Marital conflict, trauma exposure, posttraumatic stress disorder, and depressive symptoms among Malaysian firefighters.

Multiple exposures to life-threatening events may lead to various mental health issues and indirectly affect the marriage of those affected. Very few studies have investigated trauma exposure, posttraumatic stress disorder (PTSD), depressive symptoms, and marital conflicts among firefighters, a group that faces such exposure occupationally. The present study explores the relationship between trauma exposure, PTSD, and depression in relation to marital conflicts among firefighters in Sarawak, adopting a cross-sectional research design. Different marital status reported significant PTSD and depressive symptoms. The widowed scored higher PTSD and depressive symptoms than the married and single groups. Firefighters with PTSD and depressive symptoms reported having more problems in aggression family history of distress, sexual dissatisfaction, and problem solving communication than those without. Regression analysis showed that problem solving communication (t (212) = 2.59, p = .01) and global distress scores (t (212) = 2.17, p < .05) in type of marital conflicts served as a significant predictor for depressive symptoms. The present study suggests that proper planning for treatment and intervention is needed to improve psychological well-being among firefighters and other high-risk professions following multiple exposures to traumatic events in carrying their job duty. Proper intervention programs also should be initiated for spouses of firefighters dealing with traumatized partners.

Development and Validation of a Cross-Cultural Heart Failure-Specific Quality of Life Questionnaire.

OBJECTIVES: Heart failure (HF) is a common clinical syndrome with an enormous impact on prognosis and lifestyle. Accordingly, rehabilitation measures need to be patient-specific and consider various sociocultural factors so as to improve the patient's quality of life (QOL). This study aimed to develop and validate a HF-specific QOL (HFQOL) questionnaire within a multicultural setting. METHODS: This study took place at the National Heart Institute and Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia, between March 2013 and March 2014. A self-administered 75-item HFQOL questionnaire was designed and administrated to 164 multi-ethnic Malaysian HF patients. Exploratory factor analysis was performed to assess the instrument's construct validity. Cronbach's alpha coefficients were used to determine internal consistency. RESULTS: A total of 33 out of 75 items were retained in the final tool. The HFQOL questionnaire had three common factors-psychological, physical-social and spiritual wellbeing-resulting in a cumulative percentage of total variance of 44.3%. The factor loading ranges were 0.450-0.718 for psychological wellbeing (12 items), 0.394-0.740 for physical-social wellbeing (14 items) and 0.449-0.727 for spiritual wellbeing (seven items). The overall Cronbach's alpha coefficient of the questionnaire was 0.82, with coefficients of 0.86, 0.88 and 0.79 for the psychological, physical-social and spiritual wellbeing subdomains, respectively. CONCLUSION: The HFQOL questionnaire was found to be a valid and reliable measure of QOL among Malaysian HF patients from various ethnic groups. Such tools may facilitate cardiac care management planning among multi-ethnic patients with HF.