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Men’s Health Index: A Pragmatic Approach to Stratifying and Optimizing Men’s Health
Hui Meng Tan,Wei Phin Tan,Jun Hoe Wong,Christopher Chee Kong Ho,Chin Hai Teo,Chirk Jenn Ng 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.11
Purpose: The proposed Men’s Health Index (MHI) aims to provide a practical and systematicframework for comprehensively assessing and stratifying older men with theintention of optimising their health and functional status. Materials and Methods: A literature search was conducted using PubMed from 1980to 2012. We specifically looked for instruments which: assess men’s health, frailty andfitness; predict life expectancy, mortality and morbidities. The instruments were assessedby the researchers who then agreed on the tools to be included in the MHI. Whenthere was disagreements, the researchers discussed and reached a consensus guidedby the principle that the MHI could be used in the primary care setting targetting menaged 55-65 years. Results: The instruments chosen include the Charlson’s Combined Comorbidity-AgeIndex; the International Index of Erectile Function-5; the International ProstateSymptom Score; the Androgen Deficiency in Aging Male; the Survey of Health, Ageingand Retirement in Europe Frailty Instrument; the Sitting-Rising Test; the SeniorFitness Test; the Fitness Assessment Score; and the Depression Anxiety StressScale-21. A pilot test on eight men was carried out and showed that the men’s healthindex is viable. Conclusions: The concept of assessing, stratifying, and optimizing men’s health shouldbe incorporated into routine health care, and this can be implemented by using the MHI. This index is particularly useful to primary care physicians who are in a strategic positionto engage men at the peri-retirement age in a conversation about their life goalsbased on their current and predicted health status.
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The Decision-Making Journey of Malaysian Women with Early Breast Cancer: A Qualitative Study
Abdullah, Adina,Abdullah, Khatijah Lim,Yip, Cheng Har,Teo, Soo-Hwang,Taib, Nur Aishah,Ng, Chirk Jenn Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.12
Background: The survival outcomes for women presenting with early breast cancer are influenced by treatment decisions. In Malaysia, survival outcome is generally poor due to late presentation. Of those who present early, many refuse treatment for complementary therapy. Objective: This study aimed to explore the decision making experiences of women with early breast cancer. Materials and Methods: A qualitative study using individual in-depth interviews was conducted to capture the decision making process of women with early breast cancer in Malaysia. We used purposive sampling to recruit women yet to undergo surgical treatment. A total of eight participants consented and were interviewed using a semi-structured interview guide. These women were recruited from a period of one week after they were informed of their diagnoses. A topic guide, based on the Ottawa decision support framework (ODSF), was used to facilitate the interviews, which were audio recorded, transcribed and analysed using a thematic approach. Results: We identified four phases in the decision-making process of women with early breast cancer: discovery (pre-diagnosis); confirmatory ('receiving bad news'); deliberation; and decision (making a decision). These phases ranged from when women first discovered abnormalities in their breasts to them making final surgical treatment decisions. Information was vital in guiding these women. Support from family members, friends, healthcare professionals as well as survivors also has an influencing role. However, the final say on treatment decision was from themselves. Conclusions: The treatment decision for women with early breast cancer in Malaysia is a result of information they gather on their decision making journey. This journey starts with diagnosis. The women's spouses, friends, family members and healthcare professionals play different roles as information providers and supporters at different stages of treatment decisions. However, the final treatment decision is influenced mainly by women's own experiences, knowledge and understanding.
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