1.Mental Health Status and Its Associated Factors Among Caregivers of Psychiatric Patients in Kuching, Sarawak
Cheah Whye Lian ; Ivan Vun Jan Shui ; Helmy Hazmi
Malaysian Family Physician 2019;14(2):18-25
Introduction: Caregivers have a high risk of mental health disorders. The quality of patient care is
inseparable from the mental health status of caregivers. The objective of this research was to study the
mental health status among caregivers of psychiatric patients and its associated factors.
Method: A cross-sectional study was conducted among 198 caregivers in Kuching from January till
July 2014. The respondents were recruited using systematic sampling and were required to provide
information on sociodemographic and environmental factors as well as complete the Hospital Anxiety
and Depression Scale (HADS) questionnaire. The data was analysed using the IBM SPSS Statistical
Software Version 20.0.
Results: The prevalence rates of anxiety and depression among caregivers were 32.8% and 27.8%,
respectively. The caregiver’s age (OR=0.97, 95% CI = 0.953 - 0.996), the perception of caregiving as an economic burden (OR= 2.70, 95% CI= 1.256 - 5.803) and the dependence of the patient (OR= 2.27, 95% CI= 1.087 - 4.719) were associated with anxiety. A caregiver who was male (OR= 2.21, 95% CI= 1.143 - 4.262), a caretaker who held the perception that a patient was dependent on them (OR=2.53, 95% CI= 1.203 - 5.337) , and a caretaker who lacked stress-coping skills (OR=2.48, 95% CI= 1.030 - 5.973) were found to be significant factors in depression.
Conclusion: A high prevalence of probable anxiety and depression among caregivers points to the need to screen caregivers. There is a vital need to train healthcare workers to be able to detect early anxiety and depression. Culturally sensitive research should be carried out for different ethnicity, and improving the support system for caregivers is necessary
2.Perceptions of Receiving Bad News about Cancer among Bone Cancer Patients in Sarawak General Hospital - A Descriptive Study
Cheah Whye Lian ; Nurul Bahariah Dollah ; Chang Ching Thon
Malaysian Journal of Medical Sciences 2012;19(3):36-42
Background: This study aimed to determine the perceptions and expectations of bone cancer patients with respect to their doctors and the breaking of bad news as well as the environment in which the news was delivered.
Methods: A cross-sectional study using a pretested 41-item questionnaire was conducted using convenience sampling among bone cancer patients in Sarawak General Hospital. Face-to-face interviews were conducted after consent was obtained. Data were analysed using SPSS version 16 (SPSS Inc., IL, US).
Results: A total of 30 patients were interviewed. The majority of the respondents were younger than 40-years-old, Malays, and female. All of the respondents perceived that they received news in a comfortable place, agreed that the doctor used simple language and appropriate words during the interaction, and believed that the way the doctor delivered the news might influence their life. The majority of the respondents reported that their news was received without interruption, that the doctor was sitting close but without making physical contact, and time was given for patient to ask questions and they were informed accordingly.
Conclusion: Delivering bad news regarding cancer is an important communication skill and a complex task that can be learned and acquired. Specially tailored training is proposed to improve medical practice in this area.
3.The Prevalence of Cardiovascular Risk Factors in the Young and Middle-Aged Rural Population in Sarawak, Malaysia
Ching Thon Chang ; Ping Yein Lee ; Whye Lian Cheah
Malaysian Journal of Medical Sciences 2012;19(2):27-34
Background: Coronary heart disease (CHD) was the second leading cause of death in Malaysia in 2006. CHD has known risk factors including hypertension, diabetes mellitus, and obesity.
Methods: This cross-sectional study examined the prevalence of cardiovascular risk factors among 260 participants aged 20 to 65 years in a rural community in Sarawak.
Results: The prevalences of overweight and obesity in this study were 39.6% and 11.9%, respectively. Approximately 13% of participants had hypertension, and 1.5% had a random blood sugar greater than 11.1 mmol/L. Chi-square tests showed significant associations between obesity and gender (P = 0.007), low high-density lipoprotein cholesterol and race (P = 0.05), high total cholesterol and age (P = 0.007), age and hypertension (P = 0.011), smoking and gender (P < 0.001), and smoking and income (P = 0.050). Age-adjusted logistic regression showed that women were 0.246 times more likely to be obese, that older participants (> 45 years) were 0.395 times more likely to have high cholesterol and that those with a higher monthly household income (> RM830) were 2.471 times more likely to smoke.
