Impact of factor rotation on Q-methodology analysis.

The Varimax and manual rotations are commonly used for factor rotation in Q-methodology; however, their effects on the results may not be well known. In this article we investigate the impact of different factor rotation techniques in Q-methodology, specifically how the factors and their distinguishing statements might be affected. We applied three factor rotation techniques including Varimax, Equamax, and Quartimax rotations on two exemplary datasets and compared the results based on the number of Q-sorts loaded on each factor, number of distinguishing statements for each factor, and changes in the number of distinguishing statements. We also estimated the Pearson correlation between the extracted factors based on rotation techniques. This analysis shows that factors can change substantially from one rotation to another. For instance, there was only 3 common distinguishing statements between Factor 1 of no-rotation of Dataset 1 and its matched factor from Varimax rotation. Even for 3 common statements, the factor scores were quite different from no-rotation to Varimax rotation. This analysis shows that the effects of factor rotation on emerging factors are complex. The changes are usually substantial such that the rotated factors might be quite different from the original factors.

Staff views about involving service users in team formulation.

OBJECTIVES: The aim of the study was to explore staff views about whether and how service users should be involved in the process of team formulation. DESIGN: This study used Q methodology to explore health care professionals' views about service user involvement in team formulation meetings. METHODS: Forty staff members with experience of attending team formulation meetings completed a Q Sort in which they ranked how much they agreed or disagreed with 58 statements about service user inclusion in team formulation. Factor analysis was used to identify viewpoints within the data set. RESULTS: A three-factor solution accounting for 60% of the variance was considered the best fit for the data. The factors were: 'A safe space for staff', 'Concerns about inclusion and collaboration' and 'Service users might find attendance harmful'. Consensus statements identified areas where all participants agreed. CONCLUSIONS: This is an important area for exploration, given the growing practice of team formulation and the professional and ethical issues raised by service user involvement. There are a range of ways to promote inclusion within the practice, and staff should always consider the individual needs of service users.

Factor structure of the Mini-Maternal Behavior Q-Sort and associations with infant attachment: Informing precision in research and intervention.

We examined the factor structure of parental sensitivity to infants as assessed by the Mini-Maternal Behavior Q-Sort (Mini-MBQS), a 25-item short-form of the original 90-item MBQS. We aimed to: (1) identify latent factors of the Mini-MBQS; and (2) validate each factor by testing associations with infant attachment classifications. Data on parent-infant dyads (n = 313; 222 mothers with 281 children, 29 fathers with 32 children) were drawn from a three-generation Australian cohort study. Exploratory Factor Analysis and Exploratory Structural Equation Modelling examined the structure of the Mini-MBQS. Two latent Mini-MBQS factors were identified, requiring 8 of 25 original items: (1) Attention and Responsiveness and (2) Contingency in Interactions. Infants with insecure attachment classifications had parents with lower sensitivity across both factors relative to infants classified secure. In particular, infants with resistant attachment classifications had parents with notably low Contingency in Interactions scores. Infants with disorganised attachment classifications had parents with the lowest relative sensitivity across both factors, and in these dyads Attention and Responsiveness scores were especially low. Results provide an empirically derived factor structure for the Mini-MBQS. Two subscales, each with significant infant attachment associations, may improve precision in clinical intervention and research translation.

Feasibility of Using Q-Sort to Map Conditional Participation in Physical Activity in Adolescents With Autism Spectrum Disorder.

BACKGROUND: Participation in physical activity among adolescents with autism is often conditional. However, there is a lack of methods for identifying these specific conditions. Therefore, the purpose of this study was to develop and investigate the feasibility of a Q-sort tool to map individual-specific conditions for participation in physical activity among adolescents with autism and to identify different viewpoints regarding conditions for such participation. METHOD: An exploratory mixed-methods design was employed to investigate the feasibility of using Q methodology and the Q-sort procedure to identify what individual-specific conditions are important for participation in physical activity for adolescents with autism. RESULTS: The adolescents ranked the statements with varying levels of ease. Two viewpoints were identified: Autonomous participation without surprises and Enjoyment of activity in a safe social context. CONCLUSION: Q-sort is a feasible method for mapping conditions for participation, which can guide the development of tailored physical activity interventions.

