1.Clival Chordoma in an Adolescent: A Perspective from Primary Care
Hayatul Najaa MIPTAH ; Siti Fatimah BADLISHAH-SHAM ; Hilwati HASHIM ; Anis Safura RAMLI
Korean Journal of Family Medicine 2020;41(6):427-430
Clival chordoma is a rare malignant tumor of the brain that typically occurs in older adults. It has a high local recurrence rate and is hence associated with poor prognosis. Here, we report a case of an adolescent who presented with a 1-month history of worsening headache and blurring of vision, as well as a 6-month history of left-sided facial and body numbness. Clinical findings were consistent with left upper motor neuron lesion of the seventh cranial nerve with involvement of the fifth cranial nerve. He was also found to have a sixth cranial nerve palsy demonstrated by diplopia upon lateral gaze with no evidence of papilledema. Magnetic resonance imaging of the brain suggested clival chordoma. He was subsequently referred to the neurosurgical team, and he successfully underwent an endoscopic trans-sphenoidal surgery to excise the lesion. He recovered well, continued his follow-ups with the neurosurgical team, and showed good progress. He also attended regular follow-ups with his primary care physician to ensure ongoing psychosocial support and monitoring of his overall health status. This case demonstrates the importance of prompt identification and treatment of clival chordoma in an adolescent. Long-term follow-ups and shared care between primary and secondary care physicians are essential to monitor recurrence of tumor and to provide psychosocial support.
2.Adaption, translation and validation of the Diabetes Mellitus in the Offspring Questionnaire (DMOQ): The Malay version
Siti Fatimah BADLISHAH-SHAM ; Anis Safura RAMLI ; Mohamad Rodi ISA ; Yung Wen HAN ; David Leonard WHITFORD
The Medical Journal of Malaysia 2018;73(1):16-24
Background: The Diabetes Mellitus in the OffspringQuestionnaire (DMOQ) assesses the perceptions of Type 2diabetes mellitus (T2DM) patients on the risk of theiroffspring developing T2DM and the possibility ofintervention to reduce this risk. It has 34 items framed withinseven domains. This study aimed to adapt, translate andvalidate the DMOQ from English into the Malay language.Methods: This was a cross-sectional validation study among159 T2DM patients attending a public primary care clinic inSelangor. The DMOQ English version underwent adaptation,translation, face validation and field testing to produce theMalay version. Psychometric analysis was performed usingExploratory Factor Analysis, internal consistency and testretestreliability.Results: The DMOQ domains were conceptually equivalentbetween English and Malay language. A total of 13 items andtwo domains were removed during the validation process(three items during the content validation, three items due topoor factor loadings, five items as they loaded onto twodomains which were not interpretable, one item as it did notfit conceptually into the factor it loaded onto and one openendedquestion as it did not fit into the retained domains).Therefore, the final DMOQ Malay version consisted of 21-items within five domains. The Cronbach alpha was 0.714and the intraclass-correlation coefficient was 0.868.Conclusion: The DMOQ Malay version is a valid and reliabletool which is consistent over time. It can be used to examinethe perception of T2DM patients towards the risk of theiroffspring developing diabetes and possibility of interventionin Malay-speaking patients.
3.Adaptation, Translation and Validation of the Condom Use SelfEfficacy Scale (CUSES) Malay Version Among STD/HIV Patients in Primary Care
Nurainee Ibrahim ; Siti Fatimah Badlishah-Sham ; Nafiza Mat Nasir ; Fazlina Mohammed Yusof
Malaysian Journal of Medicine and Health Sciences 2020;16(No.4):21-28
Introduction: Consistent condom use can reduce the rate of transmission of STD/HIV. Condom self-efficacy is an
important determinant of consistent condom use. The Condom Use Self-Efficacy Scale (CUSES) assesses the individual's confidence and expectations to obtain, use, dispose and negotiate use of condom with their sexual partners.
This study aimed to adapt, translate and determine the validity and reliability of CUSES Malay version among STD/
HIV patients in a primary care clinic. Methods: This was a cross sectional validation study conducted among STD/
HIV patients in a primary care clinic. The CUSES Malay version underwent content validation (calculation of I-CVI),
forward and backward translation, face validation and field testing for psychometric analysis. Psychometric analysis
used included Principal Axis Factoring with direct oblimin rotation, internal consistency reliability (Cronbach's α)
and test-retest reliability analyses (Intraclass Correlation (ICC)). Results: A total of 168 participants were enrolled into
this study (99% response rate). In content validation, all items were retained as the I-CVI were >1.00. Feedback from
face validation resulted in simpler phrases of some items. One item (B2) was removed due to poor factor loading of
<0.3. This resulted in 27 items framed within four factors. These factors were identified as Mechanics, Perceived
Barriers, Assertiveness and Intoxicants. Reliability analysis achieved an overall Cronbach's α of 0.878 and ICC >0.4.
Conclusion: The CUSES-M is a valid, reliable and stable tool to measure condom use self-efficacy among STD/HIV
patients in primary care.
4.Validity and reliability of the Patient Activation Measure® (PAM®)-13 Malay version among patients with Metabolic Syndrome in primary care
Anis Safura Ramli ; Nur Hidayah Bahrom ; Mohamad Rodi Isa ; Noorhida Baharudin ; Siti Fatimah Badlishah Sham ; Mohamed Syarif Mohamed Yassin ; Hasidah Abdul Hamid
Malaysian Family Physician 2020;15(3):22-34
Introduction: The Patient Activation Measure (PAM) is one of the most extensively used, widely
translated, and tested instruments worldwide in measuring patient activation levels in self-management.
This study aimed to determine the validity and reliability of the PAM-13 Malay version among patients
with Metabolic Syndrome (MetS) attending a primary care clinic.Methods: This work is a cross-sectional validation study among patients with MetS attending a
university primary care clinic in Selangor. The PAM-13 Malay version underwent a validation process
and field testing. Psychometric properties were examined using principal component analysis (PCA)
with varimax rotation, scree plot, Monte Carlo simulation, internal consistency, and test-retest
reliability analyses.
Results: The content of the PAM-13 Malay version and the original version were conceptually
equivalent. The questionnaire was refined after face validation by 10 patients with MetS. The refined
version was then field-tested among 130 participants (response rate 89.7%). The Kaiser–Meyer–
Olkin test was 0.767, and Bartlett’s test of sphericity was ≤0.001, indicating sampling adequacy. Two
factors were identified and labeled as (1) Passive and Building Knowledge, and (2) Taking Action and
Maintaining Behavior. These labels were chosen as they were conceptually consistent with the items
representing the levels of activation in PAM-13. The validated PAM-13 Malay version consisted of
13 items, framed into two domains. The overall Cronbach’s α was 0.79, and the intraclass correlation
coefficient was 0.45.
Conclusions: The PAM-13 Malay version is valid, reliable, and fairly stable over time. This
questionnaire can be used to evaluate the levels of activation among patients with MetS in primary care in Malaysia.