Introduction: Caring for gastrointestinal cancer patients can be demanding and to some, caregivers, burdensome; resulting in them having low quality of life (QOL) and thus they may become the next potential patients. Hence, true heartfelt experiences need to be captured to highlight issues and preventive measures that are not voiced out as most often caregiving is done in silence and out of responsibility. Therefore, this study aimed to explore on the caregivers’ insights on how caregiving experience has resulted in their low QOL. Methods: Seven family caregivers were purposively selected from two oncology centres in the Klang Valley, Malaysia for this qualitative case study. The selection was based on the low scores obtained from Malay Caregiver Quality of Life Cancer (MCQOL) questionnaire during an initial cross-sectional study. Following that, in-depth interviews were performed on those selected caregivers. Interview data were triangulated with the questionnaire and observations for validity. Member and expert checking were conducted to ensure credibility and trustworthiness. A thematic content analysis was later performed. Results: Thematic analysis revealed four distinct contributors to the caregivers’ QOL; namely, patients’ financial and stress management; impact towards physical, psychological, social (including relationship) wellbeing, communication; and support from families, organisation and community. Conclusion: The qualitative study discovered evidence for collaborative support needed to ensure better QOL for the caregivers.

Pregnant adolescents have been shown to have a higher incidence of health and non-health-related complications that affect both mothers and infants. These include increased risk of pregnancy-related diseases such as anemia and pre-eclampsia, preterm and low-birth-weight babies, as well as other social consequences such as educational and financial difficulties. This mini review evaluates selected articles which explain the attitudes, knowledge, behavior and other risk factors associated with pregnancy among adolescents in developing countries. It also revealed that inadequate knowledge among adolescents about reproductive and sexual health, other social, cultural and peer influences, parenting values, and poor financial and educational status were factors that contribute to adolescent pregnancy. Likewise, a lack of support from parents, educators and healthcare workers had negative impacts on healthy sexual behavior among adolescents, which may ultimately lead to adolescent pregnancy. We conclude that the factors discussed in this review need to be evaluated and taken into consideration by policymakers and healthcare workers when formulating strategies to prevent pregnancies among adolescents.

Background: The patient’s intention to engage in diabetes care is the hallmark of role acceptance as a health manager and implies one’s readiness to change. The study aimed to understand the process of having the intention to engage in diabetes care. Methods: A qualitative study using narrative inquiry was conducted at a public primary care clinic. Ten participants with type 2 diabetes of more than a 1-year duration were selected through purposive sampling. In-depth interviews were conducted using a semi-structured protocol guide and were audio-taped. The interviews were transcribed and the texts were analyzed using a thematic approach with the Atlas.ti ver. 8.0 software (Scientific Software Development GmbH, Berlin, Germany). Results: Three themes emerged from the analysis. The first theme, “Initial reactions toward diabetes,” described the early impression of diabetes encompassing negative emotions, feeling of acceptance, a lack of concern, and low level of perceived efficacy. “Process of discovery” was the second overarching theme marking the journey of participants in finding the exact truth about diabetes and learning the consequences of ignoring their responsibility in diabetes care. The third theme, “Making the right decision,” highlighted that fear initiated a decision-making process and together with goal-setting paved the way for participants to reach a turning point, moving toward engagement in their care. Conclusion Our findings indicated that fear could be a motivator for change, but a correct cognitive appraisal of diabetes and perceived efficacy of the treatment as well as one’s ability are essentially the pre-requisites for patients to reach the stage of having the intention to engage.

