The psychometric characteristics of the revised depression attitude questionnaire (R-DAQ) in Pakistani medical practitioners: a cross-sectional study of doctors in Lahore

BACKGROUND: Depression is common mental health problem and leading contributor to the global burden of disease. The attitudes and beliefs of the public and of health professionals influence social acceptance and affect the esteem and help-seeking of people experiencing mental health problems. The attitudes of clinicians are particularly relevant to their role in accurately recognising and providing appropriate support and management of depression. This study examines the characteristics of the revised depression attitude questionnaire (R-DAQ) with doctors working in healthcare settings in Lahore, Pakistan. METHODS: A cross-sectional survey was conducted in 2015 using the revised depression attitude questionnaire (R-DAQ). A convenience sample of 700 medical practitioners based in six hospitals in Lahore was approached to participate in the survey. The R-DAQ structure was examined using Parallel Analysis from polychoric correlations. Unweighted least squares analysis (ULSA) was used for factor extraction. Model fit was estimated using goodness-of-fit indices and the root mean square of standardized residuals (RMSR), and internal consistency reliability for the overall scale and subscales was assessed using reliability estimates based on Mislevy and Bock (BILOG 3 Item analysis and test scoring with binary logistic models. Mooresville: Scientific Software, 55) and the McDonald's Omega statistic. Findings using this approach were compared with principal axis factor analysis based on Pearson correlation matrix. RESULTS: 601 (86%) of the doctors approached consented to participate in the study. Exploratory factor analysis of R-DAQ scale responses demonstrated the same 3-factor structure as in the UK development study, though analyses indicated removal of 7 of the 22 items because of weak loading or poor model fit. The 3 factor solution accounted for 49.8% of the common variance. Scale reliability and internal consistency were adequate: total scale standardised alpha was 0.694; subscale reliability for professional confidence was 0.732, therapeutic optimism/pessimism was 0.638, and generalist perspective was 0.769. CONCLUSIONS: The R-DAQ was developed with a predominantly UK-based sample of health professionals. This study indicates that this scale functions adequately and provides a valid measure of depression attitudes for medical practitioners in Pakistan, with the same factor structure as in the scale development sample. However, optimal scale function necessitated removal of several items, with a 15-item scale enabling the most parsimonious factor solution for this population

The role of Sehat Insaf Card in access to healthcare services: Exploring health professional perceptions in Lahore

Introduction:  The Sehat Insaf Card (SIC) scheme has the potential to improve access to healthcare services for low-income families in Pakistan, there are several challenges that healthcare professionals may face during its implementation. Objectives: This study aims to assess the workload, reimbursement rates, quality of care, and job satisfaction and burnout levels of healthcare professionals in private hospitals providing services under the Sehat Insaf Card scheme. The study's findings will provide insights into the effectiveness of the scheme and inform policymakers about healthcare workforce well-being. Methodology: The study utilized a cross-sectional survey design to collect data from private hospitals in Lahore, using a one-day survey and questionnaires to achieve a snapshot of the research problem at a societal level. A sample size of 200 was calculated and data were analyzed using SPSS. Regression analysis was done to calculate value significance of the analysis.  Results: The study assessed the impact of Sehat Insaf Card on healthcare professionals in private hospitals. Results showed a significant impact on increased work and demand (mean score: 76.09, p-value: 0.0071), due to administrative requirements (mean score: 65.09, p-value: 0.0082), and insufficient reimbursement rates (mean score: 56.98, p-value: 0.0032)