1.Reliability and Validity of Malay Language Version of International Physical Activity Questionnaire (IPAQ-M) among the Malaysian Cohort Participants
Norsham Shamsuddin ; Poh Bee Koon ; Syed Zulkifli Syed Zakaria ; Mohd Ismail Noor ; Rahman Jamal
International Journal of Public Health Research 2015;5(2):643-653
Validation of instruments is essential when assessing physical activity (PA). The aim of this study was to validate a Malay language version of the International Physical Activity Questionnaire (IPAQ-M) against Actical accelerometer and to determine its reliability and validity. A total of 90 Malay adults aged 35-65 years old participating in The Malaysian Cohort project were recruited for this study. The IPAQ-M is comprised of 12 items, covering vigorous, moderate, walking, sitting and sleeping activities, and was administered on two occasions (Day 1 and Day 9) by interviewing the participants. Participants wore the Actical accelerometer for seven consecutive days between the two interview sessions. Validity tests showed that time spent in moderate-vigorous physical activity (MVPA) (min wk-1) from IPAQ-M was significantly correlated with MVPA from accelerometer (ρ=0.32, p<0.01). Time spent in vigorous activity (ρ=0.44) and total activity (ρ=0.36) from IPAQ-M were significantly correlated (p<0.01) with that measured by accelerometer, but no correlation was observed for sedentary behaviour. Reliability tests revealed significant correlations between the two interview sessions for all intensities of PA (=ρ0.55 to 0.71, p<0.01). Bland-Altman plots showed that time spent in MVPA for IPAQ-M was significantly different from that measured by accelerometer (mean difference: 98.02 min wk-1; 95% limits of agreement: -785.33 to 1317.83 min wk-1; p<0.01). When classifying people into meeting PA recommendation, the agreement between the two instruments was fair (κ=0.22). The IPAQ-M has acceptable validity for MVPA, vigorous and total physical activity, and was reliable for assessing the physical activity of Malay adults.
3.Parental Knowledge on Nephrotic Syndrome and Disease Relapse in children
Shiau Chuen Diong ; Syed Zulkifli Syed Zakaria ; Rahmah Rasat ; Wan Jazilah Wan Ismail
The Medical Journal of Malaysia 2019;74(4):288-295
Introduction: Parental knowledge on nephrotic syndrome
and disease relapse is important for early recognition and
treatment of relapse to prevent the complications. Parental
knowledge on nephrotic syndrome was reported to be
inadequate from published studies. To date, there is no
study on parental knowledge on childhood nephrotic
syndrome in Malaysia. This study is thus aimed at to
determine the level of knowledge on NS and disease relapse
among parents of children with nephrotic syndrome and
determine factors that influence knowledge on nephrotic
syndrome and disease relapse. Study Design and
Methods: This was a cross-sectional study conducted in
Paediatric Nephrology Clinic, Hospital Selayang from
November 2016 to November 2017. Seventy-eight parents
were recruited based on universal sampling. Selfadministered questionnaire in Bahasa Malaysia and English
was designed through focus group discussion with five
subject matter experts and validated through content
validity. Data was analysed using IBM SPSS Statistics 23.0.
Results: Majority of parents or guardians (91%) were able to
answer more than 50% of the questions correctly. Of these,
56% were able to answer more than 75% of the questions
correctly. A 'cut-off' of 75% was defined as good knowledge.
Parents of children with frequent relapses had higher
parental knowledge and this was statistically significant
(p=0.025).
Conclusion: Parental knowledge on nephrotic syndrome
and disease relapse was still inadequate as only 56%
parents had good knowledge. The main areas of deficit in
parental knowledge were related to medications, infections,
home urine dipstick monitoring, and recognition of warning
signs during relapse.
4.A validation study of the Bahasa Malaysia version of the National Institute of Health Stroke Scale
Najma Kori ; Wan Asyraf Wan Zaidi ; Rabani Remli ; Azman Ali Raymond ; Norlinah Mohamed Ibrahim ; Hui Jan Tan ; Syed Zulkifli Syed Zakaria ; Zhe Kang Law ; Kartini Ahmad ; Wan Nafisah Wan Yahya ; Ramesh Sahathevan
Neurology Asia 2018;23(3):225-232
Background & Objectives: The National Institute of Health Stroke Scale (NIHSS) provides a valid
and quick assessment of stroke severity in hyperacute stroke management. Stroke patients who are
eligible for reperfusion therapy require prompt assessment. There is no validated Bahasa Malaysia
(BM) version of the NIHSS that allows easier assessment by BM-speaking health professionals.
This study aimed to translate and validate a BM version of the NIHSS. Methods: The English NIHSS
was translated to BM, then back translated to ensure linguistic accuracy. We also adapted the language
assessment of the NIHSS to be more culturally appropriate. Training and certification videos were
downloaded from the NIH website and dubbed into BM. We determined intra-class correlation and
unweighted kappa as the best measure of reliability. Median scores were used in the analysis for
language items. Results: One hundred and one raters participated in the test-retest reliability study.
Agreement between the original NIHSS and our translated version of the BM-NIHSS was good (ICC
= 0.738, 95% CI: 0.611 to 0.823). Fair to moderate agreement was found on item-by-item analysis
(unweighted κ=0.20-0.50) despite high observed agreement. Fifty patients participated in the language
assessment arm. Scores were better in BM for reading, naming objects and repetition (Mdn = 100, p
< 0.001). There was no difference in the median scores for the description component.
Conclusions: The BM-NIHSS is a valid translation of the NIHSS, and may be used in clinical practice
by BM-speaking healthcare professionals.
5.Incidence and risk factors of delirium in patients with acute ischaemic stroke
Boon Hau Ng ; Zhe Kang Law ; Rabani Remli ; Hui Jan Tan ; Norlinah Mohamed Ibrahim ; Azman Ali Raymond ; Wan Asyraf Wan Zaidi ; Syed Zulkifli Syed Zakaria ; Nafisah Wan Yahya ; Ramesh Sahathevan
Neurology Asia 2019;24(4):295-302
Background & Objectives: The reported incidence of post-stroke delirium varies substantially in current
medical literature. The impact of delirium on mortality and morbidity is significant and there is need
for sustained research on the topic. We aimed to determine the incidence, risk factors and outcome of
delirium in acute ischaemic stroke. Methods: We conducted a cross-sectional observational study on
consecutive patients with ischaemic stroke. The Confusion Assessment Method was used to diagnose
delirium within seven days of stroke onset. Results: Two hundred and eighty patients were recruited
(mean age 63.6 years) and 36 (12.9%) developed delirium. After adjustments for covariates, age >65
years (odds ratio, OR 5.2; 95% confidence interval 1.6-17.5); pre-existing dementia (6.5; 1.1-38.2);
TACI (7.2; 1.5-35); and a National Institute of Health Stroke Scale of ≥10 (6.8; 1.7-26.4), were
independently associated with a risk of developing delirium. Lacunar infarcts were not associated with
delirium (0.07; 0.03-0.16). The majority of patients with delirium were cared for in a dedicated stroke
unit but this proportion was not significant compared to those without delirium (69.4% vs 58.2%,
p=0.20). Delirious patients had significantly higher in-patient mortality (8.3% vs 0%, p=0.002) and
longer length of hospital stay (6.94 vs 3.98 days, p< 0.001).
Conclusions: One in 8 patients with ischaemic stroke in our centre developed delirium. Older age,
pre-existing dementia and severe stroke were independent predictors of delirium. Patients with lacunar
infarcts did not develop delirium as often as those with other stroke types. Delirium significantly
increased in-patient mortality and length of hospital stay.