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According to Sinhalese tradition, this language was introduced to Sri Lanka by a banished prince in the 6th century who conquered the local 'demons'. It has a relatively flexible grammar, so it won't take you long to conquer that language barrier. Lonely Planet gets you to the heart of a place. Our job is to make amazing travel experiences happen. We visit the places we write about each and every edition. We never take freebies for positive coverage, so you can always rely on us to tell it like it is.
It has a relatively flexible grammar, so it won't take you long to conquer that language barrier. Lonely Planet gets you to the heart of a place.
Our job is to make amazing travel experiences happen.
We visit the places we write about each and every edition. We never take freebies for positive coverage, so you can always rely on us to tell it like it is. About Lonely Planet: Started in , Lonely Planet has become the world's leading travel guide publisher with guidebooks to every destination on the planet, as well as an award-winning website, a suite of mobile and digital travel products, and a dedicated traveller community.
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If you are a seller for this product, would you like to suggest updates through seller support? Lonely Planet: The world's leading travel guide publisher According to Sinhalese tradition, this language was introduced to Sri Lanka by a banished prince in the 6th century who conquered the local 'demons'. Comprehensive dictionary Guide to pronunciation and grammar Fail-safe small talk Practicalities - how to catch a train or ask for antibiotics Lonely Planet gets you to the heart of a place.
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Sinhalese, with its nine cases and unique alphabet, is a difficult nut to crack.
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The author did not make it easier with this phrase book. Some examples of its shortfalls: Many of the phrase examples are given in the past.
The dictionary is maddeningly incomplete. Why the translation for man, but not woman? Tomorrow but not yesterday? Examples are rife. The selection might have been improved by referencing words included in any dictionary aimed at junior high school students. Phonemic modifications of common case endings are not provided. The initial forward translation, from English to Sinhala was done by an independent translator, whose mother language was Sinhalese, who is familiar with terminology of the area covered by the instrument.
The panel included the original translator, experts in pharmacology PG and diabetes PK and GRC , and those with experience in instrument development and translation PR. The panel also modified the individual questions in order to achieve a cultural adaptation of the questionnaire.
In the third stage using the same approach as that outlined in the first step, the instrument was translated back to English by an independent second translator, who has no knowledge of the original BMQ questionnaire. Discrepancies in the back translation were discussed with the expert panel, and further work was carried out until a satisfactory Sinhalese experimental version of the BMQ questionnaire was produced.
The translated experimental Sinhalese BMQ questionnaire in stage three was pretested in a sample of 10 patients with diabetes. This subset of patients was recruited from a different medical clinic other than from where patients were recruited for validation. The sample represented both males and females from different socioeconomic groups. After filling the questionnaire, each respondent was individually interviewed, where the respondents were asked what they thought the questions were asking, whether they could repeat the questions in their own words and what came to their mind when they heard a particular phrase or term.
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Respondents were also asked about any word they did not understand as well as any word or expression that they found unacceptable. A written report of the pretesting exercise, together with selected information regarding the participating individuals, was provided to the expert panel.
The final Sinhala version of the BMQ was produced after the completion of all the steps described above. This version was used during data collection for the validation study Annexure 1. Data were collected during a period of 8 months in the medical clinics of the University Medical Unit at the National Hospital of Sri Lanka. The questionnaire on sociodemographic data age, gender, ethnicity, level of education, and monthly income and illness-related data was filled by the investigator and then the Sinhalese version of the self-reported BMQ was given to the recruited patients for self-completion.
The translated questionnaire validation included evaluation of internal consistency, temporal stability, and performance in regards to the gold standards. It was assumed that content validity was performed by the authors of the original study.
For the analysis of temporal stability, 30 patients with stable therapeutic schemes were retested at an interval of 30 days. Concordance between test and retest was evaluated by a gamma correlation coefficient. Characteristics of the study population are also described according to the level of adherence identified by the BMQ.
For the comparisons, chi-square tests, t -tests and Mann—Whitney tests were used according to the distribution of variables. SPSS version The total number of subjects recruited for the study was Majority of the study participants were Sinhalese in ethnicity The mean duration of diabetes in the study population was Majority of the patients were on 2 drugs for the control of diabetes Sociodemographic and disease characteristics are summarized in Table 1.
Analysis of the internal consistency of the BMQ was performed in the patients recruited for the study. As the number of positive responses to the questionnaires increased, the specificity in screening for low adherence also increased in relation to the gold standard Table 2.
The overall BMQ score with a cutoff value of 2 for the score of problems identified by the BMQ presented better equilibrium between sensitivity and specificity for the gold standard.
This cutoff value can be utilized in screening for low adherence. Performance of the BMQ according to the gold standard. To study the relationship between adherence and sociodemographic and disease factors, we considered good adherence as a positive response in only 1 screen or negative responses to all questions in the 3 screens in the overall BMQ score.
