Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 22
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Artigo em Inglês | MEDLINE | ID: mdl-31817328

RESUMO

Anxiety is one of the most common mental health disorders in childhood, and children with anxiety have an increased risk of psychiatric disorders during adulthood. This study aimed to evaluate the effectiveness of a school-based anxiety prevention program for reducing anxiety among primary school students relative to a school-as-usual control group. Secondary to this, the current study aimed to examine the effect of a school-based prevention program on worry coping skills and self-esteem. A two-group parallel cluster randomized controlled trial of a single-blinded study was conducted to evaluate the effectiveness of the program, with schools as the unit of allocation and individual participants as the unit of analysis. The intervention program was conducted between May 2016 and December 2017. The primary outcome was anxiety, whereas the secondary outcomes were worry coping skills and self-esteem measured at three months post-intervention. Data were analyzed by using a generalized linear mixed model, accounting for the clustering effect. Subgroup analyses were performed for children with anxiety. A total of 461 students participated in this study. At baseline, there was no significant difference between groups for anxiety score, worry coping skills score, and self-esteem score (p > 0.05). The intervention was effective in reducing anxiety for the whole sample (p = 0.001) and the anxiety subgroup (p = 0.001). However, it was not effective in improving worry coping skills and self-esteem. These findings suggest that the program could be effective for reducing symptoms of anxiety when delivered in schools and provide some support for delivering this type of program in primary school settings.

2.
AIDS Rev ; 21(3): 23-27, 2019 08 06.
Artigo em Espanhol | MEDLINE | ID: mdl-31386650

RESUMO

Non-adherence remains a significant barrier to achieving successful HIV treatment outcomes. This review aimed to holistically examine the concept of adherence in the light of current research evidence and to provide a basic and adaptable conceptual framework for investigating and influencing adherence behavior among various HIV populations. We reviewed published journal articles and gray literature within the period from 2000 to 2017. A comprehensive search from major online databases and repositories such as PubMed, Scopus, Medline, Google Scholar, and Cochrane Database of Systematic Reviews was conducted using focused search terms that included "social cognition models" or "theories and models of health behavior change" or "behavior change in health psychology" or "theory-based interventions" or "behavioral frameworks" and "adherence behavior" or "medication adherence," and "HIV patients" or "HIV/AIDS." Only papers published in English were included in this study. We found varied and extensive literature evidence supporting the use of psychobehavioral models to promote conceptual understanding of adherence behavior among HIV-positive patients globally. We observed that certain approaches at investigating nonadherence worked better among certain populations and epidemics than others, largely because of contextual differences in barriers and burden of non-adherence among these populations. We synthesized the evidence and applied social cognition models in explaining and providing a basic, evidence-based and adaptable conceptual framework for investigating and influencing adherence behavior among HIV-positive populations around the world, regardless of geographical and HIV epidemiological context.

3.
AIDS Rev ; 21(1): 28-39, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30899114

RESUMO

Successful HIV treatment is contingent on sustained high levels of treatment adherence. Several barriers to optimal adherence have been documented. In this article, we first review the global burden of non-adherence among HIV/AIDS positive individuals on a public health scale. Second, we synthesized available evidence from different study designs and stratified across the European, African, and Asian literature to determine the factors influencing adherence to scheduled clinic appointments and medication non-adherence. Third, we discuss common measurement techniques that quantify the magnitude of non-adherence, their relative advantages and limitations in current practice. From January to May 2018, we reviewed guidelines, standard operating procedures, journal articles, and book chapters on treatment adherence among HIV patients receiving adherence to antiretroviral therapy (ART) globally. We searched PubMed, Medline, Google Scholar, and Cochrane Database of Systematic Reviews with the search terms "adherence," "adherence behavior," "medication adherence," and "HIV patients," or "HIV/AIDS," and "Antiretroviral Therapy" or "ART" or "ARVs" or "highly active ART " from 2000 to 2017. We also identified articles through searches of authors' files and previous research on HIV. We included only papers published in English in this review. We then generated a final list of reference on the basis of originality and the broad scope of this review. We found rich literature evidence of research findings and best practice recommendations on the importance of adherence in HIV/AIDS management, a general understanding of factors associated with non-adherence and approaches to investigating non-adherence behavior among different populations. We observed significant contextual differences exist with regard to barriers and burden of non-adherence among these populations.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Pessoal de Saúde , Adesão à Medicação , Participação dos Interessados , Fármacos Anti-HIV/administração & dosagem , Humanos
4.
Health Qual Life Outcomes ; 16(1): 163, 2018 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-30103759

