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Copyright of Eastern Mediterranean Health Journal is the property of World Health Organization and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Despite the existence of different screening methods, the response to cancer screening is poor among Malaysians. The current study aims to examine cancer patients’ perceptions of cancer screening and early diagnosis. Methods A qualitative methodology was used to collect in-depth information from cancer patients. After obtaining institutional ethical approval, patients with different types and stages of cancer from the three major ethnic groups (Malay, Chinese and Indian) were approached. Twenty semi-structured interviews were conducted. All interviews were audiotaped, transcribed verbatim, and translated into English for thematic content analysis. Results Thematic content analysis yielded four major themes: awareness of cancer screening, perceived benefits of cancer screening, perceived barriers to cancer screening, and cues to action. The majority of respondents had never heard of cancer screening before their diagnosis. Some participants reported hearing about mammogram and Pap smear tests but did not undergo screening due to a lack of belief in personal susceptibility. Those who had negative results from screening prior to diagnosis perceived such tests as untrustworthy. Lack of knowledge and financial constraints were reported as barriers to cancer screening. Finally, numerous suggestions were given to improve screening behaviour among healthy individuals, including the role of mass media in disseminating the message ‘prevention is better than cure’. Conclusions Patients’ narratives revealed some significant issues that were in line with the Health Belief Model which could explain negative health behaviour. The description of the personal experiences of people with cancer could provide many cues to action for those who have never encountered this potentially deadly disease, if incorporated into health promotion activities.

Background: This study aims to assess the profile and predictors of Health-Related Quality of Life (HRQoL) in Type II Diabetes Mellitus (T2DM) patients in Quetta, Pakistan.Methods: The study was designed as a questionnaire based, cross sectional analysis. 300 Type II diabetic patients attending public and private hospitals were targeted for data collection. In addition to demographic and disease related information, Euroqol Quality of Life was used to measure HRQoL. Moreover, Drug Attitude Inventory and Michigan Diabetes Knowledge Test were used to assess medication adherence and diabetes related knowledge respectively. Treatment satisfaction was assessed by patient's experience towards health care professionals and available facilities. Descriptive statistics were used to elaborate patients' demographic and disease related characteristics. Binary logistic regression was used to predict factors independently associated with HRQoL. SPSS v. 20 was used for data analysis and p < 0.05 was taken as significant.Results: Patients in the current study reported poor HRQoL with a mean score of 0.48 ± 0.36. Age, duration of disease, number of prescribed drugs, medication adherence and treatment satisfaction were significantly associated (p < 0.05) with HRQoL in the cross tabulation analysis. The significant variables were entered into the model that showed significant goodness of fit with highly significant Omnibus Test of Model Coefficient (Chi-square = 12.983, p = 0.030, df = 4). Medication adherence was reported as a significant predictor of HRQoL with an increase of one adherence score was associated with improvement of HRQoL by a factor of 1.75 provided other variables remain constant.Conclusion: The study presents a model that is associated with HRQoL with patient with T2DM, where medication adherence shaped as a predictor of HRQoL. Healthcare professionals should pay special attention on patients' medication taking behavior and should put their efforts in explaining the benefits of the medication adherence to the patients. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the association between patient's knowledge of Hepatitis-B and Health Related Quality of Life (HRQoL). Methods: A cross sectional, descriptive study was undertaken with 390 hepatitis-B patients attending two public hospitals in Quetta City, Pakistan. Knowledge of hepatitis-B was assessed using a pre-validated questionnaire. European Quality of Life scale was used for the assessment of HRQoL. Descriptive analysis was used to elaborate patients' demographic characteristics while inferential statistics were applied to report the association among study variables. Spearman's rho correlation was used to identify the association between variables. Results: Out of 390, (230, 59.5 %) were males and the mean age of the subjects was 36.2 ± 9.2 years. One hundred and three (26 %) had primary level of education and 109 (27.9 %) were employees in the private sector. Eighty four (21 %) had a monthly income of between 10001-15000 Pakistan rupees (1 PKR = 0.0115527 USD) with 272 (69.7 %) respondents resident in urban areas. Mean HRQoL and Hepatitis-B related knowledge (HBRK) scores were categorized as poor (0.37± 0.3) and (8.52 ± 2.7) respectively. The correlation coefficient between HRQoL and HBRK was -0.102 (p < 0.001), indicating a week negative association between the study variables. Conclusion: The findings indicate a negative association between Hepatitis-B related knowledge and HRQoL. Therefore, providing disease-related knowledge to patients does not necessarily improve HRQoL. More attention should be given to identify individual factors that affect HRQoL among patients with Hepatitis-B. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to describe the profile and predictors of health related quality-of-life (HRQoL) in a hypertensive population of Pakistan. Materials and Methods: A questionnaire based, cross-sectional study was conducted among 385 hypertensive patients visiting two public hospitals in the city of Quetta, Pakistan. Demographic and disease related data was obtained from patients and their hospital records. Euroqol quality-of-life questionnaire was used to measure HRQoL while drug attitude inventory and hypertension fact questionnaire were used to measure medication adherence and HTN related knowledge respectively. Scale scores were compared with Mann-Whitney and Kruskal-Wallis test. Standard multiple regression analysis was used to identify predictors of HRQoL. Results: Patients in the current study reported poor HRQoL with a mean score of 0.46 ± 0.28. In terms of practical implementation, age (ß =0.298, P < 0.001), educational level (ß =0.493, P = 0.025) and knowledge score (ß =0.351, P = 0.024) reached level of significance in the multivariate analysis. The multiple regression analysis also found that variables such as gender, occupation, income, locality, duration of disease and medication adherence were not significantly associated with HRQoL. Conclusion: The results of the present study provide an evidence for a model that correlates with patients' socio-demographic information and HRQoL. The findings after implication in clinical practice can prove useful in guiding patients receiving treatment for HTN. It will also help the physicians to maintain and adjust treatment behaviors with drug or non-drug related interventions. [ABSTRACT FROM AUTHOR]