Background: The patient’s intention to engage in diabetes care is the hallmark of role acceptance as a health manager and implies one’s readiness to change. The study aimed to understand the process of having the intention to engage in diabetes care. Methods: A qualitative study using narrative inquiry was conducted at a public primary care clinic. Ten participants with type 2 diabetes of more than a 1-year duration were selected through purposive sampling. In-depth interviews were conducted using a semi-structured protocol guide and were audio-taped. The interviews were transcribed and the texts were analyzed using a thematic approach with the Atlas.ti ver. 8.0 software (Scientific Software Development GmbH, Berlin, Germany). Results: Three themes emerged from the analysis. The first theme, “Initial reactions toward diabetes,” described the early impression of diabetes encompassing negative emotions, feeling of acceptance, a lack of concern, and low level of perceived efficacy. “Process of discovery” was the second overarching theme marking the journey of participants in finding the exact truth about diabetes and learning the consequences of ignoring their responsibility in diabetes care. The third theme, “Making the right decision,” highlighted that fear initiated a decision-making process and together with goal-setting paved the way for participants to reach a turning point, moving toward engagement in their care. Conclusion Our findings indicated that fear could be a motivator for change, but a correct cognitive appraisal of diabetes and perceived efficacy of the treatment as well as one’s ability are essentially the pre-requisites for patients to reach the stage of having the intention to engage.

Introduction: Mental health problem is an important public health issue which causes deterioration in quality of life, function and financial capabilities. According to the National Health and Morbidity Survey (NHMS) 1996, the prevalence of mental problem among adults in Malaysia was 10.7% and this has increased to 29.2% in NHMS 2015. The aim of this study was to evaluate the burden of depression, anxiety and stress among adults in a city in Klang Valley, Malaysia including its associated factors. Methods: A cross-sectional study was conducted by analysing secondary data obtained from screening program performed in six primary health clinics in the city throughout 2016. There were 576 adults participated in the screening program which consisted of mental health screening using Depression, Anxiety, Stress 21 (DASS-21) questionnaire and health status screening using Health Status Screening Form. Results: The prevalence of depression was 20.5%, anxiety was 44.5%, while stress was 10.1%. By using logistic regression, history of being abused was the only significant protective factor associated with depression, anxiety and stress with OR of 0.062 (95% CI 0.007; 0.563, p=0.004), OR of 0.001 (95% CI 0.000; -, p=0.001) and OR of 0.026 (95% CI 0.003; 0.238, p<0.001) respectively. Other independent variables were not statistically significant. Conclusions: As conclusions, surprisingly the risk of depression, anxiety and stress were not increased among participants who reported history of being abused. This was probably due to good coping mechanism among them. Nevertheless, early intervention needs to be emphasized to prevent mental disorders among this group of people in community.

Introduction: Dyslexia, which is a learning disability that affects many aspects of children’s development, has a prevalence of 5 – 17%, worldwide. There are many negative perceptions towards children with dyslexia, and one of it is when there is lack of teachers’ knowledge about this problem. Aim: The objective of this study is to develop and discuss on a newly developed module on dyslexia, i.e. Dyslexia Health Education Module (DHEM) for preschool teachers, Method: This module is developed using the ADDIE model (A-Analysis, D-De- sign, D-Develop, I- Implement, E-Evaluate). The content of DHEM consists of general information for pre-school teachers about dyslexia, identification and intervention for dyslexia among children as well as its mental health implications. Results: The newly developed module was found to have a good content validity with a score of 0.7 when evaluated by eight expert panels from respective fields. The Cronbach alpha’s value for reliability test was 0.90. These findings suggest that this module is good, reliable and applicable. Discussion: It is hoped that with the development of DHEM, this would increase teachers’ knowledge on dyslexia among children in Malaysia, especially in recognizing at-risk children and consequently may lead to early intervention in managing the problem. This study also suggests that future longitudinal studies should be carried out using this module to ensure its effectiveness in the long run.

Introduction: Measles outbreaks are endemic in Southeast Asia. A possible reason for such outbreaks is low vaccine coverage. In Malaysia, there is a lack of studies on measles outbreaks. The urban district of Petaling in Selangor, Peninsular Malaysia, reported a high number of outbreaks in 2014–2018. Thus, we analysed the trend of measles outbreaks and identify the common characteristics of measles cases in Petaling District. Methods: This was a cross-sectional study using secondary data from the Petaling District Health Office online surveillance system. Data from 2014 until 2018 from the e-Measles and eWabak systems were extracted, and the trend and common characteristics of measles cases were analysed. Results: A total of 48 outbreaks involving 124 cases were reported during the period investigated. The outbreaks showed an increasing trend from 2.1% in 2014 to 37.5% in 2016, and decreased slightly from 29.2% in 2017 to 27.1% in 2018. The common characteristics were age 1 to <7 years (50.8%), female sex (55.6%), Malay ethnicity (89.5%), Malaysian citizenship (95.2%) and being unvaccinated (55.6%). Of the cases, 63.7% were admitted to hospital, and siblings were the common source of infection (75.8%). Most cases occurred at home (75.8%). Most of the children who were infected at home were unvaccinated (60.6%). Conclusion: Unvaccinated children aged 1 to <7 years are at highest risk of contracting measles and spreading it to their siblings. Thus, awareness of the importance of vaccination needs to be emphasized to their parents to prevent related issues such as vaccine hesitancy.

