Pusat Pengajian Sains Kesihatan - Tesis
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- PublicationTranslation and adaptation of self evaluation of listening function and ease of listening form (self+) into Malay version(2025-07)Yusuf, Nur HidayahHearing loss is a significant global health issue, affecting more than 430 million people worldwide, including a considerable number of children. Early detection and intervention were crucial to reducing the negative effects of hearing impairment on a child’s communication skills, social development, and academic performance. Subjective assessment tools, such as the Self Evaluation of Listening Function and Ease of Listening Form (SELF+), provide valuable insights into children’s listening experiences in everyday situations. However, a validated Malay version of the SELF+ questionnaire was previously unavailable, limiting its use among Malay-speaking populations.This study aimed to translate and culturally adapt the SELF+ into the Malay language for use with Malaysian children aged 7 to 12 years. A cross-sectional design was employed, following a standardized six-step process that included preparation, forward translation, back translation, expert committee review, field testing, and finalization. The validation process involved assessment of content validity by experts.The findings revealed that the Malay version of SELF+ demonstrated strong content validity, with content validity index (CVI) values exceeding the recommended threshold of 0.80. For each item, the Item-level Content Validity Index (I-CVI) for items Q2, Q3, Q4 ,Q6,Q7,Q8,Q9 and Q10 achieved perfect I-CVI scores of 1.00, indicating agreement on clarity and appropriateness. Items such as Q1, Q5, Q11, and Q12 each received I-CVI scores of 0.94, showing strong agreement with minor reservations. The Scale-level Content Validity Index Average (S-CVI/Ave) was 0.98, demonstrating overall excellent clarity across the questionnaire write this in malay version Feedback from children and experts confirmed that the questionnaire items were clear, appropriate, and culturally relevant. The final version was well understood by the target age group. The adapted tool also showed excellent coherence among items, indicating its stability and consistency in assessing listening-related experiences.In conclusion, the Malay version of SELF+ is a valid and reliable tool for evaluating listening function and ease of listening among Malay-speaking children. Its careful cultural and linguistic adaptation makes it a useful instrument for clinicians, educators, and researchers in improving auditory assessments and enhancing hearing healthcare services for children across Malaysia.
- PublicationValidation of the arabic version of soho-5 and its use to assess oral impact on quality of life in 5-year-old children(2025-10)Alhammadi, Fatema Khalfan Mohamed IbrahimPoor oral health can significantly impair young children’s daily functioning, affecting eating, speaking, playing, and self-esteem. Consequently, measuring oral health-related quality of life (OHRQoL) in preschoolers is essential to understand and address these impacts. The study objectives were to (1) translate the original English version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) into Arabic, and validate the Arabic version (A-SOHO-5), and (2) assess the impact of dental conditions on the OHRQoL of Arabic-speaking preschoolers in the United Arab Emirates (UAE). The study was conducted in two stages. Stage I involved cross-cultural adaptation (CCA) and psychometric assessment of A-SOHO-5. The translation process adopted and modified the guideline of Beaton, and pre-testing was conducted among 32 child-parent pairs. A separate sample of 157 child-parent pairs was recruited from government preschools for the psychometric assessment. Children participated in structured Arabic interviews, while parents completed self-administered questionnaires. Clinical dental examinations were conducted following WHO criteria. Psychometric evaluation included internal consistency, test–retest reliability (n=30), and validity testing (discriminant, convergent, and construct). Stage II was cross-sectional study assessed the association between oral health conditions and OHRQoL using a cluster sample of 372 child-parent