RESUMO

BACKGROUND: Cancer is a serious public health problem not only in Malaysia, also worldwide. The aim of this study was to determine the determinants of quality of life (QOL) among cancer patients in Peninsular Malaysia. METHODS: A cross sectional study was conducted among 2120 cancer patients in Peninsular Malaysia, between April 2016 to January 2017. All cancer patients aged 18 years old and above, Malaysian citizens and undergoing cancer treatment at government hospitals were approached to participate in this study and requested to complete a set of validated questionnaires. Inferential statistical tests such as t-test and one-way ANOVA were used to determine the differences between demographic variables, physical effects, clinical factors, psychological effects and self-esteem with the quality of life of cancer patients. Predictor(s) of quality of life were determined by using Multivariate linear regression models. RESULT: A total 1620 out of 2120 cancer patients participated in this study, giving a response rate of 92%. The majority of cancer patients were female 922 (56.9%), Malays 1031 (63.6%), Muslim 1031 (63.6%), received chemotherapy treatment 1483 (91.5%). Overall, 1138 (70.2%) of the patients had depression and 1500 (92.6%) had anxiety. Statistically significant associations were found between QOL and clinical factors, physical side effects of cancer, psychological effects and self-esteem (p < 0.05). However, among socio-demographics only age, race, religion, working status were significantly associated with QOL. Based on the multivariate regression analysis, the main predictors of QOL among cancer patients in Malaysia were age, self-esteem as positive predictors, and Indian race, nausea, fatigue, hair loss, bleeding as negative predictors. CONCLUSION: The findings of this study provide a scientific basis to develop a comprehensive program for improving quality of life of cancer patients in Malaysia.


Assuntos
Neoplasias/psicologia , Neoplasias/terapia , Qualidade de Vida/psicologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Malásia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Fatores Socioeconômicos , Inquéritos e Questionários
5.
PLoS One ; 13(2): e0192276, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29470530

RESUMO

INTRODUCTION: The risk of development of active TB in HIV-infected individuals is 20-37 times higher than those that are HIV negative. Poor knowledge of TB amongst people living with HIV has been associated with high transmission. OBJECTIVES: To determine the effectiveness of a new health education intervention module in improving knowledge, attitude, and practice (KAP) regarding tuberculosis among HIV patients in General Hospital Minna, Nigeria. METHODS: A randomized control trial was carried out from July 2015 to June 2017. A random number generating program was used to allocate 226 respondents into 2 groups. The intervention group received health education regarding tuberculosis using the developed module. The control group received the normal services provided for HIV patients. Data were collected from December 2015 to September 2016 at baseline, immediate post intervention, three, six and nine months. The outcome measures were knowledge, attitude, and practice. RESULTS: There was no significant difference with respect to socio-demographic characteristics, KAP of the respondents in the intervention and control group at baseline. However, there was significant improvement in knowledge in the intervention group compared to the control group, group main effect (F = (1,218) = 665.889, p = 0.001, partial á¼ 2 = 0.753, d = 5.4); time (F = (3.605, 218) = 52.046, p = 0.001, partial á¼ 2 = 0.193, d = 1.52) and interaction between group with time (F = (3.605, 218) = 34.028, p = 0.001, partial á¼ 2 = 0.135, d = 1.23). Likewise, there was significant improvement in attitude, group main effect (p = 0.001, d = 1.26) and time (p = 0.001, p, d = 0.65). Similarly, there was improvement in practice, group main effect, time, and interaction of group with time (p < 0.05). CONCLUSION: The health education intervention program was effective in improving KAP regarding tuberculosis among HIV patients.


Assuntos
Infecções por HIV/psicologia , Educação em Saúde/normas , Conhecimentos, Atitudes e Prática em Saúde , Tuberculose/complicações , Adulto , Feminino , Infecções por HIV/complicações , Educação em Saúde/organização & administração , Hospitais Gerais , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Avaliação de Programas e Projetos de Saúde
6.
Patient Educ Couns ; 101(5): 862-871, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29336859

