Pusat Pengajian Sains Kesihatan - Tesis
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- PublicationThe effect of mawangdui exercise on the pulmonary function, physical fitness and quality of life in chronic obstructive pulmonary disease (COPD) patients(2024-08)Zhenggang, ZhuPhysical exercise is an important component of pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD) patients. However, certain physical therapy may be restrictive to COPD patients, as it induces fatigue and shortness of breath, thus reducing quality of life. Mawangdui exercise, a type of low-to-medium-intensity aerobic exercise, has been gaining popularity in China as adjuvant physical therapy, particularly for patients with contraindications to exercise. This study aims to: (1) understand the characteristics and risk factors of patients with COPD (age, sex, cigarette smoking, smoking cessation, COPD grade, average length of hospital stay, and comorbidities); (2) investigate the effects of Mawangdui exercise on pulmonary function (FEV1, FVC, FEV 1 %pred), exercise capacity (6MWT, Borg CR-10, and SpO2), physical fitness (back-leg-chest muscle strength and sit-and-reach flexibility), dyspnoea symptoms (CAT, mMRC), and quality of life (SGRQ) in patients with COPD. Two studies were conducted. Study 1 is a retrospective, cross-sectional investigation of the COPD patients’ clinical records conducted in Changde First Hospital of Traditional Chinese Medicine in China and Hospital Universiti Sains Malaysia (HUSM), Kota Bharu, in Malaysia; In study 2, 45 COPD patients in stable stage (mean age: 65.2 years) underwent 12 weeks sessions in communities. Intervention group (n=22) practised Mawangdui exercise for 60 minutes per session, 5 times per week, while the control group (n=23) maintained daily activities without additional exercise. The outcomes were assessed at baseline, 24 hours, 6 weeks, and 12 weeks post-intervention. Analysis of study 1 revealed that COPD was prevalent in male patients, both in China and Malaysia. Cigarette smoking was prevalent in COPD patients, with men smoking more than women. The number of smoking cessation in COPD patients was less than 50% in both hospitals. COPD patients in Changde hospital have higher severity and longer hospital stays than HUSM. However, there are more comorbidities in COPD patients from HUSM than in Changde hospital. As for study 2, at 12 weeks post intervention, Mawangdui exercise showed improvement in dyspnoea symptoms (CAT, mMRC), exercise capacity (6MWT, Borg CR-10, and SpO2), back-leg-chest muscle strength, sit-and-reach flexibility, BMI, body fat%, fat mass and quality of life (SGRQ). In conclusion, COPD patients living in different climates have similar smoking habits and comorbidities, and they should improve their healthy lifestyles. Mawangdui exercise improved exercise capacity, dyspnoea symptoms, physical fitness, and quality of life in stable mild and moderate COPD patients. Mawangdui exercise can be recommended as part of pulmonary rehabilitation for COPD patients in the mild and moderate stages of the disease.
- PublicationThe effect of group cognitive behavior hypnotherapy (gcbh) on neuroendocrine and somatic symptoms in patients with anxiety disorders in Nanjing, China(2024-09)Hanyue, ZhangThe prevalence of anxiety disorder is increasing and has a significant impact on quality of life. This study aims to determine the effects of group cognitive behavior hypnotherapy on somatic symptoms and neuroendocrine levels in patients with anxiety disorder. This study utilized a randomized control trial design. A total of 84 patients who met the inclusion criteria were randomly selected and assigned to either the intervention group (42 participants) or the control group (42 participants) using computer randomization. After completing psychological measurement scales (Hamilton Anxiety Scale (HAMA), Self-Rating Anxiety Scale (SAS), and Somatic Symptom Self-Rating Scale (SSS)) and blood tests (Cortisol (COR), Serum triiodothyronine (T3), Thyroxine (T4), Thyroid-Stimulating Hormone (TSH) and Adrenocorticotropic Hormone (ACTH)), the intervention group received group cognitive behavior hypnotherapy once a week for six consecutive weeks. The control group only received routine treatment and care. After six weeks, both groups completed the psychological measurement scales (HAMA, SAS, SSS) and blood tests (COR, ACTH, TSH, T3, T4) again. Data was analyzed using a chi-square test and t-test to compare differences between the two groups. The results showed that after group cognitive behavior hypnotherapy, the HAMA score in the experimental group decreased from 24.79±5.479 to 7.52±3.194 (P<0.01), SAS decreased from 59.07±3.047 to 28.14±3.00 , and SSS decreased from 56.12±3.262 to 27.50±1.82 (P<0.001) . The blood test results for COR (581.66±78.241 vs 343.05±50.378 nmol/L), ACTH (14.37±1.481 vs 12.66±0.775 pmol/L), TSH (3.53±0.657 vs 2.83±0.758 mIU/L), T3 (1.22±0.081 vs 0.93±0.041 ng/ml), and T4 (8.32±0.711 vs 6.73±0.638 ng/ml) were all lower than before treatment, with statistical significance (P<0.001). At the same time, the control group showed significant decreases in HAMA (26.88±4.763 VS 19.21±2.464) and SAS(59.07±3.047 VS 28.14±3.000) full scores compared with 6 weeks earlier (P ＜0.001). This study found that group cognitive behavior hypnotherapy can alleviate physical symptoms in patients with anxiety disorders and improve their neuroendocrine levels.
