Performing self-care activities can be challenging but it is important for favourable outcomes of type 2 diabetes mellitus (T2DM). It may be influenced by psychological problems. Therefore, this study examined the level of self-care activities and the presence of psychological problems among patients with T2DM. The association between these activities and the psychological problems was assessed too. This cross-sectional study was conducted at a public health clinic in Sabah. Data was collected between July and September 2017 using a validated self-administered questionnaire which include the depression, anxiety and stress scale-21 (DASS-21) and the summary of diabetes self-care activities (SDSCA) questionnaire. About 91% of 331 participants took diabetes medications in ≥6 days per week. They followed a healthful eating plan, inspected feet and exercised 30 minutes a day in 5.0 (IQR 4.0), 4.0 (IQR 7.0) and 1.0 (IQR 4.0) days per week respectively. Among owners of glucometer, the median (IQR) of monitoring blood glucose was 1.0 (1.0) days per week. The participants with depression, anxiety and stress were 4.5%, 8.8% and 5.7% respectively. Following a healthful eating plan (p<0.001) was found to be significantly associated with anxiety; those with anxiety practised this activity in fewer days than those without anxiety. Generally, self-care activities were poorly practiced by the participants, except for taking diabetes medications. Thus, the patients should be encouraged to improve their self-care activities. Psychological problems were also found to be uncommon. However, anxiety symptoms should not be ignored as it may negatively affect their adherence to healthy diet.

Teenage pregnancy carries serious impacts on adolescent health. This study aimed to examine the effects of pregnancy on adolescents and to explore how they cope with the problems they faced during the pregnancy. It involved 26 adolescents residing in a government shelter home in Kuala Lumpur. A self-administered questionnaire containing a mixture of open- and closed-ended questions was used. Among physical (sleeping problem and self-care problem), psychological (emotional difficulties and low self-efficacy) and social (stigma and discrimination, financial difficulty, friendship problem and school dropout) problems, emotional difficulties were the most common problems, whereas stigma and discrimination was the least common. Young adolescents aged less than 16 years old were significantly associated with poor self-care (p=0.01). To cope with their problems, the adolescents generally used avoidance, withdrawal, and social support, particularly from parents and peers. Doctors were the least popular among all. In conclusion, holistic and individualised care is needed. Strategies to reduce emotional problem experienced by pregnant adolescents should be implemented. The available healthcare services for teenage pregnancy should also be promoted.

Background: The prevalence of teenage smoking has decreased over the past decade following the implementation of the national tobacco control programme. However, the effect of the programme on smoking cessation in teenagers has not been determined. Methods: Twenty-eight participants (12 teenagers, 8 teachers, and 8 doctors) were interviewed using 5 in-depth interviews and 3 group discussions. Social cognitive theory (SCT) was applied as the theoretical framework. Semi-structured interview protocols were used, and thematic analysis and analytic generalisation utilising SCT were performed. Results: The current national tobacco control programme was found to be ineffective in promoting smoking cessation among teenagers. The participants attributed the ineffective campaign to the followings: inadequacy of message content, lack of exposure to the programme, and poor presentation and execution. In addition, the participants perceived the developed tobacco control policies to be a failure based on poor law enforcement, failure of retailers to comply with the law, social availability of cigarettes to teenagers, and easy availability of cheap, smuggled cigarettes. This study highlighted that the programme-related problems (environmental factors) were not the only factors contributing to its perceived ineffectiveness. The cunning behaviour of the teenagers (personal factor) and poor self-efficacy to overcome nicotine addiction (behavioural factor) were also found to hinder cessation. Conclusion: Tobacco control programmes should include strategies beyond educating teenagers about smoking and restricting their access to cigarettes. Strategies to manage the cunning behaviour of teenagers and strategies to improve their self-efficacy should also be implemented. These comprehensive programmes should have a foundation in SCT, as this theory demonstrates the complex interactions among the environmental, personal, and behavioural factors that influence teenage smoking.

