agnes ngoh

Self-efficacy in essential hypertension can be measured using scales, such as the "Hypertension Self-Care Profile" (HTN-SCP) questionnaire. It assesses "Behavior", "Motivation", and "Self-efficacy" in 3 domains, respectively. This study aimed to validate the Mandarin version of HTN-SCP instrument (HTN-SCP-Mn) targeted at patients of Chinese ethnicity with hypertension.Our study recruited Chinese patients, aged 40 years and older, with essential hypertension from a public primary healthcare clinic in Singapore. The 60-item HTN-SCP-Mn questionnaire was completed online using a tablet or smartphone on enrolment. A retest was conducted 2 weeks after the initial test. Reliability was assessed by internal consistency and test-retest reliability using Cronbach alpha and intraclass correlation coefficients (ICC). Differences between the overall HTN-SCP-Mn scores of the patients and their self-reported self-management activities were also determined us...

A symptom-based written asthma action plan (WAAP) was introduced to both adult and pediatric patients as part of the evidence-based local clinical practice guidelines to educate patients in asthma self-management in Singapore in 1998. This article aimed to explore the issues pertaining to the parental use of the WAAP for their children with asthma. A qualitative method using focus group discussions was used to gather qualitative data from parents of children with asthma who are on review at primary care clinics in Singapore. Qualitative data analysis based on grounded theory was carried out to identify emergent themes. Parents expressed difficulty in differentiating asthma-related symptoms from early symptoms of an upper-respiratory tract infection. Because of the failure to recognize cough as an asthma-related symptom, they focused more on symptomatic treatment of cough. They often relied on their own assessment of their children’s asthma status and sought medical consultation soon...

Background: Smoking is a known trigger of asthma exacerbation. Yet some patients with asthma continue to smoke. Little is known about their smoking literacy, which is defined as an individual’s capacity to comprehend and use healthcare information relating to smoking. This study aimed to determine the level of smoking literacy amongst patients with asthma, who were smokers (S) and non-smokers (NS). Methods: Standardised questionnaires were administered by trained research assistants to adult multi-ethnic Asian patients with asthma, who were managed in three public primary care clinics (polyclinics) in Singapore. Demographic data and information on a subject’s understanding and effects of smoking on health and complications were collected. The latter were computed into knowledge scores and the mean scores between S and NS were compared using the independent two-sample t-test with adjustment for potential confounders via multiple linear regression. Results: A total of 174 S and 183 NS...

Little is known about the decision pathway that family physicians (FP) take in considering drug therapy for their asthma patients. This study aimed to explore the factors that influence FPs' decisions in prescribing medications for their asthma patients. A qualitative method using focus group discussions (FGD) was used to gather qualitative data based on a semi-structured topic guide from FPs of different training backgrounds and practices. 29 Singapore FPs working as private general practitioners (GP), polyclinic doctors and locums were recruited into five FGDs. The FPs' asthma drug prescription decisions were related to the FPs' medical training and acquisition of asthma-related information and updates. Uncertainty of disease diagnosis, patients' beliefs and their perceptions of the disease and treatment, as well as the FPs' concerns about drug side effects, were significant considerations for the participants. Costs related to differential subsidies in the con...

Smoking is a health hazard. Current smoking cessation measures such as behavioral change counselling by trained professionals, nicotine replacement therapy and medications have limited success. Smoking intensity is assessed using a portable device to measure the smokers’ exhaled breath carbon monoxide (eCO) level. A systematic review suggests the potential of serious gaming to increase smoking quit rate. However, the related studies were unable to explain and determine the effect gamification on smoking cessation. A handy personalized eCO measurement device linked to a smart-phone applications (app) has been developed (integrated STEADES-2 system). This novel system incorporates app-based video and print learning resources, authentication function and gamification using the eCO data as game element. Trained multidisciplinary healthcare professionals access the STEADES-2 data to monitor smoking status and support smokers via asynchronous virtual coaching. The pilot randomized control...

The Written Asthma Action Plan (WAAP) educates patients on the early recognition and treatment of deteriorating asthma. It has been adopted in Singapore polyclinics and restructured hospitals in the past few years as recommended by the Singapore National Asthma Programme. Local asthma patients can choose to be treated by family physicians at public polyclinics or by private general practitioners (GPs). In a previous study, half of the physicians in primary care self-reported that they formulated an asthma action plan for their patients, but little is known about their actual practices. This qualitative study explored family physicians' views of WAAP and its implementation in primary care in Singapore. Qualitative data was obtained for 29 participants from polyclinics, GP clinics or locum doctors at five separate focus group discussions. The data was coded using NVivo-7 software, audited and analysed to identify emergent themes. The participants generally perceived the usefulness...