pairs from one government and five private schools in Sharjah and Ajman. Clinical examinations and structured interviews/questionnaires were conducted as in Stage I. Results demonstrated strong internal consistency for the parent version (Cronbach’s alpha = 0.89) and moderate for the child version (α = 0.68). Test–retest reliability was excellent (Cronbach’s alpha = 0.97 for child, 0.98 for parent; ICC range: 0.77–1.00). Discriminant validity was confirmed by significantly higher A-SOHO-5 mean scores in caries-experienced children (child 1.72; parent 2.38) than in caries-free peers (child 0.02; parent 0.39). Convergent validity was demonstrated by a strong correlation between A-SOHO-5 (parent version) and A-ECOHIS functional scores (r = 0.72, p < 0.001). Construct validity confirmed using A-SOHO-5 and global rating questions. A moderate correlation between child and parent A-SOHO-5 scores (r = 0.42, p < 0.001) supported the agreement. Children with dental caries had significantly poorer OHRQoL. Multivariable regression identified clinical status, parental education, and school type as significant predictors of impaired OHRQoL (p < 0.05). The findings confirm that the A-SOHO-5 is a valid and reliable instrument for assessing OHRQoL in Arabic-speaking preschoolers. This study highlights the substantial impact of oral conditions on children's well-being and emphasises the importance of targeted preventive strategies across diverse populations in the UAE
- PublicationTrend and factors associated with delayed sputum conversion among elderly with smear-positive pulmonary tuberculosis in peninsular Malaysia from 2015 – 2024(2025-06)Zulkifli, ZainalBackground: Tuberculosis (TB) remains a major public health concern in Malaysia, with the elderly population disproportionately affected due to age-related immunosenescence, comorbidities, and social vulnerabilities. Delayed sputum conversion (DSC), defined as the persistence of sputum smear positivity beyond the two-month intensive phase, is a critical marker of poor treatment response, ongoing infectiousness, and increased risk of drug resistance. Despite these concerns, research on DSC among Malaysia's elderly remains limited. Objectives: This study aimed to examine trends and identify factors associated with DSC among elderly patients (aged ≥60 years) with smear-positive pulmonary TB (PTB) in Peninsular Malaysia from 2015 to 2024. Methods: A comparative cross-sectional study was conducted using secondary data from the National Tuberculosis Registry (NTBR). For trend analysis, all 15,736 elderly smear-positive PTB cases registered from 2015 to 2024 were included. For analytical purposes, 1,620 patients (810 with DSC and 810 with timely conversion) were selected via proportionate stratified random sampling. Descriptive analysis as well as simple and multiple logistic regression were conducted using SPSS Version 29. Results: The overall prevalence of DSC among elderly patients was 8.83%, with a notable increase from 6.87% in 2015 to 12.95% in 2024. Descriptive analysis showed that most patients were aged 60–74 years (82.6%), male (74.0%), and of Malay ethnicity (66.5%). Diabetes mellitus (43.7%) and smoking (34.0%) were common comorbidities. Multiple logistic regression identified significant predictors of DSC: rural residency (AdjOR=1.49, 95% CI: 1.20–1.84), diabetes mellitus (AdjOR=1.30, 95% CI: 1.05–1.61), advanced chest X-ray lesions (AdjOR=3.31, 95% CI: 1.50–7.32), relapse TB cases (AdjOR=1.77, 95% CI: 1.12–2.78), poor DOTS adherence (AdjOR=3.63, 95% CI: 2.20–5.99), and current smoking (AdjOR=1.28, 95% CI: 1.02–1.60). The final model showed modest discrimination (AUC = 62.3%). Conclusion: DSC among elderly TB patients in Malaysia has shown a rising trend, particularly after 2020, and is influenced by a combination of sociodemographic, clinical, treatment-related, and lifestyle factors. These findings call for targeted interventions to strengthen adherence support, especially among diabetics, relapse cases, and rural residents. Implementation of community-based DOTS (CB-DOTS), enhanced radiographic screening, and integrated tobacco cessation programs are critical to improving bacteriological response and achieving national TB control targets under the National Strategic Plan to End TB 2021–2030.