RESUMO

OBJECTIVES: The aim of this study was to implement and evaluate the outcomes of chemotherapy counselling based on the "Managing Patients on Chemotherapy" module on self-esteem and psychological affect (anxiety, depression) of cancer patients by pharmacists in ten selected government hospitals in Peninsular Malaysia. METHODS: A randomized control trial was conducted among 2120 cancer patients from April 2016 to January 2017 in ten selected government hospitals in Peninsular Malaysia. Cancer patients were randomly assigned to intervention and control groups. The intervention group received chemotherapy counselling by pharmacists based on the "Managing Patients on Chemotherapy" module. The outcomes were assessed at baseline, 1st, 2nd and 3rd follow-ups after counselling. In the course of data analysis; independent sample t-test, chi-square and two-way repeated measures ANOVA were conducted. RESULTS: Mean scores of self-esteem in the intervention group had significant difference in comparison with those of the control group in the 1st, 2nd and 3rd follow-ups after counselling (P < 0.0001). Also, among those with depression and anxiety at baseline, there was reduction in depression and anxiety scores after the 1st, 2nd and 3rd follow-ups after counselling (p < 0.05). CONCLUSION: Repetitive counselling by pharmacists based on the "Managing Patients on Chemotherapy" module had positive effect on improving self-esteem and psychological affect of cancer patients undergoing chemotherapy in Peninsular Malaysia. PRACTICE IMPLICATIONS: This module can be used for all Malaysian cancer patients undergoing chemotherapy to improving self-esteem and psychological affect.


Assuntos
Antineoplásicos/uso terapêutico , Ansiedade/psicologia , Aconselhamento/métodos , Depressão/psicologia , Neoplasias/tratamento farmacológico , Farmacêuticos , Autoimagem , Adulto , Antineoplásicos/efeitos adversos , Feminino , Humanos , Malásia , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia , Qualidade de Vida
7.
J Hand Surg Asian Pac Vol ; 22(4): 484-489, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29117832

RESUMO

BACKGROUND: Palmaris Longus is being widely used in reconstructive, plastic and cosmetic surgeries due to its long tendon. It is the most readily available source for tendon grafting. The objective of this study was to determine the prevalence of absence of Palmaris Longus and its association with gender, hand dominance and absence of FDS (flexor digitorum superficialis) tendon to little finger among Malay population. METHODS: An analytical cross sectional study design was used and a self-administered proforma was distributed for data collection. 1239 Malay secondary school children in Putrajaya were tested for absence of Palmaris Longus using Schaffer's test. 4 additional tests namely Thompson's test, Mishra's test I, Mishra's test II and Pushpakumar's 'two-finger sign' method were used to confirm its absence in respondents with negative Schaffer's test. Function of Flexor Digitorum Superficialis tendon to little finger was determined by flexing PIP of little finger while hyperextend the other fingers. RESULTS: The prevalence of absence of Palmaris Longus was 11.7%. Left side absence of Palmaris Longus was much common. There was a significant association between absence of Palmaris Longus with gender in which female had higher prevalence of absence of Palmaris Longus than male. CONCLUSIONS: In conclusion, the prevalence of absence of Palmaris Longus in Malay population was lower than Indian but higher than Chinese population. Females had higher prevalence of absence of Palmaris Longus and no association can be found with hand dominance and absence of Flexor Digitorum Superficialis tendon to little finger.


Assuntos
Dedos/anormalidades , Músculo Esquelético/anormalidades , Anormalidades Musculoesqueléticas/epidemiologia , Tendões/anormalidades , Adolescente , Estudos Transversais , Feminino , Lateralidade Funcional , Humanos , Malásia/epidemiologia , Masculino , Músculo Esquelético/cirurgia , Anormalidades Musculoesqueléticas/diagnóstico , Anormalidades Musculoesqueléticas/cirurgia , Exame Físico , Prevalência , Amplitude de Movimento Articular , Procedimentos Cirúrgicos Reconstrutivos/métodos , Punho/fisiopatologia
8.
Patient Prefer Adherence ; 11: 1273-1284, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28794617

RESUMO

BACKGROUND: Inconsistent literature evidence suggests that sociodemographic, economic, and system- and patient-related factors are associated with clinic attendance among the HIV-positive population receiving antiretroviral therapy (ART) around the world. We examined the factors that predict outpatient clinic attendance among a cohort of HIV-positive patients initiating ART in Selangor, Malaysia. PATIENTS AND METHODS: This cross-sectional study analyzed secondary data on outpatient clinic attendance and sociodemographic, economic, psychosocial, and patient-related factors among 242 adult Malaysian patients initiating ART in Selangor, Malaysia. Study cohort was enrolled in a parent randomized controlled trial (RCT) in Hospital Sungai Buloh Malaysia between January and December 2014, during which peer counseling, medication, and clinic appointment reminders were provided to the intervention group through short message service (SMS) and telephone calls for 24 consecutive weeks. Data on outpatient clinic attendance were extracted from the hospital electronic medical records system, while other patient-level data were extracted from pre-validated Adult AIDS Clinical Trial Group (AACTG) adherence questionnaires in which primary data were collected. Outpatient clinic attendance was categorized into binary outcome - regular attendee and defaulter categories - based on the number of missed scheduled outpatient clinic appointments within a 6-month period. Multivariate regression models were fitted to examine predictors of outpatient clinic attendance using SPSS version 22 and R software. RESULTS: A total of 224 (93%) patients who completed 6-month assessment were included in the model. Out of those, 42 (18.7%) defaulted scheduled clinic attendance at least once. Missed appointments were significantly more prevalent among females (n=10, 37.0%), rural residents (n=10, 38.5%), and bisexual respondents (n=8, 47.1%). Multivariate binary logistic regression analysis showed that Indian ethnicity (adjusted odds ratio [AOR] =0.235; 95% CI [0.063-0.869]; P=0.030) and heterosexual orientation (AOR =4.199; 95% CI [1.040-16.957]; P=0.044) were significant predictors of outpatient clinic attendance among HIV-positive patients receiving ART in Malaysia. CONCLUSION: Ethnicity and sexual orientation of Malaysian patients may play a significant role in their level of adherence to scheduled clinic appointments. These factors should be considered during collaborative adherence strategy planning at ART initiation.

