1.Sample Size Calculation in Animal Studies Using Resource Equation Approach
Wan Nor Arifin ; Wan Mohd Zahiruddin
Malaysian Journal of Medical Sciences 2017;24(5):101-105
Animal research plays an important role in the pre-clinical phase of clinical trials.
In animal studies, the power analysis approach to sample size calculation is recommended.
Whenever it is not possible to assume the standard deviation and the effect size, an alternative to
the power analysis approach is the ‘resource equation’ approach, which sets the acceptable range
of the error degrees of freedom (DF) in an analysis of variance (ANOVA). The aim of this article is
to guide researchers in calculating the minimum and maximum numbers of animals required in
animal research by reformulating the error DF formulas.
2.Psychometric Properties of the Heart Disease Knowledge Scale: Evidence from Item and Confirmatory Factor Analyses
Bee Chiu Lim ; Yee Cheng Kueh ; Wan Nor Arifin ; Kok Huan
Malaysian Journal of Medical Sciences 2016;23(4):33-45
Background: Heart disease knowledge is an important concept for health education, yet there is
lack of evidence on proper validated instruments used to measure levels of heart disease knowledge
in the Malaysian context.
Methods: A cross-sectional, survey design was conducted to examine the psychometric
properties of the adapted English version of the Heart Disease Knowledge Questionnaire (HDKQ).
Using proportionate cluster sampling, 788 undergraduate students at Universiti Sains Malaysia,
Malaysia, were recruited and completed the HDKQ. Item analysis and confirmatory factor analysis
(CFA) were used for the psychometric evaluation. Construct validity of the measurement model was
included.
Results: Most of the students were Malay (48%), female (71%), and from the field of science
(51%). An acceptable range was obtained with respect to both the difficulty and discrimination indices
in the item analysis results. The difficulty index ranged from 0.12.0.91 and a discrimination index of
. 0.20 were reported for the final retained 23 items. The final CFA model showed an adequate fit to
the data, yielding a 23-item, one-factor model [weighted least squares mean and variance adjusted
scaled chi-square difference = 1.22, degrees of freedom = 2, P-value = 0.544, the root mean square
error of approximation = 0.03 (90% confidence interval = 0.03, 0.04); close-fit P-value = > 0.950].
Conclusion: Adequate psychometric values were obtained for Malaysian undergraduate
university students using the 23-item, one-factor model of the adapted HDKQ.
3.Adaptation and Validation of the Malay Version of the Index of Dental Anxiety and Fear (IDAF-4C+) for Malaysian Secondary School Children
Izyan Hazwani BAHARUDDIN ; Wan Nor ARIFIN ; Kueh Yee CHENG ; Normastura Abd RAHMAN
Malaysian Journal of Medical Sciences 2018;25(3):111-119
Background: Many questionnaires have been developed to measure dental anxiety andfear. Among them is the Index of Dental Anxiety and Fear Scale (IDAF-4C+), which consists of adental anxiety and fear module (IDAF-4C), a phobia module (IDAF-P) and a stimulus module(IDAF-S). The objective of this research was to report the adaptation and validation of the IDAF-4C+ for Malaysian secondary school children.Methods: This was a cross‑sectional validation study. The original English version of theIDAF-4C+ was translated into Malay, back-translated, and then sent for content validation via anexpert validation and face validation by the target student population. Three hundred and seventyquestionnaires were then distributed among 16-year-old school children. Confirmatory factoranalysis (CFA) was conducted for the IDAF-4C module using a bootstrapped maximum likelihoodestimator. Spearman’s rank correlation was used to assess the relationship between the IDAF‑Sand IDAF-4C modules. Intraclass correlation (ICC) was used to determine the stability of theIDAF-S and IDAF-4C modules, while kappa values were used for the IDAF-P module.Results: The response rate was 86.5% for CFA and 76.9% for stability. CFA showed theexistence of only one factor with a reliability estimate of 0.921, obtained via Raykov’s procedure.All items in the IDAF-S module were significantly correlated with the IDAF-4C module (P <0.001). The IDAF-S and IDAF-4C modules were stable, as determined via a two-way mixed modelwith absolute agreement, a single measure and a Case 3 ICC (A, 1). The IDAF-P module showedsatisfactory stability, as assessed via kappa values.Conclusion: The Malay version of the IDAF-4C+ is valid and reliable in measuring dentalanxiety and fear among Malaysian secondary school children.