South Korean Early Cancer Patients' Perceptions of Difficulties in Fighting Their Disease: A Q Methodological Approach.

This study applied the Q methodology to explore breast cancer patients' perceived difficulties in their fight against the disease. We used literature analysis and in-depth interviews and selected 162 statements for the Q population. Then, we chose 40 universal and representative statements for the Q samples from the Q population. The P sample included 13 breast cancer patients in the early stage of the disease who participated in the Q sorting. We interviewed the study participants with high factor weights by type of P sample. The study's results showed three types of breast cancer patients' perceptions of difficulties in the initial fight against the disease. Type 1 showed 'fear of the future', Type 2 showed 'helplessness against what cannot be controlled', and Type 3 showed 'frustration due to difficulties in role performance.' Based on these results, we discuss the characteristics, meanings, and significance of individual types of breast cancer patients' perceptions of the disease, including suggestions for follow-up studies.

Japanese infants' attachment insecurity and externalizing/internalizing problems: Using strange situation and attachment Q-sort methods.

According to attachment theory, an infant-mother attachment is universal, and infants who develop an insecure attachment relationship with their mother are likely to show mental health problems compared to those who develop a secure attachment relationship. These hypotheses have been empirically supported in Western cultures. However, the cross-cultural evidence is still insufficient. The purpose of this study was to examine the association between Japanese infants' attachment insecurity and mental health problems. We studied 81 Japanese infants (Mage = 14.64 months, SD = 1.43, females = 54%) mostly from middle-class families. The Strange Situation Procedure (SSP) and Attachment Q-sort (AQS) assessed infant attachment security. Infant externalizing and internalizing problems were rated concurrently by the mother and 6 months later by the mother and another adult (father or grandmother). Japanese infants' attachment insecurity measured by the AQS was associated with their externalizing problems concurrently and 6 months later. Infants with insecure-resistant attachment measured by the SSP had higher externalizing problems compared to those with secure attachment concurrently (not 6 months later). Attachment insecurity was not related to internalizing problems. These findings partly supported the association between attachment insecurity and mental health problems. This research also recommends observing infant attachment at home.

De acuerdo con la teoría de la afectividad, una unión afectiva infante-madre es universal y los infantes que desarrollan una insegura relación de afectividad con sus madres están propensos a mostrar problemas de salud mental, comparados con aquellos que desarrollan una relación afectiva segura. Estas hipótesis han sido empíricamente apoyadas en las culturas occidentales. Sin embargo, la evidencia entre las culturas es aún insuficiente. El propósito de este estudio fue examinar la asociación entre la inseguridad de la afectividad de los infantes japoneses y los problemas de salud mental. Estudiamos a 81 infantes japoneses (edad promedio = 14.64 meses, SD = 1.43, niñas = 54%), principalmente de familias de clase media. El Procedimiento de la Situación Extraña (SSP) y la Afectividad Q-sort (AQS) evaluaron la seguridad de afectividad del infante. Las madres, concurrentemente, les dieron un puntaje a los problemas de externalización e internalización del infante, y seis meses después los hicieron la madre y otro adulto (el padre o la abuela). La inseguridad de la afectividad de los infantes japoneses, tal como se midió por medio de AQS, se asoció con sus problemas de externalización concurrentemente y seis meses después. Los infantes con una afectividad insegura y de resistencia, tal como se midió por SSP, tenían más altos problemas de externalización comparados con aquellos con una afectividad segura concurrentemente (no a los seis meses después). La inseguridad de la afectividad no se relacionó con problemas de internalización. Estos resultados en parte apoyan la asociación entre la inseguridad de la afectividad y los problemas de salud mental. Esta investigación también recomienda observar la afectividad del infante en casa.

