Assoc Professor, Faculty Of Medicine, University of Malaya Founder, KeepAble Cancer Community, PJ Phone: 03-79496678 // 0379493120 Address: syloh@ummc.edu.my 0379496678
Chronic pressure at work has debilitating impact on healthcare employers (e.g. reduced productivi... more Chronic pressure at work has debilitating impact on healthcare employers (e.g. reduced productivity, high costs, poor patient care) and on female healthcare employees (e.g. sickness, dysfunction). This paper highlights relationship at work as the key occupational source of work-stress which is organisational in nature. A cross-sectional study (n = 230) was conducted using the Pressure Management Inventory on several female dominated health professions within a large public hospital. Analysis of variance was used to show relationship between sources and outcome of pressure. Linear regressions were used to predict which sources of pressure (IV) was linked to the outcomes of occupational pressure (DV). The number one source of occupational pressure is relationships at work (i.e. with supervisors), and not workload. 'Relationship' is also the key predictor of several negative outcomes of pressure at work. Analysis of variance showed significant differences in two sources of pressures, i.e. Workload (P = 0.04) and Home-work balance (P = 0.03). This paper provides insights into the occupational pressure of women health professionals by highlighting the organisational sources of pressure and the implications for preventing occupational dysfunction secondary to stress at work.
Journal of the University of Malaya Medical Centre
Evidence suggests that breast cancer is taking the form of a chronic illness. This will add on to... more Evidence suggests that breast cancer is taking the form of a chronic illness. This will add on to the present burden of managing chronic diseases in the healthcare delivery system. The burden of breast cancer being a chronic illness, calls for greater efforts to address the many neglected, physical-psycho-social and occupational functioning consequences. Timely efforts are needed to identify and implement interventions that are aim at improving the quality of life of women with breast cancer. At present, research evidence is highlighting that chronic diseases may best be managed using a self-management approach, and best treated by a balance of traditional medical care and the day-to-day practice of self-management skills. This paper presents the perspective of breast cancer as a chronic illness and its implication for rehabilitation and medical education. It is imperative that health professionals be made aware of these survivorship issues through medical education. The goals are t...
There is a general lack of valid tools to measure work stress of Malaysian. This study examines t... more There is a general lack of valid tools to measure work stress of Malaysian. This study examines the validity and reliability of the Pressure Management Inventory (PMI). Reliability was evaluated using test retest method, and its correlation coefficient was calculated using Pearson's r. Internal consistencies were examined using Cronbach's Alpha. For precision, the Intraclass coefficients (ICC) were calculated for all the scales. Face Validity and Content Validity were assessed using an open-ended questionnaire on 6 content experts (psychiatrists in HKL). The results show good internal consistencies (alpha < or = 0.7) for most subscales, with the best results in the 'Pressure Scale'. The weak scales are 'Individual-Differences' scale and 'Social Support' scale. The test-retest correlation coefficients were significant at the level of p<0.001 for all, except one scale. The ICC coefficients were high (>0.7) for most scales, particularly for Pres...
In a clinical controlled trial involving repeated measures of continuous outcomes such as quality... more In a clinical controlled trial involving repeated measures of continuous outcomes such as quality of life, distress, pain, activity level at baseline and after treatment, the possibilities of analyzing these outcomes can be numerous with quite varied findings. ...
Breast self-examination (BSE) is a self-generated, non-invasive and non-irradiative method of bre... more Breast self-examination (BSE) is a self-generated, non-invasive and non-irradiative method of breast cancer detection. This paper documents Malaysian women's awareness and practice of regular BSE as a potent breast cancer detection tool. A pre-test post-test ...
Breast self-examination (BSE) is a self-generated, non-invasive and non-irradiative method of bre... more Breast self-examination (BSE) is a self-generated, non-invasive and non-irradiative method of breast cancer detection. This paper documents Malaysian women's awareness and practice of regular BSE as a potent breast cancer detection tool. A pre-test post-test ...
Across Asia, health professions such as Occupational therapy, physical and speech disciplines are... more Across Asia, health professions such as Occupational therapy, physical and speech disciplines are losing their autonomy due to entrenched medical hagemony, which allows a medical discipline to rule over all other health disciplines deemed as of lower prestige. More awareness and international collaborations need to step up to rectify these occupational violation and continuous occupational deprivation of newer health profession to develop their professions.