4.Reporting Statistical Results in Medical Journals
Wan Nor Arifin ; Abdullah Sarimah ; Bachok Norsa’adah ; Yaacob Najib Majdi ; Ab Hamid Siti-Azrin ; Musa Kamarul Imran ; Abd Aziz Aniza ; Lin Naing
Malaysian Journal of Medical Sciences 2016;23(5):1-7
Statistical editors of the Malaysian Journal of Medical Sciences (MJMS) must go through
many submitted manuscripts, focusing on the statistical aspect of the manuscripts. However, the
editors notice myriad styles of reporting the statistical results, which are not standardised among
the authors. This could be due to the lack of clear written instructions on reporting statistics in the
guidelines for authors. The aim of this editorial is to briefly outline reporting methods for several
important and common statistical results. It will also address a number of common mistakes
made by the authors. The editorial will serve as a guideline for authors aiming to publish in the
MJMS as well as in other medical journals.
5.Understanding Dieting and Previous Weight Loss Attempts among Overweight and Obese Participants: Insights into My Body Is Fit and Fabulous at Work Program
Tengku Alina Tengku ISMAIL ; Rohana Abdul JALIL ; Wan Rosli WAN ISHAK ; Noor Fadzlina HAMID ; Wan Suriati WAN NIK ; Hamid Jan JAN MOHAMED ; Nor Haslina MOHD ; Wan Nor ARIFIN ; Wan Mohd Izani Wan MOHAMED ; Mohd Ismail IBRAHIM ; Rohaida ISMAIL ; Tengku Fatimatul Tengku HASSIM ; Tahir ARIS ; Wan Manan WAN MUDA
Korean Journal of Family Medicine 2018;39(1):15-22
BACKGROUND: A qualitative study providing an in-depth exploration of people's view and the increasing burden of overweight and obesity is required. This study aimed to explore the understanding of dieting and previous experiences on weight loss attempts among overweight and obese government employees in Kelantan, Malaysia, prior to recruitment into the intervention program. METHODS: Thirteen focus group discussions involving 129 participants from a weight-loss intervention program were conducted within the first 1 month of recruitment. These discussions were moderated by two trained researchers in the Malay language and assisted by an interview guide. They were audio-recorded and transcribed verbatim. A thematic analysis was performed, and codes and themes from each discussion were constructed. RESULTS: The participants understood dieting with various meanings, including skipping meals and removing rice from daily diets. They applied numerous methods to lose weight and achieved various outcomes. Health and appearance, social support, and compliance with current trends were the factors motivating these participants to lose weight. Their determination to lose weight was limited by lack of self-control and motivation, experiences of unpleasant effects, influence on weight, and environmental and health factors. CONCLUSION: Real-life weight loss experiences and perceptions provided relevant insights into current weight loss management strategies. Some of these issues and misunderstandings should be emphasized in weight loss strategies during health promotion.
Compliance
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Diet
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Focus Groups
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Health Promotion
;
Malaysia
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Meals
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Motivation
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Obesity
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Overweight
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Qualitative Research
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Self-Control
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Weight Loss
6.Development of a new questionnaire to assess childcare providers’ KAP regarding infant and young child feeding
Najihah Mahfuzah Zakria ; Tengku Alina Tengku Ismail ; Wan Nor Arifin Wan Mansor ; Zaharah Sulaiman ; Tengku Fatimatul Tengku Hassim
Malaysian Journal of Nutrition 2020;26(No.1):51-63
Introduction: The integration of infant and young child feeding into childcare settings is important to the overall wellbeing of a community. To our knowledge, there is no questionnaire at the national context specifically on the knowledge, attitude and practice (KAP) of infant and young child feeding among childcare providers. Preexisting questionnaires are unsatisfactory due to different target populations and validation approaches. This study aims to develop a new questionnaire for assessing the KAP regarding infant and young child feeding among childcare providers in Malaysia. Methods: A new questionnaire on childcare providers’ KAP was developed using literature review, expert opinions, and a theoretical framework. It was developed using a modified Delphi technique in five phases: 1. Identification of the domains, 2. Verification of the identified domains, 3. Definition of the domains, 4. Identification of relevant and representative items for each domain, and 5. Final verification of the domains and items, followed by a pre-survey evaluation. Results: The final items were verified by experts with references to relevant literatures, other questionnaires, and experts’ experiences. A total of 236 items were selected after consideration of their relevancy and representativeness: 104, 90, 42 items addressing knowledge, attitude, and practice, respectively. The questionnaire was named Borang Kaji Selidik Pemakanan Bayi dan Kanak-kanak dalam kalangan Pengasuh, or IYCFCCPQ. Conclusion: The IYCF-CCPQ is a newly developed questionnaire to measure childcare providers’ KAP regarding infant and young child feeding.
