Diabetes mellitus is a public health concern in Malaysia. Treatment of diabetes is costly and can lead to complications if disease is poorly controlled. Diabetes self-management (DSM) is found to be essential for optimal glycemic control. This cross-sectional study was conducted among samples from four randomly selected diabetes clinics in Sarawak, Malaysia. The aim was to determine the predictors for DSM. Face-to-face interview using questionnaire was used to collect data. Four hundred respondents with type 2 diabetes mellitus (T2DM) were recruited. Majority of the respondents were Sarawak Bumiputra (Iban and Bidayuh, 48.6%) and female (68.6%). The mean age was 58.77 years (SD = 11.46) and approximately half of the respondents (50.6%) had T2DM for six years (SD = 4.46). The mean fasting blood glucose (FBG) was 8.06 mmol/L (SD = 2.94), with majority (76.1%) having the level higher than 6.1 mmol/L. Multiple logistic regression tests showed significant linear relationship between DSM and belief in treatment effectiveness (p = 0.001), family support (p = 0.007), and self-efficacy (p = 0.027). Health care personnel must convince patients with T2DM of the effectiveness of the treatment, empower and enhance their self-efficacy, and enlist the family support so as to ensure patients sustain their DSM efforts.

Context:Breaking of bad news is an important component in the management of cancer patients.Aims:This study aimed to assess the perceptions of breaking bad news of cancer diagnosis.Settings and Design:It was a cross-sectional study using Breaking Bad News Assessment Schedule (BAS) questionnaire on cancer patients in Serian district.Materials and Methods:Using snowballing sampling method, a total of 134 patients were interviewed face-to-face after the consent was obtained from each of the respondents.Statistical Analysis Used:Data was entered and analyzed using SPSS version 19.0.Results:Majority were comfortable with the current method of breaking bad news. The main aspects found to be the areas of concern were the importance of the usage of body language, management of time and identifying patients’ key area of concerns. There were significant difference between sex and “information giving” (P = 0.028) and “general consideration” (P = 0.016) and also between “the age and setting the scene” (P = 0.042). Significant difference was also found between the types of cancer and “the setting of scene” (P = 0.018), “breaking bad news technique” (P = 0.010), “eliciting concerns” (P = 0.003) and “information giving” (P = 0.004).Conclusion:Good and effective communication skill of breaking bad news is vital in the management of cancer patients. As the incidence of new cases of cancer increase every year, breaking of bad news has become a pertinent to the medical professionals’ role. Specific aspects of communication skills based on local characteristics should be more emphasized in the formulation of training for doctors.

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Purpose: This study aimed to determine the prevalence of unmet supportive care needs among bone sarcoma patients in Kuching, Sarawak and explored the relationship between these needs with various associated factors.  Methods: It was a descriptive cross-sectional study conducted among all bone sarcoma patients recruited from Sarawak General Hospital in Kuching, Sarawak. Data collection was done using an adopted questionnaire via interview assisted survey. Unmet needs were assessed using the 59-item Supportive Care Needs Survey (SCNS-SF59). Data was entered and analyzed using SPSS version 20.    Results: A total of 75 respondents participated in the study. The patients were mainly above 36 years (56%), Sarawak natives (33.3%) and married (54.7%). Majority of patients were not undergoing any active treatment (52%). Nine out of 10 items with highest ‘moderate’ to ‘high’ level unmet needs were from the domain of Health system and information.  Needs from Physical and daily living, and sexuality domains were found to have statistically significant associations with ethnicity, age and marital status.  Conclusion: Patients who were diagnosed with bone sarcoma had substantive unmet supportive care needs in relation with their illness trajectory. It is important that such needs to be acknowledged in order to provide quality healthcare services to them.   Key words : bone sarcoma, unmet needs, Malaysia, SCNS-SF59,supportive care needs