Background: The quality of life (QoL) describes the multidimensional self-perceived well-being of a person, which is an important diabetes outcome. This study aimed to measure the QoL scores among patients with type 2 diabetes mellitus (T2DM), as well as their clinical and sociodemographic predictors. Methods: This cross-sectional study involved 180 randomly sampled patients at a primary care clinic on the East Coast of Peninsular Malaysia. A self-administered questionnaire containing the Audit of Diabetes Dependent Quality of Life-18 (ADDQoL-18) was used. Results: Most of the respondents (96.7%) were Malay, with a median (interquartile range, IQR) age of 54.0 (14.0) years old. The majority of them were females (60.0%), married (81.1%) and from low-income families (63.3%), who attained a secondary education or lower (75.6%). Only 49.4% of them were employed. The mean (standard deviation, SD) ADDQoL-18 average weighted impact score was −4.58 (2.21) and all 18 domains were negatively affected, particularly the living condition, family life and working life. The multiple linear regression analysis showed that the age (adjusted B = 0.05, P = 0.004) and insulin use (adjusted B = −0.84, P = 0.011) were QoL predictors. Conclusion: T2DM negatively impacts the patient’s QoL in all aspects of their life. The QoL improvement with age suggests that the older patients had accepted and adapted to their illness. The need to improve the QoL among insulin users was also highlighted.

Background: Primary care doctors are responsible to provide smoking cessation intervention (SCI) to smokers in a community. This study aimed to assess the SCI practice among primary care doctors themselves and its associated factors. Methods: This cross-sectional study was conducted from July to October 2016. All the 140 doctors in 12 public primary care clinics in Kuala Lumpur were invited to participate in this study. However, only 122 doctors (females, 82.8%) completed the self-administered questionnaire that assessed their demography, clinical experience, SCI practice and its barriers, self-efficacy in delivering and knowledge on smoking and SCI. Results: Only 42.6% of the doctors had good SCI practice. Almost all doctors assessed the smoking status of their patients (98.4%) and advised them to quit (98.4%). However, lesser proportions of the doctors followed up the practice of patients (50.0%), taught smokers on various methods of quit smoking (46.70%) and discussed about the barriers and resources to quit prior to the quit date (27.9%). Less than one-fourth of the doctors were confident in providing SCI. Although 69.7% had previous training in SCI, many felt they had inadequate knowledge (56.6%) and skills (47.5%). Only 11.5% of doctors thought their previous training was enough. Having higher level of knowledge on smoking and SCI was significantly associated with good SCI practice [adjusted Odds Ratio (95% Confidence Intervals): 1.21 (1.02, 1.43), p=0.026]. Conclusion: The SCI practiced by the primary care doctors in this study was sub-standard, particularly in assisting smokers to quit and arranging follow up. Low self-efficacy in providing SCI was also common. These inadequacies may be due to poor knowledge and skills, which needs to be improved through effective clinical training.

Introduction: The ability of a person to self-regulate and practise healthy lifestyle behaviours determine one’s weight status. The objective of this study was to determine the relationship of self-regulation, dietary practices, and physical activity with overweight status among male and female adolescents. Methods: This crosssectional study used multistage cluster sampling involving government secondary school students aged between 13 and 14 years old in Hulu Langat, Selangor. Students answered a validated self-administered questionnaire comprising socio-demography, dietary practices, physical activity, and self-regulation items. Their body mass index (BMI) was calculated, and weight status was determined using the Centers for Disease Control and Prevention (CDC) BMI chart. Results: Among 636 students, 27.0% were “overweight”, affecting more male than female students (p=0.032). Majority of them (96.7%) were motivated to maintain healthy body weight, but only a third of the students took vegetables, fruits and grains (32.4%), and performed vigorous physical activity (31.1%) regularly. Regardless of the “overweight” status, there were no significant differences in dietary practices, physical activity, and autonomous regulation for both genders. Female students showed a higher level of controlled regulation than male students in non-overweight (p=0.005) and overweight (p<0.001) groups. Higher controlled regulation increased the odds of being overweight among female students (AOR=1.04, 95% CI=1.04-1.08, p=0.010). Conclusion: Thus, health authorities need to develop programmes to assist, particularly female students, in practising higher autonomous regulation to combat overweight and obesity, as this group exhibits a high level of controlled regulation, which increases the likelihood of being overweight.