- PublicationDevelopment, validation and evaluation of the modified basic life support training (mblst) on the knowledge, practice and confidence levels among nurses in Jordanian government hospitals(2024-07)Wardeh, Yousef Shukry Mohammad Abu-Exemplary educators use simulation and modern facilities to enhance the BLS knowledge, practice, and confidence of newly employed nurses. To support this, a study was conducted to develop, validate, and evaluate the modified Basic Life Support Training (MBLST) for newly employed nurses in Jordanian governmental hospitals. The study has two phases. Phase one involved the development and validation of the MBLST module, based on the American Heart Association's 2020 training materials update, a literature review, and the integration of Miller's Pyramid and Kolb's Cycle as theoretical models. Experts at the Jordanian AHA-BLS training center and potential users evaluated the study's content and face validity. Phase two used a randomized control trial (RCT) with two groups: the intervention group (n = 51) and the control group (n = 51). The trainer implemented the MBLST module for the intervention group and used standard brochures for the control group. After the study, the control group was placed on a waiting list for the MBLST module. Repeated assessments included a pre-test, an immediate post-test after the intervention, and a late post-test three months later. One-way repeated measures ANOVA showed that the MBLST module significantly improved BLS knowledge (F (2,182) = 58.514; p < 0.001), practice (F (2,182) = 20.134; p < 0.001), and confidence (F (2,182) = 37.969; p < 0.001) when comparing pre-test and post-test results. Additionally, the researcher found that the MBLST module had a large effect (Cohen’s d >1) when comparing pre test and post-test results between the control and intervention groups. In summary, the MBLST module was an effective method for improving BLS knowledge, practice, and confidence among newly employed nurses. This study is the first in Jordan to assess these variables and serves as an evidence-based tool for future research on simulation in nursing training.
- PublicationA study on knowledge, attitude and confidence level on pre-hospital airway management among pre-hospital care providers in Perak.(2023-04)Halim, Khairul Effendy AbdulPre-Hospital Airway Management (PHAM) is an important aspect of patient care outside the hospital setting. Pre-Hospital Care (PHC) Providers should master PHAM skills to treat patients safely. The objective of the study is to determine the level of knowledge, attitude, and confidence about PHAM among PHC Provider in the PHC Unit and to identify the factors that affect the level of knowledge, attitude, and self-confidence about PHAM. This cross-sectional study was conducted in 14 hospitals under the Malaysian Ministry of Health (MOH) in Perak using a validated digital questionnaire consists of demographics profile, knowledge, attitudes, and self-confidence involving 118 respondents. From the 3 domain scores analysed, the Knowledge domain; 35.6% (n = 42) were good. The other two which are Attitude domains; 89.8% (n = 106) and Confidence domain; 31.4% (n = 37) both were good. The study also found that there are factors that influence the domain of knowledge, which is work experience (95% CI (1.31, 9.10), p = 0.012); attitude domain factor is attending PHAM courses (95% CI (1.75, 44.84), p = 0.008); while confidence domain factor is getting enough training (95% CI (1.21, 7.06), p = 0.018). The results from this study found that only the attitude domain was good. Researchers suggest Continuous Medical Education (CME) and frequent involvement in Simulation Training related to PHAM to increase knowledge, attitude, and self-confidence.
- PublicationAssociation between nutritional status, frailty domains, physical activity, physical fitness, emotional status and quality of life with sarcopenia among older adults in Kelantan.(2024-10)Ganggaya, Keerthana SreeSarcopenia is a disease that affects health, functional independence and the quality of life among older adults which leads to adverse effects like falls, physical disability, hospitalization and mortality. Therefore, the current study aimed to assess the association between frailty domains, nutritional status, physical fitness, physical activity, emotional status, cognitive function and well-being of older adults with sarcopenia. This crosssectional study involved 287 community-dwelling older adults in Kelantan aged 60 and above, recruited through simple random sampling. The data collected were entered and analyzed using IBM SPSS Statistics 26 software. Data on socio-demography, sleep quality, supplement intake, geriatric syndrome, medical history, self-rated health status, frailty domains, cognitive function, functional limitation, physical activity, anthropometry, body composition, blood pressure, handgrip strength, physical fitness, emotional status, quality of life and sarcopenia were obtained through interview administered method. Binary logistic regression analysis was used to determine the factors associated with sarcopenia. The prevalence of possible sarcopenia, sarcopenia and severe sarcopenia were 59%, 9% and 14% respectively which was higher in men than in women (p = 0.029). A total of 84.0% of sarcopenic subjects were underweight while 46.7% of possible sarcopenia subjects were overweight which could lead to sarcopenic obesity. Significant association was found between physical frailty and sarcopenia (p <0.001) but not social frailty (p = 0.227) and cognitive frailty (p = 0.345). Significant association was found between sarcopenia and poor nutritional status, lack of physical fitness and cognitive function. However, no significant association was found between sarcopenia, emotional status and quality of life among older adults in Kelantan. After adjusting for confounding factors such as age, gender, smoking and education years, the factors associated with sarcopenia were muscle mass, gait speed, sit-to-stand test and physical frailty were found to be factors associated with sarcopenia. Approximately, more than half of the community-dwelling older adults in this study had possible sarcopenia (59 %). Therefore, older adults should be educated on the steps to prevent sarcopenia via healthy eating, exercising, emotional stress management and involvement in voluntary activities.