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This study aims to determine the effectiveness of a multicomponent exercise and therapeutic lifestyle (CERgAS) intervention at improving gait speed among older people in an urban poor setting in Malaysia. A total of 249 participants were divided into the intervention (n = 163) and control (n = 86) groups. The mean (SD) age of participants was 67.83 (6.37) and consisted of 88 (35.3%) males and 161 (64.7%) females. A generalized estimating equation with an intention-to-treat analysis was used to measure gait speed at four time points, baseline (T0), 6 weeks (T1), 3 months postintervention (T2), and 6 months postintervention (T3). The results showed significant changes for time between T0 and T3 (mean difference = 0.0882, p =.001), whereas no significant association were found for group (p =.650) and interaction (p =.348) effects. A 6-week intervention is inadequate to improve gait speed. Future efforts should introduce physical activity monitoring and increase exercise duration, frequency, and intensity. [ABSTRACT FROM AUTHOR]

This study examined quitting behavior and use of cessation aids (CAs) among Malaysian adult smokers aged ≥18 years (n = 1,047). Data were from the 2020 International Tobacco Control (ITC) Malaysia Survey were analyzed. A total of 79.9% of Malaysian smokers attempted to quit in the past 12 months and 85.2% intended to quit in the next 6 months. The most common CAs were e-cigarettes (ECs) (61.4%), medication/nicotine replacement therapies (NRTs; 51.0%), and printed materials (36.7%); the least common CA was infoline/quitline services (8.1%). Multivariable logistic regression analysis was performed to examine the association between sociodemographic variables and CAs use. Male smokers were more likely to use infoline/quitline services (adjusted odds ratio [aOR] = 3.27; P =.034). Malay smokers were more likely to use infoline/quitline services (aOR = 3.36; P =.002), ECs (aOR = 1.90; P =.004), printed materials (aOR = 1.79; P =.009), and in-person services (aOR = 1.75; P =.043). Most Malaysian smokers wanted to quit smoking. Furthermore, ECs were the most popular CAs, highlighting the need to assess the effectiveness of ECs for quitting smoking in Malaysia. [ABSTRACT FROM AUTHOR]

Objectives: To explore the views of nurses on challenges, perceived roles and improvement strategies concerning elder abuse intervention in Malaysia. Design and sample: Eleven focus group discussions were conducted using a semi‐structured interview based on the socio‐ecological framework. The data were analyzed using a multistep process of thematic analysis. Results: Three themes emerged from the data analysis: (1) The predicament: being unwilling or not able to intervene (2) Bridging the older people and health system gap (3) Getting to grips with the barriers. There are multifactorial contributors identified at the individual, interpersonal, organizational, community and policy levels in each theme. These factors interact across the levels to influence nurses' capability to intervene in elder abuse. Conclusion: A framework is needed to articulate Malaysian nurses' role in elder abuse intervention in terms of personal and professional development through culturally sensitive education and the establishment of clinical guidelines in the primary care setting. Strengthening organizational support and the institution of national policy and permissive reporting laws of elder abuse will empower the primary care nurses to address elder abuse in primary care settings and communities. [ABSTRACT FROM AUTHOR]

Elder abuse and neglect (EAN) goes largely unrecognized and underreported globally by health care professionals. Despite acknowledging their role to intervene elder abuse, health care professionals lacked knowledge and skills in this issue. This is a single-blinded, three-armed, cluster randomized controlled trials aimed to evaluate the effectiveness of the face-to-face I mproving N urses' d E tection and manag E ment of el D er abuse and neglect (I-NEED) intensive training program and I-NEED educational video in improving primary care nurses' knowledge, attitude, and confidence to intervene EAN; 390 primary care nurses were randomized equally into two intervention groups—ITP group (intensive training program) and ITP+ group (intensive training program and educational video)—and a control group. The knowledge, attitudes, and confidence to intervene EAN were measured using questionnaires at four intervals during 6-month follow-up. A total of 269 primary care nurses participated in this study. There was a significant increase in knowledge, attitude, and confidence to intervene EAN immediately post intervention observed in both intervention groups compared to the control group (p <.001). At the end of sixth month, there was an increase of knowledge favoring ITP group than the ITP+ group (p <.001). There is, however, no significant difference in attitude score between ITP and ITP+ group. There is a significant difference of confidence to intervene among the participants between both intervention groups with ITP+ participants reporting higher scores post intervention (p <.05). An intensive training module improved the knowledge, attitude, and confidence to intervene EAN. Other co-existing barriers for abuse victims getting help, resources, policy, and law of EAN need further highlights. [ABSTRACT FROM AUTHOR]