9.
Health Qual Life Outcomes ; 15(1): 104, 2017 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-28506305

RESUMO

BACKGROUND: Cancer is now becoming a leading cause of death. Chemotherapy is an important treatment for cancer patients. These patients also need consultation during their treatment to improve quality of life and decrease psychological disorders. The objectives of the study were to develop, implement and evaluate the effectiveness of a chemotherapy counseling module by pharmacists among oncology patients on their quality of life and psychological outcomes in Malaysia. METHOD: A single-blind randomized controlled trial was carried out among 162 oncology patients undergoing chemotherapy from July 2013 to February 2014 in a government hospital with oncology facilities in Malaysia. Participants were randomized to either the intervention group or the control group. Chemotherapy counseling using the module on 'Managing Patients on Chemotherapy' by Pharmacists was delivered to the intervention group. The outcome measures were assessed at baseline, first follow-up and second follow-up and third follow-up post-intervention. Chi-square, independent samples t-test and two-way repeated measures ANOVA were conducted in the course of the data analyses. RESULTS: In assessing the impact of the chemotherapy counseling module, the study revealed that the module along with repetitive counseling showed significant improvement of quality of life in the intervention group as compared to the control group with a large effect size in physical health (p = 0.001, partial È 2 = 0.66), psychological (p = 0.001, partial È 2 = 0.65), social relationships (p = 0.001, partial È 2 = 0.30), and environment (p = 0.001, partial È 2 = 0.67) and decrease in the anxiety (p = 0.000; partial È 2 = 0.23), depression (p = 0.000; partial È 2 = 0.40). CONCLUSION: The module on 'Managing Patients on Chemotherapy' along with repetitive counseling by pharmacists has been shown to be effective in improving quality of life and decreasing anxiety and depression among oncology patients undergoing chemotherapy. TRIAL REGISTRATION NUMBER: National Medical Research Register (NMRR) of Malaysia and given a registration number NMRR-12-1057-12,363 on 21 December 2012.


Assuntos
Aconselhamento/métodos , Neoplasias/psicologia , Farmacêuticos , Qualidade de Vida , Idoso , Análise de Variância , Ansiedade/psicologia , Ansiedade/terapia , Depressão/psicologia , Depressão/terapia , Feminino , Humanos , Malásia , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Método Simples-Cego , Inquéritos e Questionários
10.
PLoS One ; 12(5): e0177698, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28520768

RESUMO

BACKGROUND: Adherence to treatment remains the cornerstone of long term viral suppression and successful treatment outcomes among patients receiving Antiretroviral Therapy (ART). OBJECTIVE(S): Evaluate the effectiveness of mobile phone reminders and peer counseling in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia. METHODS: A single-blind, parallel group RCT conducted in Hospital Sungai Buloh, Malaysia in which 242 adult Malaysian patients were randomized to intervention or control groups. Intervention consisted of a reminder module delivered through SMS and telephone call reminders by trained research assistants for 24 consecutive weeks (starting from date of ART initiation), in addition to adherence counseling at every clinic visit. The length of intended follow up for each patient was 6 months. Data on adherence behavior of patients was collected using specialized, pre-validated Adult AIDS Clinical Trial Group (AACTG) adherence questionnaires. Data on weight, clinical symptoms, CD4 count and viral load tests were also collected. Data was analyzed using SPSS version 22 and R software. Repeated measures ANOVA, Friedman's ANOVA and Multivariate regression models were used to evaluate efficacy of the intervention. RESULTS: The response rate after 6 months follow up was 93%. There were no significant differences at baseline in gender, employment status, income distribution and residential location of respondents between the intervention and control group. After 6 months follow up, the mean adherence was significantly higher in the intervention group (95.7; 95% CI: 94.39-96.97) as compared to the control group (87.5; 95% CI: 86.14-88.81). The proportion of respondents who had Good (>95%) adherence was significantly higher in the intervention group (92.2%) compared to the control group (54.6%). A significantly lower frequency in missed appointments (14.0% vs 35.5%) (p = 0.001), lower viral load (p = 0.001), higher rise in CD4 count (p = 0.017), lower incidence of tuberculosis (p = 0.001) and OIs (p = 0.001) at 6 months follow up, was observed among patients in the intervention group. CONCLUSION: Mobile phone reminders (SMS and telephone call reminders) and peer counseling are effective in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia. These findings may be of potential benefit for collaborative adherence planning between patients and health care providers at ART commencement.


