Pusat Pengajian Sains Kesihatan - Tesis
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- PublicationThe roles of psychophysiological stress and cognitive markers on perceptual responses during low volume high intensity interval exercise in overweight-to-obese adults(2025-12)Ruohan, ZhangThe increasing prevalence of overweight or obesity and physical inactivity poses a major global health challenge. Although low-volume high-intensity interval exercise (Lv-HIIE) has gained acceptance as a time-efficient exercise strategy, the mechanisms influencing perceptual responses to Lv-HIIE remain poorly understood in overweight-to-obese adults. This study employed a within-subjects repeated-measures longitudinal intervention design to investigate how psychophysiological stress markers and cognitive traits shape perceptual responses during a 10-week Lv-HIIE programme. Thirty-two healthy participants (11 men and 21 women; aged 28.3 ± 4.9 years; body mass index = 28.21 ± 2.93; physical activity (PA) levels = 518±334 MET-min/week) completed 30 Lv-HIIE supervised sessions (3 per week). Each session included 6 to 10 cycles of 1-minute work intervals at 90% of maximal aerobic speed, interspersed with 75 seconds of self-paced recovery. Blood samples were collected before, immediately after, and 30 minutes after exercise for Sessions 1, 15, and 30 to measure ACTH and cortisol. Cognitive markers were represented by two stable cognitive traits; goal orientation is assessed using the Goal Orientation in Exercise Measure (GOEM), and personality hardiness is assessed using the Connor–Davidson Resilience Scale–Revised (CDRS-R) before the intervention. Physical health and cardiorespiratory fitness were assessed at pre-, mid-, and post-intervention. Perceptual responses were recorded throughout the intervention, with enjoyment assessed at the end of sessions1, 15, and 30. Data were analysed using repeated-measures ANOVA, paired-samples t-tests, Pearson correlation, and multiple linear regression to examine changes, associations, and interaction effects. Significant improvements were observed in physical health and cardiorespiratory fitness following the 10-week Lv-HIIE programme. Working heart rate (HR), HR recovery, and RPE progressively decreased, while affective valence, felt arousal, perceived recovery and post-exercise enjoyment significantly improved in Sessions 15 and 30 compared with Session 1 (all P<0.05). Significant associations were observed among perceptual variables across the intervention. ACTH and cortisol displayed dynamic session-dependent changes, with ACTH showing greater acute-phase variation. Both markers were significantly associated with perceptual responses. Higher levels of personality hardiness and goal orientation were also associated with more favourable perceptual patterns. Interaction effects between stress markers and cognitive traits influenced working HR, affective valence and perceived exertion, with cortisol generally playing a dominant role. Lv-HIIE appears to be a time-efficient and psychologically adaptive strategy for overweight-to-obese adults, shaped by the interplay between psychophysiological stress markers and cognitive markers.
- PublicationThe effectiveness of rain classroom-based flipped classroom method in surgical training among nursing students at the affiliated hospital of southwest medical university, China(2024-09)Qin, XuClinical nursing education empowers students to critically evaluate, consolidate, and enrich their theoretical knowledge while seamlessly integrating it with practical application. It plays a pivotal role in facilitating the seamless transition of nursing students into future clinical roles. The Rain Classroombased Flipped Classroom (RC-BFC), which combines advanced technology with the innovative Flipped Classroom teaching method, effectively caters to the learning preferences of contemporary youth in an information-driven society, facilitating the seamless transition of nursing students into future clinical roles. Therefore, it brings fresh vitality into the field of education. This study compares the self-directed learning and critical thinking ability between RCBFC and the traditional method among nursing students undergoing surgical nursing training. This study also determines the satisfaction level of RC-BFC. This intervention study was undertaken among 286 nursing students from the Affiliated Hospital of Southwest Medical University, China. Data was gathered through purposive sampling using questionnaires developed by integrating the self-directed learning ability scale, critical thinking scale, and teaching satisfaction survey. The students were divided into two groups: the control group (n = 143), which followed the traditional teaching method,; and the intervention group (n = 143), which utilizsed the RC-BFC method. The data was analysed using the Statistical Package Social Sciences (SPSS) software version 26. The study's findings indicate that the scores of self-directed ability (IG = 232.80 ± 20.986; CG = 202.89 ± 16. 109) and critical thinking ability (IG = 266.55 ± 8.474; CG = 227.72 ± 29.030) in the RC-BFC intervention group are higher than those in the control group. Furthermore, the practical exam scores of students from different educational backgrounds in the RC-BFC group after training were higher than those of the control group (p < 0.001). The satisfaction scores for the intervention group were as follows: 2469 (82.22%) rated as excellent, 530 (17.65%) as satisfied, and 4 (0. 13%) as poor. The research findings suggest that integrating of RCBFC in nursing education yields positive outcomes. The statistically significant disparities (p < 0.001) observed in self-directed learning ability, critical thinking ability, and practical exam exams scores between the two groups indicate that the inclusion of RC-BFC in surgical nursing training effectively fosters students' independence in learning, proficiency in analytical thinking, and competence in nursing practice. In addition, the significant improvements in self-directed learning and critical thinking abilities suggest that RC-BFC could be a valuable tool in nursing education, potentially leading to more effective training programs that better prepare students for clinical roles.
