Sinhala translation, cultural adaptation and validation of Recovery Assessment Scale-24 in a Sri Lankan population

Background: The concept of recovery in schizophrenia has shifted from a purely clinical focus to a broader, person-centred perspective encompassing multiple dimensions. Despite growing global interest, research on personal recovery in Sri Lanka remains limited. The lack of culturally adapted and validated tools has constrained systematic evaluation in local settings. The Recovery Assessment Scale (RAS-24) is widely used to measure personal recovery, but its applicability in Sri Lanka has not yet been established.
Aims: The study aimed to translate, culturally adapt, and validate the Sinhala version of the Recovery Assessment Scale (RAS-S 24).
Methods: This study translated, culturally adapted, and validated the RAS-24 for Sinhala-speaking patients with schizophrenia. It comprised forward-backward translation, expert panel review, content validation, and pilot testing with 20 patients to assess clarity, relevance, and cultural acceptability. The Sinhala RAS-24 (RAS-24-S) was administered to 50 randomly selected patients attending a follow-up psychiatry clinic at the National Hospital of Sri Lanka to assess internal consistency and construct validity.
Results: RAS-24-S demonstrated strong cultural acceptability and psychometric performance. Content validity was excellent, with an S-CVI/Ave of 0.93. The total scale showed excellent internal consistency, while domain reliability ranged from acceptable to excellent. Exploratory factor analysis supported a four-factor structure that explained 79.2% of the variance. Recovery level was significantly associated with relapse frequency, insight, alcohol use, cannabis use, psychiatric comorbidity, medical illness, and family history.
Conclusion: RAS-24-S is a valid, reliable, and culturally appropriate tool for assessing recovery among patients with schizophrenia in Sri Lanka.