Assuntos
Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Terapia Antirretroviral de Alta Atividade/métodos , Telefone Celular , Aconselhamento à Distância/métodos , Cooperação do Paciente , Grupo Associado , Adolescente , Adulto , Feminino , Humanos , Malásia , Masculino , Pessoa de Meia-Idade , Telemedicina/métodos , Resultado do Tratamento
11.
Asia Pac J Public Health ; 29(4): 304-314, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28397533

RESUMO

Medication adherence remains a critical link between the prescribed ART regimen and treatment outcome. Several factors may influence adherence behavior. This cross-sectional study aimed to highlight socioeconomic predictors of adherence behavior among a cohort of 242 adult Malaysian patients receiving antiretroviral therapy in Hospital Sungai Buloh, Malaysia, where they were enrolled in a parent study (single-blinded randomized controlled trial) between January and December 2014. Statistical analysis of secondary data on adherence behavior and sociodemographic characteristics of the patients revealed mean age of 33.4 years and ranged from 18 to 64 years; 88.8% were males. A total of 224 (93%) patients who completed 6 months' adherence assessment were included in the model. Of these, 135 (60.3%) achieved optimal adherence. Multivariate binary logistic regression analysis revealed that patient's income and ethnicity were significant predictors of adherence behavior. This may be valuable for targeted programmatic interventions to further enhance successful treatment outcomes among the target population.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Malásia , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto Jovem
12.
JMIR Res Protoc ; 5(2): e112, 2016 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-27329333

RESUMO

BACKGROUND: Mental disorders are a major public health problem and are debilitating in many nations throughout the world. Many individuals either do not or are not able to access treatment. The Internet can be a medium to convey to the community accessible evidenced-based interventions to reduce these burdens. OBJECTIVE: The objective of this study is to investigate the effectiveness of 4 weeks of a Web-based psychoeducational intervention program for depressive and anxiety symptoms in the community of Selangor, Malaysia. METHODS: A two-arm randomized controlled trial of a single-blind study will be conducted to meet the objective of this study. We aim to recruit 84 participants each for the intervention and control groups. The recruitment will be from participants who participated in the first phase of this research. The primary outcomes of this study are depressive and anxiety scores, which will be assessed using the Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7, respectively. The secondary outcome includes mental health literacy of the participants, which will be assessed using the self-developed and adapted Mental Health Literacy Questionnaire. The psychoeducational intervention program consists of four sessions, which will be accessed each week. The depressive and anxiety symptoms will be compared between participants who participated in the psychoeducational program compared with the control group. Depressive and anxiety scores and mental health literacy will be assessed at week 1 and at follow-ups at week 5 and week 12, respectively. RESULTS: The psychoeducational intervention program consists of four sessions, which will be accessed at each week. The depressive and anxiety symptoms will be compared between the intervention and control groups using a series of mixed ANOVAs. Depressive and anxiety scores and mental health literacy will be assessed at week 1 and at two follow-ups at week 5 and week 12, respectively. CONCLUSIONS: To our knowledge, this study will be the first randomized controlled trial of a Web-based psychoeducational intervention program for depression and anxiety in an adult community in Malaysia. The results from this study will determine the effectiveness of a psychoeducational intervention program in the management of depression and anxiety among adults in the community. If proven to be effective, the intervention can serve as a new modality to manage and reduce the burden of these disorders in the community. CLINICALTRIAL: International Standard Randomized Controlled Trial Number (ISRCTN): 39656144; http://www.isrctn.com/ISRCTN39656144 (Archived by WebCite at http://www.webcitation.org/6hSVhV71K).

