This new edition of Ann Bowling's well-known and highly respected text has been thoroughly revised and updated to reflect key methodological developments in health research. It is a comprehensive, easy to read, guide to the range of methods used to study and evaluate health and health services. It describes the concepts and methods used by the main disciplines involved in health research, including: demography, epidemiology, health economics, psychology and sociology.The research methods described cover the assessment of health needs, morbidity and mortality trends and rates, costing health services, sampling for survey research, cross-sectional and longitudinal survey design, experimental methods and techniques of group assignment, questionnaire design, interviewing techniques, coding and analysis of quantitative data, methods and analysis of qualitative observational studies, and types of unstructured interviewing. With new material on topics such as cluster randomization, utility analyses, patients' preferences, and perception of risk, the text is aimed at students and researchers of health and health services. It has also been designed for health professionals and policy makers who have responsibility for applying research findings in practice, and who need to know how to judge the value of that research.

Research Methods in Health. Investigating health and health services

The study group.

eMedicine创建于1996年，由近万名临床医师作为作者或编辑参与此临床医学知识库的建设，其中编辑均是来自美国哈佛、耶鲁、斯坦福、芝加哥、德克萨斯、加州大学等各分校医学院的教授或副教授。

eMedicine

Influence of Race, Ethnicity and Social Determinants of Health on Diabetes Outcomes.

Introduction
Diabetes self-management education is a cornerstone of diabetes care. However, many diabetics in the United Arab Emirates (UAE) lack sufficient knowledge about their disease due to illiteracy. Thus, before considering any possible intervention it was imperative to assess present knowledge, attitudes, and practices of patients towards the management of diabetes.

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Knowledge, attitude and practices of diabetic patients in the United Arab Emirates.

The eight-item Morisky Medication Adherence Scale MMAS: translation and validation of the Malaysian version.

Background Most of interventions that have attempted to improve medication adherence in type 2 diabetes have been educational; on the assumption that knowledge regarding diabetes might affect patients’ adherence to their treatment regimen. Objectives The purpose of the study was to investigate any association of knowledge and medication adherence with glycemic control in patients with type 2 diabetes mellitus. Setting The study was conducted at the Diabetes Outpatients Clinic, Hospital Pulau Penang. Methods A cross-sectional study was conducted with a convenience sample of 540 adult patients with type 2 diabetes attending the clinic. A questionnaire including previously validated Michigan Diabetes Knowledge Test and Morisky Medication Adherence Scale was used and the patients’ medical records were reviewed for haemoglobin A1C (HbA1C) levels and other disease-related information. A total of 35 (6.48%) patients were excluded after data collection due to lack of HbA1C results. Results Five hundred and five patients were included in the final analysis, with a mean age of 58.15 years (SD = 9.16), 50.7% males and median HbA1C of 7.6 (IQR was 6.7–8.9). The median total knowledge score was 7.0 (IQR was 5.0–10.0) while the median adherence score was 6.5 (IQR was 4.75–7.75). Significant correlations were found between the three variables (HbA1C, knowledge and adherence). A significantly higher score for knowledge and adherence (P < 0.05) was found in those patients with lower HbA1C. Higher diabetes knowledge, higher medication adherence and using mono-therapy were significant predictors of good glycemic control in the multivariate analysis. Conclusion Patients’ knowledge about diabetes is associated with better medication adherence and better glycemic control. In addition to other factors affecting medication adherence and glycemic control, healthcare providers should pay attention to knowledge about diabetes that the patients carry towards medication adherence.

Diabetes knowledge, medication adherence and glycemic control among patients with type 2 diabetes.

Background Diabetic patients' experience and knowledge about their medication play an important role in determining the success of long-term adherence in their disease management. Objective This study aimed to explore diabetic patients' experience and knowledge about diabetes and its medication and to understand the factors contributing to medication adherence in Malaysian population. Methods A qualitative research approach was adopted to gain a better understanding of the current perceptions and knowledge held by diabetic patients. Twelve patients were interviewed using a semi-structured interview guide. Saturation point of the interview was reached after the 10th interview, and no more new themes emerged from the subsequent 2 interviews. All interviews were transcribed verbatim and analyzed by means of a standard content analysis framework. Results A total of 4 themes were identified from the interview analysis: knowledge about diabetes and its medication, experiences of adverse effects of medication, issues related to adherence, and the impact of medical and family relationships on well-being. Most of the patients were aware of the disease known as diabetes but unaware which type of diabetes they were suffering from. None of the participants knew the adverse effects of their medication, and most of them considered it to be safe. Financial barriers, forgetfulness, self-medication, and quality of relationships with doctor and family members seem to be the factors that challenge adherence in our sample of diabetic patients. Conclusion This study identified a number of key themes that might be useful in enhancing the awareness of experiences, knowledge, adherence, and attitudes of Malaysian patients with diabetes. More efforts should be taken to estimate how diabetic patients take their medication, and a well-planned educational program is also required to educate and encourage patients to practice a healthy lifestyle.

Perception and knowledge of patients with type 2 diabetes in Malaysia about their disease and medication: A qualitative study

The aims of this study were to translate the Michigan Diabetes Knowledge Test (MDKT) into the Malaysian language, and to examine the psychometric properties of the Malaysian version.

A standard translation procedure was used to create the Malaysian version of the MDKT from the original English version. A convenience sample of 307 outpatients with type 2 diabetes was identified between May and October 2009. All data were collected from the Penang General Hospital, Penang, Malaysia. Instruments consisted of the Malaysian version of the MDKT and a socio-demographic questionnaire. Medical records were reviewed for haemoglobin A1c (HbA1c) levels and other clinical data. Reliability was tested for internal consistency using Cronbach's alpha coefficient.

Employing the recommended scoring method, the mean±SD of MDKT scores was 7.88±3.01. Good internal consistency was found (Cronbach's alpha = 0.702); the test-retest reliability value was 0.894 (p<0.001). For known group validity, a significant relationship between MDKT categories and HbA1c categories (chi-square = 21.626; p≥0.001) was found.

The findings of this validation study indicate that the Malaysian version of the MDKT is a reliable and valid measure of diabetes knowledge which can now be used in clinical and research practice. Copyright © 2010 John Wiley & Sons.

https://www.onlinelibrary.wiley.com/doi/pdf/10.1002/pdi.1495

Shameni Sundram

Papers

The eight-item Morisky Medication Adherence Scale MMAS: translation and validation of the Malaysian version.

Diabetes knowledge, medication adherence and glycemic control among patients with type 2 diabetes.

Perception and knowledge of patients with type 2 diabetes in Malaysia about their disease and medication: A qualitative study

The 14-item Michigan Diabetes Knowledge Test: translation and validation study of the Malaysian version

Pdb66 the 8-item morisky medication adherence scale mmas: translation and validation study of the malaysian version