Objectives: Prayers, spiritual healing, yoga, meditation, t'ai chi, qigong and support groups are classified as mind body complementary therapies (MBCTs). The study aimed to examine the prevalence of MBCTs use and the Health Related Quality of Life (HRQoL) in a group of Malaysian cancer patients. Methods: This crosssectional study was conducted on 184 cancer patients at the oncology clinic of Penang general hospital, Malaysia. MBCTs was assessed using a self- administered questionnaire while the HRQoL of the participants was assessed by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Results: Among the complementary and alternative medicines (CAM) users, 75(40.7%) patients self-reported using MBCTs while having cancer. Majority of MBCTs users were female 60(80%, p=0.01), aged between 38 and 57 (58%), and were of Malay ethnicity (61%). Socio-demographic factors including age (r=0.15, p=0.03) and monthly house-hold income (r= -0.25, p<0.001) were significantly correlated with MBCTs use. Prayers for health reasons was the most frequently practised MBCTs modality, followed by spiritual practices 20(10.8%), meditation 7(5.9%), t'ai chi 7(3.8%), music therapy 4(2.1%), qigong 1(0.5%), hypnotherapy 1(0.5%), and reiki 1(0.5%). Recommendations from friends and family members 53(70%) were the most common reasons of MBCTs use followed by patient's own will 22(29.3%). Health related Quality of Life (HRQoL) scores showed significant difference in all functional and symptoms scores among MBCTs users and non-users (p<0.05). Conclusion: The study helps to identify numerous MBCTs commonly practised by a group of Malaysian cancer patients. Prayers specifically for health reasons and spiritual practices were somewhat common among patients. Viewing MBCTs, not as alternative but to complement conventional cancer therapies may help to address cancer patients' emotional and psychological needs. [ABSTRACT FROM AUTHOR]

