Principle investigator:Dato’ Dr. Hajah Marlia Mohammed Salleh

Co-investigators:Dr. ThillainathanDr. Ng Kok Huan

Presenter:

YANTIE SHAHIDA BT ABDUL MANANPegawai Pendidikan Kesihatan

Jabatan Kesihatan Negeri Pahang

HEALTH SCREENING STUDY HEALTH SCREENING STUDY AMONG HOSPITAL STAFFAMONG HOSPITAL STAFF

HEALTH SCREENING IHEALTH SCREENING IWe often assume that when a person is

not sick - he or she must be in good health, but this is not always the case.

The root of many common diseases such as HPT, DM, MI and cancer often set in years before the illness actually surfaces.

Therefore, early detection of risk factors is essential (Patel et al. 2011).

HEALTH SCREENING IIHEALTH SCREENING IIo As it not only improves chances of successfully

treating early stages of medical conditions but also of preventing or delaying disease, thus maintaining a high quality of life and prolonged life expectancy.

o CVD is one of the most prevalent and devastating health problems in the world and is responsible for approximately 30% of deaths worldwide (WHO, 2005) which equate to about 16.6 million deaths. (Erhardt, Moller & Puig, 2007).

o Our study emphasized on coronary risk.

OBJECTIVESOBJECTIVESo GeneralGeneral

To investigate the health status of the staff

o Specific Specific Screening on => Obesity => BMI => MI risk => Procam => Lifestyle factors

STUDY DESIGN & STUDY DESIGN & SAMPLE SELECTIONSAMPLE SELECTION

Cross-sectional study All hospital staff with age ≥ 40 years old Duration: 3 months Study centre: HTAA Participants were asked to fast for at

least 8 hours before the study begun

INSTRUMENTINSTRUMENT

Health status Health status screening screening

questionnairequestionnaire

Medical history

Personal Particulars

Personal

Family

Life styleBasic health screening

Biometry measurement

s

PROCAM Screening

Habits

o SPSS 17.0 for Windows was utilized.

o Patients’ socio-demographic data was descriptively presented as frequencies and percentages.

o Procam calculator was used to determine the risk of MI.

STATISTICAL ANALYSISSTATISTICAL ANALYSIS

PROCEDUREPROCEDUREBriefing.Agreement of participation.On the day of participation

eligible participants were asked to complete the instruments- BSSK/W/I/2008 biometry assessment

Blood pressure (Bp) Waist circumference (WC) Weight and height Blood test => glucose, lipid profile

Male (n = Male (n = 97) n (%)97) n (%)

Female Female (n = 256)(n = 256) n (%)n (%)

Nationality Nationality Malaysian Malaysian

Non- citizenNon- citizen94 (96.9)94 (96.9)

3 (3.1)3 (3.1)254 (99.2)254 (99.2)

2 (0.8)2 (0.8) RaceRaceMalayMalay

Chinese/Indian/Chinese/Indian/OthersOthers

84 (86.6)84 (86.6)13 (13.4)13 (13.4)

232 (90.6)232 (90.6)24 (9.4)24 (9.4)

ReligionReligionIslamIslam

Buddha/Hindu/Buddha/Hindu/Christian/OthersChristian/Others

82 (84.5)82 (84.5)15 (15.5)15 (15.5)

233 (91.0)233 (91.0)23 (9.0)23 (9.0)

Level of educationLevel of education> Higher > Higher (> SPM)(> SPM)< Lower (≤ SPM)< Lower (≤ SPM)

33 (34.0)33 (34.0)64 (66.0)64 (66.0)

45 (17.6)45 (17.6)211 (82.4)211 (82.4)

Marital StatusMarital StatusMarriedMarried

SingleSingle//DivorceDivorce94 (96.9)94 (96.9) 3 (3.1)3 (3.1)

235 (91.8)235 (91.8)22 (9.2)22 (9.2)

Results: DemographyResults: Demography

•A total of 398 participants A total of 398 participants were recruitedwere recruited

• only only 353 353 included in included in the analysisthe analysis• 97 male and 256 97 male and 256 femalefemale

•The average The average mean age mean age for for male participants was 48.59 male participants was 48.59 and female was 47.82 years and female was 47.82 years

Female n (%) Male n (%)Yes No Yes No

Breakfast 208 (81.2)

48 (18.8) 90 (92.8) 7 (7.2)