- PublicationSpiritual needs and its associated factors among cancer patients in shanxi bethune hospital, Taiyuan, China(2026-01)Ting, WangBackground: Spiritual needs are an essential component of holistic cancer care, particularly in addressing patients’ emotional and psychological well-being. However, limited research has explored these needs among Chinese cancer populations. Objectives: This study aimed to assess the spiritual needs and their associated factors among hospitalized cancer patients in Shanxi Bethune Hospital, China. Methods: A cross-sectional survey was conducted among 189 cancer patients using validated Chinese versions of the Spiritual Needs Questionnaire (SpNQ-Ch-27), Patient Health Questionnaire (PHQ-9), and Multidimensional Scale of Perceived Social Support (MSPSS). Descriptive statistics, simple and multiple linear regression analyses were applied. Results: Participants exhibited a moderate level of spiritual needs (Mean = 37.23, SD = 16.91). The highest needs were in the “Actively Giving” dimension (M= 8.59, SD= 3.47), while the lowest were in “Religious Sources” (M= 1.21, SD= 1.37). Multiple liner regression revealed that spiritual needs were significantly higher among patients diagnosed within the past 6 months (B= 15.68, CI: 11.90–19.45, p < 0.001), living in rural areas (B = 4.94, 95% CI: 1.72–8.16, p = 0.003), with high school education (B = 4.23, 95% CI: 0.39–8.06, p = 0.031), monthly income below 3000 RMB (B = -4.41, 95% CI: -8.35 to -0.47, p = 0.028), and those diagnosed with stomach cancer (B = 5.04, 95% CI: 0.75–9.33, p = 0.022). Depression scores were positively associated with spiritual needs (B = -4.41, 95% CI: -8.35 to -0.47, p = 0.028). The final regression model explained 79.8% of the variance in spiritual needs (R² = 0.798). Conclusion: Spiritual needs among Chinese cancer patients are shaped by clinical, psychological, and sociodemographic factors. Early assessment and culturally appropriate spiritual support are essential to enhance patients’ quality of life and emotional well-being during treatment.
