Introduction: Posttraumatic growth (PTG) is a positive psychological change in life that occurs as a result of struggle with highly challenging life crises. There is a growing need to explore posttraumatic growth (PTG) in cancer patients, as higher PTG may enhance well-being of patients. Objectives: The aim of this study was to translate the Posttraumatic Growth Inventory-Short Form (PTGISF) into the Malay language and evaluate its psychometric properties for assessing Malaysian cancer patients in future studies. Methods: Two parallels forward and backward translations of the PTGI-SF into the Malay language were conducted. The test was administered to 195 cancer patients. Reliability was evaluated by testing internal consistency (Cronbach’s α) and calculating the test-retest intra-class correlation coefficient, and validity was examined by determining face, convergent, and discriminant validities and using confirmatory factor analysis (CFA). Results: The Malay version of the PTGI-SF and its five domains demonstrated good internal consistencies and acceptable test-retest reliability. All 10 items of this version were highly correlated with their own domains and thus exhibited convergent validity. Discriminant validity was achieved, as all domains of the Malay PTGI-SF was not highly correlated with the domains of the Source of Social Support Scale. CFA resulted in a bestfitting 5-factor model. Conclusion: The Malay version of the PTGI-SF is a suitable tool for measuring PTG in Malaysian cancer patients.

Objective: It is important to investigate the association between spousal support and psychology of cancer patients, thus a validated instrument to measure the degree of perceived spousal support is required. We translated and evaluated the psychometric properties of the Sources of Social Support Scale-Malay version (SSSS-Malay) among Malaysian cancer patients. Methods: In this study, the SSSS-Malay and Hope Scale-Malay [used to compare with the SSSS-Malay to assess discriminant validity] were administered to 195 Malaysian cancer patients during baseline assessment. The SSSS-Malay was re-administered 2 months after the baseline assessment during follow-up. Results: The SSSS-Malay total score (Cronbach’s α = 0.70, intraclass correlation coefficient (ICC) = 0.72) and its domains (Cronbach’s α ranging from 0.70 to 0.83, intraclass correlation coefficient ranging from 0.6 to 0.76) exhibited good internal consistencies and good test-retest reliability. The SSSS-Malay also demonstrated good convergent and discriminant validities. However, confirmatory factor analysis of the SSSSMalay showed that it was best fit into a 3-factor model instead of the 4-factor model of the original English version. Conclusion: The SSSS-Malay demonstrated good psychometric properties for use in Malaysian cancer patients.

Introduction: Geriatric Giants are the impairment that appear in older people. It comprises of impaired cognition, urinary incontinence, instability, fall and immobility. The aim of this study is to determine the prevalence of Geriatric Giants among older people living in three different living environment; own home, pondok and old folks home. Methods: This comparative study involved 471 respondents from Kelantan. There were 157 participants each from own home, pondok and old folks home. The prevalence of Geriatric Giants were determine by 10 minutes comprehensive screening which was developed to diagnose and manage the Geriatric Giants (WHO, 2007) and prevalence were compared using chi-square tests or Fisher exact test. Results: Prevalence of dementia among respondents of old folks home (11.5%), pondok (6.4%) and own home (0.6%). Prevalence of urinary incontinence among respondents of own home (22.3%), old folks home (16.6%) and pondok (14.0%). Prevalence of instability among respondents of old folk home (31.2%), pondok (27.4%) and own home (14.0%). Prevalence of fall among respondents of pondok (33.1%), old folks home (24.25) and own home (19.7%). Old folk home respondents had the highest prevalence of moderate and severe immobility There were significant difference in prevalence of dementia ((Fisher exact p value <0.001), instability (χ2(2)=13.957,p=0.001), fall (χ2(2)=7.629,p=0.022) and mild and moderate immobility. Conclusion: Old folks home respondents had more prevalence of Geriatric Giants compared to their other counter parts.
Old folks home

Hope leads to lower depression and anxiety and is associated with improved quality of life of cancer patients. In thisstudy, Hope Scale (HS) was translated into Malay, and the psychometric properties of the Malay version of the HopeScale were investigated among Malaysian cancer patients. Concurrent translation and back translation of the originalEnglish version of the Hope Scale were performed, and the Malay version was administered to 195 cancer patientswith different cancer diagnoses at baseline assessment and 2 months later at follow-up. The Hope Scale (Malay) totalscore (Cronbach’s α = 0.72; intraclass correlation coefficient (ICC) = 0.67) and its domains (Cronbach’s α [pathway] =0.7; Cronbach’s α [agency] = 0.7; ICC[Pathway] = 0.64; ICC[Agency] = 0.70) demonstrated acceptable internal consistencies andtest-retest reliability. Convergent and discriminant validities were also achieved by the Hope Scale (Malay). The HopeScale (Malay) demonstrated construct validity, as confirmatory factor analysis demonstrated that the items in the HopeScale (Malay) best fit into two domains, which was true for the original English version. The Hope Scale (Malay) hadacceptable psychometric properties and thus is suitable for assessing hope in Malaysian cancer patients.

