Raishan Shafini Bakar

Objective: To explore parents' experiences addressing sexual health among adolescents with autism spectrum disorder (ASD) in northeastern Malaysia. Background: Parents are central to sexual health guidance but may face developmental, communication, sociocultural, and service‐related challenges. Method: This qualitative exploratory study involved 16 parents recruited from a community autism support centre in Kelantan, Malaysia. Semi‐structured interviews were conducted in Malay, audio‐recorded, transcribed verbatim, and analysed using reflexive thematic analysis. Results: Five themes were identified: navigating uncertainty about sexuality and puberty; communicating sexuality within developmental boundaries; negotiating sexuality within sociocultural and religious boundaries; heightened safeguarding concerns and monitoring practices; and adaptive parenting amid limited support and guidance. Parents described tensions between protecting adolescents perceived as vulnerable and preparing them for increasing independence. Sexuality was often framed through modesty, behavioural appropriateness, family responsibility, and safeguarding within the local sociocultural and religious context. Conclusion: Parents of adolescents with ASD navigated sexual health guidance within intersecting developmental, communicative, sociocultural, religious, and safeguarding challenges. Implications: Culturally sensitive, autism‐informed, and developmentally appropriate support may strengthen parents' confidence and improve coordinated family–school–healthcare guidance.

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by impairments in social communication and restricted or repetitive behaviors. In Malaysia, timely identification within routine primary care services remains challenging, particularly outside major urban centres. This study examined factors associated with ASD diagnosis among children attending government primary care clinics in Kelantan to inform strategies for strengthening primary care developmental surveillance. Methods: A clinic-based cross-sectional study was conducted from March to September 2025 in five districts. Using purposive sampling, 207 children aged 18 months to 12 years were recruited during routine clinic visits, developmental presentations and primary care visits. Sociodemographic and clinical data were captured via a structured proforma. All enrolled children underwent Sensory-Behavior Profile screening followed by clinical assessment utilizing the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria regardless of screening result. Simple and multiple logistic regression were applied to examine associations between child and parental characteristics and ASD diagnosis. Results: Of the 207 children analysed, 29 were newly diagnosed with ASD during the study assessment and 178 were classified as non-ASD. In the multivariable analysis, two factors remained independently associated with ASD diagnosis. Older age at assessment was associated with higher odds of ASD diagnosis (aOR 1.30, 95% CI 1.10,1.55; p = 0.003), a finding that likely reflects later recognition, presentation, referral, or diagnostic confirmation within primary care pathways rather than an etiologic risk factor. First-born children were more likely to have an ASD diagnosis than second- or later-born children (aOR 2.48, 95% CI 1.08,5.71; p = 0.033). Conclusions: These findings support the strengthening of primary care developmental surveillance through consistent routine screening, improved clinician competency in developmental surveillance, increased parent awareness, and clear, time-bound referral pathways linked to timely assessment capacity within routine child health services.

Aim: This study aimed to evaluate the readiness of nursing students in China to respond to patients experiencing intimate partner violence (IPV) and to identify key influencing factors.Background: Nurses play a crucial role in providing care and support to IPV survivors. However, limited research has examined the extent to which nursing students are prepared for this responsibility. Gaining insights into their level of readiness and the factors that shape it is essential for informing educational strategies and policy development.Design: A cross-sectional study was conducted among 532 nursing students recruited from four public universities in Hunan Province, China, via multistage sampling.Methods: Data were collected using validated instruments, including the Readiness to Encounter Partner Abuse Patients (READI) Scale and the Modified Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS). Pearson correlation analyses were conducted to examine the associations among perceived knowledge, attitudes, skill preparedness, and readiness. Logistic regression (LR) was employed to identify significant predictors of readiness, and mediation analyses were performed to assess the intermediary roles of perceived knowledge, skill preparedness, and attitudes.Results: 82.7% of participants reported poor readiness to respond to IPV cases. Significant predictors of readiness included perceived knowledge (OR=2.938; 95% CI: 2.246–3.931), skill preparedness (OR=3.592; 95% CI: 2.700–4.095), attitudes (OR=4.472; 95% CI: 1.925-10.800), IPV-related education (OR=2.654; 95% CI: 1.297–5.230), and IPV training experience (OR=3.072; 95% CI: 1.444–6.310). Mediation analyses further revealed that both perceived knowledge and skill preparedness partially mediated the relationship between IPV training and readiness.Conclusion: The study identified a substantial gap in the readiness of nursing students to manage IPV-related cases, underscoring the critical need to enhance educational and training programs. Incorporating comprehensive IPV-related content into nursing curricula may significantly improve preparedness and foster survivor-centered care within the healthcare system.