- PublicationDetermination of the financial burden borne by the healthcare provider in treating nasopharyngeal carcinoma (NPC) patient based on casemix system in Hospital Pakar Universiti Sains Malaysia (HPUSM)(2025-09)Hanan, Nur Andriana SufeaNasopharyngeal carcinoma (NPC), previously known as lymphoepithelioma, is an undifferentiated form of squamous cell carcinoma arising from the epithelium of the nasopharynx. It is the most common malignancy of the nasopharynx. In Malaysia, NPC is ranked as the fourth (5.2%) of all cancers and third (8.4%) most common cancer among the male population. NPC in Malaysia mostly occurs among Chinese (49%), followed by natives of Sabah and Sarawak (28%) and Malay (22%). Cancer is one of the most expensive medical conditions to treat in the world. The Ministry of Health Malaysia's cancer survey reported that the total treatment cost of nasopharyngeal cancer in Malaysia was approximately RM70,000 per individual. The general objective of this study was to determine the health financial burden borne in treating nasopharyngeal carcinoma (NPC) patients by the HPUSM based on the Casemix System output. The specific objectives of this study are to determine the prevalence of NPC cases treated in HPUSM from 2020 to 2022, to identify the clinical criteria of NPC cases, to investigate the treatment cost borne by the health care provider (HPUSM) in treating NPC patients based on the MY-DRG® Tariff, and to determine the associated factors of MY-DRG® Tariff between clinical criteria for NPC patients treated in HPUSM. This retrospective cross-sectional study was conducted using secondary data obtained from the Medical Record Department, HPUSM, and financial data was provided by the Finance Department, HPUSM. The data was analysed using IBM Statistical Package for Social Science (SPSS) software version 28.0. The prevalence of NPC cases is 0.024% from 2020 to 2022. The clinical criteria identified from the data were length of stay (LOS), number of diseases, number of procedures, and disease severity. The average LOS of NPC patients treated in HPUSM is 5.71 days. The NPC cases data analysis showed 82.9% of patients have more than one complication and 31.4% patients have three complications, and this number of complications was the most frequently encountered by patients. While the majority of patients underwent one clinical procedure (48.6%). Most of the NPC patients treated in HPUSM were diagnosed with severity 2 (48.6%). The average MY-DRG® Tariff for NPC treatment is RM8647.77. There was a significant relationship between the number of diseases, number of procedures, disease severity, and MY-DRG® Tariff (p- value<0.05). The length of stay (LOS) was not significantly associated with the MY- DRG® Tariff (p>0.05). Findings from the study show that the tariff for the NPC treatment was associated with the number of diseases, number of procedures, and disease severity level. This study provides valuable information for future studies and research about the financial burden borne by the healthcare provider in treating NPC patients and it also can provide novel insights regarding the influence of significant factors on the financial burden borne by HPUSM.
- PublicationThe effectiveness of Brazilian spinach supplementation on health outcomes among type 2 diabetes patients in Hospital Pakar Universiti Sains Malaysia(2026-01)Arifin, Noorul AyshaBrazilian spinach is a green, leafy vegetable that is rarely commercially available in Malaysia but is considered to have potential health benefits for individuals with type 2 diabetes mellitus (T2DM). The present study evaluated the effects of Brazilian spinach supplementation on health outcomes in patients with T2DM. A single-blind randomised controlled trial was conducted at Hospital Pakar Universiti Sains Malaysia from March to June 2023 (12 weeks), enrolling 53 participants aged 30 to 65 years with T2DM. Participants were randomly allocated to a control group (n = 26) receiving standard dietary counselling or an intervention group (n = 27) receiving both dietary counselling and Brazilian spinach supplementation (15 g per serving). In Phase 1, proximate analysis of Brazilian spinach (per 100 g) indicated low energy (35.83 kcal), carbohydrate (6.20 g), and fat (0.06 g) content, with moderate protein (2.62 g) and dietary fibre (4.15 g) levels. Phase 2 assessed anthropometric (BMI, waist circumference, body fat percentage), biochemical (capillary random blood glucose [RBS], HbA1c, liver and renal function tests), clinical (blood pressure), dietary intake, and self-care behaviours at baseline, week 6, and week 12. Gender distribution was similar between groups (27 males, 26 females), with mean ages of 52.96 ± 10.07 years (control) and 55.70 ± 9.88 years (intervention). Within-subject analysis revealed significant time effects on BMI (p = 0.005), waist circumference (p = 0.006), body fat percentage (p < 0.001), and dietary fibre intake (p = 0.001). Between-group analysis identified significant differences in capillary RBS (p = 0.010) and dietary intake, including energy (p = 0.006) and carbohydrate intake (p = 0.012). No significant changes were observed in HbA1c or other health parameters (p > 0.05). Liver and renal function tests confirmed the safety of the intervention. In summary, Brazilian spinach supplementation significantly improved capillary RBS levels and dietary intake without adverse effects, indicating its potential as a dietary supplement for T2DM management. Further large-scale and long-term studies are recommended to confirm its efficacy.