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

Abstract

BackgroundDepression 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.MethodsA 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.Results601 (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.ConclusionsThe 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.

A systematic review of mental health literacy in Pakistan

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Interventions to Reduce Stigma Related to Mental Illnesses in Educational Institutes: a Systematic Review

“…A plethora of research in recent decades has shown that stigmatizing attitudes toward mental illnesses are strongly driven by sociocultural and religious factors, as well as individual factors especially empathy and experience and education levels [58][59][60][61]. This is particularly relevant in context of low-and middle-income countries where such attitudes and beliefs toward mental illnesses are prevalent even among the learned.…”

<p>Spanish Validation Of The Revised Depression Attitude Questionnaire (R-DAQ)</p>

“…8 Furthermore, Cronbach's alpha for the 21-item scale was 0.78, a higher value compared to that reported in another validation study, which yielded a Cronbach's alpha of 0.638 in a 15-item model. 30 Focused interventions can have a more significant impact on improving the quality and outcomes of depression care. Validated instruments, such as the R-DAQ, allows researchers and policymakers to determine the relative need for different interventions and to identify specific points in depression management from the provider's side that could be improved upon.…”