1
|
Johari SM, Razalli NH, Chua KJ, Shahar S. The efficacy of self-monitoring of blood glucose (SMBG) intervention package through a subscription model among type-2 diabetes mellitus in Malaysia: a preliminary trial. Diabetol Metab Syndr 2024; 16:135. [PMID: 38902819 PMCID: PMC11191324 DOI: 10.1186/s13098-024-01379-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/11/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND The aim of this study was to determine the effect of a Self-Monitoring Blood Glucose (SMBG) intervention package through a subscription model in improving HbA1c and health parameters among type-2 diabetes mellitus (T2DM) individuals in Malaysia. METHODS This is a quasi-experimental study involving a total number of 111 individuals with T2DM (mean age 57.0 ± 11.7 years, 61% men) who were assigned to intervention (n = 51) and control (n = 60) groups. The intervention group participants were the subscribers of SugO365 program which provided a personalized care service based on self-recorded blood glucose values. Subscribers received a Contour® Plus One glucometer which can connect to Health2Sync mobile app to capture all blood glucose readings as well as physical and virtual follow up with dietitians, nutritionists, and pharmacists for 6 months. Outcome measures were body weight, body mass index (BMI), random blood glucose (RBG), glycated haemoglobin (HbA1c) and health-related quality of life (HRQoL, assessed by SF-36 questionnaire). Data were measured at baseline, third and sixth months. RESULTS Repeated-measure analysis of covariance showed significant improvement in HbA1c level (ƞp2 = 0.045, p = 0.008) in the intervention (baseline mean 7.7% ± 1.1%; end mean 7.3% ± 1.3%) as compared to control (baseline mean 7.7% ± 0.9%; end mean 8.1% ± 1.6%) group. Similar trend was observed for Role Emotional domain of the quality of life (ƞp2 = 0.047, p = 0.023) in the intervention (baseline mean 62.8 ± 35.1, end mean 86.3 ± 21.3) compared to control (baseline mean group 70.5 ± 33.8; end mean 78.4 ± 27.3) group. Negative association was found in HbA1c changes using Z-score and Physical Function domain (r = - 0.217, p = 0.022). CONCLUSION A 6 months SMBG intervention package through a subscription model improved blood glucose control as measured by HbA1c and health-related quality of life, particularly the Role Emotional domain. Elevated HbA1c levels are correlated with decreased physical function.There is a need to further examine the efficacy of SMBG intervention package using a larger sample and a longer period of intervention and to determine its cost efficacy.
Collapse
Affiliation(s)
| | - Nurul Huda Razalli
- Dietetic Program, Centre for Healthy Aging and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
| | | | - Suzana Shahar
- Dietetic Program, Centre for Healthy Aging and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| |
Collapse
|
2
|
Wu Q, Chen Y, Zhou Y, Zhang X, Huang Y, Liu R. Reliability, validity, and sensitivity of short-form 36 health survey (SF-36) in patients with sick sinus syndrome. Medicine (Baltimore) 2023; 102:e33979. [PMID: 37327281 PMCID: PMC10270486 DOI: 10.1097/md.0000000000033979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 05/22/2023] [Indexed: 06/18/2023] Open
Abstract
Patients with sick sinus syndrome (SSS) experience a decrease in health-related quality of life (HRQoL), but there is currently no scale available to measure their unpleasant symptoms. The Short Form 36 Health Survey (SF-36) is a commonly used scale to assess HRQoL. In this study, we aimed to evaluate the reliability, validity, and sensitivity of SF-36 in patients with SSS. The sample included 199 eligible participants. We estimated the reliability through test-retest reliability, internal consistency, and split-half reliability. To examine the validity of the questionnaire, confirmatory factor analysis, convergent validity, and discriminant validity were conducted. Sensitivity was determined by the differences in age (cutoff 65 years) and New York Heart Association class. The intraclass correlational coefficients scores showed high test-retest reliability (intraclass correlational coefficients > 0.7). The overall Cronbach α was 0.87 (8 scales range: 0.85-0.87), showing good internal consistency reliability. The split-half reliability coefficient of the SF-36 is 0.814, indicating good reliability. Factor analysis showed that SF-36 subscales could be drawn into 6 components that explain 61% of the total variance. Results of model fit indicate comparative fit index = 0.9, incremental fit index = 0.92, Turker-Lewis index = 0.90, approximate root mean square error = 0.07, and normalized root mean square residual = 0.06. Convergent validity and discriminative validity showed adequate results. Comparison of different ages and New York Heart Association class groups showed statistical significance on most SF-36 subscales. We confirmed the SF-36 as a valid instrument for evaluating HRQoL patients with SSS. The reliability, validity, and sensitivity of SF-36 are acceptable for patients with SSS.
