1.A Review of Smoking Research In Malaysia
Wee Lei Hum ; Caryn Chan Mei Hsien ; Yogarabindranath Swarna Nantha
The Medical Journal of Malaysia 2016;71(3 Suppl.):29-41
Two hundred and seventy one original published materials
related to tobacco use were found in a search through a
database dedicated to indexing all original data relevant to
Medicine and Health in Malaysia from 1996 - 2015. A total of
147 papers were selected and reviewed on the basis of their
relevance and implications for future research. Findings
were summarised, categorised and presented according to
epidemiology, behaviour, clinical features and management
of smoking. Most studies are cross-sectional with small
sample sizes. Studies on smoking initiation and prevalence
showed mixed findings with many small scale studies within
the sub-groups. The majority of the studies were related to
factors that contribute to initiation in adolescents.
Nonetheless, there are limited studies on intervention
strategies to curb smoking among this group. There is a
lack of clinical studies to analyse tobacco use and major
health problems in Malaysia. In addition, studies on the best
treatment modalities on the use of pharmacotherapy and
behavioural counselling have also remained unexplored.
Reasons why smokers do not seek clinic help to quit
smoking need further exploration. A finding on the extent of
effort carried out by healthcare providers in assisting
smokers to make quit attempts is not known. Studies on
economic and government initiatives on policies and
tobacco use focus mainly on the effects of cigarette bans,
increased cigarettes taxes and the influence of the tobacco
industry. Recommendations are given for the government to
increase efforts in implementing smoke-free legislation,
early and tailored interventions. Clinical studies in this area
are lacking, as are opportunities to research on ways to
reduce smoking initiation age and the most effective quit
smoking strategies.
Smoking
;
Tobacco Use
2.Predicting Burnout And Psychological Distress Risks Of Hospital Healthcare Workers
Ching Sin Siau ; Lei-Hum Wee ; Norhayati Ibrahim ; Uma Visvalingam ; Lena Lay Ling Yeap ; Seen Heng Yeoh ; Suzaily Wahab
Malaysian Journal of Public Health Medicine 2018;18(Special Volume (1)):125-136
Burnout and psychological distress were reported at higher rates among hospital healthcare workers. Despite this, there is a paucity of research examining the associated risk factors among workers across specialties and occupations in Asia. This paper aimed to examine the risk factors associated with burnout and psychological distress among Malaysian hospital healthcare workers from diverse medical specialties and occupations. A total of 368 doctors, nurses, assistant medical officers and hospital attendants were recruited from major medical and surgery departments in an urban general hospital. The participants were self-administered a questionnaire consisting of demographic information, Maslach Burnout Inventory-Human Services Survey and Depression Anxiety and Stress Scale. In the fully adjusted multivariate analyses, doctors were about four to five times more likely to be emotionally exhausted (aOR [adjusted Odds Ratio], 4.826; 95% CI [Confidence Interval]: 1.492-15.604, p<0.01), depressed (aOR, 5.221; 95% CI: 1.995-13.661, p<0.01) and stressed (aOR, 3.990; 95% CI: 1.473-10.809, p<0.01). Paediatric workers demonstrated three to five times higher risks of depression (aOR, 3.105, 95% CI: 1.043-9.243, p<0.05), anxiety (aOR, 3.517, 95% CI: 1.194- 10.356, p<0.05) and stress (aOR, 5.404, 95% CI: .1.628-17.942, p<0.01). Emotional exhaustion (aOR, 1.046, 95% CI: .1.013-1.079, p<0.01) and depersonalization (aOR, 1.078, 95% CI: .1.015-1.145, p<0.05) led to higher risks of psychological distress, while stress predicted higher risks of burnout (aOR, 1.153, 95% CI: 1.062-1.251, p<0.01). There were occupational and departmental differences in susceptibility to burnout and psychological distress, requiring further investigation into the unique working environments and roles of hospital healthcare workers.
Burnout
;
psychological distress
;
healthcare worker
;
healthcare personnel
;
hospital
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Malaysia
3.Effectiveness of Debriefing towards Healthcare Professionals’ Nontechnical Skills: A Critical Review
Muhamad Nur FARIDUDDIN ; Wee Lei HUM ; Lilia HALIM ; Mohd Joh Ar Jaafar
Malaysian Journal of Health Sciences 2018;16(1):17-28
The importance of nontechnical skills among healthcare professionals is gaining widespread recognition as criticalelements complementing technical skills that are used to improve patients’ safety. These skills are typically acquiredthrough simulation training which has emerged as an effective way to complement clinical training. Effective simulationrequires structure and effective debriefing methods to enhance its learning outcome. In previous literature, evidence of theeffectiveness of healthcare simulation was available but studies evaluating debriefing method(s) remain sparse. In thispaper, the effectiveness of debriefing methods in eight studies on the acquisition of nontechnical skills among healthcareprofessionals is reviewed. Articles published from 1st January 2016 across three different databases were referred to. Theresults of the review show a statistically significant improvement in the performance of nontechnical and technical skillsacross different professionals through various methods of debriefing. Nontechnical skills such as teamwork, effectivecommunication, decision-making, and situational awareness have improved significantly. In addition, integration ofrealism in simulation learning has begun to emerge as an effective technique of providing a real world experience.However, there was lack of detailed information on the length and type of debriefing conducted in the studies. Thesemethods clearly require further research since the key to successful simulation learning is through debriefing which isthe heart of simulation.
