ORIGINAL RESEARCH * PEER-REvIEwEd 662894C PHXXX10.1177/1715163516662894C P J / R P CC P J / R P C

BackgroundThis study utilized a validated combination of a COPD Population Screener (COPD-PS) questionnaire and a handheld spirometric device as a screening tool for patients at high risk of COPD, such as smokers. The study aimed to investigate and pilot the feasibility and application of this combined assessment, which we termed the “VitalQPlus”, as a screening tool for the early detection of COPD, especially in primary care settings.MethodsThis was a cross-sectional study screening potentially undiagnosed COPD patients using a validated five-item COPD-PS questionnaire together with a handheld spirometric device. Patients were recruited from selected Malaysian government primary care health centers.ResultsOf the total of 83 final participants, only 24.1% (20/83) were recruited from Perak and Penang (peninsular Malaysia) compared to 75.9% (63/83) from Sabah (Borneo region). Our dual assessment approach identified 8.4% of the surveyed patients as having potentially undiagnosed COPD. When only the Vitalograph COPD-6 screening tool was used, 15.8% of patients were detected with a forced expiratory volume in 1 second/forced expiratory volume in 6 seconds (FEV1/FEV6) ratio at <0.75, while 35.9% of patients were detected with the COPD-PS questionnaire. These findings suggested that this dual assessment approach has a greater chance of identifying potentially undiagnosed COPD patients compared to the Vitalograph COPD-6 or COPD-PS questionnaire when used alone. Our findings show that patients with more symptoms (scores of ≥5) yielded twice the percentage of outcomes of FEV1/FEV6 <0.75 compared to patients with fewer COPD symptoms (scores <5).ConclusionWith the availability of a simple screening questionnaire and the COPD-6, there is an opportunity easily to make patients more aware of their lung symptoms and to encourage the provision of early treatment. The proposed dual assessment approach, which we termed the VitalQPlus, may play a profound role in the early diagnosis of COPD, which is crucial in improving the clinical management of the disease.

Objectives: The mental health (MH) issue has emerged as one of the great public health concerns worldwide, and its prevalence is escalating substantially among Malaysians. An individual’s daily living, physical health, and relationships can be hard-hit by an MH disorder. The present study aimed to (i) estimate the probable psychological distress in warded adult patients at Hospital Tapah, Malaysia, and (ii) investigate the key antecedents intrinsically linked to depression, anxiety, and stress that may precipitate psychological distress symptoms.Material and Methods: This study was a cross-sectional questionnaire-based study involving 191 participants sampled from the warded adult patients at Hospital Tapah. The psychological distress was assessed using the Depression, Anxiety and Stress Scale-21 (DASS-21). Data were analysed by logistic regression using SPSS 16.0.Results: Anxiety (34.0%) was detected as the highest prevalence of probable psychological distress by a wide margin, trailed by stress (16.8%) and depression (15.2%). Race, Orang Asli (native people) and mental health awareness were associated with the depression. Respondents who exercised regularly, were employed, non-smokers, non-alcoholic drinkers, and without mental health awareness were at risk of anxiety. Income was found to be significantly associated with stress. Conclusion: This study detected a two-fold increase in the risk of anxiety compared to stress and depression. Further studies should be conducted to identify the factors related to the high DASS-21 scores in detail.

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