1.Identifying self-care behaviour and its predictors among type 2 diabetes mellitus patients at a district of Northern Peninsular Malaysia
Kang Chia YEE ; Salmiah Md SAID ; Rosliza Abdul MANAF
Malaysian Journal of Medicine and Health Sciences 2018;14(2):17-29
Introduction: The prevalence of diabetes mellitus among Malaysian aged ≥ 18 years increased from 11.6% (2006) to 17.5% (2015). Positive self–care behaviour leads to good glycaemic control. The objective of this study is to determine the self-care behaviour, its associated factors and predictors among type 2 diabetes mellitus (T2DM) patients in government health clinics at a district of Northern Peninsular Malaysia. Methodology: A cross-sectional study was conducted on 546 T2DM patients aged ≥ 18 years, recruited by simple random sampling method. A validated self-administered questionnaire including socio-demographic characteristics, diabetes profile, knowledge, Health Belief Model (HBM) and Summary of Diabetes Self-care Activity Scale (SDSCA) was used. Data were analysed using SPSS version 22.0. Self-care behaviour is the dependent variable. Results: The respondents practised 3.4 (SD = 1.11) days self-care behaviour past 1 week. The predictors of self-care behaviour were self-efficacy (standardized β = 0.257, p< 0.001), knowledge (standardized β = 0.112, p = 0.007), female (standardized β = 0.107, p = 0.010), combination oral hypoglycaemic agents (OHA) and insulin (standardized β = -0.182, p = 0.002), and monthly income < RM1,000 (standardized β = -0.129, p = 0.002). The entire group of variables significantly predicted self-care behaviour [F (6, 539) = 15.79, p < 0.001, adjusted R2 = 0.140] with total variance of 14.9%. Self-efficacy was the strongest predictor in self-care behaviour. Conclusion: The findings enable us to identify the specific groups with predicted lower self-care behaviour which are useful in future planning and implementation of intervention.
4.Treatment outcomes of patients with stage II pure endometrioid-type endometrial cancer: a Taiwanese Gynecologic Oncology Group (TGOG-2006) retrospective cohort study.
Hung Chun FU ; Jen Ruei CHEN ; Min Yu CHEN ; Keng Fu HSU ; Wen Fang CHENG ; An Jen CHIANG ; Yu Min KE ; Yu Chieh CHEN ; Yin Yi CHANG ; Chia Yen HUANG ; Chieh Yi KANG ; Yuan Yee KAN ; Sheng Mou HSIAO ; Ming Shyen YEN
Journal of Gynecologic Oncology 2018;29(5):e76-
OBJECTIVE: Choice of hysterectomy and adjuvant treatment for International Federation of Gynecology and Obstetrics (FIGO) 2009 stage II endometrioid endometrial cancer (EEC) is still controversial. Aims of this study were to evaluate survival benefits and adverse effects of different hysterectomies with or without adjuvant radiotherapy (RT), and to identify prognostic factors. METHODS: The patients at 14 member hospitals of the Taiwanese Gynecologic Oncology Group from 1992 to 2013 were retrospectively investigated. Patients were divided into simple hysterectomy (SH) alone, SH with RT, radical hysterectomy (RH) alone, and RH with RT groups. Endpoints were recurrence-free survival (RFS), overall survival (OS), disease-specific survival (DSS), adverse effects and prognostic factors for survival. RESULTS: Total of 246 patients were enrolled. The 5-year RFS, OS, DSS and recurrence rates for the entire cohort were 89.5%, 94.3%, 96.2% and 10.2%, respectively. Patients receiving RH had more adverse effects including blood loss (p < 0.001), recurrent urinary tract infections (p = 0.013), and leg lymphedema (p = 0.038). Age over 50-year (HR = 9.2; 95% confidence interval [CI], 1.2–70.9) and grade 3 histology (HR = 7.28; 95% CI, 1.45–36.6) were independent predictors of OS. Grade 3 histology was an independent predictor of RFS (HR = 5.13; 95% CI, 1.38–19.1) and DSS (HR = 5.97; 95% CI, 1.06–58.7). Patients receiving adjuvant RT had lower locoregional recurrence (p = 0.046), but no impact on survival. CONCLUSION: Different treatment modalities yield similar survival outcomes. Patients receiving SH with RT had lower locoregional recurrent with acceptable morbidity. Age and tumor grading remained significant predictors for survival among patients with FIGO 2009 stage II EEC.
Cohort Studies*
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Endometrial Neoplasms*
;
European Union
;
Female
;
Gynecology
;
Humans
;
Hysterectomy
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Leg
;
Lymphedema
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Neoplasm Grading
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Obstetrics
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Radiotherapy
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Radiotherapy, Adjuvant
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Recurrence
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Retrospective Studies*
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Urinary Tract Infections
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Uterine Neoplasms