4.Juara Sihat: assessing the sustained impact of a school-based obesity intervention
Wilfred Kok Hoe Mok ; Bee Koon POH ; Lei Hum WEE ; Dewi Gunasekaran DEVANTHINI ; Abd Talib RUZITA
The Medical Journal of Malaysia 2018;73(2):100-105
Introduction: Obesity and physical inactivity among schoolchildren are among the most challenging health problems inMalaysia. The present study aimed to evaluate the sustainedimpact of Juara Sihat programme on physical activity leveland anthropometric status at 18-month post-intervention.Method: Participants of Juara Sihat (n=55) were followed-upat 18 months after completion of the intervention. JuaraSihat intervention was implemented over 12 weeks andfocused on four key components: (i) five one-hour nutritioneducation classes, (ii) four one-hour physical activityeducation sessions, (iii) family involvement, and (iv)empowerment of Parents and Teachers Association.Anthropometric variables (body mass index, body fatpercentage and waist circumference) were measured andphysical activity level was evaluated by using PhysicalActivity Questionnaire for Children (PAQ-C) at baseline (P0),immediately upon completion of intervention (P1), atthree-month post-intervention (P2), and at 18-month postintervention(P3). Analyses of repeated measures analysisof covariance (ANCOVA) with intention-to-treat principlewere applied.Results: Sustained effects were found in BMI-for-age z-scorewhich showed a reduction (P0 2.41±0.84 vs P3 2.27±0.81)and physical activity level which showed positiveimprovements (P0 2.46±0.62 vs P3 2.87±0.76) at 18 monthsafter intervention was completed. Body fat and waistcircumference had increased over the same time period.Conclusion: Overall, this study successfully demonstratedsustained intervention effects of Juara Sihat intervention onBMI-for-age z-score and physical activity, but not on body fatpercentage and waist circumfere
5.Prevalence and characteristics of e-cigarette users among Malaysian current and ex-smokers
Ho Bee Kiau ; Mohamad Haniki b. Nik Mohamed ; Jamalludin Ab Rahman ; Samsul Draman ; Mira Kartiwi ; Syafinaz Ab Rahman ; Noor Zurani Md Haris Robson ; Caryn Mei Hsien Chan ; Lim Kuang Hock ; Nizam bin Baharom ; Norliana Ismail ; Tee Guat Hiong ; Jane Ling Miaw Yn ; Lei-Hum Wee
Malaysian Family Physician 2019;14(2):10-17
Introduction: Electronic cigarettes (ECs) are new devices that have been accepted widely by both
smokers and non-smokers. However, the evidence on EC used in Malaysia is scarce. The objective of thisstudy was to determine the prevalence of EC use and the socio-demographic and smoking characteristicsassociated with current EC use among Malaysian current and ex-smokers.
Methods: This was a sub-analysis of data from a cross-sectional, national-population- based EC study
conducted from May to June in 2016 in Malaysia. A detailed description of the sampling methods can
be found in the National E-cigarette Survey (NECS) 2016 report. Briefly, data were obtained from 1396
individuals who had ever been smokers, i.e., 957 (68.6%) current smokers and 439 (31.4%) ex-smokers.
Results: Current EC use was found predominantly among current smokers (8.0%) as compared with
ex-smokers (4.3%). Among current smokers, the main reasons given for smoking ECs were wanting to
try it (44.7%), followed by intention to quit tobacco smoking (15.8%) and to reduce tobacco smoking
(10.5%). Using multiple logistic regression analysis, we found that among current smokers, current EC
users were more likely to be younger, i.e., 18-44 years (aOR= 4.83, 95% CI= 1.97-11.86, p=0.001),
urban residents (aOR= 1.89, 95% CI= 1.15-3.11, p=0.012), single/ divorced/ widowed (aOR= 2.11,
95% CI= 1.24-3.61, p=0.006) and students (aOR= 2.25, 95% CI= 1.01-5.01, p=0.048). Among exsmokers, only younger respondents (18-44 years old) was reported as being more likely to be current EC users (aOR= 3.81, 95% CI= 1.14-12.76, p=0.030).
