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@#Introduction: Previous medication adherence studies primarily focused on the domains of non-adherence in hypertension treatment and less attention has been given on domains that encourage adherence to anti-hypertensive medications. The current study is aimed to identify the domains of adherence and non-adherence to anti-hypertensive medications among hypertensive patients in Kuala Lumpur, Malaysia. Methods: Hypertensive patients from two public health clinics in Kuala Lumpur were invited for in-depth interviews until thematic saturation. Audio recordings from these interviews were transcribed verbatim. Transcripts were then analysed deductively with the guidance of the World Health Organization Medication Adherence Framework to extract the domains of adherence and non-adherence to anti-hypertensive medications. Results: Ten patients who were predominantly Malays and aged 34-73 years old participated the study. Patient-related (encompassing knowledge, attitude, belief and culture, lifestyle, personal barriers, self-efficacy, and cue to action), socioeconomic (encompassing social support), condition-related (encompassing nature of illness and presence of multiple co-morbidities), therapy-related (encompassing experience of receiving treatment, barrier in treatment, and side effects of treatment), and healthcare system (encompassing access to healthcare and healthcare center experience) domains were identified as central to the medication-taking behaviour of hypertensive patients. Conclusion: Sixteen codes of adherence and 22 codes of non-adherence to anti-hypertensive medications were identified, which were distributed across five domains (patient-related, socioeconomic, condition-related, therapy related, and healthcare system domains). These findings can help to inform future development of medication adherence questionnaires, individualised interventions for patients with adherence problems, and targeted health promotion programmes to reduce uncontrolled hypertension.
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@#Introduction: Domains of adherence and non-adherence to hypertensive medications have not been extensively documented in Malaysia due to the absence of theoretically driven and culturally appropriate measurement tools, leading to a poor understanding of the adherence and underlying factors. We aim to identify these domains in Malaysian hypertensive patients and subsequently apply the findings to develop and validate the Malaysian Anti-Hypertensive Agents Non-Adherence Scale (MAANS). Methods: This study has an exploratory mixed-methods design. In Phase 1, we will recruit hypertensive patients from two health clinics to participate in a semi-structured interview. Recruitment of participants will terminate once thematic saturation is achieved. Coding and thematic analyses will be performed to identify the domains of adherence and non-adherence to anti-hypertensive medications. In Phase 2, based on the domains generated from Phase 1, we will develop the Malaysian Anti-Hypertensive Agents Non-Adherence Scale (MAANS). Four hundred hypertensive patients will be randomly selected. Data from 200 participants (serving as the calibration sample) will be subjected to exploratory factor analysis while data from additional 200 participants (serving as the validation sample) will be subjected to confirmatory factor analysis. Factor structure, predictive validity, and reliability of the MAANS will be statistically tested. Discussion: With the presence of the MAANS, health care providers can gather crucial information regarding barriers and facilitators to hypertensive treatment adherence and design effective health promotion programmes to reduce complications of uncontrolled hypertension. Trial registration: Ethical approval is granted by the Medical Research Ethics Committee, Ministry of Health, Malaysia (NMRR-18-3251-44694).
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@#Introduction: Obesity is a global issue called as “globesity”. Overweight and obesity may lead to many noncommunicable diseases (NCDs). Primary care is the first centre to monitor and follow-up the progress of NCD patients. Therefore, the objective of this study was to determine the effectiveness of an integrated-Weight Management Programme (i-WMP) to reduce body weight among NCD patients from two Government primary care clinics from Hulu Langat District. Methods: This study was single-blinded randomised controlled trial by design. There were 244 eligible patients were randomised into intervention (n = 122) or wait-list control group (n = 122). The i-WMP was developed based on the behaviour change wheel through the operationalization of behaviour change techniques. The duration of this intervention programme was four weeks. Data collected at week 0, week 4, and week 12. The software IBM SPSS was used to analyse the data. Generalized linear mixed model analysis with intention-to-treat principle was applied. Results: The retention rate was 74.2%. Findings showed that the i-WMP was significantly effective in reducing not only body weight as primary outcome but also secondary outcomes such as waist-to-height ratio, waist circumference, body mass index, and total sitting time. It also improved effectively other secondary outcomes such as participants’ knowledge, attitude, and practice towards dietary and towards physical activity. However, no significant changes were reported for body fat percentage and total physical activity metabolic equivalent of task-minutes/week. Conclusion: Implications surrounding the implementation of i-WMP in the primary care clinics are recommended.
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@#Introduction: Internet gaming disorder (IGD) has recently been incorporated into the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) as a disorder for future research. The primary objectives of the present study are to describe the level of IGD and to examine its correlations with sociodemographic factors and psychological comorbidities among undergraduate students in a Malaysian university. Methods: A total of 411 undergraduate students completed an online questionnaire. They were selected from a random sample of participating university faculties. The online questionnaire contained the Internet Gaming Disorder Scale-Short-Form and the Depression, Anxiety, Stress Scale. Results: The presents study reported that 52.8% of the participants had high IGH. Using hierarchical multiple regression, age (β = -0.09, p < 0.05), gender (β = -0.40, p < 0.001) and stress (β = 0.23, p < 0.05) were statistically significant predictors of IGD. Academic performance, depression and anxiety did not emerge as significant predictors. Conclusion: These findings highlight the risk factors (in particular, stress) of IGD. Further studies on interventions, particular that of preventative strategies, will be needed to combat this emerging public health problem.
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Abstract@#The aim of this systematic review was to evaluate the effectiveness of educational programs on parenting stress and coping mechanism among parents of children with Autism Spectrum Disorder. Our current review retrieved the articles from databases such as CINAHL, Springer, Ovid, PubMed, Google Scholar, and EBSCO host. Only articles published between the years of 2000 and 2018 in these databases were recruited using keywords such as Autism Spectrum Disorder, education program, parenting stress, coping mechanism, and coping strategies. The search generated 17 articles; 8 articles were relevant. This systematic review provides an important opportunity to advance our understanding of the effectiveness of the educational program for reducing parenting stress and improving coping mechanism among parents of children with Autism Spectrum Disorder. Nurses could also have a pivotal role in delivering the educational program for parents of children with ASD.