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Sleep Deprivation and Its Associated Factors Among Undergraduate Students in Malaysia

Naito R, Yun Low W, Wan Yuen C

Asia Pac J Public Health, 2021 07;33(5):530-538.
PMID: 34137287 DOI: 10.1177/10105395211019930

This cross-sectional study examines the prevalence of sleep deprivation and its associated factors among 1017 undergraduate students in Malaysia. Sociodemographic and lifestyle factors such as smoking, alcohol, dietary habits, Internet/smartphone use, physical activity, and sedentary behavior were assessed. Sleep deprivation was defined as sleeping less than 7 hours in a day. There were almost equal proportions of females (51.0%) and males (49.0%), and the average age was 20.71 ± 1.47 years. Prevalence of sleep deprivation was 58.1% and its associated factors were students in Year 3 and Year 4, Chinese ethnicity, Indian ethnicity, and consuming fast food more than once a week. Understanding the associated lifestyle factors with sleep deprivation among young generation will be beneficial to develop public health policies and programs to tackle the issue.
Alone and Lonely: A Case Report on Elder Abuse in Malaysia

Sooryanarayana R, Wan Yuen C, Hairi NN

J Am Med Dir Assoc, 2017 05 01;18(5):447.
PMID: 28283379 DOI: 10.1016/j.jamda.2017.01.018
Fulltext The association between elder abuse and childhood adversity: A study of older adults in Malaysia

Asyraf M, Dunne MP, Hairi NN, Mohd Hairi F, Radzali N, Wan Yuen C

PLoS One, 2021;16(7):e0254717.
PMID: 34292992 DOI: 10.1371/journal.pone.0254717

OBJECTIVES: Childhood adversity has been linked with later victimization of young and middle-aged adults, but few studies have shown persistence of this effect among elders, especially outside of North America. This research examined the association between adverse childhood experiences (ACEs) and elder abuse among older adults aged 60 years and over in Malaysia.
DESIGN: Cross sectional data were collected via face-to-face interview from June to August 2019.
SETTING: Eight government community health clinics in Kuala Pilah, a district in Negeri Sembilan state approximately 100km from Malaysian capital city Kuala Lumpur.
PARTICIPANTS: Older adults aged 60 years and above (N = 1984; Mean age 69.2, range 60-93 years) attending all eight government health clinics in the district were recruited for a face-to-face interview about health and well-being.
MEASUREMENT: The Adverse Childhood Experience International Questionnaire (ACE-IQ) and the Revised Conflict Tactics Scale (CTS) were utilized to estimate childhood adversity and elder abuse respectively.
RESULTS: Multiple logistic regression analysis revealed a significant relationship between the number of cumulative ACEs and elder abuse. Compared to older adults with no self-reported adversity, those reporting three ACEs (OR 2.67, 95% CI 1.84,3.87) or four or more ACEs (OR 1.7, 95% CI 1.16, 2.48) had higher risk of any elder abuse occurrence since age 60 years. The effect was most prominent for financial and psychological elder abuse. The associations persisted in multivariate logistic regression models after adjusting for sociodemographic and health factors.
CONCLUSION: Early life adversities were significantly associated with victimization of older adults. Social and emotional support to address elder abuse should recognize that, for some men and women, there is a possibility that vulnerability to maltreatment persisted throughout their life course.
Evaluating the Effectiveness of I-NEED Program: Improving Nurses' Detection and Management of Elder Abuse and Neglect-A 6-Month Prospective Study

Mohd Mydin FH, Wan Yuen C, Othman S, Mohd Hairi NN, Mohd Hairi F, Ali Z, et al.