Low adherence was considered as the positive responses in two or more screens in the overall BMQ score. Among sociodemographic characteristics, male gender was associated with good adherence, while age, education level, or monthly income was not significantly different between the two groups Table 3.
Being only on one antidiabetic medication was associated with good adherence, while insulin therapy was associated with low adherence. The present study aimed at translating and validating the Sinhalese version of the Brief Medication Questionnaire BMQ for use in evaluating medication adherence in patients with diabetes. The translation of the original BMQ to Sinhalese and validation were done following accepted standards [ 14 , 15 ]. The translated questionnaire demonstrated good reliability, temporal stability, and validity.
The temporal stability test-retest reliability of the translated Sinhalese version of the BMQ was also evaluated. Similar results for temporal stability have been observed in previous studies validating translated versions of the BMQ [ 8 ].
The performance of the Sinhalese translation of the BMQ was evaluated using HbA1c as the gold standard for glycaemic control criterion validity. The overall BMQ score with a cutoff value of 2 presented better equilibrium between sensitivity We were unable to identify previous studies evaluating BMQ in relation to control of blood glucose. This may be due to differences in the sample, culture, and the gold standard used. The results of the present study show that male gender and usage of only one antidiabetic medication was associated with good adherence, while insulin therapy was associated with low adherence.
Adherence to antidiabetic medications is known to be associated with different factors, including age, duration and severity of disease, level of education, and monthly income [ 17 , 18 ].
For example, in a study conducted to evaluate medication adherence in Palestinian patients with diabetes, female gender was associated with good medication adherence, whereas the opposite was observed in the present analysis [ 17 ]. Jin et al. Hence, measurement of adherence using culturally validated measurement tools and identification of factors affecting low adherence in those different cultures are both equally important, in order to improve compliance and disease outcomes of a given population.
The present study has several limitations that need to be acknowledged. The lack of a practically acceptable gold standard to measure adherence was an important limiting factor. MEMS medication bottles contain a microelectronic chip that registers the date and time of every bottle opening. In the present study, disease control as evaluated by HbA1c was used as the gold standard [ 8 ].
We also did not measure other confounding factors that could affect glycaemic control, such as dietary intake and physical activity. However, it was assumed that these factors would be evenly distributed in a large population. The present study translated and validated the Sinhalese version of the Brief Medication Questionnaire, using accepted standard methods. Using culturally validated tools to evaluate adherence may help clinicians to identify low adherence and institute appropriate corrective measures to improve disease outcomes.
Annexure 1: Sinhalese translation of the Brief Medication Questionnaire used for validation. National Center for Biotechnology Information , U. Journal List J Diabetes Res v.
J Diabetes Res. Published online May Ranasinghe , 1 R. Jayawardena , 2 P. Katulanda , 3 G. Constantine , 3 V. Ramanayake , 1 and P. Galappatthy 1. Author information Article notes Copyright and License information Disclaimer.
Corresponding author. Received Feb 14; Accepted May 8. Ranasinghe et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background Adherence to long-term therapy for diabetes remains low. Methods The study was conducted at the National Hospital of Sri Lanka between April and December , including patients with diabetes.
Conclusion The translated questionnaire demonstrated good reliability internal consistency , temporal stability test-retest reliability , and validity when assessed using a gold standard for disease control.
Introduction It is estimated that over million people have diabetes around the world, with nearly 78 million people living in the Southeast Asian region, a figure which is expected to rise to million by [ 1 ].
Methods 2. Translation and Cultural Adaptation Translation and cultural adaption was carried out following steps recommended by the WHO for the translation and adaptation of study instruments [ 14 ].
Statistical Analysis and Validation The translated questionnaire validation included evaluation of internal consistency, temporal stability, and performance in regards to the gold standards.
Results 3. Sociodemographic and Disease Characteristics The total number of subjects recruited for the study was Table 1 Sociodemographic and disease characteristics of the study population. Open in a separate window. Figure 1. Table 2 Performance of the BMQ according in comparison to gold standard.
Association between Adherence, Sociodemographic, and Disease Factors To study the relationship between adherence and sociodemographic and disease factors, we considered good adherence as a positive response in only 1 screen or negative responses to all questions in the 3 screens in the overall BMQ score.
Table 3 Relationship between adherence, sociodemographic, and disease characteristics.
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Discussion The present study aimed at translating and validating the Sinhalese version of the Brief Medication Questionnaire BMQ for use in evaluating medication adherence in patients with diabetes.
Conclusions The present study translated and validated the Sinhalese version of the Brief Medication Questionnaire, using accepted standard methods. Conflicts of Interest The authors declare that they have no conflicts of interest. Supplementary Materials Supplementary Materials Annexure 1: Click here for additional data file. References 1. Ogurtsova K.
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