Purpose: To explore community pharmacists' perception of the sale of non-clinically proven health supplements and over-the-counter (OTC) products available in Penang, Malaysia. Methods: A cross-sectional survey using a self-completed postal questionnaire was conducted in July 2010 among 200 community pharmacists practicing in Penang Island. Results: Fifty six pharmacists participated in the study (response rate, 28.0 %). A total of 10.7 % respondents indicated that the sale of non-clinically proven products result in high profit. Only 25.0 % of the pharmacists believed that non-clinically proven OTC products are effective, while 35.7 % thought that it is not ethical to sell these products. A majority of the respondents (94.7 %) agreed that manufacturers' advertisement have a huge effect on positive consumers' behaviour towards such products. Most respondents agreed that manufacturers of these products claim that their products are effective (57.1 %) and have few or no side effects (60.7 %). Conclusions: Pharmacists who participated in the study have mixed opinions on the efficacy and effectiveness of non-clinically proven products. There is a need for pharmacists to be well educated on the evidence-based use of these products in order to be able to offer appropriate advice to those who come to them to purchase the items. [ABSTRACT FROM AUTHOR]

Objective: This study aims to evaluate the association between health related quality of life and disease state knowledge among hypertensive populations in Pakistan. Methods: A cross sectional descriptive study was undertaken with a representative cohort of hypertension patients. Using prevalence based sampling techniques, a total of 385 hypertensive patients were selected from two public hospitals in Quetta City, Pakistan. The Hypertension Fact Questionnaire (HFQ) and the European Quality of Life scale (EQ-5D) were used for data collection. Statistical Package for the Social Sciences 16.0 was used to compute descriptive analyses of patients' demographic and disease related information. Categorical variables were described as percentages while continuous variables were expressed as mean ± standard deviation (SD). Spearman's rho correlation was used to identify any association between study variables. Results: The mean (SD) age of the patients was 39.02 (6.59) years, with 68.8% being males (n=265). The mean (SD) duration of hypertension was 3.01 (0.93) years. Forty percent (n=154) had bachelor's degrees with 34.8% (n=134) working in the private sector. Almost forty one percent (n=140) had a monthly income of more than 15000 Pakistan rupees and 75.1% (n=289) resided in urban areas. The mean EQ-5D descriptive score (0.46±0.28) and EQ-VAS score (63.97±6.62) indicated lower health related quality of life (HRQoL) in our study participants. The mean knowledge score was 8.03 ± 0.42 while the correlation coefficient between HRQoL and knowledge was 0.208 (p< 0.001), indicating a weak positive association. Conclusions: Results of this study highlight hypertension knowledge is weakly associated with HRQoL, suggesting that imparting knowledge to patients does not necessarily improve HRQoL. More attention should be given to identifying individual factors that affect HRQoL. [ABSTRACT FROM AUTHOR]

The use of Complementary and Alternative Medicine (CAM; bǔ chōng yǔ tì dài yī xué) has been rapidly increasing among cancer patients. However, this pervasiveness is still largely unexplored among Malaysian cancer patients. The current study aimed to evaluate the patterns of CAM use among cancer patients from a local hospital in Malaysia. In addition, the study focused on the information-seeking behavior and CAM use disclosure to doctors. Of 393 patients, 184 (46.1%) had used CAM for their cancers. CAM usage was significantly associated with gender ( p =  0.021), level of education ( p =  0.001), employment status ( p  = 0.02), and monthly income ( p <  0.001). Among frequently used CAM were nutritional supplements ( n =  77, 41.8%), natural products ( n =  74, 40.2%), and multivitamin ( n =  62, 33.6%). Friends and family members were the most common source of CAM information ( n =  139, 75.5%). Seventy-nine (43%) reported to disclose their CAM use to the health care providers. The most common ( n =  63, 34.2%) reason of nondisclosure was "it is not important to discuss it with oncologist." This study confirmed that CAM use is common among Malaysian cancer patients, thus highlighting a greater need for patient education regarding CAM therapies and their potential interactions with conventional therapies. Although some types of CAM therapies may help patients to cope with emotional distress and improve quality of life, CAM, with no proven efficacy, may pose dangers to patients' health due to interactions with conventional therapies. Doctors and other health care providers including nurses and pharmacists should engage cancer patients in an open nonjudgmental dialog to ascertain CAM use disclosure to their health care providers.