13.
BMC Psychiatry ; 15: 262, 2015 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-26497745

RESUMO

BACKGROUND: Anxiety is the most common mental health disorders in the general population. This study aimed to determine the prevalence of anxiety, its associated factors and the predictors of anxiety among adults in the community of Selangor, Malaysia. METHODS: A cross sectional study was carried out in three districts in Selangor, Malaysia. The inclusion criteria of this study were Malaysian citizens, adults aged 18 years and above, and living in the selected living quarters based on the list provided by the Department of Statistics Malaysia (DOS). Participants completed a set of questionnaires, including the validated Malay version of Generalized Anxiety Disorder 7 (GAD 7) to detect anxiety. RESULTS: Of the 2512 participants who were approached, 1556 of them participated in the study (61.90%). Based on the cut-off point of 8 and above in the GAD-7, the prevalence of anxiety was 8.2%. Based on the initial multiple logistic regression analysis, the predictors of anxiety were depression, serious problems at work, domestic violence and high perceived stress. When reanalyzed again after removing depression, low self-esteem and high perceived stress, six predictors that were identified are cancer, serious problems at work, domestic violence, unhappy relationship with family, non-organizational religious activity and intrinsic religiosity. CONCLUSION: This study reports the prevalence of anxiety among adults in the community of Selangor, Malaysia and also the magnitude of the associations between various factors and anxiety.


Assuntos
Transtornos de Ansiedade/epidemiologia , Adolescente , Adulto , Idoso , Transtornos de Ansiedade/etnologia , China/etnologia , Estudos Transversais , Depressão/psicologia , Violência Doméstica/psicologia , Emprego/psicologia , Feminino , Humanos , Índia/etnologia , Relações Interpessoais , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias/psicologia , Prevalência , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adulto Jovem
14.
PLoS One ; 9(4): e95395, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24755607

RESUMO

INTRODUCTION: Depression is one of the most common mental health disorders and is an emerging public health problem. The objectives of this paper were to determine the prevalence of depression, its associated factors and the predictors of depression among adults in the community of Selangor. METHODS: A cross sectional study was conducted in three districts in Selangor, from 11th June to 30th December 2012. The sampling frame was obtained from the Department of Statistics Malaysia (DOS) in May 2012, using the National Population and Housing Census 2010. Adults aged 18 years and above, living in the selected living quarters were approached to participate in the study and requested to complete a set of questionnaires. RESULTS: A total of 1,556 out of 2,152 participants participated in this study, giving an overall study response rate of 61.90%. Patient Health Questionnaire 9 (PHQ-9) was used to determine the presence of depression. The prevalence of depression was 10.3%, based on the PHQ-9 cut off point of 10 and above. Based on multiple logistic regression analysis, the predictors of depression were presence of anxiety, serious problems at work, unhappy relationship with children, high perceived stress, domestic violence, unhappy relationship with spouse, low self-esteem, unhappy relationship with family, serious financial constraint and presence of chronic diseases. When reanalyzed after removing anxiety, high perceived stress and low self-esteem, additional predictors of depression were found to be serious marital problems and religiosity. CONCLUSION: The prevalence of depression in this study is similar to that found in other studies. Findings from this study are being used as baseline data to develop an effective program to assist in the management of common mental health disorders in the community, in particular depression. The identification of predictors of depression in the community is important to identify the target population for the program.


Assuntos
Depressão/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Demografia , Depressão/complicações , Depressão/psicologia , Violência Doméstica/estatística & dados numéricos , Feminino , Geografia , Humanos , Modelos Logísticos , Malásia/epidemiologia , Masculino , Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Fatores de Risco , Autoimagem , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Adulto Jovem
15.
Genes Genet Syst ; 88(3): 199-209, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24025248

RESUMO

Identifying susceptible genes associated with the pathogenesis of atherosclerosis (ATH) may contribute toward better management of this condition. This preliminary study was aimed at assessing the expression levels of 11 candidate genes, namely tumor protein (TP53), transforming growth factor, beta receptor II (TGFBR2), cysthathionenine-beta-synthase (CBS), insulin receptor substrate 1 (IRS1), lipoprotein lipase (LPL), methylenetetrahydrofolate reductase (MTHFR), thrombomodulin (THBD), lecithin-cholesterol acyltransferase (LCAT), matrix metallopeptidase 9 (MMP9), low density lipoprotein receptor (LDLR), and arachidonate 5-lipoxygenase-activating protein (ALOX5AP) genes associated with ATH. Twelve human coronary artery tissues (HCATs) were obtained from deceased subjects who underwent post-mortem procedures. Six atherosclerotic coronary artery tissue (ACAT) samples representing the cases and non-atherosclerotic coronary artery tissue (NCAT) samples as controls were gathered based on predetermined inclusion and exclusion criteria. Gene expression levels were assessed using the GenomeLab Genetic Analysis System (GeXP). The results showed that LDLR, TP53, and MMP9 expression levels were significantly increased in ACAT compared to NCAT samples (p < 0.05). Thus, LDLR, TP53, and MMP9 genes may play important roles in the development of ATH in a Malaysian study population.