Lunch 207 (80.9)

49 (19.1) 78 (80.4) 19 (19.6)

Dinner 200 (78.1)

56 (21.9) 81 (83.5) 16 (16.5)

Cereal 249 (97.3)

7 (2.7) 91 (93.8) 6 (6.2)

Fruits 219 (85.5)

37 (14.5) 62 (63.9) 35 (36.1)

Vegetables

245 (95.7)

11 (4.3) 87 (89.7) 10 (10.3)

Dairy 180 (70.3)

76 (29.7) 49 (50.5) 48 (49.5)

Meats 242 (94.5)

14 (5.5) 89 (91.8) 8 (8.2)

LIFE STYLE ILIFE STYLE IHealthyHealthy

LIFE STYLE IILIFE STYLE IIFemale n (%)Female n (%) Male n (%)Male n (%)

YesYes No No YesYes NoNoSmokingSmoking 4 (1.6)4 (1.6) 252 252

(98.4)(98.4)26 26

(26.8)(26.8)71 (73.2)71 (73.2)

AlcoholAlcohol 3 (1.2)3 (1.2) 253 253 (98.8)(98.8)

7 (7.2)7 (7.2) 90 (92.8)90 (92.8)

DrugsDrugs 3 (1.2)3 (1.2) 253 253 (98.8)(98.8)

1 (1.0)1 (1.0) 96 (99.0)96 (99.0)

Other Other substancesubstancess

0 (0.0)0 (0.0) 256 256 (100.0)(100.0)

0 (0.0)0 (0.0) 97 97 (100.0)(100.0)

Female n (%) Male n (%)< 3 times

a week≥ 3 times a

week< 3 times a

week≥ 3 times a

week

Exercise > 30minutes > 3 times a week

202 (78.9)

54 (31.1) 61 (62.9) 36 (37.1)

HealthyHealthy

LIFE STYLE IIILIFE STYLE IIIFemale n (%)Female n (%) Male n (%)Male n (%)

Depression Depression YesYes No No YesYes NoNo

Symptom Symptom 11

59 59 (23.0)(23.0)

197 197 (77.0)(77.0)

5 (5.2)5 (5.2) 92 (94.8)92 (94.8)

Symptom Symptom 22

24 (9.4)24 (9.4) 232 232 (90.6)(90.6)

8 (8.2) 8 (8.2) 89 (91.8)89 (91.8)

HealthyHealthy

Calculation of marks for life style health score:Calculation of marks for life style health score:Yes = 5 mark No = 0 mark Yes = 5 mark No = 0 mark

E.g- Scores for depression (yes, no)E.g- Scores for depression (yes, no)

Sum of depression symptoms 1 + 2 / Total scores x Sum of depression symptoms 1 + 2 / Total scores x 100100

= 5 + 0 / 10 x 100= 5 + 0 / 10 x 100

= 50% of risk of unhealthy life style= 50% of risk of unhealthy life style

Female n (%)Female n (%) Male n (%)Male n (%)HealthyHealthy UnhealthyUnhealthy HealthyHealthy UnhealthyUnhealthy

Eating HabitsEating Habits 203 203 (79.3)(79.3)

53 (20.7)53 (20.7) 51 (52.6)51 (52.6) 46 (47.7) 46 (47.7)

SubstancesSubstances 254 254 (98.8)(98.8)

2 (7.8)2 (7.8) 89 (91.8)89 (91.8) 8 (8.2)8 (8.2)

Physical Physical activitiesactivities

202 202 (78.9)(78.9)

54 (31.1)54 (31.1) 61 (62.9)61 (62.9) 36 (37.1)36 (37.1)

DepressionDepression 215 215 (83.9)(83.9)

41 (16.1)41 (16.1) 91 (93.3)91 (93.3) 6 (6.1)6 (6.1)

LIFE STYLE IIILIFE STYLE III

Score interpretation - 0- <50 – HealthyScore interpretation - 0- <50 – Healthy - >50 -100 – Unhealthy - >50 -100 – Unhealthy

lifestylelifestyle

FemaleFemale MaleMaleHealthyHealthy UnhealthyUnhealthy HealthyHealthy UnhealthyUnhealthy

Total lifestyle Total lifestyle scores (mean)scores (mean)

85.285.2 18.918.9 75.275.2 24.8 24.8

PROCAM IPROCAM Io The PROCAM Risk Scores?

o It was developed based on 450 coronary events occurring in a cohort of about 5,000 men aged 35-65 years at recruitment and with at least 10 years of unbroken follow-up.

o Generally two type => PROCAM Quick Check and the PROCAM Health Check.