Background: This study is on the robust validation of the Malay version "Participation in Childho... more Background: This study is on the robust validation of the Malay version "Participation in Childhood Occupation"-a tool for measuring "limitations in participation" which is an important social determinant of occupational functioning in 6-10 years old children. Methods: Standard forward-backward translations were conducted to translate the PICO (English version) to PICO-M (Malay version) by bilingual language experts, and reviewed by a panel of 10 expert working in the area of paediatric. A pilot test (30 parents) for test-retest reliability check and content validation. Data were collected (347 parents of healthy 6-10 years old children) using the new PICO_M, and analysed for factor analyses. Both exploratory (n=100), and confirmatory (n=247) factor analyses were conducted to examine the variances attributable to its latent construct and to test the hypothesised 3-factor model. Results: The psychometric analyses of PICO_M was tested robustly with consideration of its three dimensions of participation-i) difficulties in performance, ii) frequency of performance and iii) enjoyment in performing of the activity being measured. Confirmatory factor Analyses on its latent variables confirmed PICO-M as a modified 3-factor model (Academic, Activities of Daily living, & Play-leisure/Social skill/Habits-routine), with a high composite reliability (CR) for items (ranging between 0.850 and 0.919) and with good discriminant validity. Conclusions: PICO_M is a valid tool for measuring the pattern of limitation in participation among 6-10 years old children. It is robustly tested as a modified 3-factor instrument. Children with participation-limitations should be screened with PICO-M for earlier detection of functional difficulties, to initiate earlier therapeutic intervention in partnership with the parents.
COVID-19 has disrupted people's occupational daily activities with detrimental impact on their da... more COVID-19 has disrupted people's occupational daily activities with detrimental impact on their daily living performances and quality of life. Occupational therapy contributes toward restoring health by remediating limitation in participation in meaningful occupation with lifestyle redesign interventions. However, the research gap on the area of "participation-limitation" for the field of Occupational Therapy in cancer survivorship during the COVID-19 is largely untapped and unknown. This commentary-review paper discussed the PEO-OT (person-environment-occupation) grid as a conceptual toolkit for stimulating research in the domain of occupational participation-an essential aspect in the field of occupational therapy, for cancer survivors. It applies the expertise finding from a large Delphi study on research priority in the fields and integrating these into evidenced methodology, to provide a structure to guide the novice researchers towards rapid reviews, by selecting evidencebased methods to ensure contextually-relevant enquiry to identify the "occupational-participation issues"-i.e., an emerging social determinant of health, affecting the daily self-management of cancer survivors with or without comorbidities.
Background: Stroke is currently the main cause of neurological disability in Nigeria. The impact ... more Background: Stroke is currently the main cause of neurological disability in Nigeria. The impact of stroke can be devastating, leaving a person with significant residual impairment of physical, psychological, and social functions. The residual physical consequences can pose a significant threat to a survivor’s quality of life: yet, we have an incomplete understanding of how stroke affects long-term quality of life.Objective: To develop a thorough understanding how essential social relationship and support systems are to enabling long-term QOL following stroke.Methods: This study reports finding from an in-depth interview with 15 stroke patients to understand the importance of social relationship and support system as essential dimensions of long-term quality of life following stroke.Results: The key themes identified by the patients were: social and instrumental supports, communication, autonomy, social role adjustments, sexual relationship and stigma. A lot of the interviews with t...
International journal of applied & basic medical research, 2011
The Cancer Behavior Inventory (CBI), a measure of self-efficacy for coping with cancer, was used ... more The Cancer Behavior Inventory (CBI), a measure of self-efficacy for coping with cancer, was used to examine the feasibility and impact of a self-management program for women with breast cancer. This controlled clinical trial was conducted on newly diagnosed breast cancer patients, using a time series, block design. Sixty-nine patients were allocated to receive four weekly sessions of the self-management training program, while 78 patients were allocated to the control (usual-care) group. A significant difference was found between the means of the experimental and the control group at post-test (T2; P=.01) and at follow-up (T3; P=.02). The multivariate analyses of the three repeated measures showed significant differences (P=.001; partial eta-squared = 0.092). Pair-wise comparison shows that the differences were significant between baseline (T1) measure and follow-up (T3) measure (P=.01), and between post-test (T2) and follow-up (T3) (P=.03). For women undergoing intervention, the ca...