Collapse
Affiliation(s)
- Qiaomin Wu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yao Chen
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - YuTong Zhou
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xin’ai Zhang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu Huang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ruxiu Liu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
3
|
Ahmad Pouzi NA, Shaharir SS, Mohd Tamil A, Mustafar R, Ahmad Maulana S, Mageswaren E, Wan Ghazali WS. Validation and the associated factors of the Malay version of systemic lupus erythematosus-specific health-related quality of life questionnaires (SLEQoL and LupusQoL). PLoS One 2023; 18:e0285461. [PMID: 37186611 PMCID: PMC10184909 DOI: 10.1371/journal.pone.0285461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/25/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVES To assess the reliability and validity of two disease-specific questionnaires that assess the quality of life (QoL) among patients with Systemic Lupus Erythematosus (SLE); SLEQoL and LupusQoL in Malay language. This study also identified the factors affecting each domain of the questionnaires. METHODS This cross-sectional study was conducted from June 2021 until April 2022, and SLE patients were recruited to complete the SLEQoL, LupusQoL and Short Form Health Survey (SF-36) in Malay language. Disease activity were recorded using the modified SLE Disease Activity Index (M- SLEDAI) and British Isles Lupus Assessment Group 2004 (BILAG-2004) index. Presence of organ damage was determined using the SLICC Damage index. Cronbach's alpha was calculated to determine internal consistency while exploratory factor analysis was done to determine the construct validity. Concurrent validity was evaluated using correlation with SF-36. Multiple linear regression analysis was deployed to determine the factors affecting each domain of SLEQoL and LupusQoL. RESULTS A total of 125 subjects were recruited. The Cronbach's α value for the Malay-SLEQoL (M-SLEQoL) and Malay-LupusQOL (M-LupusQoL) was 0.890 and 0.944 respectively. Exploratory factor analysis found formation of similar number of components with the original version of questionnaires and all items have good factor loading of >0.4. Both instruments also had good concurrent validity with SF-36. M-SLEQoL had good correlations with BILAG-2004 and M-SLEDAI scores. Musculoskeletal (MSK) involvement was independently associated with lower M-SLEQoL in physical function, activity and symptom domains. Meanwhile, MSK and NPSLE were associated with fatigue in M-LupusQoL. CONCLUSION Both M-SLEQoL and M-LupusQoL are reliable and valid as disease -specific QoL instruments for Malaysian patients. The M-Lupus QoL has better discriminative validity compared to the M-SLEQoL. SLE patients with MSK involvement are at risk of poor QoL in multiple domains including physical function, activity, symptoms and fatigue.
