016
    STUDY PURPOSE: This study was conducted to examine the relationship between religious practice, religious coping methods and psychological distress among parents caring for children with transfusion-dependent thalassemia.

    DESIGN AND METHODS: This is a cross-sectional survey. Data were collected on 162 parents of children diagnosed with thalassemia aged 12 years and younger in thalassemia day care centers of three public hospitals in Sabah, Malaysia. Data were collected using questionnaires, including General Health Questionaire-12 (GHQ-12), Duke University Religion Index (DUREL) and Brief RCOPE.

    RESULTS: Forty-two percent of parents had psychological distress with GHQ score ≥ 3 (mean score of 2.85 ± 3.17). Ninety-five percent of parents used positive religious coping methods (mean P-COPE score 22.35 ± 2.33) more than negative religious coping methods (mean N-COPE score was 12.19 ± 5.23). They used Organized Religious Activities (mean ORA score of 4.20 ± 1.27), and Non-Organized Religious Activities (NORA, the mean was 4.17 ± 1.37). Positive and negative religious coping methods were significantly related to parents' psychological distress (P-COPE and GHQ-12 scores (rs (df) = 0.19, p 

  13. Abdul Halain A, Tang LY, Chong MC, Ibrahim NA, Abdullah KL
    J Clin Nurs, 2022 Mar;31(5-6):497-507.
    PMID: 34254377 DOI: 10.1111/jocn.15962
    AIMS AND OBJECTIVES: To map research-based psychological distress among the family members with patients in the intensive care unit (ICU).

    BACKGROUND: Having a loved one in the ICU is a stressful experience, which may cause psychological distress for family members. Depression, anxiety and stress are the common forms of psychological distress associated with ICU patient's family members. Directly or indirectly, psychological distress may have behavioural or physiological impacts on the family members and ICU patient's recovery.

    DESIGN: The study was based on the five-stage methodological framework by Arksey and O'Malley (International Journal of Social Research Methodology, 2005, 8, 19) and were guided by the PRISMA-ScR Checklist.

    METHODS: A comprehensive and systematic search was performed in five electronic databases, namely the Scopus, Web of Sciences, CINAHL® Complete @EBSCOhost, ScienceDirect and MEDLINE. Reference lists from the screened full-text articles were reviewed.

    RESULTS: From a total of 1252 literature screened, 22 studies published between 2010-2019 were included in the review. From those articles, four key themes were identified: (a) Prevalence of psychological distress; (b) Factors affecting family members; (c) Symptoms of psychological distress; and (d) Impact of psychological distress.

    CONCLUSIONS: Family members with a critically ill patient in ICU show high levels of anxiety, depression and stress. They had moderate to major symptoms of psychological distress that negatively impacted both the patient and family members.

    RELEVANCE TO CLINICAL PRACTICE: The review contributed further insights on psychological distress among ICU patient's family members and proposed psychological interventions that could positively impact the family well-being and improve the patients' recovery.

  14. Al Sawad AA, Lim SK, Tang LY, Rashid AA, Chew BH
    BMC Nephrol, 2022 Dec 01;23(1):384.
    PMID: 36457069 DOI: 10.1186/s12882-022-03016-x
    BACKGROUND: There is growing evidence that self-management behaviour can improve outcomes for patients with chronic kidney disease (CKD). However, no measures are available in Malay to effectively assess the self-management of CKD. The aim of this study was to translate, culturally adapt and validate the Malay Chronic Kidney Disease Self-Management (MCKD-SM) instrument for Malay-speaking health professionals and patients.

    METHODS: This study was carried out in two phases: the translation and cultural adaptation phase and the validation phase. The instrument was translated from English to Malay and then adapted and validated in a sample of 337 patients with CKD stages 3-4 attending a nephrology clinic in a tertiary hospital in Malaysia. Structural validity was evaluated by exploratory factor analysis. The instrument's reliability was assessed by internal consistency and test-retest reliability. The correlations between the MCKD-SM and kidney disease knowledge and the MCKD-SM and self-efficacy were hypothesised a priori and investigated.

    RESULTS: The MCKD-SM instrument has 29 items grouped into three factors: 'Understanding and Managing My CKD', 'Seeking Support' and 'Adherence to Recommended Regimen'. The three factors accounted for 56.3% of the total variance. Each factor showed acceptable internal reliability, with Cronbach's α from 0.885 to 0.960. The two-week intra-rater test-retest reliability intraclass correlation coefficient values for all items ranged between 0.938 and 1.000. The MCKD-SM scores significantly correlated with kidney disease knowledge (r = 0.366, p 

