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Introduction and Objectives There are limited studies conducted on the needs of cancer survivorsin developing countries like Malaysia. This qualitative study aimed at exploring the post-treatmentimpact and needs of prostate cancer survivors.Method: A qualitative study design was used. One in-depth interview and four focus groupdiscussions were conducted with 24 prostate cancer survivors (age range: 58–79 years) fromgovernment and private hospitals in Malaysia in 2013. Trained researchers used a topic guide toguide the interviews, which were audio-recorded, transcribed verbatim, checked and managed withNvivo 10 software. A thematic approach was used to analyse the data.Result: Three main themes emerged from the analysis: (a) impact of prostate cancer on thesurvivors, (b) support needed for coping and (c) information needs. Prostate cancer has animportant impact on the survivors’ lifestyle after treatment. Some of them have to live with thepost-treatment side effects. They were anxious about the possibility of relapse. In addition tofamily and peer support, there were participants who felt that spiritual support was important inhelping them cope with the possibility of relapse. The survivors felt that they did not receive enoughinformation about post-treatment care, dietary measures and supplements for relapse prevention,treatment and prognosis.Conclusion: Prostate cancer has a significant impact on the survivor’s lifestyle, emotional andphysical health. They need information and emotional support from the healthcare professionals,family and peers. Therefore, it is important for healthcare providers to explore the needs of prostatecancer survivors and provide the necessary support.
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Introduction: Hill-Bone compliance to high blood pressure therapy scale (HBTS) is one of the useful scales in primary care settings. It has been tested in America, Africa and Turkey with variable validity and reliability. The aim of this paper was to determine the validity and reliability of the Malay version of HBTS (HBTS-M) for the Malaysian population. Materials and methods: HBTS comprises three subscales assessing compliance to medication, appointment and salt intake. The content validity of HBTS to the local population was agreed through consensus of expert panel. The 14 items used in the HBTS were adapted to reflect the local situations. It was translated into Malay and then back-translated into English. The translated version was piloted in 30 participants. This was followed by structural and predictive validity, and internal consistency testing in 262 patients with hypertension, who were on antihypertensive agent(s) for at least 1 year in two primary healthcare clinics in Kuala Lumpur, Malaysia. Exploratory factor analyses and the correlation between HBTS-M total score and blood pressure were performed. The Cronbach’s alpha was calculated accordingly. Results: Factor analysis revealed a three-component structure represented by two components on medication adherence and one on salt intake adherence. The Kaiser–Meyer–Olkin statistic was 0.764. The variance explained by each factors were 23.6%, 10.4% and 9.8%, respectively. However, the internal consistency for each component was suboptimal with Cronbach’s alpha of 0.64, 0.55 and 0.29, respectively. Although there were two components representing medication adherence, the theoretical concepts underlying each concept cannot be differentiated. In addition, there was no correlation between the HBTS-M total score and blood pressure. Conclusion: HBTS-M did not conform to the structural and predictive validity of the original scale. Its reliability on assessing medication and salt intake adherence would most probably to be suboptimal in the Malaysian primary care setting.
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Introduction: Hypertension is highly prevalent in the older people. Chronic disease care is a major burden in the public primary care clinics in Malaysia. Good blood pressure (BP) control is needed to reduce the morbidity and mortality of cardiovascular disease (CVD). This study aimed to determine the status of BP control and its associated factors among older people with hypertension in public primary care clinics. Materials and methods: A cross-sectional study on hypertensive patients aged 18 years and above was conducted in six public primary care clinics in Federal Territory, Malaysia. A total of 1107 patients were selected via systematic random sampling. Data from 441 (39.8%) patients aged 60 years and more were used in this analysis. BP control was determined from the average of two BP readings measured twice at an interval of 5 min. For patients without diabetes, poor BP control was defined as BP of ≥140/90 mm Hg and ≥150/90 for the patients aged 80 years and more. For patients with diabetes, poor control was defined as BP of ≥140/80 mm Hg. Results: A total of 51.7% (𝑛 = 228) of older patients had poor BP control. The factors associated with BP control were education level (p = 0.003), presence of comorbidities (p = 0.015), number of antihypertensive agents (p = 0.001) and number of total medications used (p = 0.002). Patients with lower education (less than secondary education) (OR = 1.7, p = 0.008) and the use of three or more antihypertensive agents (OR = 2.0, p = 0.020) were associated with poor BP control. Conclusion: Among older people with hypertension, those having lower education level, or using three or more antihypertensive agents would require more attention on their BP control.
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INTRODUCTION: Hypertension is a common co-morbidity in diabetes mellitus (DM) that may lead to serious complications if not adequately controlled. METHOD: This is a descriptive study based on data from the Audit of Diabetes Control and Management (ADCM) registry. This audit assessed the treatment and standard of control of hypertension in diabetic patients aged 18 years and above. Data were analysed using STATA version 9. RESULTS: From a total of 20 646 cases, about two third of them, 13 417 (65%) were reported to have hypertension. 19 484 (94.4%) had their blood pressure (BP) recorded and out of these, 11 414 (58.5%) were found to have BP >130/80 mmHg. 13 601 cases (65.9%) of the total sample were on antihypertensive drugs. 64.1% of those on antihypertensive drugs were prescribed angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers. 14.2% were on more than two types of antihypertensive drugs. Older patients and those with longer duration of DM were less likely to achieve the target BP of ≤130/80. In general, about 40% of diabetic cases registered in the ADCM project had their hypertension well controlled.
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This case illustrates an 80-year-old lady who presented with acute low back pain and finally succumbed from complications of osteoporotic vertebral fracture. Among the contributing factors are delayed diagnosis and a lack of continuity of care. It reminds the practitioners of the importance to look out for red flag symptoms and to have a high index of suspicion for vertebral fracture in high risk patients presenting with low back pain.