Collapse
Affiliation(s)
- Nur Aqeelah Ahmad Pouzi
- Department of Internal Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Cheras, Kuala Lumpur, Malaysia
| | - Syahrul Sazliyana Shaharir
- Department of Internal Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Cheras, Kuala Lumpur, Malaysia
| | - Azmi Mohd Tamil
- Department of Public Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Cheras, Kuala Lumpur, Malaysia
| | - Ruslinda Mustafar
- Department of Internal Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Cheras, Kuala Lumpur, Malaysia
| | | | - Eashwary Mageswaren
- Medical Department, Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia
| | - Wan Syamimee Wan Ghazali
- Department of Internal Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| |
Collapse
|
4
|
Ibrahim N, Chu SY, Siau CS, Amit N, Ismail R, Abdul Gafor AH. The effects of psychosocial and economic factors on the quality of life of patients with end-stage renal disease and their caregivers in Klang Valley, Malaysia: protocol for a mixed-methods study. BMJ Open 2022; 12:e059305. [PMID: 36691236 PMCID: PMC9171257 DOI: 10.1136/bmjopen-2021-059305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 05/12/2022] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION The number of patients in Malaysia requiring dialysis is expected to rise substantially in the future due to the ageing population and increasing prevalence of diabetes mellitus and hypertension. Hence, more individuals will be expected to adopt the role of caregivers in the future. The upward trend of end-stage renal disease (ESRD) and caregiving for dialysis patients has detrimental consequences for both patients and caregivers in terms of their psychological well-being and quality of life. Despite the current circumstances, there are very few studies in Malaysia that have explored the psychosocial factors, specifically on the economic impact of the management of ESRD. METHODS AND ANALYSIS This two-phase sequential explanatory mixed-methods design, incorporating a quantitative design (phase I) and a qualitative study (phase II), is to be conducted in 4 government hospitals and 10 other non-governmental organisations or private dialysis centres within Klang Valley, Malaysia. A cross-sectional survey (phase I) will include 236 patient-caregiver dyads, while focus group discussions (phase II) will include 30 participants. The participants for both phases will be recruited purposively. Descriptive statistics, independent sample t-tests and multiple regression analysis will be used for analyses in phase I, and thematic analysis will be used in phase II. ETHICS AND DISSEMINATION Approval for the study has been obtained from the National Medical Research and Ethics Committee (MREC) (NMRR-21-1012-59714) and the Research Ethics Committee of Hospital Canselor Tuanku Muhriz UKM (UKM PPI/111/8/JEP-2021-078) and University of Malaya Medical Centre (MREC ID NO: 2 02 178-10346). Informed consent of the participants will be obtained beforehand, and no personal identifiers will be obtained from the participants to protect their anonymity. The findings will be published in peer-reviewed scientific journals and presented at national or international conferences with minimal anonymised data.
Collapse
Affiliation(s)
- Norhayati Ibrahim
- Centre for Health Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
- Institute of Islam Hadhari, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Sin Yee Chu
- Centre for Health Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Noh Amit
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Rozmi Ismail
- Centre for Research in Psychology and Human Well-being (PsiTra), Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Abdul Halim Abdul Gafor
- Department of Medicine, Hospital Canselor Tuanku Muhriz UKM, Cheras, Federal Territory of Kuala Lumpur, Malaysia
| |
Collapse
|
5
|
Liu Y, Liu L, Yan F. Levosimendan improves postoperative heart function recovery and prognosis in patients with heart disease. Am J Transl Res 2022; 14:2092-2100. [PMID: 35422928 PMCID: PMC8991159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 02/27/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Previous studies have shown that levosimendan can reduce mortality and complications in patients undergoing cardiac surgery. The purpose of this study was to investigate the effect of levosimendan on the recovery of cardiac function, quality of life and prognosis in patients with heart disease after operation. METHODS From October 2017 to August 2019, 93 patients admitted to our hospital for cardiac surgery were retrospectively enrolled in this study. Fifty-three patients treated with levosimendan were included in the experimental group (EG) and 40 who did not receive levosimendan were recruited into the control group (CG). After operation, the length of ICU stay and hospitalization, mean arterial pressure, central venous pressure, heart rate, the changes of cardiac parameters (left ventricular end diastolic volume (LVEDV), end-systolic volume (LVESV), left ventricular ejection index (LVEF) and cardiac index (CI) at different time points), and the changes of high sensitive troponin I (hs-cTnI), creatine kinase isoenzyme (CK-MB) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were compared between the two groups. The stroke volume index (SVI), left ventricular stroke work index (LVSWI), systemic vascular resistance index (SVRI) and other hemodynamic indexes were also compared. RESULTS The length of ICU stay and hospitalization time in the EG were shorter than those in the CG. After treatment, MAP (mean arterial pressure), CVP (central venous pressure), HR (heart rate), LVEDV, LVESV, HS CTN, NT proBNP and SVRI in the EG were lower than those in the CG group, while LVEF, CI, SVI and LVSWI were higher than those in the CG. The quality of life of patients in the EG was better than that of those in the CG one month after treatment. Logistics regression analysis revealed that the use of levosimendan can reduce the risk of death. CONCLUSION Levosimendan can improve the cardiac function and prognosis of patients after cardiac surgery, which is worthy of clinical promotion.