  15. Al Raimi AM, Chong MC, Tang LY, Chua YP, Al Ajeel LY
    Comput Inform Nurs, 2022 Sep 01;40(9):648-657.
    PMID: 35994240 DOI: 10.1097/CIN.0000000000000927
    Bronchial asthma among children is a common chronic disease that may impact quality of life. Health education is one of the strategies to improve knowledge and quality of life. This study aims to assess the effect of health education via a mobile application in promoting the quality of life among schoolchildren with asthma in urban Malaysia during the COVID-19 era. A quasi-experimental, pre- and post-intervention design was used in this study involving a total of 214 students, randomly assigned into two groups (an intervention group and a control group). The control group received face-to-face health education, whereas the experimental group received health education via a mobile application. The findings showed that the total score of quality of life improved from a mean total score at pre-intervention of 5.31 ± 1.27 to post-intervention of 5.66 ± 1.28 for the control group, compared with the experimental group with a mean total score of quality of life at pre-intervention of 5.01 ± 1.36 and post-intervention of 5.85 ± 1.29. A comparison between the experimental and control groups using an independent t test showed statistically significant differences in their mean quality of life scores. The effect of health education via a mobile application showed a statistically significant improvement in the mean quality of life score from pre- to post-intervention ( F1,288 = 57.46, P < .01). As recommended, the use of mobile technology in health education improved the quality of life of schoolchildren with asthma as compared with the traditional methods of a face-to-face lecture and/or a handbook. Thus, educational modules using mobile applications do improve quality of life.
  16. Gunarathne TGNS, Tang LY, Lim SK, Nanayakkara N, Damayanthi HDWT, Abdullah KL
    PMID: 35564935 DOI: 10.3390/ijerph19095540
    People with end stage renal disease and undergoing hemodialysis experience a high symptom burden that impairs quality of life. This study aimed to assess the prevalence, dynamicity and determinants of symptom burden among middle-aged and older adult hemodialysis patients. A descriptive cross-sectional study together with a longitudinal assessment was used. A total of 118 and 102 hemodialysis patients were assessed at baseline and at a 6-month follow-up. Validated questionnaires were used to assess the symptom burden, stress, illness perception and social support. Multiple linear regression analysis was used to determine the factors associated with symptom burden. The median number of symptoms experienced was 21 (Interquartile Range (IQR); 18−23) and 19 (IQR; 13−22) at baseline and 6 months, respectively. Having elevated stress (β = 0.65, p ≤ 0.005) and illness perception (β = 0.21, p = 0.02) were significantly predicted symptom burden at baseline (F (4, 112) = 55.29, p < 0.005, R2 = 0.664). Stress (β = 0.28, p = 0.003), illness perception (β = 0.2, p = 0.03), poor social support (β = −0.22, p = 0.01) and low body weight (β = −0.19, p = 0.03) were the determinants for symptom burden at 6 months (F (5, 93) = 4.85, p ≤ 0.005, R2 = 0.24). Elevated stress, illness perception level, poor social support and low post-dialysis body weight were found to be determinants for symptom burden. Attention should be given to psychosocial factors of hemodialysis patients while conducting assessment and delivering care to patients.
  17. Yu X, Lim KS, Tang LY, Tang V, Lim YH, Fong SL, et al.
    Epilepsy Behav, 2023 Oct;147:109395.
    PMID: 37619469 DOI: 10.1016/j.yebeh.2023.109395
    BACKGROUND: Caregivers of adults with epilepsy (AWE) play an important role in the healthcare pathway of AWE and are described as the "co-client." Being caregivers can be stressful and the negative impacts might accumulate over time, affecting their quality of life and well-being.

    OBJECTIVES: This qualitative study aimed to explore the lived experience of caregivers of AWE in Malaysian families and understand their caregiving challenges. Individual semi-structured interviews were held with 12 primary caregivers of AWE. Interpretative Phenomenological Approach (IPA) was used. The interview transcripts were analyzed using NVivo12 software.

    RESULTS: Primary caregivers of AWE were parents or siblings, with ages ranging from 56 to 80 years old and years of caregiving from 24 to 40 years. Most AWE (58%) were intellectually disabled and fully dependent on ADL needs. Two categories of themes emerged, including four themes on caregiver burden, i.e., physical, emotional, and social burdens, and challenges in future planning of care, and two themes on coping strategies (problem- or emotional-focused). In future planning of care, most caregivers especially parents carried a burden of responsibility and were reluctant to depend on others or institutional services.

    CONCLUSION: The caregiving burden among caregivers for adult AWE was not confined to current burdens only but also challenges in future planning. A better understanding of the caregiving burden for AWE and coping strategies is needed to provide tailored psychoeducation or psychosocial intervention to support this population.