- PublicationFactors associated with non-initiation of tuberculosis preventive treatment among latent tuberculosis infection cases in Negeri Sembilan from 2022-2024(2025-06)Marimuthu, SanggaryBackground: Tuberculosis Preventive Treatment (TPT) is essential in reducing the risk of progression from latent tuberculosis infection (LTBI) to active disease. However, the factors associated with the non-initiation of TPT have not been explored thoroughly. Objective: This study aimed to determine the proportion of LTBI patients who did not initiate TPT and to identify factors associated with non-initiation in Negeri Sembilan between 2022 and 2024. Methodology: A retrospective cross-sectional study was conducted involving 757 LTBI cases reported from January 2022 to December 2024. Data were extracted from the National Tuberculosis Registry system using a universal sampling method and analysed with SPSS software. Univariable and multivariable logistic regression analyses were performed to determine the factors significantly associated with non-initiation of TPT. Results: Overall, 9.3% of patients did not initiate TPT. Occupation emerged as a significant predictor; the “unemployed young” group (comprising students and children under five) had significantly higher odds of non-initiation compared to professionals (aOR = 3.52; 95% CI: 1.35,9.16; p = 0.010). The district of residence was also influential, with patients from Tampin having five times the odds of not initiating TPT compared to those from Seremban (aOR = 5.12; 95% CI: 2.59,10.11; p < 0.01), while residence in Jempol had lower odds (aOR = 0.10; 95% CI: 0.01,0.74; p = 0.024). In addition, foreign nationals were significantly more likely not to initiate treatment compared to Malaysian citizens (aOR = 3.83; 95% CI:1.65,8.85; p = 0.020). Conclusion: Occupation, nationality, and geographical location significantly influence the initiation of TPT among LTBI patients in Negeri Sembilan. These findings highlight the importance of centralised LTBI care, robust follow-up mechanisms, and tailored health education efforts to improve treatment uptake especially among high-risk group such as people living with HIV (PLHIV), contact of TB index cases, healthcare worker, prisoners and residents of nursing home.
- PublicationKnowledge, attitude, and practice of telemedicine among attendees in outpatient clinics at Hospital Pakar USM Kelantan(2025-06)Zulkifli, NurfarihahIntroduction: Telemedicine has become an increasingly important modality in delivering healthcare services, especially in the post COVID-19 era. Despite growing uptake, limited data exist on patient knowledge, attitudes, and behaviors regarding telemedicine use in public tertiary hospitals in East Coast Malaysia. Objective: This study aimed to determine the prevalence of good knowledge, attitude, and practice (KAP) and to identify associated factors toward telemedicine among outpatient clinic attendees at Hospital Pakar USM Kelantan. Methodology: A cross-sectional study was conducted between October 2024 and June 2025 involving 255 participants, systematically sampled from four outpatient clinics. A previously validated Bahasa Malaysia KAP instrument was used to assess telemedicine-related knowledge, attitude and practice. Data were analyzed descriptively and using multivariable logistic regression. Results: A total of 255 participants from outpatient clinics at Hospital Pakar USM were included in the study. The prevalence of good knowledge, attitude, and practice toward telemedicine was 60.4%, 75.7%, and 52.2% respectively. Telemedicine practice was reported by only 52.2% of participants, despite generally high knowledge and positive attitudes. Multivariable logistic regression revealed that younger age (AOR = 0.95, 95% CI: 0.96–0.98, p < 0.05), being married (AOR = 2.86, 95% CI: 1.34–6.24, p < 0.05), and having a history of telemedicine use (AOR = 2.82, 95% CI: 1.27–6.98, p < 0.05) were significantly associated with good knowledge of telemedicine. Younger age (AOR = 0.95, 95% CI: 0.92–0.97, p < 0.05) and being married (AOR = 3.69, 95% CI: 1.51–9.34, p < 0.05) were significantly associated with good attitude. Meanwhile, younger age (AOR = 0.97, 95% CI: 0.95–0.99, p < 0.05) and a history of telemedicine use (AOR = 3.11, 95% CI: 1.42–7.43, p < 0.05) were significant predictors of good practice toward telemedicine. Conclusion: Although knowledge and attitude toward telemedicine were relatively high, findings highlight a moderate uptake gap, particularly among older and higher-income individuals. Interventions targeting digital literacy and guided exposure to telemedicine may help improve utilization in these subgroups. These findings can inform targeted components of Malaysia’s digital health roadmap, including integration into tele-primary care expansion and public hospital teleconsultation protocols. Given the single-center design and exclusion of acutely ill patients, findings may not fully represent the broader outpatient population in Malaysia.