Pusat Pengajian Sains Perubatan - Tesis

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Translation and validation of NIOSH worker’s well-being questionnaire among healthcare workers (Wellbq)
(2023-06)
Sampil, Nionella Stephen
Introduction: The measurement of a worker’s well-being is multidimensional that includes the work life of a worker, mental and physical condition, positive feelings, negative feelings, workplace environment, and workplace safety outside of work life. As we progress toward developing nations and countries, the measurement of workers’ well-being is increasingly being prioritized. NIOSH Worker’s Well-being Questionnaire is developed to measure workers’ well-being holistically. This study aims to establish the validity and reliability of this instrument before it can be used due to the cultural, language, and environmental differences between the Western and Eastern populations. Objectives: To translate to Malay language and to determine the validity and reliability of the Malay version NIOSH Worker’s Well-Being Questionnaire among healthcare workers in Hospital Universiti Sains Malaysia. Methods: A cross-sectional study involving a web-based survey was employed among healthcare workers at Hospital Universiti Sains Malaysia, Kubang Kerian. The study involved Forward and Backward Translation of the NIOSH Worker Well-being Questionnaire (WellBQ) to Malay version with Content Validation and Face Validation, and Confirmatory Factor Analysis (CFA) to determine the construct validity. Participants were recruited using a random sampling method through a selection of emails to healthcare workers. Descriptive, confirmatory factor analysis was applied in the statistical analysis. Results: Four expert panels were involved in content validation for the translation phase, and 30 medical officers were to rate the Face validation process. The CVI was calculated to be 0.92 for both S-CVI/Ave, and the FVI score was calculated to be 0.98, indicating that all items in the questionnaire are relevant to the domain, clear, and comprehensible. For the Confirmatory Factor Analysis phase, a total of 366 respondents participated in this study, the majority of the respondents being female (76%), Malay ethnicity (97.5%), between 30 to 44 years old (71%), works as nurses (52.7%) and holding education level of Diploma (63.9%) with permanent post (91.3%). The final measurement model of CFA had fit indices: CFI = 0.841, TLI = 0.834, RMSEA = 0.053, χ2 / df = 2.008. The fit indices were within the acceptable range. The composite reliability ranged from 0.603 to 0.963. Conclusion: The final model for Confirmatory Factor Analysis showed a reasonably acceptable model fit, valid and reliable after model revision of higher-order factors and after removing nine items. The translated Malay version of the NIOSH Worker’s Well-being Questionnaire comprised 117 items across five domains/factors. The questionnaire is valid and reliable for healthcare workers in local settings.
A study of hippocampal T2 relaxometry value in temporal lobe epilepsy patient
(2023)
Basri, Niemah
Background: In the advance of the current imaging technique for the detection of mesial temporal sclerosis for temporal lobe epilepsy patient, there are multiple quantitative techniques for Magnetic resonance imaging (MRI). One of the long known to be valuable technique is T2 relaxometry study where there is overall better accuracy for detection of mesial temporal sclerosis if compared with the qualitative assessment only. Methods: This is a comparative cross-sectional study that was conducted at the Hospital Universiti Sains Malaysia, Kubang Kerian. A total of 51 participant were included in this study where 19 were temporal lobe epilepsy patients and 32 were control. Total duration of this study is one year and five months from August 2021 to January 2023. The hippocampal T2 relaxometry was calculated for control and temporal lobe epilepsy patient and the mean reading for these groups were compared. This is to get the normal value of hippocampal T2 relaxation time and abnormal value cut off point for epilepsy patient. The mean reading of T2 relaxometry for control and patient will be determine. Using Pearson correlation, the T2 relaxometry value correlation is made with age, duration of epilepsy and seizure frequency. Results: The mean T2 relaxometry for epilepsy patient was higher than control. It is also noted to be higher in right hippocampus than left hippocampus in both patient and control. For temporal lobe epilepsy patient, the reading for right and left hippocampus were 110.13 (10.51)ms and 107.15 (9.43)ms respectively. Meanwhile for control the reading for right and left hippocampus were 99.54 (4.00)ms and 97.00 (3.46)ms respectively. For correlation, moderate to good positive correlation was seen between the duration of epilepsy with T2 relaxometry of right hippocampus. Whereas poor positive correlation between the right hippocampus T2 relaxometry with age (P>0.01), as well poor positive correlation between both hippocampus T2 relaxometry with seizure frequency(P>0.01). Conclusion: T2 relaxometry is a quantitate technique that can help in detection of subtle abnormality of hippocampus. In our study, one patient was reported to has normal hippocampus by qualitative assessment but had raised T2 relaxometry which follow the clinical diagnosis of epilepsy.
