Association of socio-demographic characteristics with pattern of health seeking behavior among hepatitis C patients in Pakistan

Objectives: To identify association between socio-demographic characteristics and pattern of health seeking behavior among hepatitis C patients in Karachi, Pakistan

Study design, settings and duration: A descriptive, cross-sectional study done at Aga Khan University Hospital and the Civil Hospital Karachi between March and May 2013

Patients and Methods: Hepatitis C patients who were coming for treatment at the above 2 sites underwent a filling of questionnaire by the researcher. The questionnaire collected basic demographic information and their health seeking behavior i.e. visit to traditional healer or spiritual healer or medical doctor. Sample size of 250 patients was calculated. Analysis was done by using Chi square test and Fisher's exact test. p-value of 0.05 was considered as statistically significant

Results: A total of 250 hepatitis patients were interviewed. The study showed that patient's occupation and educational level had significant association with their first visit either to a spiritual healer or traditional healer. More educated group consulted the medical doctor while those with none or low education initially went to see spiritual healers [p < 0.008] and second visit was made to traditional healers [p < 0.002]. Patients with larger number of children went less often to visit a medical doctor on their second visit [p = 0.007], and family members belonging to the medical field were more likely to make their first visit to doctors [p < 0.05]

Conclusion: Socio-demographic characteristics greatly influence the pattern of health seeking behavior among hepatitis C patients

Validity and reliability testing: Urdu translated modified response to symptoms questionnaire

To determine validity and reliability of the Urdu translated, modified "Response to symptoms questionnaire" [RSQ] among acute coronary syndrome [ACS] patients in Karachi. A qualitative, tool validation study. Two tertiary care hospitals in Karachi, the Aga Khan University Hospital, Karachi and the Karachi Institute of Heart Diseases, from December 2010 to April 2011. After making certain modifications, the original tool in English was translated into Urdu. Next, five cardiology experts evaluated the tool for its content and face validity. Test retest and inter rater reliabilities were computed for the RSQ using 5% of the total sample size of the parent study. Sufficient conceptual and semantic equivalence was found between the Urdu and English versions of the modified RSQ. Content validity index was calculated to be 1 for both relevance and linguistic clarity. Test retest and inter rater reliabilities were calculated to be 95.9% and K = 0.97, respectively. The Urdu translated modified RSQ has sufficiently acceptable content validity, test retest and inter rater reliability; hence, it should be used by the researchers for the evaluation of factors associated with pre-hospital delay among Urdu speaking ACS patient populations

Informed consent: consent by signature or information?

Obtaining informed consent is an ethical requirement for respecting the autonomy of the patient. However, assumptions concerning the patient's capacity to understand the explanation and its risks sometimes lead to a situation in which the patient signs consent form without a true understanding of the possible complications and ramifications of the procedure. Sufficient time must be allocated to assure that the patient has a full understanding of the risks and benefits and that the patient's questions have been answered before he or she signs the consent form