Objective: Family Environment Scale (FES) is one of the most widely used instruments to measure many family aspects. Cross cultural adaptation of the original FES is essential prior to local utilization as different cultures percept their family environments differently. We attempted to translate the FES into the Bahasa Malaysia language for adolescents, evaluate its reliability using internal consistency and compare its results with the original study. Methods: This is a cross-sectional study, involving adolescents aged 12-17 from four secondary schools. The adolescents were selected using quota sampling for different age, ethnic and academic performance. The study was divided into four phases, namely: i) translation of FES, ii) pilot test iii) internal consistency reliability test and iv) comparison of the study results with the original FES. Results: A total of 295 adolescents participated in this study. All of the reliability measurements generated (ranged between Cronbach’s alpha 0.10 - 0.70) were lower than those originally reported for this instrument (ranged between Cronbach’s alpha 0.61 -0.78). Five subscales in the Bahasa Malaysia version were found to be less than Cronbach’s alpha 0.5, which were below the acceptable level for practical or research use. There was considerable variation observed between the sample population of this study and that of the original study, which could be due to the social cultural differences. Conclusion: The Bahasa Malaysia version of FES requires further culturally appropriate revision. A new measuring scale could also be devised to provide an accurate evaluation of the family environment as perceived by Malaysian adolescents, which has acceptable levels of reliability and validity.

Background: Parenting behaviour is culturally sensitive. The aims of this study were (1) to translate the Parental Bonding Instrument into Malay (PBI-M) and (2) to determine its factorial structure and validity among the Malaysian population. Methods: The PBI-M was generated from a standard translation process and comprehension testing. The validation study of the PBI-M was administered to 248 college students aged 18 to 22 years. Results: Participants in the comprehension testing had difficulty understanding negative items. Five translated double negative items were replaced with five positive items with similar meanings. Exploratory factor analysis showed a three-factor model for the PBI-M with acceptable reliability. Four negative items (items 3, 4, 8, and 16) and item 19 were omitted from the final PBI-M list because of incorrect placement or low factor loading (< 0.32). Out of the final 20 items of the PBI-M, there were 10 items for the care factor, five items for the autonomy factor and five items for the overprotection factor. All the items loaded positively on their respective factors. Conclusion: The Malaysian population favoured positive items in answering questions. The PBI-M confirmed the three-factor model that consisted of care, autonomy and overprotection. The PBI-M is a valid and reliable instrument to assess the Malaysian parenting style. Confirmatory factor analysis may further support this finding.

Teenage pregnancy carries serious impacts on adolescent health. This study aimed to examine the effects of pregnancy on adolescents and to explore how they cope with the problems they faced during the pregnancy. It involved 26 adolescents residing in a government shelter home in Kuala Lumpur. A self-administered questionnaire containing a mixture of open- and closed-ended questions was used. Among physical (sleeping problem and self-care problem), psychological (emotional difficulties and low self-efficacy) and social (stigma and discrimination, financial difficulty, friendship problem and school dropout) problems, emotional difficulties were the most common problems, whereas stigma and discrimination was the least common. Young adolescents aged less than 16 years old were significantly associated with poor self-care (p=0.01). To cope with their problems, the adolescents generally used avoidance, withdrawal, and social support, particularly from parents and peers. Doctors were the least popular among all. In conclusion, holistic and individualised care is needed. Strategies to reduce emotional problem experienced by pregnant adolescents should be implemented. The available healthcare services for teenage pregnancy should also be promoted.

Background: The prevalence of teenage smoking has decreased over the past decade following the implementation of the national tobacco control programme. However, the effect of the programme on smoking cessation in teenagers has not been determined. Methods: Twenty-eight participants (12 teenagers, 8 teachers, and 8 doctors) were interviewed using 5 in-depth interviews and 3 group discussions. Social cognitive theory (SCT) was applied as the theoretical framework. Semi-structured interview protocols were used, and thematic analysis and analytic generalisation utilising SCT were performed. Results: The current national tobacco control programme was found to be ineffective in promoting smoking cessation among teenagers. The participants attributed the ineffective campaign to the followings: inadequacy of message content, lack of exposure to the programme, and poor presentation and execution. In addition, the participants perceived the developed tobacco control policies to be a failure based on poor law enforcement, failure of retailers to comply with the law, social availability of cigarettes to teenagers, and easy availability of cheap, smuggled cigarettes. This study highlighted that the programme-related problems (environmental factors) were not the only factors contributing to its perceived ineffectiveness. The cunning behaviour of the teenagers (personal factor) and poor self-efficacy to overcome nicotine addiction (behavioural factor) were also found to hinder cessation. Conclusion: Tobacco control programmes should include strategies beyond educating teenagers about smoking and restricting their access to cigarettes. Strategies to manage the cunning behaviour of teenagers and strategies to improve their self-efficacy should also be implemented. These comprehensive programmes should have a foundation in SCT, as this theory demonstrates the complex interactions among the environmental, personal, and behavioural factors that influence teenage smoking.