Conclusion: This study showed that currently using and ever having used ECs were more prevalent
among current smokers. The reasons given for initiating EC use among current smokers were mainly
wanting to try it, followed by intention to quit and to reduce tobacco smoking. Current EC use appears
to be common among current smokers who are younger, urban residents, single/divorced/widowed and students. Therefore, EC cessation intervention strategies and policies should target these high-prevalence
groups
6.Prevalence and characteristics of e-cigarette users among Malaysian current and ex-smokers
Ho Bee Kiau ; Mohamad Haniki b. Nik Mohamed ; Jamalludin Ab Rahman ; Samsul Draman ; Mira Kartiwi ; Syafinaz Ab Rahman ; Noor Zurani Md Haris Robson ; Caryn Mei Hsien Chan ; Lim Kuang Hock ; Nizam bin Baharom ; Norliana Ismail ; Tee Guat Hiong ; Jane Ling Miaw Yn ; Lei-Hum Wee
Malaysian Family Physician 2019;14(2):10-17
Introduction: Electronic cigarettes (ECs) are new devices that have been accepted widely by both
smokers and non-smokers. However, the evidence on EC used in Malaysia is scarce. The objective of thisstudy was to determine the prevalence of EC use and the socio-demographic and smoking characteristicsassociated with current EC use among Malaysian current and ex-smokers.
Methods: This was a sub-analysis of data from a cross-sectional, national-population- based EC study
conducted from May to June in 2016 in Malaysia. A detailed description of the sampling methods can
be found in the National E-cigarette Survey (NECS) 2016 report. Briefly, data were obtained from 1396
individuals who had ever been smokers, i.e., 957 (68.6%) current smokers and 439 (31.4%) ex-smokers.
Results: Current EC use was found predominantly among current smokers (8.0%) as compared with
ex-smokers (4.3%). Among current smokers, the main reasons given for smoking ECs were wanting to
try it (44.7%), followed by intention to quit tobacco smoking (15.8%) and to reduce tobacco smoking
(10.5%). Using multiple logistic regression analysis, we found that among current smokers, current EC
users were more likely to be younger, i.e., 18-44 years (aOR= 4.83, 95% CI= 1.97-11.86, p=0.001),
urban residents (aOR= 1.89, 95% CI= 1.15-3.11, p=0.012), single/ divorced/ widowed (aOR= 2.11,
95% CI= 1.24-3.61, p=0.006) and students (aOR= 2.25, 95% CI= 1.01-5.01, p=0.048). Among exsmokers, only younger respondents (18-44 years old) was reported as being more likely to be current EC users (aOR= 3.81, 95% CI= 1.14-12.76, p=0.030).
Conclusion: This study showed that currently using and ever having used ECs were more prevalent
among current smokers. The reasons given for initiating EC use among current smokers were mainly
wanting to try it, followed by intention to quit and to reduce tobacco smoking. Current EC use appears
to be common among current smokers who are younger, urban residents, single/divorced/widowed and students. Therefore, EC cessation intervention strategies and policies should target these high-prevalence
groups
7.Intervensi Kesihatan Di Tempat Kerja Bagi Aktiviti Fizikal Dan Atau Nutrisi Di Negara-Negara Berpendapatan Rendah Dan Sederhana: Satu Ulasan Sistematik Workplace Health Intervention For Physical Activity And Or Nutrition In Middle Income And Low Income Countries : A Systematic Review
NADIA ATIQAH MOHAMAD NOR ; WEE LEI HUM ; CARYN MEI HSIEN CHAN
Malaysian Journal of Health Sciences 2021;19(No.2):1-13
A systematic review was conducted to summarize health intervention program that aimed to increase physical activity
and/or nutrition among middle income and low income countries employees from January 2008 until December 2019.
The objective of this review is to identify the types of health intervention and its effects on increasing physical activities
and nutrition at the workplace. A systematic search of the following databases was conducted: Scopus, PubMed and
Web of Science following the Preferred Reporting Items for Systematic Review and Meta Analysis (PRISMA) guideline.
A modified McMaster critical appraisal tool for quantitative studies was used to assess the methodological quality of
the included studies. Given the heterogeneity of the included studies, a descriptive synthesis was conducted. Out of 6940
studies, 36 studies met the inclusion criteria range from health education, environmental change and behavioural
change of healthy lifestyle. Based on a heterogeneous evidence base it can be surmised that workplace health
interventions may have a positive impact on the health and behaviour of the employees. Current evidence however lacks
clarity and uniformity in terms of intervention parameters and measurement outcomes, which limits broader application
of these results. In conclusion, workplace health intervention is potential for increasing physical activity and improving
the nutritional status of employees. Recommendation with regard to effectiveness however cannot be made. It is hoped
that findings from this review may inform and guide future policies and practices regarding workplace health promotion.