Background: The Strengths and Difficulties Questionnaire (SDQ) is a screening questionnaire that measures children’s emotional and behavioural problems. This study examines the reliability and validity of the Malay parent-report version of the SDQ. Methods: The Malay adult-report version of the SDQ was administered to 495 parents and 432 teachers, respectively. At the same time, a newly translated Malay child-report version of the SDQ was also administered to 150 children aged 13 to 14 years old in this community study. W e measured internal reliability using Cronbach’s Alpha for all reported data. Construct validity of the parent-report data was assessed using factor analysis. Confirmatory Factor Analysis (CFA) was also subsequently perform on parent-report data to explain the model fit indices of this questionnaire. Result: Cronbach’s Alpha was acceptable for all parent, teacher and child-report data with values of 0.74, 0.77 and 0.78, respectively. Factor analysis of the parent’s report showed a fivefactor solution, which was consistent with other psychometric evaluations of the SDQ in other languages. CFA showed good model fit of the original five factor model which consists of Emotional, Conduct, Hyperactivity, Peer problem and Pro-social scale. Conclusion: This study shows that the psychometric properties of the Malay parent-report version of the SDQ were similar to other parent-report version of the SDQ questionnaires in other languages, although cross-cultural differences may still exist.

Emotional and behavioural problems among children have been increasing in many western as well as the eastern countries. Although the problem has been given attention and priority in terms of early detection, many children with early symptoms of emotional and behavioural problems has still not been detected at the early stages. This phenomenon is worrying as mental health problems were shown to be stable in the long run and if left undetected it may manifest into various problems in adulthood. This paper explores the issues on emotional and behavioural problems in terms of its definition, prevalence, aetiology, long term consequences and treatment. It also explores on mental health problems in a non-western country, i.e. Malaysia including its prevalence and intervention strategies which has been carried out in overcoming this worrying issue. Finally this review paper stresses the importance of providing a well-designed epidemiological study in Malaysia in assessing the current prevalence of emotional and behavioural problems in young children and adolescent.​​

Introduction: Adolescents’ involvement in sexual practices are becoming a major public health concern in Malaysia. This study aims to determine the prevalence of sexual practices among Malaysian school-going adolescents and its predictive factors. Methods: A cross-sectional study was carried out from April 2012 till September 2012 among 16-year-old school adolescents from two different schools. They were selected through simple random sampling and these adolescents answered a self-administered questionnaire consisting of three sections i.e. socio-demography, risk-taking behaviours and family-adolescents relationship. Data were analysed using Pearson Chi-Square test while Simple Logistic Regression and Multiple Logistic Regression were applied to determine the predictive factors. Results: The prevalence of sexual practices among the adolescents was 30.1% in which they were either involved in pornography (26.8%), pre-sexual activities (8.5%) or premarital sex (2.9%). Six predictive factors associated with sexual practices among this age group were identified which were male (adjusted Odds Ratio (aOR) 2.7, 95% Confidence Interval (95%CI) 1.4 to 2.5), truancy (aOR 2.3, 95%CI 1.3 to 4.2), bully (aOR 3.5, 95%CI 1.7 to 7.3), hanging out (aOR 2.8, 95% 1.4 to 5.6), staying out late (aOR 3.2, 95%CI 1.5 to 6.8) and conflict with family (aOR 4.1, 95%CI 1.9 to 8.9). Discussion: Asian background differs from the western countries and findings of this study may suggest suitable intervention programmes that can prevent high-risk sexual practices among Asian school-going adolescents.
Adolescent ; Bullying ; Behavior