Conclusion: These findings indicate that we should be concerned about the high rates of overweight in this rural community to prevent obesity.
4.Spatial, environmental and entomological risk factors analysis on a rural dengue outbreak in Lundu District in Sarawak, Malaysia.
Whye Lian Cheah ; Moh Seng Chang ; Yin Chai Wang
Tropical biomedicine 2006;23(1):85-96
The objective of this study was to elucidate the association of various risk factors with dengue cases reported in Lundu district, Sarawak, by analyzing the interaction between environmental, entomological, socio-demographic factors. Besides conventional entomological, serological and house surveys, this study also used GIS technology to generate geographic and environmental data on Aedes albopictus and dengue transmission. Seven villages were chosen based on the high number of dengue cases reported. A total of 551 households were surveyed. An overall description of the socio-demographic background and basic facilities was presented together with entomological and geographical profiles. For serological and ovitrap studies, systematic random sampling was used. Serological tests indicated that 23.7% of the 215 samples had a history of dengue, either recent or previous infections. Two samples (0.9%) were confirmed by IgM ELISA and 49 samples (22.8%) had IgG responses. A total of 32,838 Aedes albopictus eggs were collected in 56 days of trapping. Cluster sampling was also done to determine whether any of the risk factors (entomological or geographical) were influenced by geographical location. These clusters were defined as border villages with East Kalimantan and roadside villages along Lundu/Biawas trunk road. The data collected were analyzed using SPSS version 10.01. Descriptive analysis using frequency, means, and median were used. To determine the association between variables and dengue cases reported, and to describe the differences between the two clusters of villages, two-sample t-test, and Pearson's Chi-Square were used. Accurate maps were produced with overlay and density function, which facilitates the map visualization and report generating phases. This study also highlights the use of differential Global Positioning System in mapping sites of 1m accuracy. Analysis of the data revealed there are significant differences in clusters of villages attributable to container density, house density, distance of the house from the main road, and number of Ae. albopictus eggs from ovitraps set indoor, outdoor and in dumping sites (Person's Chi-Square = 6.111, df = 1, p < 0.01). Further analysis using t-test showed that house density, container density, indoor mosquitoes egg count, outdoor mosquitoes egg count, and dumping sites mosquitoes egg count were higher at the roadside villages compared to border villages. A number of potential risk factors including those generated from GIS were investigated. None of the factors investigated in this study were associated with the dengue cases reported.
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5.Blood pressure profile for children aged 5 to 6 years and its associated factors – a crosssectional study in Kuching district, Sarawak
Cheah Whye Lian ; Edmund Shin Chin Vui ; Ayu Akida Abdul Rashid
Malaysian Family Physician 2019;14(1):2-9
Introduction: This study aimed to determine the blood pressure profile for preschool children in
Kuching Sarawak and its relationship with sociodemographic characteristics, nutritional status and
parental hypertension.
Methods: This was a cross sectional study conducted in a government preschool in Kuching district
from January to June 2017. Data were collected using questionnaire as well as anthropometric and
blood pressure measurements. Data were entered into and analyzed using SPSS Version 22.
Results: A total of 229 preschool children participated in this study (response rate of 81%). About
9.7% of the respondents were at risk for hypertension. The mean systolic blood pressure was 95.6
mmHg (SD=8.36), and the mean diastolic blood pressure was 59.9 mmHg (SD=6.09). Ten
percent of the children were overweight and 7.4% were obese. Binary logistics regression analysis
indicated that gender (Male: OR = 3.085, p< 0.05), parent’s education level (comparing primary
education and below with secondary education: OR = 4.88, p<0.05; comparing primary education
and below tertiary education: OR = 7.63, p<0.05) and ethnicity (comparing Malay with Chinese:
OR = 0.10, p< 0.01) were significantly associated with being at risk for hypertension.
Conclusion: The study showed that 9.7% of the children were at risk for hypertension and that
17.4% had abnormal body weights. Identifying and tackling the factors leading to these issues
will help to improve and ensure a better quality of non-communicable disease programs offered in
primary health clinics and school health programs.
