A scoping review of Q methodology nursing education studies

Challenge or threat? A Q-methodological study into nursing students' perceptions on learning to collaborate under stress

INTRODUCTION

Nursing students will come across stressful situations during their internships and will continue to do so in future practice. Because of the impact stress can have on performance, nursing students need to be equipped to work and collaborate in such situations. Careful consideration of the needs and desires of nursing students should be taken in account, in order to create a training environment that fosters students' ability to learn to collaborate under stress.

AIM

The aim of this study is to identify viewpoints of undergraduate nursing students towards the learning of collaboration in stressful situations, to understand their needs and desires, and to improve educational designs for training to collaborate in stressful situations.

METHODS

We conducted a Q-methodology study, a mixed methods approach that studies and charts subjectivity, and uses a by-person factor analytical procedure to create profiles of shared viewpoints. The process of our Q-study is based on the following five steps: Q-set development (54 statements), participant selection (n = 29), Q-sorting procedure, data analysis, and factor interpretation.

RESULTS

Q-factor analysis resulted in two prevailing factors that answer our research question. Twenty-five students loaded on these two factors, and factor interpretation resulted in Profile 1 "Practice makes perfect, so let's do it" and Profile 2 "Practice is needed, but it scares me". Whereas Profile 1 regarded learning to collaborate in stress mainly as a challenge, Profile 2 appeared anxious despite feeling the necessity to learn this. An overarching consensus factor revealed the importance of a learning environment in which mistakes can be made.

DISCUSSION

The two described profiles align with the biopsychosocial model of challenge and threat, and could help to recognize and address the individual needs of nursing students when learning to collaborate in stressful situations. Incorporating these profiles in training may guide students towards a more challenge-like appraisal of stressful situations.

Understanding factors that influence the drug choice of prescribers: A Q-methodology study

INTRODUCTION

Therapeutic decision-making often involves weighing several treatment options on the basis of, among other things, the disease profile, patient characteristics but also prescriber-specific factors. This study investigated the factors influencing therapeutic decision-making among prescribers and explores how these factors differ between healthcare professionals.

METHODS

This Q-methodology study involved 37 participants from different medical backgrounds, including physicians, dentists, midwives, physician assistants and advanced nurse practitioners from various intra- and extramural settings in the Netherlands. Participants ranked 55 factors on their importance for medication prescribing, and factor analysis was used to identify distinct prescriber profiles. These profiles were subsequently enriched using qualitative data derived from post-sorting interviews.

RESULTS

Four prescriber profiles were identified that explained 59% of the study variance: pragmatic contextual, guideline oriented, experience driven and vulnerability focused. Several factors were ranked differently in each profile. The pragmatic contextual profile emphasized patient context and risk prevention, the guideline-oriented profile adhered to clinical guidelines, the experience-driven profile relied on clinical experience and patient-centred communication, and the vulnerability-focused profile prioritized personalized care for specific patient groups.

CONCLUSION

This study sheds light on the diverse factors influencing prescriber decision-making in medical practice. By identifying four prescriber profiles, it reveals the complexity and diversity in how prescribers balance guidelines, clinical experience and patient-specific considerations in their practice. These findings offer direction for developing educational and policy initiatives to enhance the quality of prescribing, ultimately improving patient outcomes.

Perspectives on advance care planning and related end-of-life care in people with heart failure: A Q methodology study

Negative perspectives around advance care planning (ACP) prevent people with heart failure (HF) from preparing their end-of-life (EOL) effectively. A Q methodology study was conducted to identify types of ACP perspectives in Koreans with HF. The Q sample (31 statements representing ACP perspectives) was constructed through an extensive literature review and in-depth qualitative interview. The P sample (individuals with HF) completed each grid with a statement on the Q sorting table. The data were analyzed using the PQ program. Individuals with HF have both different and common perspectives on ACP. Three types of perspectives were identified: "positive acceptance," "contemplative support," and "hesitancy in acceptance." Common perspectives across types indicated that people with HF had positive attitudes toward ACP and emphasized their autonomy in EOL decisions. Clinicians need to consider these different and common perspectives on ACP to facilitate patients' engagement and provide relevant support.

Identifying, classifying and prioritizing factors affecting human errors in the mine design process: A mixed methods research

BACKGROUND: Mines are often home to many dangers with a high rate of accidents and occupational diseases. One of the most effective ways to prevent these adverse incidents is to identify and control the influential factors causing human error in design and the ensuing negative consequences. OBJECTIVE: This study aimed to explore, categorize and prioritize factors affecting human errors in the mine design process. METHODS: The study has a mixed-method design combining qualitative and quantitative data. In the qualitative phase, the required data were collected by conducting semi-structured interviews with 12 surface mine designers. The causes of errors were extracted and categorized by the latent content analysis using MAXQDA2022 software. The identified causes in the qualitative phase were sent to expert designers in Q tables, and the data were analyzed by factor analysis. RESULTS: Of the identified codes in the qualitative phase, 40 main themes in five different categories (individual, organizational, external, task, and environmental factors) were determined as causes. The results of the quantitative phase suggest the existence of four different mental patterns regarding the causes of design errors (DEs). The data analysis also shows that organizational and personal factors, particularly supervision and inspection, experience, and technical knowledge, were the strongest causes of DEs and environmental (hotness, coldness, indoor air quality, and noise) and external (work-family conflict) factors being the weakest ones. CONCLUSION: This study not only identifies and categorizes the causes of design errors in the mining industry but also suggests some control strategies for these errors based on the mental patterns of the experts.