Introduction As a minority group homosexuality poses the risk of various mental illnesses and medical comorbidities. In Malaysia, homosexuality is prohibited according to culture, law, and religion. Thus, this group is reluctant to seek help due to the negative attitude of certain healthcare professionals. Healthcare professionals’ negative attitudes towards this group may negatively impact patient care quality. This study aimed to identify predictors of health sciences students’ attitudes toward homosexuality. Materials and methods An online cross-sectional study was conducted among 307 undergraduate clinical students at a university on the east coast of Malaysia from December 2020 to February 2021. The instruments consisted of the Homosexual Attitude Scale Malay Version (HASMV), Self-Reflection and Insight Scale (SRIS), and Duke University Religion Index (DUREL). Results The mean (SD) age of participants was 22.91 (0.78) years old. The majority are female, Malay, and Muslim. Mean (SD) scores of attitudes towards homosexuality among health sciences students were 61.53 (17.06). Non-Muslims, final-year students, and those with higher self-reflection scores in central and southern Peninsular Malaysia displayed a more positive attitude towards homosexuality, as did students with a history of contact with homosexuals. Students with higher intrinsic religiosity scores were shown to be more negative towards homosexuality. Conclusion The attitude towards homosexuality of Malaysian future health practitioners leaned mostly towards the positive attitude towards homosexuality. These findings shall aid the relevant authorities in revising the curriculum to raise awareness about homosexual health, as well as arranging training programs. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1120-1128

Parents, guardians, and teachers are the informal sources of mental health support that adolescents rely on. Nevertheless, limited mental health knowledge limits their ability and confidence in providing appropriate assistance. This study aims to (1) evaluate the relationship between the roles of parents/guardians and teachers and their responses to discover the common misconceptions on mental health among those providing informal support to adolescents and (2) determine which demographic factors would act as the strongest predictor influencing their mental health literacy (MHL) status. The cross-sectional study recruited 867 parents, guardians, and teachers of adolescents from 24 government secondary schools’ parent–teacher associations via multistage stratified random sampling. Parents, guardians, and teachers’ MHL were evaluated using the Mental Health Knowledge Schedule—Malay Version (MAKS-M). The collected data were analyzed using Pearson’s Chi-squared test to investigate the association between the respondents’ roles and responses. Multiple Regression analysis was used to determine the predictors of MHL. The score of MAKS-M for the current study sample is 73.03% (M = 43.82, SD = 4.07). Most respondents responded incorrectly on Items 1 (employment), 6 (help-seeking), 8 (stress), and 12 (grief). Teachers provided more favorable responses on several items than parents and guardians. Finally, younger age, higher income, knowing someone with mental disorders, and having experience of attending formal training on mental health first aid were the significant predictors of MHL. MHL interventions in Malaysia should cater to older adults of lower socioeconomic status and lesser experience in mental health, specifically highlighting the stigmas on mental health help-seeking behaviors, treatment, and employment concerns, plus the recognition of various mental health diagnoses.

The 27-item Literacy of Suicide Scale (LOSS) is a test designed to measure the respondent’s suicide knowledge. The purpose of this study is to examine the psychometric properties of the Malay-translated version of the LOSS (M-LOSS) and its association to sociodemographic factors and mental health literacy. The 27-item LOSS was forward–backward translated into Malay, and the content and face validities were assessed. The version was distributed to 750 respondents across West Malaysia. Rasch model analysis was then conducted to assess the scale’s psychometric properties. The validated M-LOSS and the Malay version of the Mental Health Knowledge Schedule (MAKS-M) were then distributed to 867 respondents to evaluate their level of suicide literacy, mental health literacy, and their correlation. Upon Rasch analysis, 26 items were retained. The scale was found to be unidimensional, with generally satisfying separation and reliability indexes. Sex, socio-economic status, and experience in mental health were found to significantly impact the mean score for mental health literacy. This study also found a significant mean difference for suicide literacy across school types. Furthermore, while this study observed a weak but significant negative correlation between age and suicide literacy, no correlation was found between mental health and suicide literacy.