6.An intervention based on the stages of change, health profiles and physical activity levels of overweight and obese adults in Sarawak, Malaysia – a feasibility study
Cheah Whye Lian ; Chang Ching Thon ; Helmy Hazmi ; Wan Manan Wan Muda
Malaysian Family Physician 2019;14(3):46-54
Introduction: Physical inactivity is the one of the leading causes of major non-communicable
diseases in the world. The aim of this study is to assess the feasibility of an intervention program
based on the stages of change, physical activity levels and health profiles of selected overweight and
obese adults in Sarawak.
Methods: This intervention study was carried out using selected overweight and obese adults in
Sarawak. A total of 75 participants were placed in the intervention group, and 80 respondents were
placed in the control group participated. Respondent-determined weekly aerobic exercise sessions
were conducted for six months. The Malay version of the long-form International Physical Activity
Questionnaire (IPAQ) and Transtheoretical model of change (TTM) questionnaire were used,
together with anthropometric measurements and the collection of venous fasting blood profiles.
Data was entered and analyzed using SPSS Version 20.
Results: The intervention group had significant better stage transitions compared to the control
group (p<0.01). They also had significantly lower total cholesterol, although both groups showed
significant results (difference= 0.53, p<0.01; difference= 0.38, p=0.01). The respondent-determined
intervention program was effective in improving stage transition; however, an intervention of longer
duration could provide more conclusive health outcomes.
Conclusion: Physical activity plays a role in assisting overweight and obese adults to be more active
and healthier.
7.Physical Activity And Cardiovascular Risk Factors Among Malays In Selected Rural And Urban Communities In Sarawak
Cheah Whye Lian ; Helmy Hazmi ; Chang Ching Thon ; Wan Manan Wan Muda
Malaysian Journal of Public Health Medicine 2015;15(3):104-111
The objective of this study was to describe the differences in physical activity with socio-demographic factors and its association with cardiovascular risk factors. It was a cross-sectional study among selected urban and rural Malays communities in Kuching and Samarahan. Physical activity data was obtained using International Physical Activity Questionnaire (IPAQ) short version. Assessment of cardiovascular risk factors was based on blood pressure, fasting cholesterol and glucose and body mass index (BMI). Data was analysed using SPSS version 20. A total of 223 participated with higher response from rural areas (60.1%) and females (61.9%). More than half of the respondents (58.5%) were overweight and obese, with a mean BMI of 25.9 kg/m2 (SD=4.9). About 25% of the respondents were found to have blood pressure in the at-risk range. The prevalence of at-risk blood glucose was 52.3% with a mean value of 7.3mmol/L (SD=3.46). The prevalence of at-risk cholesterol were lower with 31.8%, mean value of 3.5 mmol/L (SD=2.94). There were more active respondents living in rural area (p=0.02). Logistics regression analysis showed that urban area (OR=1.988 95% CI 1.082 to 3.652), systolic blood pressure (OR1.020 95% CI 1.003 to 1.037) and blood cholesterol (OR0.884 95% CI 0.785 to 0.996) were associated with physical activity level. Change of physical activity due to urbanization can increase the risk of obesity and other chronic diseases. Efforts to include physical activity in intervention programme should be more intensified, with more provision of suitable built environment.
8.A qualitative study on malnutrition in children from the perspectives of health workers in Tumpat, Kelantan.
Cheah Whye Lian ; Wan Manan Wan Muda * ; Zabidi-Hussin Z.A.M.H. ** ; Chang Kam Hock
Malaysian Journal of Nutrition 2007;13(1):19-28
Underlying causes of most nutrition related problems are diverse, including biological, social, cultural, and economic factors. Qualitative approaches complement quantitative methods in identifying the underlying meanings and patterns of relationships involved in managing malnutrition. This study examined perceptions regarding malnutrition among health workers from 7 clinics (community and health clinics) in Tumpat, Kelantan. A total of 18 nurses and 2 doctors, who were involved in monitoring child health and nutrition, were included in the study. These health workers were interviewed using a semi-structured questionnaire adapted from Sastry’s framework on malnutrition (Sastry, 1996). The questionnaire included biological, behavioral and environmental factors that influence child health and nutrition. All the health workers perceived that mothers/caregivers play the main role in improving the health of malnourished children. The quality of childcare was rated as moderately satisfactory by the health workers. Most of the affected families who were given the Food Baskets did not fully use all the items for the malnourished child. Child feeding practice was based on the needs of the whole family rather than according to the target child’s needs. Most of the mothers preferred processed cereals than rice porridge because the former is easier to prepare for the child. Although they were from a low socioeconomic background, most of the mothers were not earning additional income for the family. The qualitative methodology provided information that can be used as a basis for the designing of quantitative questionnaires to assess malnutrition among children. The induction characteristic of qualitative methods was used to gain an understanding of the underlying reasons or phenomena such as behaviours that are directly observable.
