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Fulltext Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes

Minas H, Zamzam R, Midin M, Cohen A

BMC Public Health, 2011;11:317.
PMID: 21569613 DOI: 10.1186/1471-2458-11-317

The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes.
An assessment of the prescribing skills of undergraduate dental students in malaysia

Akram A, Zamzam R, Mohamad NB, Abdullah D, Meerah SM

J Dent Educ, 2012 Nov;76(11):1527-31.
PMID: 23144489

Most dental schools lack a module on prescription writing in pharmacology. This study assessed the prescription writing skills of a group of Malaysian dental students at the end of their undergraduate training program. A quantitative study of a two-group posttest experiment was designed, and thirty-seven fifth-year (final-year) dental students were divided into two groups (A [n=18] and B [n=19]). Group A received a didactic lecture on how to write a complete prescription, while Group B served as a control group. For prescription writing, three standardized dental scenarios with a diagnosis of irreversible pulpitis associated with a child and a pregnant woman and periapical pulpitis for an adult man were administered. Thus, a total of 111 prescriptions (Group A [n=54] and Group B [n=57]) were collected. Twelve elements in each prescription were assessed by frequency and a chi-square test. Improvements in eight out of the twelve elements were observed in prescriptions written by students in Group A. The significantly improved elements were provision of the symbol R(x) (39.8 percent) (p<0.001), inclusion of the prescriber's signature (75.3 percent) (p<0.001), inclusion of the date with the prescriber's signature (54.6 percent) (p<0.001), and inclusion of the prescriber's registration (30.5 percent) (p<0.001). Overall, Group A gained almost a 50 percent improvement in writing complete prescriptions due to the intervening lecture. It appeared a traditional lecture led to the more accurate writing of a complete prescription. It was suggested that a module on prescription writing be added to the school's pharmacology curriculum, so that dental graduates will be competent in prescription writing for the sake of their patients' health.
Fulltext Psychiatric morbidity among adult patients in a semi-urban primary care setting in Malaysia

ZamZam R, Thambu M, Midin M, Omar K, Kaur P

Int J Ment Health Syst, 2009 Jun 18;3(1):13.
PMID: 19538711 DOI: 10.1186/1752-4458-3-13

BACKGROUND: Screening for psychiatric disorders in primary care can improve the detection rate and helps in preventing grave consequences of unrecognised and untreated psychiatric morbidity. This is relevant to the Malaysian setting where mental health care is now also being provided at primary care level. The aim of this paper is to report the prevalence of psychiatric illness in a semi-urban primary care setting in Malaysia using the screening tool Patient Health Questionnaire (PHQ).
METHODS: This is a cross-sectional study carried out in a semi-urban primary healthcare centre located south of Kuala Lumpur. Systematic random sampling was carried out and a total of 267 subjects completed the PHQ during the study period.
RESULTS: The proportion of respondents who had at least one PHQ positive diagnosis was 24.7% and some respondents had more than one diagnosis. Diagnoses included depressive illness (n = 38, 14.4%), somatoform disorder (n = 32, 12.2%), panic and anxiety disorders (n = 17, 6.5%), binge eating disorder (n = 9, 3.4%) and alcohol abuse (n = 6, 2.3%). Younger age (18 to 29 years) and having a history of stressors in the previous four weeks were found to be significantly associated (p = 0.036 and p = 0.044 respectively) with PHQ positive scores.
CONCLUSION: These findings are broadly similar to the findings of studies done in other countries and are a useful guide to the probable prevalence of psychiatric morbidity in primary care in other similar settings in Malaysia.
Fulltext Schizophrenia in Malaysian families: A study on factors associated with quality of life of primary family caregivers

ZamZam R, Midin M, Hooi LS, Yi EJ, Ahmad SN, Azman SF, et al.

Int J Ment Health Syst, 2011 Jun 08;5(1):16.
PMID: 21651770 DOI: 10.1186/1752-4458-5-16

BACKGROUND: Schizophrenia is a chronic illness which brings detrimental effects in the caregivers' health. This study was aimed at highlighting the socio-demographic, clinical and psychosocial factors associated with the subjective Quality of Life (QOL) of Malaysian of primary family caregivers of subjects with schizophrenia attending an urban tertiary care outpatient clinic in Malaysia.
METHODS: A cross-sectional study was performed to study patient, caregiver and illness factors associated with the QOL among 117 individuals involved with caregiving for schizophrenia patients. The study used WHOQOL-BREF to assess caregivers' QOL and Brief Psychiatric Rating Scale (BPRS) to assess the severity of patients' symptoms. Social Readjustment Rating Scale (SRRS) assessed the stress level due to life events.
RESULTS: The mean scores of WHOQOL-BREF in physical, psychological, social and environmental domains were 66.62 (14.36), 61.32 (15.52), 62.77 (17.33), 64.02 (14.86) consecutively. From multiple regression analysis, factors found to be significantly associated with higher QOL were higher educational level among caregivers in social and environmental domains; caregivers not having medical problem/s in physical and psychological domains; later onset and longer illness duration of illness in social domains; patients not attending day care program in environmental domain; lower BPRS score in physical and environmental domains. SRRS score of caregivers was also found to have a significant negative correlation with QOL in environmental and psychological domains. Other factors were not significantly associated with QOL.
CONCLUSION: Caregivers with more social advantages such as higher educational level and physically healthier and dealing with less severe illness had significantly higher QOL in various aspects. Supporting the caregivers in some of these modifiable factors in clinical practice is important to achieve their higher level QOL.
Fulltext Clinical and cognitive correlates of employment among patients with schizophrenia: a cross-sectional study in Malaysia

Midin M, Razali R, Zamzam R, Fernandez A, Hum LC, Shah SA, et al.

Int J Ment Health Syst, 2011 May 30;5:14.
PMID: 21624111 DOI: 10.1186/1752-4458-5-14

BACKGROUND: Gainful employment is one major area of functioning which is becoming an important goal in psychiatric rehabilitation of patients with schizophrenia. Studies in western countries are pointing to evidence that certain sociodemographic and clinical factors may contribute to employment outcomes in this group of people. However, the area is still largely unexplored in Malaysia. The aim of this study was to examine the sociodemographic, clinical and cognitive correlates of employment status among patients with Schizophrenia.
METHODS: This was a cross-sectional study. All participants who fulfilled the requirements of the study according to the inclusion and exclusion criteria were enrolled. Study instruments included a demographic data questionnaire, Positive and Negative Symptom Scale (PANSS), Trail Making Tests, Rey's Auditory Verbal Learning Test (RAVLT) and Digit Span. Bivariate analyses were done using chi-square for categorical data and t-test for continuous data and multiple logistic regression analysis was done to identify predictors of employment status.
RESULTS: A total of 95 participants who fulfilled the inclusion criteria were enrolled into the study. Among the sociodemographic, clinical and cognitive variables studied marital status, educational level, mean scores of negative symptoms, Digit Span and RAVLT and Trail Making Tests were found to show significant association with employment status on bivariate analyses. However, when entered into a logistic regression model, only cognitive variables ie. Trail A and B, Digit Span and RAVLT were significant predictors of employment status.
CONCLUSIONS: The results from this study support the role of cognitive function, particularly, attention, working memory and executive functioning on attaining and maintaining employment in persons with schizophrenia as measured by the RAVLT, Digit Span and Trail Making Tests. These findings may act as preliminary evidence suggesting the importance of integrating cognitive rehabilitation in the psychosocial rehabilitation program for patients with schizophrenia in Malaysia.