  18. Ayat Ali AS, Lim SK, Tang LY, Rashid AA, Chew BH
    Sci Prog, 2021;104(2):368504211026159.
    PMID: 34143698 DOI: 10.1177/00368504211026159
    The complexity of chronic kidney disease (CKD) and its treatments have made self-management behaviors inevitably challenging. However, supplementing education with self-management skills may improve numerous health outcomes in people with nondialysis CKD. This study protocol describes a randomized controlled trial (RCT) aimed to evaluate the effects of a nurse-led self-management support program as an intervention for kidney disease knowledge and CKD self-management behaviors among people with pre-dialysis CKD. In Phase 1, people with CKD stage 3-4 and their family members are involved in co-designing, development and pilot testing of a theory-based self-management intervention. In Phase 2, we perform a cross-cultural adaptation of the Kidney Disease Knowledge Survey, CKD Self-Management and Self-efficacy for Managing Chronic Disease questionnaires. In Phase 3, a parallel RCT will be conducted to evaluate the intervention where 154 participants with CKD stage 3-4 will be randomly assigned to either the intervention (n = 77) or control group (n = 77). The intervention group will receive 6-week self-management program from a nurse-coach in addition to standard usual care, while the control group will receive only standard usual care. Outcome measures include kidney disease knowledge, CKD self-management behavior, self-efficacy, quality of life, blood pressure control and adherence to CKD diet as indicated by 24-h urine urea nitrogen, 24-h urine sodium and net endogenous acid production. Data will be collected at baseline and 12-week post-baseline. The between- and within-group intervention effects will be estimated using the Generalized Estimating Equations. The self-management intervention offers strategies to delay CKD progression and to encourage motivation to better self-manage at home. This study integrates self-management education and psychosocial support with culturally relevant scenarios, and evaluates important self-reported and objective outcomes.Clinical Trials Registration: www.ClinicalTrials.gov, identifier: NCT03974646.
  19. Lee WL, Lim ZJ, Tang LY, Yahya NA, Varathan KD, Ludin SM
    Comput Inform Nurs, 2021 Nov 02;40(4):244-250.
    PMID: 34740221 DOI: 10.1097/CIN.0000000000000854
    The COVID-19 pandemic has rerouted the healthcare ecosystem by accelerating digital health, and rapid adoption of eHealth is partly influenced by eHealth literacy (eHL). This study aims to examine patients' eHL in relation to their "technology readiness"-an innate attitude that is underexplored in clinical research. A total of 276 adult inpatients with hypertension, diabetes mellitus, and coronary heart disease were surveyed cross-sectionally in 2019 using self-reported questionnaires: eHealth Literacy Scale and Technology Readiness Index (2.0). The study found moderate eHL (mean, 27.38) and moderate technology readiness (mean, 3.03) among patients. The hierarchical regression model shows that lower eHL scores were associated with patients of minor ethnicity (Malaysian Chinese), with an unemployed status, and having >1 cardiovascular risk (β = -0.136 to -0.215, R2 = 0.283, Ps < .005). Technology readiness is a strong determinant of eHL (ΔR2 = 0.295, P < .001) with its subdomains (optimism, innovativeness, and discomfort) significantly influencing eHL (|β| = 0.28-0.40, Ps < .001), except for the insecurity subdomain. Deployment of eHealth interventions that incorporate assessment of patients' eHL and technology readiness will enable targeted strategies, especially in resource-limited settings hit hard by the pandemic crisis.
  20. Rubbai YS, Chong MC, Tang LY, Abdullah KL, Mohammad WT, Mohajer S, et al.
    BMC Palliat Care, 2024 Aug 30;23(1):217.
    PMID: 39210456 DOI: 10.1186/s12904-024-01543-y
    BACKGROUND: Despite increasing interest in quality end-of-life care (EOLC), critically ill patients often receive suboptimal care. Critical care nurses play a crucial role in EOLC, but face numerous barriers that hinder their ability to provide compassionate and effective care.

    METHODS: An integrative literature review was conducted to investigate barriers impacting the quality of end-of-life care. This review process involved searching database like MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, EBSCO, and ScienceDirect up to November 2023. Search strategies focused on keywords related to barriers in end-of-life care and critical care nurses from October 30th to November 10th, 2023. The inclusion criteria specified full-text English articles published between 2010 and 2023 that addressed barriers perceived by critical care nurses. This integrative review employs an integrated thematic analysis approach, which combines elements of deductive and inductive analysis, to explore the identified barriers, with coding and theme development overseen by the primary and secondary authors.

    RESULTS: Out of 103 articles published, 11 articles were included in the review. There were eight cross-sectional descriptive studies and three qualitative studies, which demonstrated barriers affecting end-of-life care quality. Quality appraisal using the Mixed Method Appraisal Tool was completed by two authors confirmed the high credibility of the selected studies, indicating the presence of high-quality evidence across the reviewed articles. Thematic analysis led to the three main themes (1) barriers related to patients and their families, (2) barriers related to nurses and their demographic characteristics, and (3) barriers related to health care environment and institutions.

    CONCLUSION: This review highlights barriers influencing the quality of end of life care perceived by critical care nurses and the gaps that need attention to improve the quality of care provided for patients in their final stages and their fsmilies within the context of critical care. This review also notes the need for additional research to investigate the uncover patterns and insights that have not been fully explored in the existing literature to enhance understanding of these barriers. This can help to inform future research, care provision, and policy-making. Specifically, this review examines how these barriers interact, their cumulative impact on care quality, and potential strategies to overcome.

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