Chronic pressure at work has debilitating impact on healthcare employers (e.g. reduced productivi... more Chronic pressure at work has debilitating impact on healthcare employers (e.g. reduced productivity, high costs, poor patient care) and on female healthcare employees (e.g. sickness, dysfunction). This paper highlights relationship at work as the key occupational source of work-stress which is organisational in nature. A cross-sectional study (n = 230) was conducted using the Pressure Management Inventory on several female dominated health professions within a large public hospital. Analysis of variance was used to show relationship between sources and outcome of pressure. Linear regressions were used to predict which sources of pressure (IV) was linked to the outcomes of occupational pressure (DV). The number one source of occupational pressure is relationships at work (i.e. with supervisors), and not workload. &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;Relationship&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; is also the key predictor of several negative outcomes of pressure at work. Analysis of variance showed significant differences in two sources of pressures, i.e. Workload (P = 0.04) and Home-work balance (P = 0.03). This paper provides insights into the occupational pressure of women health professionals by highlighting the organisational sources of pressure and the implications for preventing occupational dysfunction secondary to stress at work.
Journal of the University of Malaya Medical Centre
Evidence suggests that breast cancer is taking the form of a chronic illness. This will add on to... more Evidence suggests that breast cancer is taking the form of a chronic illness. This will add on to the present burden of managing chronic diseases in the healthcare delivery system. The burden of breast cancer being a chronic illness, calls for greater efforts to address the many neglected, physical-psycho-social and occupational functioning consequences. Timely efforts are needed to identify and implement interventions that are aim at improving the quality of life of women with breast cancer. At present, research evidence is highlighting that chronic diseases may best be managed using a self-management approach, and best treated by a balance of traditional medical care and the day-to-day practice of self-management skills. This paper presents the perspective of breast cancer as a chronic illness and its implication for rehabilitation and medical education. It is imperative that health professionals be made aware of these survivorship issues through medical education. The goals are t...
There is a general lack of valid tools to measure work stress of Malaysian. This study examines t... more There is a general lack of valid tools to measure work stress of Malaysian. This study examines the validity and reliability of the Pressure Management Inventory (PMI). Reliability was evaluated using test retest method, and its correlation coefficient was calculated using Pearson's r. Internal consistencies were examined using Cronbach's Alpha. For precision, the Intraclass coefficients (ICC) were calculated for all the scales. Face Validity and Content Validity were assessed using an open-ended questionnaire on 6 content experts (psychiatrists in HKL). The results show good internal consistencies (alpha < or = 0.7) for most subscales, with the best results in the 'Pressure Scale'. The weak scales are 'Individual-Differences' scale and 'Social Support' scale. The test-retest correlation coefficients were significant at the level of p<0.001 for all, except one scale. The ICC coefficients were high (>0.7) for most scales, particularly for Pres...
In a clinical controlled trial involving repeated measures of continuous outcomes such as quality... more In a clinical controlled trial involving repeated measures of continuous outcomes such as quality of life, distress, pain, activity level at baseline and after treatment, the possibilities of analyzing these outcomes can be numerous with quite varied findings. ...
Breast self-examination (BSE) is a self-generated, non-invasive and non-irradiative method of bre... more Breast self-examination (BSE) is a self-generated, non-invasive and non-irradiative method of breast cancer detection. This paper documents Malaysian women's awareness and practice of regular BSE as a potent breast cancer detection tool. A pre-test post-test ...
Breast self-examination (BSE) is a self-generated, non-invasive and non-irradiative method of bre... more Breast self-examination (BSE) is a self-generated, non-invasive and non-irradiative method of breast cancer detection. This paper documents Malaysian women's awareness and practice of regular BSE as a potent breast cancer detection tool. A pre-test post-test ...
Across Asia, health professions such as Occupational therapy, physical and speech disciplines are... more Across Asia, health professions such as Occupational therapy, physical and speech disciplines are losing their autonomy due to entrenched medical hagemony, which allows a medical discipline to rule over all other health disciplines deemed as of lower prestige. More awareness and international collaborations need to step up to rectify these occupational violation and continuous occupational deprivation of newer health profession to develop their professions.