J Interpers Violence, 2022 01;37(1-2):NP719-NP741.
PMID: 32394780 DOI: 10.1177/0886260520918580

Elder abuse and neglect (EAN) goes largely unrecognized and underreported globally by health care professionals. Despite acknowledging their role to intervene elder abuse, health care professionals lacked knowledge and skills in this issue. This is a single-blinded, three-armed, cluster randomized controlled trials aimed to evaluate the effectiveness of the face-to-face Improving Nurses' dEtection and managEment of elDer abuse and neglect (I-NEED) intensive training program and I-NEED educational video in improving primary care nurses' knowledge, attitude, and confidence to intervene EAN; 390 primary care nurses were randomized equally into two intervention groups-ITP group (intensive training program) and ITP+ group (intensive training program and educational video)-and a control group. The knowledge, attitudes, and confidence to intervene EAN were measured using questionnaires at four intervals during 6-month follow-up. A total of 269 primary care nurses participated in this study. There was a significant increase in knowledge, attitude, and confidence to intervene EAN immediately post intervention observed in both intervention groups compared to the control group (p < .001). At the end of sixth month, there was an increase of knowledge favoring ITP group than the ITP+ group (p < .001). There is, however, no significant difference in attitude score between ITP and ITP+ group. There is a significant difference of confidence to intervene among the participants between both intervention groups with ITP+ participants reporting higher scores post intervention (p < .05). An intensive training module improved the knowledge, attitude, and confidence to intervene EAN. Other co-existing barriers for abuse victims getting help, resources, policy, and law of EAN need further highlights.
Social support among older adults in Malaysia

Mahmud MA, Hazrin M, Muhammad EN, Mohd Hisyam MF, Awaludin SM, Abdul Razak MA, et al.

Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:63-67.
PMID: 33370852 DOI: 10.1111/ggi.14033

AIM: This study aimed to determine the factors that influence perceived social support among older adults in Malaysia.
METHODS: We used the 11-item Duke Social Support Index to assess perceived social support through a face-to-face interview. Higher scores indicate better social support. Linear regression analysis was carried out to determine the factors that influence perceived social support by adapting the conceptual model of social support determinants and its impact on health.
RESULTS: A total of 3959 respondents aged ≥60 years completed the Duke Social Support Index. The estimated mean Duke Social Support Index score was 27.65 (95% CI 27.36-27.95). Adjusted for confounders, the factors found to be significantly associated with social support among older adults were monthly income below RM1000 (-0.8502, 95% CI -1.3523, -0.3481), being single (-0.5360, 95% CI -0.8430, -0.2290), no depression/normal (2.2801, 95% CI 1.6666-2.8937), absence of activities of daily living (0.9854, 95% CI 0.5599-1.4109) and dependency in instrumental activities of daily living (-0.3655, 95% CI -0.9811, -0.3259).
CONCLUSION: This study found that low income, being single, no depression, absence of activities of daily living and dependency in instrumental activities of daily living were important factors related to perceived social support among Malaysian older adults. Geriatr Gerontol Int 2020; 20: 63-67.
Does abuse in late life worsen sleep quality? A two-year prospective cohort study among rural older adults

Yunus RM, Hairi NN, Yuen C, Sooryanarayana R, Hairi F, Ismail N, et al.

Int J Geriatr Psychiatry, 2019 01;34(1):60-66.
PMID: 30230023 DOI: 10.1002/gps.4986

BACKGROUND: Elder abuse and neglect (EAN) is a growing public health problem, and numerous adverse health effects of abuse in late life have been documented. Little is known, however, about the impact of elder abuse on sleep quality. This study examines the longitudinal relationship between EAN and sleep quality.

METHODS: This was a 2-year prospective cohort study involving 1927 older adults in a rural Malaysian district, Kuala Pilah. A multi-stage cluster sampling strategy was employed. After 2 years, 1189 respondents were re-assessed. EAN was determined using the modified Conflict Tactic Scale, while sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI).

RESULTS: The prevalence of elder abuse was 8.1% (95% CI:6.9,9.3). Longitudinal analysis using generalized estimating equations showed that elder abuse contributed to higher PSQI scores (B:0.49, 95% CI:0.17,0.58). Sub-analyses demonstrated that psychological abuse and neglect had significant longitudinal relationships with increase of PSQI scores, while other subtypes did not.

CONCLUSION: Abuse in late life, particularly psychological abuse and neglect, result in greater PSQI scores. Even though this may imply decline in sleep quality, our findings were not considered clinically significant as they did not exceed the clinical cut-off score of five. Nevertheless, sleep quality is an important determinant of health and a predictor of mortality among older adults; thus, understanding its relationship with abuse is useful to health care providers and policy-makers in improving health services and upgrading preventive measures.