Introduction: Junior doctors are ideally placed to assist smokers quit yet little is known about their knowledge and practices.Aims: To determine knowledge and practices in providing smoking cessation support, among junior doctors in a Malaysian teaching hospital.Methods: In 2012, all junior doctors at University Malaya Medical Centre were invited to complete a self-administered questionnaire. The data were collated and analysed using standard descriptive methods.Results/Findings: Seventy per cent (n = 122/173) of those eligible completed the questionnaire, 71% reporting cessation training at medical school. Most (90%) asked patients their smoking status but only 52% asked about quitting. Sixty-one per cent lacked confidence in providing assistance to quit, especially female doctors (70.8%, p<0.01). Most (80%) were unaware of local cessation clinics, and over half (59%) were unaware of the existence of guidelines for smoking cessation (p<0.001).Conclusions: Asking about smoking was undertaken at satisfactory levels, but low knowledge, confidence and skills among this group of junior doctors indicates that cessation education should be included in undergraduate and in postgraduate curriculum training programmes. Awareness of specialist services and guidelines should be raised. Our findings are unlikely to be unique to this hospital, suggesting the need for a nationally consistent approach. [ABSTRACT FROM PUBLISHER]

Introduction The rapid adoption of telehealth services due to the COVID-19 pandemic has highlighted the necessity for effective tools to evaluate patient experiences. This study developed and validated the Telehealth Usability, Acceptability, and Satisfaction Questionnaire (TUASQ) for virtual COVID-19 Assessment Centres (CACs) in Malaysia, aiming to comprehensively measure usability, acceptability, and satisfaction. Methodology The TUASQ was developed in two phases. Initially, the questionnaire development phase included item generation guided by the Technology Acceptance Model (TAM) and the Health Belief Model (HBM), with feedback from a panel of six experts. Items were refined through Content Validity Index (CVI) - Item-Level Content Validity Index (I-CVI) ≥ 0.82, Scale-Level Content Validity Index (S-CVI) ≥ 0.82, and Content Validity Ratio (CVR ≥ 0.78); and Face Validity Index (FVI) by 10 respondents - Item-Level Face Validity Index (I-FVI) ≥ 0.82 and Scale-Level Face Validity Index (S-FVI ≥ 0.82). The psychometric validation phase involved a cross-sectional study of 705 respondents, recruited through convenience sampling from March to July 2024, to perform Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), followed by reliability testing using Cronbach's alpha, Composite Reliability (CR), and Average Variance Extracted (AVE). Results Content validation showed that most items' I-CVI exceeded 0.82, indicating significant expert consensus on relevance and clarity. The CVR also surpassed the 0.78 threshold, affirming their essential role. Face validation indices generally exceeded 0.80, confirming the questionnaire's clarity and comprehensiveness from the users' perspective. EFA with 250 participants indicated a high Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO) of 0.933 and significant Bartlett's test (χ² (136) = 3752.698, p < 0.001), supporting the factorability of the data and extracting three distinct factors. CFA with 455 participants initially showed a poor fit, prompting model adjustments that subsequently improved the fit indices (Root Mean Square Error of Approximation (RMSEA) = 0.076, Standardized Root Mean Square Residual (SRMR) = 0.045, Goodness of Fit Index (GFI) = 0.94, Tucker-Lewis Index (TLI) = 0.96, Comparative Fit Index (CFI) = 0.97). Reliability testing revealed a high internal consistency with Cronbach's alpha of 0.975. CR for each factor exceeded the 0.70 threshold, and the AVE for each factor was above 0.50, indicating good convergent validity. Conclusion The validated TUASQ is a reliable and effective instrument for assessing the experiences of Malaysian patients using virtual CAC. Demonstrating robust psychometric properties through comprehensive validation processes, the TUASQ accurately measures usability, acceptability, and satisfaction, identifying strengths and areas for improvement in telehealth services. This contributes to enhanced care quality and patient satisfaction in the evolving healthcare landscape., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethical Committee of Malaysian Research Ethical Committee (MREC) of the Ministry of Health issued approval NMRR ID-22-01180-LQL. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kannadasan et al.)