Collapse
Affiliation(s)
- Yu Liu
- Department of Cardiac Surgery, The Second Hospital of Hebei Medical University Shijiiazhuang 050000, Hebei, China
| | - Linli Liu
- Department of Cardiac Surgery, The Second Hospital of Hebei Medical University Shijiiazhuang 050000, Hebei, China
| | - Fang Yan
- Department of Cardiac Surgery, The Second Hospital of Hebei Medical University Shijiiazhuang 050000, Hebei, China
| |
Collapse
|
6
|
Musa AF, Dillon J, Md Taib ME, Yunus AM, Sanusi AR, Nordin MN, Smith JA. A double-blind randomised controlled trial on the effect of Tocovid, a tocotrienol-rich capsule on postoperative atrial fibrillation at the National Heart Institute, Kuala Lumpur: an interim blinded analysis. J Cardiothorac Surg 2021; 16:340. [PMID: 34819126 PMCID: PMC8611632 DOI: 10.1186/s13019-021-01721-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/06/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Post-operative atrial fibrillation (POAF) is associated with poorer outcomes, increased resource utilisation, morbidity and mortality. Its pathogenesis is initiated by systemic inflammation and oxidative stress. It is hypothesised that a potent antioxidant and anti-inflammatory agent such as tocotrienol, an isomer of Vitamin E, could reduce or prevent POAF. AIMS The aim of this study is to determine whether a potent antioxidative and anti-inflammatory agent, Tocovid, a tocotrienol-rich capsule, could reduce the incidence of POAF and affect the mortality and morbidity as well as the duration of ICU, HDU and hospital stay. METHODS This study was planned as a prospective, randomised, controlled trial with parallel groups. The control group received placebo containing palm superolein while the treatment group received Tocovid capsules. We investigated the incidence of POAF, the length of hospital stay after surgery and the health-related quality of life. RESULTS Recruitment commenced in January 2019 but the preliminary results were unblinded as the study is still ongoing. Two-hundred and two patients have been recruited out of a target sample size of 250 as of January 2021. About 75% have completed the study and 6.4% were either lost during follow-up or withdrew; 4% of participants died. The mean age group was 61.44 ± 7.30 years with no statistical difference between the groups, with males having a preponderance for AF. The incidence of POAF was 24.36% and the mean time for developing POAF was 55.38 ± 29.9 h post-CABG. Obesity was not a predictive factor. No statistically significant difference was observed when comparing left atrial size, NYHA class, ejection fraction and the premorbid history. The mean cross-clamp time was 71 ± 34 min and the mean bypass time was 95 ± 46 min, with no difference between groups. There was a threefold increase in death among patients with POAF (p = 0.008) and an increase in the duration of ICU stay (p = 0.01), the total duration of hospital stay (p = 0.04) and reintubation (p = 0.045). CONCLUSION A relatively low incidence rate of POAF was noted although the study is still ongoing. It remains to be seen if our prophylactic intervention using Tocovid would effectively reduce the incidence of POAF. Clinical Registration Number: US National Library of Medicine. Clinical Trials - NCT03807037. Registered on 16th January 2019. Link: https://clinicaltrials.gov/ct2/show/NCT03807037.
Collapse
Affiliation(s)
- Ahmad Farouk Musa
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor Malaysia
- Victorian Heart Institute, Monash University, Melbourne, Australia
| | | | | | | | | | | | - Julian A. Smith
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
- Department of Cardiothoracic Surgery, Monash Health, Melbourne, Australia
| |
Collapse
|