Assuntos
Doença da Artéria Coronariana/genética , Vasos Coronários/metabolismo , Metaloproteinase 9 da Matriz/genética , Receptores de LDL/genética , Proteína Supressora de Tumor p53/genética , Adulto , Perfilação da Expressão Gênica , Humanos , Proteínas Substratos do Receptor de Insulina/genética , Malásia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex , Proteínas Serina-Treonina Quinases/genética , Receptor do Fator de Crescimento Transformador beta Tipo II , Receptores de Fatores de Crescimento Transformadores beta/genética
16.
PLoS One ; 7(9): e46365, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23029497

RESUMO

INTRODUCTION: The prevalence of metabolic syndrome is increasing disproportionately among the different ethnicities in Asia compared to the rest of the world. This study aims to determine the differences in the prevalence of metabolic syndrome across ethnicities in Malaysia, a multi-ethnic country. METHODS: In 2004, we conducted a national cross-sectional population-based study using a stratified two-stage cluster sampling design (N = 17,211). Metabolic syndrome was defined according to the International Diabetes Federation/National Heart, Lung and Blood Institute/American Heart Association (IDF/NHLBI/AHA-2009) criteria. Multivariate models were used to study the independent association between ethnicity and the prevalence of the metabolic syndrome. RESULTS: The overall mean age was 36.9 years, and 50.0% participants were female. The ethnic distribution was 57.0% Malay, 28.5% Chinese, 8.9% Indian and 5.0% Indigenous Sarawakians. The overall prevalence of the metabolic syndrome was 27.5%, with a prevalence of central obesity, raised triglycerides, low high density lipoprotein cholesterol, raised blood pressure and raised fasting glucose of 36.9%, 29.3%, 37.2%, 38.0% and 29.1%, respectively. Among those <40 years, the adjusted prevalence ratios for metabolic syndrome for ethnic Chinese, Indians, and Indigenous Sarawakians compared to ethnic Malay were 0.81 (95% CI 0.67 to 0.96), 1.42 (95% CI 1.19 to 1.69) and 1.37 (95% CI 1.08 to 1.73), respectively. Among those aged ≥40 years, the corresponding prevalence ratios were 0.86 (95% CI 0.79 to 0.92), 1.25 (95% CI 1.15 to 1.36), and 0.94 (95% CI 0.80, 1.11). The P-value for the interaction of ethnicity by age was 0.001. CONCLUSIONS: The overall prevalence of metabolic syndrome in Malaysia was high, with marked differences across ethnicities. Ethnic Chinese had the lowest prevalence of metabolic syndrome, while ethnic Indians had the highest. Indigenous Sarawakians showed a marked increase in metabolic syndrome at young ages.


Assuntos
Grupos Étnicos , Síndrome Metabólica/etnologia , Síndrome Metabólica/epidemiologia , Obesidade Abdominal/etnologia , Obesidade Abdominal/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Glicemia/metabolismo , Pressão Sanguínea , Índice de Massa Corporal , Colesterol/sangue , HDL-Colesterol , LDL-Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Malásia/epidemiologia , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Obesidade Abdominal/sangue , Obesidade Abdominal/fisiopatologia , Prevalência , Fatores de Risco , Adulto Jovem
17.
Prev Med ; 55(5): 505-10, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22982947

RESUMO

OBJECTIVE: Develop, implement and evaluate the effectiveness of a peer-led education program related to HIV/AIDS among university students. DESIGN: randomized controlled trial with 276 university students at Faculty of Medicine and Health Sciences University Putra Malaysia (UPM), Serdang in 2011. INTERVENTION: A peer-led education program on HIV prevention by university students. OUTCOME: differences in knowledge, attitude and risk behavior practices related to HIV between baselines, immediate follow-up after intervention and after three months. RESULTS: Significant improvement in sound knowledge in the intervention group as compared to the control group (Odds ratio, 1.75; 95% CI 1.01, 3.00; p=0.04) and improvement in good attitude related to HIV (Odds ratio 2.22; 95% CI 1.37, 3.61; p=0.01). The odds of high substance risk behavior was significantly reduced in the intervention group as compared to the control group (Odds ratio 0.07; 95% CI 0.02, 0.34; p=0.01). The association between good knowledge and intervention was modified by the different time points (baseline, immediately after intervention and 3 months after intervention), ethnicity and gender. CONCLUSION: Peer-led education program in HIV prevention improves knowledge, attitude and substance risk behavior. Changes in sexual risk behavior may require a longer follow-up.