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9.The Perception, Level of Safety Satisfaction and Safety Feedback on Occupational Safety and Health Management among Hospital Staff Nurses in Sabah State Health Department
Whye Lian Cheah ; Nelbon Giloi ; Ching Thon Chang ; Jac Fang Lim
Malaysian Journal of Medical Sciences 2012;19(3):57-63
Background: This study aimed to determine the perception and level of safety satisfaction of staff nurses with regards to Occupational Safety and Health (OSH) management practice in the Sabah Health Department, and to associate the OSH management dimensions, to Safety Satisfaction and Safety Feedback.
Methods: A cross-sectional study using a validated self-administered questionnaire was conducted among randomly respondents.
Results: 135 nurses responded the survey. Mean (SD) score for each dimension ranged from 1.70 ± 0.68–4.04 ± 0.65, with Training and Competence dimension (mean [SD], 4.04 ± 0.65) had the highest while Safety Incidence was the least score (mean [SD], 1.70 ± 0.68). Both mean (SD) scores for Safety Satisfaction and Safety Feedback was high, 3.28 ± 0.51 and 3.57 ± 0.73, respectively. Pearson’s correlation analysis indicated that all OSH dimensions had significant correlation with Safety Satisfaction and Safety Feedback (r coefficient ranged from 0.176–0.512) except for Safety Incidence.
Conclusion: The overall perception of OSH management was rather low. Significant correlation between Safety Satisfaction and Safety Feedback and several dimensions, suggest that each organization to put in place the leaders who have appropriate leadership and supervisory skills and committed in providing staff training to improve staff’s competency in OSH practice. In addition, clear goals, rules, and reporting system will help the organization to implement proper OSH management practice.
10.A Preliminary Study on the Prevalence of Cardiovascular Disease Risk Factors in Selected Rural Communities in Samarahan and Kuching Division, Sarawak, Malaysia
Cheah Whye Lian ; Lee Ping Yein ; Khatijah Yaman ; Rasidah Abdul Wahab
Malaysian Journal of Medical Sciences 2011;18(2):58-65
Background: It is important to understand the prevalence of risk factors for cardiovascular
disease, especially in a rural setting.
Methods: A cross-sectional study was carried out in 238 rural households located in
the Kuching and Samarahan divisions of Sarawak among individuals aged 16 years and above.
Anthropometric measurements, blood levels of glucose and cholesterol, and blood pressure were
collected.
Results: Prevalence of blood pressure in the hypertensive range was 43.1%. The highest
rates of blood pressure in the hypertensive range were found in individuals aged above 60 years
(38.6%) and 50–59 years old (31.8%). Age was one factor found to be significantly associated with
blood pressure in the hypertensive range (P < 0.001). Prevalence of obesity was 49.0%. The highest
prevalence of obesity was found among those aged 40–49 years (41.9%) and 50–59 years (29.9%).
Gender was significantly associated with obesity (P = 0.004). The prevalence of blood cholesterol at
risk was 21.6%, and the highest rate was found in the 40–49 years age group (34.0%). Fifty percent
of respondents were found to have hyperglycaemia, with the highest prevalence in the 50–59 years
age group (37.5%). A significant association was found between obesity, blood pressure in the
hypertensive range and blood glucose level. When compared with non-obese individuals, those who
were obese were more likely to have blood pressure in the hypertensive range and hyperglycaemia.
Conclusion: The risk of developing lifestyle-related diseases is no longer based on geographical or socio-economic factors.