Obesity is thought to be a complicated, multifaceted chronic disease that results from the combination of environmental and genotypic variables. Implementing a wide strategy for obesity prevention and management is required given the variety and complexity of factors impacting obesity. Most healthcare practitioners use dietary therapies such calorie-restricted diets, Mediterranean diets, DASH diets, and intermittent fasting to encourage weight loss. Meal replacement products (MRPs) are used as part of a calorie restricted diet which helps to control our food choices and leads to calorie reduction. This article reviews the usage of MRP as a weight loss therapy and summarizes the literature about their effectiveness to reduce weight in patients with obesity. From the literature search, it can be concluded that MRPs contain a precise amount of macronutrients, micronutrients, and fiber to provide a nutritionally balanced meal. MRPs have been extensively studied as a weight loss therapy, and several scientific studies have confirmed their efficacy. The main ways that MRPs aid in weight loss are by reducing appetite and improving diet adherence, which makes it easier for individuals to stick to their diet plan and achieve their weight loss goals. Overall, MRPs should be considered as a viable treatment option for patients who are motivated to lose weight, as they offer a simple, convenient, and effective way to reduce calorie intake, improve diet adherence, and achieve sustainable weight loss. However, it is important to note that MRPs should be used as part of a comprehensive weight loss plan that includes regular physical activity and behavior modification strategies for long-term success.
Obesity

The Malaysian population is aging, and the elderly are less healthy than the young. The majority of the elderly remain in their own home, although some choose to live in a pondok and others are institutionalized. The main concern in the care of the elderly is maintaining the quality of life (QOL) up to the last moment. The aim of this study is to determine the effect of living place (home, pondok, or old folks’ home) on QOL of the elderly in Kelantan, Malaysia. Four-hundred seventy-one respondents participated in this cross-sectional study. Participants age 60 years old and above were selected conveniently and the WHOQOL-BREF questionnaire was administered by face to face interview to measure quality of life. Multivariate analysis of variance was applied to detect the impacts and p-value < 0.05 was considered significant. Significant differences in mean score of physical (p = 0.011), psychological (p < 0.001), social (p < 0.001), and environmental (p = 0.001) aspects of QOL were detected among participants living at home, in a pondok, and in an old folks’ home. The elderly living in their own home had the highest scores in the physical, social, and environmental domains. Those living in a pondok scored highest in the psychological domain. The elderly living in an old folks’ home had the lowest scores in all domains. A significant effect of living place on QOL of the elderly was detected (p < 0.001) and there was a significant effect of living place on QOL after medical illness and age were controlled (p < 0.001,). Conclusion: Living place had a significant effect on QOL of the elderly, with best QOL for own home living elderly. We recommend elderly should remain in their own home till the end of their life.
Aged

Perioperative Patient Blood Management is part of the patient blood management (PBM) program specifically focused on surgical patients. Even though this concept had been introduced in 2010 by World Blood Organization (WHO), earlier studies in Europe had shown poor knowledge and practice among clinicians in this area. In Malaysia, PBM approach is still not comprehensive, and there was no published data to relate this problem with clinicians’ lack of knowledge and practice. Therefore, our main objective was to study the knowledge and practice of PBM among clinicians mainly involved in the perioperative field at Hospital Universiti Sains Malaysia (Hospital USM), Kelantan. A cross-sectional study was done from 1st December 2019 to 31st October 2020 using a structured and validated questionnaire containing 41 items. Logistic regression was used to evaluate the association between socio-demographic variables with knowledge level. A total of 252 participants were involved in this study. About 61.5% of the clinicians had a poor knowledge level. Poor knowledge level among clinicians was significantly associated with clinicians' age, primary field, previous knowledge about PBM, and PBM course attendance (p<0.05). The practice was at a moderate level. Overall, there were significant knowledge gaps and inadequate practice of PBM in perioperative patients among clinicians in Hospital USM. These results might guide the local clinical division to formulate more constructive and effective training strategies to strengthen the clinicians’ knowledge and practice of PBM in perioperative patients.
Knowledge