Background: This study is on the robust validation of the Malay version "Participation in Childho... more Background: This study is on the robust validation of the Malay version "Participation in Childhood Occupation"-a tool for measuring "limitations in participation" which is an important social determinant of occupational functioning in 6-10 years old children. Methods: Standard forward-backward translations were conducted to translate the PICO (English version) to PICO-M (Malay version) by bilingual language experts, and reviewed by a panel of 10 expert working in the area of paediatric. A pilot test (30 parents) for test-retest reliability check and content validation. Data were collected (347 parents of healthy 6-10 years old children) using the new PICO_M, and analysed for factor analyses. Both exploratory (n=100), and confirmatory (n=247) factor analyses were conducted to examine the variances attributable to its latent construct and to test the hypothesised 3-factor model. Results: The psychometric analyses of PICO_M was tested robustly with consideration of its three dimensions of participation-i) difficulties in performance, ii) frequency of performance and iii) enjoyment in performing of the activity being measured. Confirmatory factor Analyses on its latent variables confirmed PICO-M as a modified 3-factor model (Academic, Activities of Daily living, & Play-leisure/Social skill/Habits-routine), with a high composite reliability (CR) for items (ranging between 0.850 and 0.919) and with good discriminant validity. Conclusions: PICO_M is a valid tool for measuring the pattern of limitation in participation among 6-10 years old children. It is robustly tested as a modified 3-factor instrument. Children with participation-limitations should be screened with PICO-M for earlier detection of functional difficulties, to initiate earlier therapeutic intervention in partnership with the parents.
COVID-19 has disrupted people's occupational daily activities with detrimental impact on their da... more COVID-19 has disrupted people's occupational daily activities with detrimental impact on their daily living performances and quality of life. Occupational therapy contributes toward restoring health by remediating limitation in participation in meaningful occupation with lifestyle redesign interventions. However, the research gap on the area of "participation-limitation" for the field of Occupational Therapy in cancer survivorship during the COVID-19 is largely untapped and unknown. This commentary-review paper discussed the PEO-OT (person-environment-occupation) grid as a conceptual toolkit for stimulating research in the domain of occupational participation-an essential aspect in the field of occupational therapy, for cancer survivors. It applies the expertise finding from a large Delphi study on research priority in the fields and integrating these into evidenced methodology, to provide a structure to guide the novice researchers towards rapid reviews, by selecting evidencebased methods to ensure contextually-relevant enquiry to identify the "occupational-participation issues"-i.e., an emerging social determinant of health, affecting the daily self-management of cancer survivors with or without comorbidities.
Background: Stroke is currently the main cause of neurological disability in Nigeria. The impact ... more Background: Stroke is currently the main cause of neurological disability in Nigeria. The impact of stroke can be devastating, leaving a person with significant residual impairment of physical, psychological, and social functions. The residual physical consequences can pose a significant threat to a survivor’s quality of life: yet, we have an incomplete understanding of how stroke affects long-term quality of life.Objective: To develop a thorough understanding how essential social relationship and support systems are to enabling long-term QOL following stroke.Methods: This study reports finding from an in-depth interview with 15 stroke patients to understand the importance of social relationship and support system as essential dimensions of long-term quality of life following stroke.Results: The key themes identified by the patients were: social and instrumental supports, communication, autonomy, social role adjustments, sexual relationship and stigma. A lot of the interviews with t...
International journal of applied & basic medical research, 2011
The Cancer Behavior Inventory (CBI), a measure of self-efficacy for coping with cancer, was used ... more The Cancer Behavior Inventory (CBI), a measure of self-efficacy for coping with cancer, was used to examine the feasibility and impact of a self-management program for women with breast cancer. This controlled clinical trial was conducted on newly diagnosed breast cancer patients, using a time series, block design. Sixty-nine patients were allocated to receive four weekly sessions of the self-management training program, while 78 patients were allocated to the control (usual-care) group. A significant difference was found between the means of the experimental and the control group at post-test (T2; P=.01) and at follow-up (T3; P=.02). The multivariate analyses of the three repeated measures showed significant differences (P=.001; partial eta-squared = 0.092). Pair-wise comparison shows that the differences were significant between baseline (T1) measure and follow-up (T3) measure (P=.01), and between post-test (T2) and follow-up (T3) (P=.03). For women undergoing intervention, the ca...
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