Browsing by Author "de Zoysa, P."

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Cognitive behavioral therapy for university students with social phobia: A method to culturally adapt group therapy
(Sri Lanka Medical Association, 2016) de Silva, B.G.R.; de Zoysa, P.; Williams, S.S.
INTRODUCTION AND OBJECTIVES: Social phobia is a debilitating anxiety disorder with negative social implications. University students in Sri Lanka appear to have high prevalence rates of social phobia according to preliminary studies. Establishing a methodology by which interventions such as, Cognitive Behavioral Group Therapy (CBGT) could be culturally adapted is the objective of this study. METHOD: The gold standard CBGT was used to construct the structure of the intervention. CBGT interventions that have been modified to suit university student participant groups in the West were reviewed to revise the structure of the therapy. Existing cross-cultural therapy adaptation models were identified to derive factors to be taken in to consideration within this adaptation process. A study of other mental health intervention programs that have been cross-culturally adapted in diverse cultural settings was carried out. RESULTS: The methodology obtained constituted of three steps. The intervention program was initially reviewed by a panel of clinical psychologists to assess for appropriateness of content. Thereafter, the finalized layout, including activity worksheets were translated to Sinhala Language, and re-translated to English to test for accuracy. Finally, the translated documents were assessed by a panel of mental health experts in Sri Lanka and consensus was reached. CONCLUSIONS: A practical methodology to cross-culturally adapt psychological therapy for social phobia in the Sri Lankan context was developed
Cross-cultural adaptation and validation of the Sinhala version of the hospital anxiety and depression scale (HADS) for patients diagnosed with ischemic heart disease (IHD) in Sri Lanka
(College of Community Physicians of Sri Lanka, 2023) Gamage, C.K.W.; de Zoysa, P.; Balasuriya, A.; Fernando, N.; Jayamanne, D.
INTRODUCTION: The Hospital Anxiety and Depression Scale (HADS) is a frequently used instrument to measure depression and anxiety symptoms among patients diagnosed with ischaemic heart disease (IHD). However, a Sinhala version of HADS for Sri Lankan IHD patients has not been validated in Sri Lanka. OBJECTIVES: To translate, cross-culturally adapt and validate the HADS in a Sinhala-speaking Sri Lankan population with IHD METHODS: The Sinhala translation of HADS was conducted in four phases: forward translation, backward translation, patient testing and proofreading with the Mapi Research Trust guidelines. Content and consensual validation of the translated scale was conducted with the Delphi method, and the ratings were evaluated for consensus. The validated scale was administered to a sample selected using systematic sampling of 140 IHD patients attending medical clinics at a base hospital in Sri Lanka. Factor structure was verified with Confirmatory Factor Analysis (CFA) and reliability with internal consistency by Cronbach's alpha. RESULTS: The HADS Sinhala version showed good content and consensual validity. CFA proved that the uncorrelated two-factor structure was compatible with the original instrument (x2=156.98; df=76; p<0.001). The Confirmatory Fit Index (CFI) was 0.89, and the Root Mean Square Error of Approximation (RMSEA) was 0.09. The reliability analysis indicated Cronbach's alpha for depression and anxiety as 0.86 and 0.83, respectively. CONCLUSIONS & RECOMMENDATIONS: The cross-culturally adapted HADS Sinhala version shows similar psychometric properties as the original instrument and can be used in future studies with confidence.
Cross-cultural adaptation of the type D personality scale for use with patients diagnosed with Ischemic heart disease in Sri Lanka
(The Sri Lanka Medical Association, 2021) Walpita Gamage, C.K.; de Zoysa, P.; Balasuriya, A.; Fernando, N.; Jayamanne, B.D.W.
INTRODUCTION: Ischemic Heart Disease (IHD), a major cardiovascular disease globally, has become the primary cause of death in Sri Lanka. Negative affectivity (NA) and social inhibition (SI) are two personality traits which increase the risk of IHD. The Type D Scale (DS-14) evaluates a person’s general level of distress on NA and SI. However, DS-14 has not been translated and validated into Sinhala in Sri Lanka. OBJECTIVES: The study aimed to cross-culturally adapt and validate the DS-14 for use with Sinhala speaking patients diagnosed with IHD. METHODS: Translation, back translation and pre-test were conducted before a two-rounds of a Delphi process which assessed content and consensual validity of the instrument. The validated questionnaires were administered to 140 patients diagnosed with IHD at a Base Hospital. Factor structure was confirmed through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) and reliability, by internal consistency with Cronbach’s alpha. RESULTS: The questionnaire was administered among 140 participants (85 females), aged 18-60 years. The DS-14 Sinhala version showed good content and consensual validity. Factor analysis proved two factors compatible with the original instrument, which explained the variance of 62.9%. CFA confirmed the two-factor model. The reliability analysis indicated Cronbach’s alpha for NA and SI as 0.93 and 0.88, respectively. CONCLUSION: The cross-culturally adapted DS-14 Sinhala version indicated the same psychometric properties as the original instrument, in the local context with IHD patients. It can be confidently applied in the investigation of Type D personality in IHD prevention and treatment, as well as in research. KEYWORDS: Ischemic Heart Disease, Type D Personality, DS-14
Translational research for diabetes self-management in Sri Lanka: A randomized controlled trial
(Elsevier, 2015) Jayasuriya, R.; Pinidiyapathirage, M.J.; Jayawardena, R.; Kasturiratne, A.; de Zoysa, P.; Godamunne, P.; Gamage, S.; Wickremasinghe, A.R.
AIMS: The study tested the hypothesis that a theory driven Diabetes Self-Management (DSM) intervention delivered by trained nurses would result in a clinically significant improvement in glycaemic control. METHODS: Patients with an HbA1c >7.5% (58mmol/mol) and free of diabetes complications were enrolled into a randomized controlled trial (n=85). Intervention consisted of four sessions and monthly follow up for 6 months. Biochemical tests, and diet and physical activity assessments were done in both groups. Analysis of covariance was used to test the effectiveness of the intervention. RESULTS: At 6 months, there was a significant difference (P=0.001) in HbA1c between the groups controlling for baseline values and other variables. Based on the primary outcome, 28% in the intervention group achieved the target value of 6.5% HbA1c, compared to 8% in the "usual care" group (P<0.001; η2=0.65). The reduction in total energy intake and increase in physical activity was significant in the intervention group between baseline and follow up. CONCLUSIONS: The DSM intervention has resulted in a clinically significant impact on glycaemia, change in diet and physical activity, and has demonstrated the feasibility of using it within existing care arrangements in a developing country setting. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.