Browsing by Person "Cheong, Wing Loong"

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Accessing palliative care for multiple sclerosis: A qualitative study of a neglected neurological disease
(Elsevier, 2019-10) Cheong, Wing Loong; Mohan, Devi; Warren, Narelle; Reidpath, Daniel
Background Despite the global consensus on the importance of palliative care for patients with multiple sclerosis (MS), many patients in developing countries do not receive palliative care. Improving access to palliative care for MS requires a contextual understanding of how palliative care is perceived by patients and health professionals, the existing care pathways, and barriers to the provision of palliative care. Objective This study aims to examine and contrast the perceptions of MS patients, neurologists, and palliative care physicians towards providing palliative care for patients with MS in Malaysia. Methods 12 MS patients, 5 neurologists, and 5 palliative care physicians participated in this qualitative study. Each participant took part in a semi-structured interview. The interviews were transcribed verbatim, and analysed using an iterative thematic analysis approach. Results Patients and neurologists mostly associated palliative care with the end-of-life and struggled to understand the need for palliative care in MS. Another barrier was the lack of understanding about the palliative care needs of MS patients. Palliative care physicians also identified the scarcity of resources and their lack of experience with MS as barriers. The current referral-based care pathway itself was found to be a barrier to the provision of palliative care. Conclusions MS patients in Malaysia face several barriers in accessing palliative care. Overcoming these barriers will require improving the shared understanding of palliative care and its role in MS. The existing care pathway also needs to be reformed to ensure that it improves access to palliative care for MS patients.
Living with a neglected neurological disease: a qualitative study of patients with multiple sclerosis in Malaysia
(Taylor & Francis, 2019-11-26) Cheong, Wing Loong; Mohan, Devi; Warren, Narelle; Reidpath, Daniel
Background The needs of patients with multiple sclerosis have been well-studied in high-income, high-prevalence countries but few studies have been based in low- and middle-income countries where resources are relatively scarce. As such, little is known about the needs of patients living in these countries. Objective The study seeks to develop an understanding of the needs of patients with multiple sclerosis living in Malaysia in order to generate insights and contribute to a global database of patients’ experience Method 12 patients with multiple sclerosis participated in this qualitative study and took part in a semi-structured interview. The interviews were transcribed and analysed using an iterative thematic analysis approach. Results The experiences, challenges and needs of the patients were reported. Five themes were developed (Daily living, Financial, Emotional and psychological, Healthcare, and Family). These predominantly revolved around the struggles of coping and adapting to the symptoms and disabilities imposed by multiple sclerosis, their heavy reliance on personal finances to cope with the increased costs of living for themselves and their families, as well as the limited healthcare services and treatments available to help them to manage the physical and emotional symptoms of multiple sclerosis. Conclusion Patients with multiple sclerosis in Malaysia have complex needs that are neglected due perceived lack of importance of the disease and the poor understanding of multiple sclerosis in general. Patients rely heavily on their finances to improve their quality of life. This perpetuates health inequities and reform of the national health financing system is needed to provide patients with the healthcare and support they need. Implications for rehabilitation Patients with multiple sclerosis in Malaysia prioritize being able to cope and adapt to their disabilities in order to continue performing their activities of daily living. There is a need to increase the availability and accessibility of healthcare professionals that are experienced with the management of multiple sclerosis. Healthcare professionals need to improve their understanding of the patients’ needs and what they consider to be important in order to provide therapy that is effective and relevant. Patients also require financial support to help them with the increased costs of living associated with MS as well as the costs of healthcare services such as physiotherapy and rehabilitation.
Palliative care in neurology
(Elsevier, 2017-11) Cheong, Wing Loong; Reidpath, Daniel
Palliative Care Research in the Asia Pacific Region: A Systematic Review and Bibliometric Analysis of Peer-Reviewed Publications
(Mary Ann Liebert, 2018-12-20) Cheong, Wing Loong; Mohan, Devi; Warren, Narelle; Reidpath, Daniel
Background: The state of palliative care research is closely linked to the development of palliative care services in a country or region. Objective: To systematically review the current state of palliative care research in the Asia Pacific region and analyze its relationship with the performance of each country in the region on the Economist Intelligence Unit's 2015 Quality of Death Index. Design: Systematic review and bibliographic analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol 2015 (PRISMA-P). Data Sources: The PubMed/MEDLINE, EMBASE, SCOPUS, CINAHL, and PsychiNFO databases were searched on February 4, 2018. Results: One thousand six hundred sixty-seven articles were reviewed. Eighteen out of 32 countries in the region published research. Around 74.15% (1236) of the articles were produced by high-income countries. Research output (articles per 1 m population) was closely linked to country performance on the Economist Intelligence Unit's 2015 Quality of Death Index (adjusted R2= 0.85). Palliative care research in the region is overwhelmingly focused on cancer (80.13% of articles reviewed). The most common themes of research were “palliative care service (24.45%)” and “clinical” (15.38%). Conclusions: Palliative care research in the region is growing but remains largely centered on the high-income countries, with many low- and middle-income countries having little published research output. Much work is required to drive research in these countries to generate the evidence required for the development of palliative care services. The emphasis on cancer in research also indicates that the needs of patients suffering from noncancer-related diseases may be neglected.
Response to de Groot ‘There is an urgent need for palliative care specialists in MS – Commentary’
(2019-09-13) Cheong, Wing Loong; Mohan, Devi; Warren, Narelle; Reidpath, Daniel