Background: The quality of life (QoL) describes the multidimensional self-perceived well-being of a person, which is an important diabetes outcome. This study aimed to measure the QoL scores among patients with type 2 diabetes mellitus (T2DM), as well as their clinical and sociodemographic predictors. Methods: This cross-sectional study involved 180 randomly sampled patients at a primary care clinic on the East Coast of Peninsular Malaysia. A self-administered questionnaire containing the Audit of Diabetes Dependent Quality of Life-18 (ADDQoL-18) was used. Results: Most of the respondents (96.7%) were Malay, with a median (interquartile range, IQR) age of 54.0 (14.0) years old. The majority of them were females (60.0%), married (81.1%) and from low-income families (63.3%), who attained a secondary education or lower (75.6%). Only 49.4% of them were employed. The mean (standard deviation, SD) ADDQoL-18 average weighted impact score was −4.58 (2.21) and all 18 domains were negatively affected, particularly the living condition, family life and working life. The multiple linear regression analysis showed that the age (adjusted B = 0.05, P = 0.004) and insulin use (adjusted B = −0.84, P = 0.011) were QoL predictors. Conclusion: T2DM negatively impacts the patient’s QoL in all aspects of their life. The QoL improvement with age suggests that the older patients had accepted and adapted to their illness. The need to improve the QoL among insulin users was also highlighted.

Introduction: The ability of a person to self-regulate and practise healthy lifestyle behaviours determine one’s weight status. The objective of this study was to determine the relationship of self-regulation, dietary practices, and physical activity with overweight status among male and female adolescents. Methods: This crosssectional study used multistage cluster sampling involving government secondary school students aged between 13 and 14 years old in Hulu Langat, Selangor. Students answered a validated self-administered questionnaire comprising socio-demography, dietary practices, physical activity, and self-regulation items. Their body mass index (BMI) was calculated, and weight status was determined using the Centers for Disease Control and Prevention (CDC) BMI chart. Results: Among 636 students, 27.0% were “overweight”, affecting more male than female students (p=0.032). Majority of them (96.7%) were motivated to maintain healthy body weight, but only a third of the students took vegetables, fruits and grains (32.4%), and performed vigorous physical activity (31.1%) regularly. Regardless of the “overweight” status, there were no significant differences in dietary practices, physical activity, and autonomous regulation for both genders. Female students showed a higher level of controlled regulation than male students in non-overweight (p=0.005) and overweight (p<0.001) groups. Higher controlled regulation increased the odds of being overweight among female students (AOR=1.04, 95% CI=1.04-1.08, p=0.010). Conclusion: Thus, health authorities need to develop programmes to assist, particularly female students, in practising higher autonomous regulation to combat overweight and obesity, as this group exhibits a high level of controlled regulation, which increases the likelihood of being overweight.

Introduction: Dyslexia, which is a learning disability that affects many aspects of children’s development, has a prevalence of 5 – 17%, worldwide. There are many negative perceptions towards children with dyslexia, and one of it is when there is lack of teachers’ knowledge about this problem. Aim: The objective of this study is to develop and discuss on a newly developed module on dyslexia, i.e. Dyslexia Health Education Module (DHEM) for preschool teachers, Method: This module is developed using the ADDIE model (A-Analysis, D-De- sign, D-Develop, I- Implement, E-Evaluate). The content of DHEM consists of general information for pre-school teachers about dyslexia, identification and intervention for dyslexia among children as well as its mental health implications. Results: The newly developed module was found to have a good content validity with a score of 0.7 when evaluated by eight expert panels from respective fields. The Cronbach alpha’s value for reliability test was 0.90. These findings suggest that this module is good, reliable and applicable. Discussion: It is hoped that with the development of DHEM, this would increase teachers’ knowledge on dyslexia among children in Malaysia, especially in recognizing at-risk children and consequently may lead to early intervention in managing the problem. This study also suggests that future longitudinal studies should be carried out using this module to ensure its effectiveness in the long run.