Introduction: Laboratory turnaround time (LTAT) is considered a reliable indicator of the quality and efficiency of a laboratory’s service. LTAT achievement, particularly of urgent tests, remains unsatisfactory and challenging in many clinical laboratories especially in tertiary health care centres with high workload and restricted resources. The unresolved issue of unsatisfactory urgent renal profile (RP) LTAT below the standard performance goal prompted our interest to improve laboratory’s handling of urgent test request. We thus implemented the Lean principle in the management of urgent test requests using urgent RP as the test model. Methods: The implementation of laboratory Lean involved 4 steps process; (1) Development of burning platform for change (2) Identification of waste (3) Planning and implementation of control measures (4) Measuring, monitoring, and sustaining the improvement. Urgent RP LTAT and the percentage of the request met the time requirement determined based on the data extracted from laboratory information system (LIS) before and after the implementation of Lean was compared to assess the effectiveness. Results: Urgent RP LTAT after the implementation of Lean was reduced i.e 35 min (before) vs 31 min (after), with the percentage of LTAT met the time requirement was significantly increased above the set target i.e 82.8% (before) to 93.5% (after) with P-value = 0.001. Conclusion: Implementation of innovation using Lean management has significantly improved urgent RP LTAT achievement, thus optimised urgent test management in our Chemical Pathology laboratory. Lean is a strongly recommended strategy to improve urgent test LTAT especially in laboratories with restricted resources.

Introduction: Non-communicable diseases (NCDs) are evolving as the leading cause of death worldwide, including in Malaysia. Changes in a socio-economic status have increased at-risk populations with NCDs. The objective of this study is to describe the prevalence of self-reported NCDs and its contributing factors in a selected low socio-economic status community in Kedah, Malaysia. Methods: A cross-sectional study with a self-administered questionnaire was done among convenience samples of 139 adults (age more than 18 years old) living in a selected low socio-economic status community in Kedah. Results: Among 139 respondents with a mean (SD) age 48.5 (13.1), there were 40.3% of respondents reported to have chronic illnesses with a prevalence of hypertension (25.9%), diabetes mellitus (21.6%), hypercholesterolemia (7.2%), chronic respiratory diseases (5.0%), heart disease (2.9%) and stroke (1.4%). The significant contributing factors of NCDs by multiple logistic regression were age, marital and working status. A person with an increase in 1 year of age has 1.05 times the odds to have NCDs (95% CI: 1.01 to 1.09, p-value=0.007). A divorcee has 3.55 times the odds compared to a married person to have NCDs (95% CI: 1.28 to 9.80, p-value=0.015). The non-working individual has 2.27 times the odds compared to working individuals to have NCDs (95% CI: 1.03 to 5.01, p-value=0.042). Conclusion: The prevalence of NCDs is high in this selected low socio-economic status community. The contributing factors are age, marital and working status.

The Coronavirus disease (COVID-19) imparted unprecedented negative impact worldwide since it was declared as a global pandemic in 2020 due to its high infectivity and mortality rate. Consequently, those who have been infected with COVID-19 experienced significant amount of social stigma which resulting in deterioration of mental well being. Hence, this study aimed to translate the Explanatory Model Interview Catalogue Stigma Scale (EMIC-SS) into Malay and investigate the reliability and validity of the Malay version (EMIC-SS-M) among COVID-19 survivors in Malaysia. Initially, concurrent translation and back translation of the EMIC-SS was conducted followed by the assessment of its face and content validity. Then, the EMIC-SS-M was administered to 219 COVID-19 survivors recruited from three targeted centers for assessment of its reliability (internal consistency) and validity (convergent and discriminant validity, exploratory factor analysis [EFA] and confirmatory factor analysis [CFA]). The EMIC-SS-M reported an acceptable internal consistency with Cronbach’s α of 0.727, while its domains reported acceptable Cronbach’s α ranged from 0.708 to 0.795. EFA and CFA confirmed that the EMIC-SS-M consisted of 15 items in 4 domains. The EMIC-SS-M exhibited good psychometric properties and ready for use to assess stigma among COVID 19 survivors in Malaysia. It can be adapted for use to assess stigma in other disease conditions among the Malaysian population in future studies.
COVID-19