The incidence of post-operative delirium among elderly patients and its associated factors
(2023)
En, Ng Li
Background: Longer life span leads to an increase in elderly patients coming for surgery. The incidence of delirium is reported to be the highest in this population. This study was the first in Malaysia to investigate the incidence and predicting factors for post-operative delirium (POD) among local elderly patients undergoing various types of surgery. Methods: A prospective cohort study was conducted on surgical patients aged 65 years and above who underwent surgery at Hospital Universiti Sains Malaysia (HUSM). Cognitive and frailty statuses were assessed pre-operatively using the Malay version of Montreal Cognitive Assessment (MMoCA) and the Frailty Index for Elderly (FIFE), respectively. Postoperatively, patients were evaluated for the development of POD twice a day for up to 5 days or until discharged. Results: A total of 153 patients were recruited. The incidence of POD was 18.3% (95% CI: 12.5% 25.4%). Factors found to be significantly associated with POD on multivariate analysis were FIFE score (adjusted odds ratio (AOR): 1.568; 95% CI: 1.16 2.10; p = 0.003), METS < 4 (AOR: 3.228; 95% CI: 1.01 10.31; p = 0.048), and presence of intra operative hypotension (AOR: 7.687; 95% CI: 2.69 21.98; p = <0.001). New York Heart Association (NYHA) class, type of anaesthesia, duration of anaesthesia and surgery, estimated blood loss, need for intraoperative transfusion, and amount transfused were only significant on univariable analysis. All of our patients had complete resolution of POD, with a median duration of two days. Conclusion: The incidence of POD among elderly patients coming for both emergency and elective surgeries is high. Patients at higher risk for POD should be identified. This allows precautionary steps to be taken to prevent the development of POD and ensure primary teams are more vigilant post-operatively to detect and treat POD earlier.
6 years review of teenage pregnancy and it’s maternal and fetal outcome in HUSM
(2022)
Muhammad, Nadhilah Izni
OBJECTIVE: To determine the incidence of the teenage pregnancy, it sociodemographic issues and to determine the obstetric risks and complications of teenage pregnancy in HUSM from the year 2015 till 2020. STUDY METHOD: This retrospective cohort study involved all the teenage pregnancy patient that delivered in Hospital Universiti Sains Malaysia. The data for sociodemographic, obstetric risks and complications were collected from the patient notes. Data were analyzed using univariate analyses and Chi square test or Fisher exact test will be used for categorical independent variable and independent t-test or Mann Whitney U test will be used for numerical independent variable depending on normality of data to look for the obstetric and neonatal outcome and as well as sociodemographic. RESULTS: A total of 405 teenage pregnancy patient participated in this study. They are divided into 2 groups, young teenage pregnancy (n=71) and older teenage pregnancy (n=334). Young teenage pregnancy group are the group that equal or less than 16 years old, while older teenage group are older than 16 years old lesser than 20 years old. The prevalence of teenage pregnancy in HUSM is 1.01% and the mean incidence are 10 births out of 1000 women. The teenage pregnancy found to have low in education level where 88.9% had only attended secondary school and 8.9% did not have any education level compare to only 1.2% had attending college or university. The incidence of eclampsia in younger teenage group found to be higher (4.1%) compare to older teenage group (0.3%). However this is not significantly different between this two group. Post-partum hemorrhage found to be higher in younger teenage group (5.6%) compare to older teenage group(2.7%). Uncomplicated intrapartum outcome are more higher in older teenage pregnancy group(93.7%) compare to young teenage pregnancy group(91.5%). Complicated delivery such as retained placenta, meconium stained liquor, shoulder dystocia and obstetric anal sphincter injuries are found to be low in both teenage group. There is however no significant different in the incidence of Pre-eclampsia, PROM, anemia and adverse birth outcome. 89.7% of the teenager pregnancy are from Malay ethnicity(87.9%) and incidence of premarital conception(17.8%) and single mother(11.9%) are higher. CONCLUSION The younger teenage group have higher rate of successful at spontaneous delivery compare to older teenage group. Both groups have uncomplicated intrapartum outcome. There are no significant different in antenatal complications, mode of deliveries and birth outcome in both teenage pregnancy groups.
Childhood systemic lupus erythematosus (CSLE) and its psychological impact: dual tertiary centre experience
(2023)
Amiruddin, Mushamma Mursheeda
Introduction: This study investigated the potential psychological problems in children with systemic lupus erythematosus (SLE) compared to healthy children. Methods: A non-probability sample study was performed on children with SLE, and their peers aged 6 to 18 years. The Child Behaviour Checklist for Ages 6–18 (CBCL 6–18) was completed by the participant's parents. The questionnaire helps to assess the children's emotional and psychological issues. In addition, their demographic and clinical information was also gathered. The analysis of CBCL scores was performed using independent t-tests. Results: A total of 111 children were recruited, 41 of whom had SLE. Most of the SLE participants were Malay females aged 13–15 who are attending secondary school. Most of them are from low socioeconomic status. The findings revealed that the children with SLE scored substantially higher than the healthy children (the control group) on three CBCL subscales. The subscales mentioned are internalising subscale [mean difference of 3.13, 95% confidence interval (CI) [0.30, 5.95] and P = 0.03], withdrawn subscale [mean difference of 1.50, 95% CI [0.42, 2.60] and P = 0.01], and attention problem [mean difference of 2.14, 95% CI [0.35, 3.94] and P = 0.02]. Besides that, SLE participants' scores on other subscales, including anxiety and somatic, were also considerably higher than the control group, although these differences were not statistically significant. Conclusion: Children with SLE are perceived to have greater psychological problems compared to their healthy peers. They were more socially withdrawn and inattentive, as indicated by the CBCL scores.

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