7.Psychometric Properties of the Self-Efficacy Scale among Undergraduate Students in Malaysia
Liu Kien Ting ; Garry Kuan ; Wan Nor Arifin ; Kueh Yee Cheng
Malaysian Journal of Medical Sciences 2019;26(3):119-128
Background: Self-efficacy (SE) is a person’s belief in his or her own capability to perform
and accomplish a task that could produce a favourable outcome, despite facing obstacles. This
study aimed to confirm the validity and reliability of an SE scale among undergraduate students at
the Health Campus of the Universiti Sains Malaysia.
Methods: A cross-sectional study was conducted among the undergraduate students
using a self-administered questionnaire. After using a purposive sampling method, 562 students
completed the questionnaire. Mplus 8 was employed to conduct the confirmatory factor analysis
on the psychometric properties of Bandura’s 18-item SE scale with three factors (internal feeling,
competing demands and situational). Then, the composite reliability was calculated for each factor.
Results: Most of the students were Malay (73.3%) females (79.0%) who exercised 2.62
times a week for an average of 43.37 min per session. The final measurement model was obtained
after removing six problematic items, and the model was deemed fit based on several indices [Root
Mean Square Error of Approximation (RMSEA) = 0.067, Standardised Root Mean Square Residual
(SRMR) = 0.004, Comparative Fit Index (CFI) = 0.924]. The composite reliability values of the
three factors were acceptable (0.65 to 0.84).
Conclusion: The simplified 12-item SE scale with three factors displayed good fit indices
with regard to the data, and they were considered to be acceptable for the current sampl
8.Effectiveness Of Community-Based Health Education On Preparedness For Flood-Related Communicable Diseases In Kelantan
Wan Mohd Zahiruddin Wan Mohammad ; Wan Nor Arifin Wan Mansor ; Noor Aman A Hamid ; Surianti Sukeri ; Habsah Hasan ; Lee Yeong Yeh ; Alwi Muhd Besari ; Nani Draman ; Rosnani Zakaria ; Zeehaida Mohamed
Malaysian Journal of Public Health Medicine 2020;20(3):117-124
The flood disaster in Kelantan in 2014 had resulted in substantial health implications including increased cases of communicable diseases. There was a lack of community preparedness including customized health educations in the prevention and control of flood-related communicable diseases in the affected areas. The research was aimed to evaluate the effectiveness of community-based health education modules on flood-related communicable diseases among communities in Kelantan. Health education modules focusing on major food-related diseases were developed. A non-randomized community-controlled trial using the modules were conducted. Outcomes were assessed on knowledge, attitude and preventive practice scores to flood-related communicable diseases using a pre-validated questionnaire. Independent t test was used to compare mean scores between the intervention community (Tumpat) and the control community (Bachok) at 1-month post intervention. One-way independent ANOVA test was done to compare score differences at baseline (pre), post 1-month and post 2-month from repeated surveys among random samples within the intervention community. There were significant improvements in all knowledge components from 9.4% to 52.6% with 10% increment in attitude scores toward preventing behaviours on flood-related communicable diseases. When compared against the control community at one-month post-intervention, there were significantly higher knowledge on types of diseases, symptoms and risk factors as well as practice scores of drinking safe water and protective habits. This research demonstrated that community-based health education is effective in improving relevant knowledge, attitude and preventive practices among affected communities as part of their preparedness toward communicable diseases related to flood.