Assuntos
Infecções por HIV/prevenção & controle , Educação em Saúde/métodos , Conhecimentos, Atitudes e Prática em Saúde , Grupo Associado , Sexo Seguro , Adulto , Feminino , Humanos , Funções Verossimilhança , Modelos Logísticos , Malásia , Masculino , Assunção de Riscos , Estudantes
18.
Int Health ; 4(4): 277-82, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24029673

RESUMO

This study aimed to develop and implement a customized training program related to the delivery of an integrated human immunodeficiency virus - sexually transmitted infections (HIV-STI) risk reduction intervention for peer-facilitators and to evaluate its immediate outcome including changes in trainee knowledge, attitudes, and self-reported competence and confidence. We developed and delivered a structured training program and materials about HIV and STI prevention in a university setting. The training was offered to candidate facilitators who were planned to be involved in a larger project, known as Integrated HIV-STI Risk Reduction Program. Ten candidate facilitators participated in the training program and completed both the pretest and posttest survey questionnaire. The data were analyzed using SPSS version 17.0 software package and Wilcoxon signed rank test was applied to assess the impact of the training program. Overall, the trainees' performance in HIV-related and STI knowledge, attitude and stigma scores had significantly increased compared to the baseline. The median scores for HIV and STI knowledge after the training significantly increased from 22.0 to 30.5 (p=0.007) and 8.0 to 9.5 (p=0.005), respectively, whereas the median score on the positive attitude towards HIV and STI prevention rose from 39.0 to 57.0 (p=0.011). Upon completion of the program, 80-100% of the trainees believed that they were competent and confident in performing most of the designed sexual health intervention activities. This preliminary study suggests that a customized on-site training program on sexual health intervention could significantly improve their knowledge, attitude and practice related to HIV-STI prevention.

19.
Asia Pac J Public Health ; 22(2): 194-202, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19443875

RESUMO

The purpose of this study was to determine the association between different ethnic groups and the prevalence, awareness, and control of diabetes in Malaysia. A population-based cross-sectional study using multistage sampling was conducted in Malaysia. Diabetes is defined as having a fasting blood glucose > or =7 mmol/L or a self-reported diabetic on treatment. Among the 7683 respondents aged > or =30 years, the prevalence of diabetes mellitus was 15.2% (95% CI = 14.1, 16.4). Multivariate analysis showed that compared with Malays, Chinese had lower odds (adjusted odds ratio [aOR] 0.71; 95% CI = 0.56, 0.91) and Indians had higher odds of having diabetes (aOR 1.54; 95% CI = 1.20, 1.98). The odds of diabetes increased with age, family history of diabetes, body mass index, and lower education levels. Among those with diabetes mellitus, 45.0% were aware and 42.7% were under treatment. Among treated diabetics, 25.1% had their fasting blood sugar under control. There is a significant association between prevalence of diabetes and different ethnic groups.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Diabetes Mellitus/etnologia , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Estudos Transversais , Diversidade Cultural , Diabetes Mellitus/prevenção & controle , Feminino , Humanos , Índia/etnologia , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Prevalência , Fatores de Risco
20.
Asia Pac Fam Med ; 8(1): 2, 2009 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-19358728

RESUMO

INTRODUCTION: The prevalence of obesity in developing countries especially among women is on the rise. This matter should be taken seriously because it can burden the health care systems and lower the quality of life. AIM: The purpose of this study was to determine the prevalence of obesity among adult women in Selangor and to determine factors associated with obesity among these women. METHODS: This community based cross sectional study was conducted in Selangor in January 2004. Multi stage stratified proportionate to size sampling method was used. Women aged 20-59 years old were included in this study. Data was collected using a questionnaire-guided interview method. The questionnaire consisted of questions on socio-demographic (age, ethnicity, religion, education level, occupation, monthly income, marital status), Obstetric & Gynaecology history, body mass index (BMI), and the Patient Health Questionnaire (PHQ-9). RESULTS: Out of 1032 women, 972 agreed to participate in this study, giving a response rate of 94.2%. The mean age was 37.91 +/- 10.91. The prevalence of obesity among the respondents was 16.7% (mean = 1.83 +/- 0.373). Obesity was found to be significantly associated with age (p = 0.013), ethnicity (p = 0.001), religion (p = 0.002), schooling (p = 0.020), educational level (p = 0.016), marital status (p = 0.001) and the history of suffering a miscarriage within the past 6 months (p = 0.023). CONCLUSION: The prevalence of obesity among adult women in this study was high. This problem needs to be emphasized as the prevalence of obesity keeps increasing, and will continue to worsen unless appropriate preventive measures are taken.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA