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The Vietnamese Version of the Health-related Quality of Life Measure for Children with Epilepsy (CHEQOL-25): Reliability

Original Research
  • Tri Huu Doan, Tran Diep Tuan, Han Bao Huu Nguyen,
  • Pages 9-14
  • 10/12/2017
  • 85
  • 1519
  • Free

Purpose: This study aimed to translate and culturally adapt the self-report and parent-proxy Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25) into Vietnamese and to evaluate their reliability.

Methods: Both English versions of the self-report and parent-proxy CHEQOL-25 were translated and culturally adapted into Vietnamese by using the Principles of Good Practice for the Translation and Cultural Adaptation Process. The Vietnamese versions were scored by 77 epileptic patients, who aged 8–15 years, and their parents/caregivers at neurology outpatient clinic of Children Hospital No. 2 – Ho Chi Minh City. Reliability of the questionnaires was determined by using Cronbach’s coefficient α and intra-class correlation coefficient (ICC).

Results: Both Vietnamese versions of the self-report and parent-proxy CHEQOL-25 were shown to be consistent with the English ones, easy to understand for Vietnamese children and parents. Thus, no further modification was required. Cronbach’s α coefficient for each subscale of the Vietnamese version of the self-report and parent-proxy CHEQOL-25 was 0.65 to 0.86 and 0.83 to 0.86, respectively. The ICC for each subscale of the self-report and parent-proxy CHEQOL-25 was in the range of 0.61 to 0.86 and 0.77 to 0.98, respectively.

Conclusion: The Vietnamese version of the self-report and parent-proxy CHEQOL-25 were the first questionnaires about quality of life of epileptic children in Vietnam. This Vietnamese version was shown to be reliable to assess the quality of life of children with epilepsy aged 8–15 years.

Graphical abstract

Evaluation of ESP Effectiveness in Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam

Original Research
  • Thao Nguyen Thi Phuong, Tien Nguyen Dong Phuong, Hai Nguyen Duc, Dat Van Truong,
  • Pages 37-45
  • 21/12/2017
  • 81
  • 1301
  • Free

Since 2011, English for Specific Purposes (ESP) curriculum in Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City (Vietnam) has been changed in accordance with pharmaceutical specialization orientation and did apply the active learning-learner centered teaching methods. Our study used three self-administered questionnaires to collect the feedbacks from sophomores, final-year and pharmacist graduating in 2016 in evaluating ESP course effectiveness. Data analyzed with STATA 13 indicated that English lecturers made efforts to organize the active learning activities in ESP class but their target has neither been effective nor met the required students’ needs in academic purposes as well as their occupational purposes. In addition, students’ passivity and lack of apparent motivation made it more difficult to apply the active learning method. Generally, final-year pharmacy students and newly graduated pharmacists, besides their moderate English competence, had a low frequency in using English. It is also found that there exists the relationship between final-year pharmacy students’ frequency of using English, their English competence and pharmaceutical specialization as well as that between English use frequency and occupation.

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The Incidence and Characteristics of Gastrointestinal Intolerance on Mechanically Ventilated Patients with Continuous versus Intermittent Feeding Method in The Intensive Care Unit: A Randomized Controlled Trial

Original Research
  • Vo Thi Hong Nhan, Alison Merrill, Tran Thien Trung,
  • Pages 46-51
  • 21/12/2017
  • 130
  • 1633
  • Free

Background: Enteral nutrition therapy via nasogastric tube can be administered through continuous or intermittent feeding methods for critically ill patients. However, there has not been existing consensus on the superiority of either method for mechanically ventilated patients due to insufficient evidence comparing the effectiveness of the two methods. The present study aimed to compare the impact of continuous versus intermittent feeding methods on gastrointestinal intolerance in mechanically ventilated patients.

Methods: 41 mechanically ventilated patients in the intensive care unit, University Medical Center, Ho Chi Minh City, Vietnam from 3/2017 to 5/2017 were enrolled in a randomized controlled trial. They were randomly and equally assigned to the two study groups and monitored for 4 consecutive days on incidence of gastrointestinal intolerance including high gastric residual volume, abdominal distention, diarrhea, and tube occlusion.

Results: There was statistically significant difference when comparing the gastric residual volumes between two groups with a median at 0.93ml (0.09-1.93) versus 11.61ml (7.61-17.28) (p < 0.001). The mean number of abdominal distention episodes in the continuous group was significantly lower than in the intermittent group (2.8 ± 2.66 versus 8.29 ± 5.1 episodes, respectively, p < 0.001). The diarrhea scores were not significantly different (p < 0.05) and there were no cases of occlusion recorded in the two groups.

Conclusions: Continuous feeding method offered less gastrointestinal intolerance than intermittent feeding method by reducing gastric residual volumes and limiting abdominal distention. The feeding method did not increase the risk of tube obstruction if it was flushed regularly.

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Phytochemical Screening and Total Phenolics and Flavonoids Contents of Hibiscus Rosa Sinensis. L Cultivated in Viet Nam

Original Research
  • Han Truong, Ly Le, Minh Tran,
  • Pages 52-57
  • 10/12/2017
  • 80
  • 1015
  • Free

Background: Phenolics and flavonoids are regarded as the highest potential of chemotherapeutic activities. This investigation was carried out to evaluate phytochemical and total phenolics content (TPC) and total flavonoids content (TFC) and Fourier-transform infrared spectroscopy (FTIR) spectral analysis of Hibiscus Rosa Sinensis L. extracts (crude extract, n-hexane extract, ethyl acetate extract, and methanol extract) for further applications in pharmaceutical development.

Method: Total phenolics were estimated by Folin-Ciocalteu method; while, Aluminum chloride was employed to quantify total flavonoids in the sample extracts. And, functional groups of Hibiscus Rosa Sinensis compound was determined using a FTIR-spectrophotometer.  

Result: Results showed the leaves extracts to encompass the high amount of total phenolic and total flavonoid content. TPC values for crude extract, methanol extract, ethyl acetate extract and n-hexane extract were 57.09 ± 0.35 mg/g, 70.98 ± 0.03 mg/g, 21.31 ± 0.01 mg/g, and 18.45 ± 0.003 mg/g as gallic acid equivalent, respectively. Crude extract, methanol extract, ethyl acetate extract and n-hexane extract showed total flavonoids 26.87 ± 0.01 mg/g, 21.08 ± 0.03 mg/g, 21.70 ± 0.001 mg/g, 14.95 ± 0.02 mg/g as rutin equivalent. FTIR spectra of four extracts were comparable and showed the presence of nitro compounds and ring aromatic compounds.  

Conclusion: Our results indicate the potential of exploiting Hibiscus Rosa Sinensis leaves as a source of chemotherapeutic compounds, and it is worthy doing further researches on isolated bioactive compounds for developing novel functional foods or new drugs.

 

Graphical abstract

How to overcome challenges related to English and academic writing skills when studying abroad

Case Study
  • Minh Cuong Duong,
  • Pages 3-5
  • 02/04/2018
  • 68
  • 1086
  • Free

Nowadays, pursuing postgraduate study abroad after completing a Medical Doctor (MD) degree in their home country is common among Vietnamese doctors. There are several challenges in studying overseas that international students need to overcome to ensure a favorable outcome of their learning journey. The presenting paper mainly discussed about the challenges related to English and academic writing skills and aimed to provide some tips for studying effectively in developed countries. Based on his own experiences as a postgraduate international student in Australia, the author found that a successful learning journey could be facilitated by (1) feeling free to ask, (2) making friends with the locals and other international students, (3) exploring the local life, (4) learning and using a reference management software, and (5) attending all free academic skills workshops and consultations provided by the university.

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Content validity of a professionalism OSCE developed in family medicine training University of Medicine and Pharmacy at Ho Chi Minh city Vietnam

Original Research
  • Pham Duong Uyen Binh, Pham Le An, Tran Diep Tuan, Jimmie Leppink,
  • Pages 6-11

Background: Assessments of professional behaviors such as professionalism Mini clinical examination (PMEX) and OSCE (POSCE) are playing an important role in driving the practice professionalism in medical training. Simulation-based assessment or POSCE has been used to evaluate several professional attributes. However, few evidence of content validity proving that whether POSCE is really measuring specific professional attributes have been reported in medical education literature.

Methods:  The four-step process of developing FM POSCE was analyzed to highlight the validity evidence according framework of Downing (2003). Group of 5 independent FM experts from Vietnam, Boston University, US and Liege, Belgium evaluated the blueprints, scenarios and item lists on a scale (1-totally disagree to 5-totally agree) regarding to what extent test blueprint, cases and item lists were relevant to the content domains and cultural context. The results of their evaluation were considered as an evidence of content validity. The mean and standard deviation of the scores given by them were calculated using SPSS, 20.0.

Results: Important evidence of content validity were found in the process of developing POSCE. Content experts’ evaluation showed that all professional attributes represented medical professionalism. However, the adequacy of professional attributes to evaluate the broad construct of professionalism was controversial (M=3.75, SD=0.95). Cases are relevant to assess these professional attributes and culture. Only the cases of “Respecting the patient” and “Making altruistic decision” contained some inappropriate marking items (M=3.75, SD=0.95; M=3.00, SD=0.92).  

Discussion and conclusion: FM POSCE developed in Vietnamese context can assess six specific professional attributes. This study suggested a process of developing POSCE that has several features such as using both sources of expertise and medical literature to build up the content of POSCE to improve the content validity.

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Switching to Effective and Optimal Study Methods - A necessary tool for Educational Success

Case Study
  • Truong Hong Hieu, Le Huu Nhat Minh, Muhammad Usman Hashmi, Heba Hussien El Tanany,
  • Pages 14-16
  • 03/04/2018
  • 79
  • 1057
  • Free

The secret of educational success and splendid future with prosperous career lies in the constant hard work performed in a smart way. By that way, the change or modification in study methods, exam strategies, and learning techniques is necessity. Deriving from our own experience as medical students from some developing countries from all over the world, authors support some tips and methods to approach the medical field more productive.

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Aspiring experience journey towards research: importance and essential skills

Case Study
  • Gehad Mohamed Tawfik, Peter Samuel Eid, Linh Tran, Le Huu Nhat Minh, Mohammad Rashidul Hashan, Muhammed Khaled Elfaituri, Ali Mahmoud Ahmed,
  • Pages 35-38
  • 07/07/2018
  • 36
  • 1127
  • Free

Research is the creative and systematic conversion of ideas into knowledge and the application of this knowledge in different life fields. The more you get involved in research, the more experiences and skills you can gain. The continuous decreasing number of medical students interested in research can affect the public health in future. Our aim is to encourage medical students to involve more in the research career and to highlight the importance and skills needed for being a successful researcher. Discipline, passion to gain the knowledge, the accuracy of data checking, team work and strict rules are the most important characteristics of a research team. A researcher should be passionate, hard-working, and patient. Teamwork is the golden key to doing research; you should be responsible for your team and develop their research skills along the study period. A researcher should be a self-learner to increase his skills to get an advanced level. From the most important skill that a researcher should gain it by time is the leadership. Being motivated along the study period is an obstacle that leaders always meet, so you should have solutions for it. Fairness is an important manner a leader should acquire. Contribution in a research lab from your youth to build your CV, personality and gain great publications by time.

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Pursuing a targeted dream specialty and a research career: Opinions and observations from a fifth-year medical student’s perspective

Letter to Editor
  • Gehad Mohamed Tawfik,
  • Pages 1-4

With our fast-pacing life, numerous learning and scientific sources and information are available and required for medical students to boost their skills since their early life to accommodate with the great knowledge they take. Medical students should re-elaborate what they studied and exploit knowledge clinically. A good doctor is a good observer, so eyes should be kept on while mentor managing patients in order to add more to our medical notions. A seed to become a great future doctor starts by searching for a specialty that fits your personality, to practice it as a volunteer, to gain its skills earlier. So when you graduate, you have more time to gain other learning experience. As long as you practice it, the more chance to become one of its experts. Managing your patient as a relative, not as a bag of money, is very important to be applied. Inability to diagnose a patient is not a shame, so never let a patient go home without referring him to another doctor who has more experience than you. Having a background in other medical specialties will help you recognize common signs of other related medical conditions that could lead you to refer him to right specialty doctor. Joining a research lab will keep you updated with new inventions, drugs, algorithms, and guidelines, which will help you become more acknowledged with medical problems that you were unaware of. Time management is the key to success as a researcher without affecting your daily life activities and study requirements.

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Translation and cross-cultural adaptation of the Vietnamese version of the Diabetes Distress Scale

Original Research
  • Ong Phuc Thinh, Huynh Ngoc Van Anh, Do Thanh Tung, To Gia Kien,
  • Pages 5-11

Background: The Diabetes Distress Scale (DDS) is a valid instrument to measure diabetes distress included in American Diabetes Association and Canadian Diabetes Association guidelines but not available in Vietnamese. This study translated and culturally adapted the DDS to assess diabetes distress of Vietnamese type 2 diabetics and evaluated its internal consistency, face and content validity.

Methods: The translation process followed standard guidelines for adaptation of an instrument: forward translation, back translation, synthesis, evaluation by an expert panel and pretest. The expert panel included three English specialists as linguistic experts and six content experts in multidisciplinary areas relevant to the study. The pretest was conducted on a sample of 31 type 2 diabetics in the Endocrinology outpatient clinic at Trung Vuong hospital. Content validity was determined based on experts’ concurrence using content validity index for items (I-CVI). Face validity is assessed by participants in pretest. Internal consistency was measured using Cronbach’s alpha.

Results: Final version was equivalent with the original English version and easy to understand. I-CVI of 17 items were 1.00 in linguistic experts and greater than 0.83 in content experts. All 31 participants involved in the pretest commented that the items were very clear and acceptable regarding their socioeconomic background. Cronbach’s alpha coefficient was 0.76 – 0.93 for each subscale and 0.94 for the overall.

Conclusion: Vietnamese version of the DDS was reliable, face and content-valid to assess diabetes distress in type 2 diabetics among Vietnamese.

Graphical abstract

Budd-Chiari syndrome due to segmental obstruction of the inferior vena cava successfully managed with endovascular stenting

Case Study
  • Vo Pham Phuong Uyen, Quach Trong Duc, Dang Minh Luan, Luu Hieu Thao, Nguyen Dinh Luan,
  • Pages 22-26

Budd–Chiari syndrome (BCS), a rare and life-threatening disorder due to hepatic venous outflow obstruction, is occasionally associated with hypoproteinemia. We herein report the first case of BCS with segmental obstruction of the intrahepatic portion of inferior vena cava (IVC) and hepatic veins (HVs) successfully treated by endovascular stenting in Vietnam. A 32-year-old female patient presented with a 2-month history of massive ascites and leg swelling. She refused history of oral contraceptives use. Hepatosplenomegaly without tenderness was noted. Laboratory data showed polycythemia, mild hypoalbuminemia and hypoproteinemia, slightly high total bilirubin and normal transaminase level. The serum ascites albumin gradient was 1.9 g/dL and ascitic protein level was 1.1 g/dL. The other data were normal. BCS was suspected because of the discrepancy between mild liver failure and massive ascites; and the presence of hepatosplenomegaly and polycythemia. On abdominal magnetic resonance imaging, the segmental obstruction of three HVs and IVC was 2-3 cm long without thrombus. Cavogram revealed the severe segmental stenosis of intrahepatic portion of IVC with no visualized HV and extensive collateral veins. A Protégé stent was deployed to IVC. Leg swelling and ascites were completely resolved within 3 days after stenting. During 1-year follow-up, edema was not recurred and repeated laboratory results were all normal.