The PROCAM Quick Check: The PROCAM Quick Check: o allows rapid initial assessment of coronary risk.

o suitable for men and women aged 20-75 years.

o provides an estimation of risk sufficiently accurate to determine if further examination by a physician is advisable..

Empana et al. 2003

Assessment Age Gender Glucose Smoking Anamnenies (Family medical history) Blood pressure Weight Hypertension history

PROCAM IIPROCAM II

Website:http://www.chd-taskforce.com/procam_interactive.html

RISK FACTORS: MIRISK FACTORS: MIFemale n (%)Female n (%) Male n (%)Male n (%)

Normal Normal AbnormalAbnormal NormalNormal AbnormalAbnormalBMIBMI 93 93

(36.3)(36.3)163 (63.7)163 (63.7) 27 (27.9)27 (27.9) 70 (71.1)70 (71.1)

Waist Waist CircumferenceCircumference

59 59 (23.0)(23.0)

197 (77.0)197 (77.0) 31 (32.0)31 (32.0) 66 (78.0)66 (78.0)

Blood PressureBlood Pressure 137 137 (50.3)(50.3)

119 (46.5)119 (46.5) 58 (59.8)58 (59.8) 39 (40.2)39 (40.2)

Normal reading: BMI <25; WC<90 (M) <80 (F); BP<100

Female Female MeanMean

MaleMaleMeanMean

PROCAM RiskPROCAM Risk 1.431.43 2.472.47

n = 32 (12.5%)n = 32 (12.5%)Ranging from 1 - 6.22 fold Ranging from 1 - 6.22 fold increased risk compared to increased risk compared to risk of average person with risk of average person with

same agesame age

n = 20 n = 20 (20.6%)(20.6%)Ranging from 1 – 3.08 fold Ranging from 1 – 3.08 fold increased risk compared to increased risk compared to risk of average person with risk of average person with

same agesame age

n =18 (18.5%)n =18 (18.5%)The risk is lower than risk of The risk is lower than risk of average person with same average person with same

ageage

DISCUSSION & DISCUSSION & CONCLUSION ICONCLUSION I

o Female tend to possess better life style scores than male in terms of all lifestyle scores

o Eating habitso Usage of substanceso Physical activities

o Majority of the staff were with healthy lifestyle => lifestyle score (mean scores> 75.5).

o Procam results showed that the staff were at risk of CORONARY diseases particularly MI.

DISCUSSION & DISCUSSION & CONCLUSION IICONCLUSION II

Limitation:Limitation:- The instruments used was not tested on

its psychometric. - Since the results was based on a sample

of hospital staff therefore, we can’t generalize the results to other cohorts.

Suggestion:Suggestion:- Future studies should also involved

psychometric evaluation and quality of life assessments.

- For intervention study with longitudinal designed should be implemented.

THE SCREENING WAS STRONGLY SUPPORTED BY HOSPITAL DIRECTOR

THE STAFFS CONCENTRATED FILLING IN BSSK/W/I/2008 FORM

TOO SCARED! BUT IT’S A MUST FOR AGE > 40 YEARS

SCREENING! SCREENING! HEALTH SCREENING!

REFERENCESREFERENCESPatel, J. V., Gill, P. S., Chackathayil, J., Ojukwu, H., Stemman, P., et al.

2011. Short-Term Effects of Screening for Cardiovascular Risk in the Deaf Community: A Pilot Study. Cardiology Research and Practice. 10.4061/2011/493546

WHO. World Health Organization. 2005. Cardiovascular disease: Prevention and control. Geneva.

Empanaa, J.P., Ducimetie`reb, P., Arveilerc, D., Ferrie`resd, J., Evanse, A., et al. 2003. Are the Framingham and PROCAM coronary heart disease risk functions applicable to different European populations? European Heart Journal 24, 1903–1911.

International task force for prevention of coronary disease. 2010. http://www.chd-taskforce.com/procam_interactive.html

Erhardt, L., Moller, R. & Puig, J.G. 2007. Comprehensive cardiovascular risk management – what does it mean in practice? 3(5): 587–603.

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