Introduction: Tobacco epidemic is a global public health concern, killing more than 8 million people annually. Individual therapy is the standard of care of behavioral intervention for smoking cessation in Malaysia and group-based therapy for smoking cessation is an alternative to behavioral intervention commonly used in the western population effectively. The study explored the feasibility and efficacy of group-based therapy for smoking cessation for smokers who want to quit smoking at a quit smoking clinic and community centers in an urban setting in Malaysia., Methods: A total of 40 participants who were active smokers and fulfilled the criteria were recruited for the study at the quit smoking clinic. Participants were given behavioral support based on the GBT-M module and individually for 7 weeks with both groups receiving behavioral intervention plus pharmacotherapy., Results: The median age of participants was 48 years for individual therapy and 45 years for group therapy. Group-based therapy was comparable to individual therapy in smoking abstinence outcome at 4 weeks post quit date (35% vs 30%)., Conclusions: Group-based therapy was equally effective compared to individual therapy, similar to the western population. Using a group format should allow more people to be treated by a therapist, and therefore could be more cost-effective. Group-based therapy is an option to be included as part of the smoking cessation program in Malaysia., Competing Interests: The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. P.M. Rashidi Mohamed reports that since the initial planning of the work, this research was funded through a Universiti Malaya Grand Challenge grants GC004-15HTM and GC004C-15HTM and that in the past 36 months there was the patent planned, issued or pending 'Group therapy for smoking cessation module'. F. Mohd Hairi reports that since the initial planning of the work this study was supported by the Universiti Malaya Grand Challenge grant GC004C-15HTM. C. Bullen reports that in the past 36 months received consulting fees from Kenvue Asia Ltd, he received honorarium for keynote lecture at APSAD annual scientific meeting Sept. 2023, support for attending meetings and/or travel and an unpaid role in other board, society, committee or advocacy groups. A.S. Amer Nordin reports that since the initial planning of the work this study was supported by the Universiti Malaya Grand Challenge grant GC004C-15HTM and that in the past 36 months received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Johnson and Johnson Malaysia (he received an unconditional educational grant and have also spoken for J&J for smoking cessation product - Nicorette), and that he participated on a Data Safety Monitoring Board or Advisory Board as one of the advisors of the medical board of Bedfont Scientific Ltd., (© 2024 Rashidi Mohamed P.M. et al.)

Background and Objectives: Caregiving outcomes have often been reported in terms of care recipients of single disease, rather than multiple health conditions. A systematic review was conducted to outline caregiving health outcomes and its association with care recipient multimorbidity for informal caregivers of older adults., Research Design and Methods: A search strategy was applied in six databases and grey literature. Inclusion criteria were primary observational studies on informal caregiving for care recipients aged 60 years and above, in the English language. Informal caregivers were those not formally hired and multimorbidity referred to presence of at least two health conditions. From a total of 2,101 titles, 230 abstracts were screened, and 19 articles were included. Quality assessment was conducted with application of the Newcastle-Ottawa-Scale., Results: Health-related and caregiving-related outcomes have been assessed for informal caregivers of older adults with multimorbidity. Caregiver subjective burden was most commonly evaluated and often reported to be low to moderate. In association with care recipient multimorbidity, caregiver burden, quality of life, and perceived difficulty in assisting the older adults were examined in 14 of the studies with mixed results. Studies were heterogeneous, with nonuniform definitions of informal caregivers and multimorbidity as well as measurement tools., Discussion and Implications: This narrative review found that caring for older adults with multimorbidity impacts caregivers, although overall evidence is not conclusive. Despite caregiving-related outcomes being most commonly assessed among the caregivers, particularly subjective burden, findings suggest that it is worthwhile to examine other outcomes to enrich the evidence base., (© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)