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Online training needs of Methadone Maintenance Treatment clinics in southern Vietnam

Original Research
  • To Gia Kien, Huynh Ngoc Van Anh, Vu Thi Tuong Vi, Vu Huy Hoang, Nguyen Song Chi Trung, Do Van Dung,
  • Pages 7-14

Introduction: Continuing Medical Education (CME) significantly improves the competency of healthcare workers in Methadone Maintenance Treatment (MMT) clinics. However, CME courses are very costly, and a few participants fully attended a course. Online training is an alternative approach to efficiently improve training outcomes. The study assessed needs and possibility of online training courses of MMT clinics in southern Vietnam.

Methods: A google form was designed to collect characteristics, man-powers, facilities, online activities and training needs of MMT clinics. E-mails were sent to all MMT clinics in southern Vietnam to ask for their participants. A representative of MMT clinics who satisfied the inclusion invited to complete the form.

Result: 93 MMT clinics completed the survey. The response rate was 62% (93/150). One MMT clinic had 3 doctors/assistant doctors, 3 pharmacists/drug dispensers, 2 consultants and 3 other professionals on average. The number of clients visiting the clinic in the last month was 150. About 94% (93/95) of MMT clinics provide other additional services. On average, 385 clients came to MMT for other services. All clinics had adequate devices for online and blended training.

Conclusion: MMT clinics had high training needs and were willing to attend online and blended training courses. Online and blended training were possible in MMT clinics.

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Commitment: A concept analysis in nursing field

Review
  • Nguyen Thi Nhan, Nguyen Thi Truong Xuan,
  • Pages 20-25

Aim: To clarify the meaning of commitment and to provide the empirical referents to measure the concept of commitment.

Method: By using the Walker and Avant (2011) methodology, data were analyzed with the focusing on critical attributes of concept, constructed cases, antecedents and consequences of the concept. Additionally, the empirical referents and implications for nursing knowledge are presented to further elucidate the concept of commitment.

Findings: The critical attributes of commitment derived from this analysis are 1) Promising to involve in an action; 2) Acceptance of responsibility for the action; and 3) Persistent involvement in an action. The process of analysis concept of commitment leads to a better understanding of the concept itself. Nurses can use the ideas of this analysis as conceptual tools to assess the level of commitment among patients/clients in their action toward the health promoting behavior.

Conclusion: This analysis proposes a definition with the critical attributes of the concept which can be considered to use in nursing practice. Nursing is a universal profession; hence, the definition was proposed from this concept analysis can be considered as a beginning point for the further study in nursing field of each country.

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Factors predicting physical and mental health-related quality of life among post-myocardial infarction patients: Bayesian model averaging analysis

Original Research
  • Nguyen Van Trung, Vu Tri Thanh, Hoang Khai Lap,
  • Pages 1-7

Coronary artery disease was the cause of half of morbidity and mortality due to cardiovascular diseases in 2013. Myocardial infarction (MI) has been a common medical emergency with high mortality rate and complications unless it is early and appropriately treated. Health-related quality of life (HRQoL) has been popularly used in assessment of health state among coronary artery disease patients undergone both medical and surgical therapies. Bayesian model averaging approach statistically facilitated for identifying potential predictors of HRQoL among post-MI patients following up at University Medical Center, Ho Chi Minh City. The cross-sectional descriptive study was conducted on 146 participants diagnosed and treated with acute myocardial infarction from April 1st 2017 to June 30th 2017. The better HRQoL in physical component summary was associated with higher educational levels (coeff­icient=1.2) and weekly moderate – intensity physical activity (coeff­icient=0.002) but the contrast status for the female (coeff­icient =-3.7) in the fit model with R2= 0.24, BIC=-25.7 and posterior probability=11.7%. The good economic household (coeff­icient=9.8), more daily sitting time (coeff­icient =1.4) and weekly moderate – intensity physical activity (coeff­icient =0.004) predicted the increase of mental component summary score in the given model with R2= 0.08, BIC=-20.3 and posterior probability=25%. The post – MI patients experienced low physical health much more than mental health. The female and suitable physical activity should be concerned in the rehabilitation program as well as follow-up care during the discharge process.

Graphical abstract