The COVID-19 pandemic and the restrictions imposed that changed the teaching and learning activities may add a psychological impact to the existing academic stress faced by university students. Past studies have associated low levels of psychological disorder with high religiosity and positive religious coping (RC). This study aimed to determine the level of psychological disorder among university students in Malaysia during the COVID-19 pandemic and measure their association with religiosity and religious coping (RC). An online cross-sectional survey was conducted between March and June 2020 involving 450 students. The survey instruments consisted of sociodemographic proforma, Duke University Religious Index (DUREL) for religiosity, Brief RCOPE Scale for RC and General Health Questionnaire-12 (GHQ-12) for psychological disorder; 36% of the participants experienced psychological disorder. Younger age, being a Muslim, living in the Green/Yellow zone and higher negative RC were significantly associated with psychological disorder. Higher positive RC was found to be protective against psychological disorder. However, the level of religiosity had no significant association with psychological disorder. In conclusion, the level of psychological disorder among university students has been high during the pandemic. Measures and interventions focusing on positive RC and reducing negative RC are recommended to improve the psychological well-being.

Background: Caregivers are the initial gatekeepers in the health care management of children with autism spectrum disorder (ASD). Methods: This cross-sectional study aimed to determine the factors associated with caregivers’ satisfaction with different levels of health care services in managing children with ASD in Kelantan. The satisfaction scores of 227 main caregivers of confirmed ASD children were assessed with a modified Parent Satisfaction Scale (PSS) questionnaire. Results: The analysis showed that caregivers who waited longer for a doctor’s consultation in primary care had a reduced PSS score, whereas caregivers who were satisfied with the waiting time in primary care had higher PSS scores. At the secondary care level, caregivers who possessed at least a diploma had reduced PSS scores, whereas caregivers who were satisfied with both doctors’ consultation times and occupational therapy appointments had higher PSS scores. At the tertiary care level, caregivers with an underlying medical problem and who had children undergoing occupational therapy for two months or more had reduced PSS scores. Nevertheless, the analysis showed that caregivers who were concerned with their children’s sleeping problems, who had been informed about parental support, who were satisfied with speech and occupational therapy appointments, who were satisfied with waiting times at tertiary care clinics, and who were satisfied with their doctor’s knowledge and experience had higher PSS scores. Conclusions: This study elucidated the importance of understanding caregivers’ satisfaction in attaining care for their ASD children and highlighted the need to promote factors that would increase caregivers’ satisfaction with current ASD services.

Background: Caregivers of children with autism spectrum disorder (ASD) experience increased stress and more significant negative caregiving consequences than those with typically developing children. There is a lack of studies specifically focusing on stress among caregivers with ASD children in Asian countries. The current study examines levels of perceived stress and factors associated with it among caregivers in Kelantan, Malaysia. Methods: In a cross-sectional study, the Malay version of the Perceived Stress Scale (PSS) was administered to 227 caregivers of children with ASD. The caregivers were recruited from ASD databases in four tertiary hospitals in Kelantan and a meeting was set up during the child’s follow-up in the clinic. Multiple linear regression analyses were applied to determine the predictors of perceived stress. Results: The mean total perceived stress score was 20.84 (4.72). This was considered higher than average. Higher perceived stress was significantly predicted among caregivers who live far from the health institution, caregivers who do not own transportation to bring the child to the treatment center, and caregivers who have an ASD child with a learning disability. Conclusion: Caregivers of an ASD child perceived significant stress while taking care of their children. Institutions should alleviate the factors that were predicted to increase the caregivers’ perceived stress to improve the quality of the lives of children and ASD families as a whole.