Selon la théorie de l'attachement, l'attachement bébé-mère est universel, et les bébés qui développent une relation d'attachement insécure avec leur mère sont à même de présenter des problèmes de santé mentale comparés à ceux ayant développé une relation d'attachement sécure. Ces hypothèses ont été soutenues empiriquement dans les cultures occidentales. Cependant l'évidence transculturelle demeure insuffisante. Le but de cette étude était d'examiner le lien entre la sécurité de l'attachement des nourrissons japonais et les problèmes de santé mentale. Nous avons étudié 81 nourrissons japonais (Mâge = 14,64 mois, SD = 1.43, filles = 54%) en grande partie issues de la classe moyenne. La Procédure de Situation Etrange (SSP) et l'AQS (en anglais Attachment Q-sort) ont évalué la sécurité de l'attachement du bébé. Les problèmes d'externalisation et d'internalisation du bébé ont été évalués en même temps par la mère et six mois plus tard par la mère et un autre adulte (père ou grand-mère). L'insécurité de l'attachement des bébés japonais mesurée par le AQS était liée à des problèmes d'externalisation simultanément et six mois plus tard. Les bébés avec un attachement insécure-résistant mesuré par le SSP avaient des problèmes d'externalisation plus importants comparé à ceux avec un attachement sécure simultané (pas six mois plus tard). L'insécurité de l'attachement n'était pas liée à des problèmes d'internalisation. Ces résultats soutiennent partiellement le lien entre l'insécurité de l'attachement et les problèmes de santé mentale. Cette recherche recommande aussi d'observer l'attachement du bébé à domicile.

The CPAP-Q: A Q-Sort Assessment Procedure for assessing traits and emerging personality patterns in childhood.

INTRODUCTION: Different from psychopathological assessment, personality assessment considers an individual's entire range of functioning. The evaluation of personality during childhood is more complex than assessment in other life phases, but crucial for understanding the risk and protective factors for personality pathology. This paper has two main goals. The first goal is to describe the CPAP-Q, including its development and features. The CPAP-Q is a 200-item clinician-report tool that can be used by therapists of any orientation. The second goal is to provide additional preliminary data on the validity of the CPAP-Q. METHOD: A sample of 257 clinicians completed the CPAP-Q to assess the personality features of 257 children (aged 4-11 years) who had been in their care for 2-12 months. Clinicians also completed a clinical questionnaire to provide information on themselves, their child patients, and their patients' families; and the Child Behavior Checklist (CBCL) to evaluate patients' behavioral problems and social competencies. RESULTS: The CPAP-Q seems to represent a useful assessment tool with good concurrent validity. Correlations between the CPAP-Q and the CBCL revealed strong convergent and divergent validity. Furthermore, the associations between personality prototypes and syndromic scales concurred with the clinical literature. CONCLUSION: The CPAP-Q is a new tool for assessing child personality, from a clinical perspective. It is effective at identifying personality styles, even during childhood.

A Study on the Subjectivity of Parents Regarding "0th-Period Physical Education Class" of Middle Schools in Korea Using Q-Methodology.

The current study examined parents' subjective perception types and characteristics regarding the 0th-Period Physical Education Class of Middle School in Korea. The Q-methodology was applied, and the final 25 Q-Samples were selected through the composition of the 42 Q-population. Among Korean parents, 20 students who participated in "Physical Education Activities in Class 0" for more than one year were selected as P-Sample. Q-sorting was performed by the P-Sample. Data collected by Q-sorting were analyzed using the PQ method program version 2.35, with centroid factor analysis and varimax rotation. The finding pointed to four types, with a total explanatory variance of 63%. Type 1 (N = 7), and was named "urgent legal and institutional settlement of 0th-period physical education". Type 2 (N = 4) has the theme of "beach-head for a vibrant school life". Type 3 (N = 4) was named "enhancement of academic capability". Type 4 (N = 4) was described as "strengthening physical and mental health". Moreover, the consensus statements between each type were investigated in Q1 and Q2. These findings highlight the importance of the "0th-period physical education class" so the program could be expanded and institutionalized in Korea.

College students' attachment to their smartphones: a subjective operant approach.

BACKGROUND: Smartphone use has become a pervasive aspect of youth daily life today. Immersive engagement with apps and features on the smartphone may lead to intimate and affectionate human-device relationships. The purpose of this research is to holistically dissect the ranked order of the various dimensions of college students' attachment to the smartphones through the by-person factorial analytical power of Q methodology. METHODS: Inspired by extant research into diverse aspects of human attachment to the smartphones, a concourse of 50 statements pertinent to the functional, behavioral, emotional and psychological dimensions of human-smartphone attachment were pilot tested and developed. A P sample of 67 participants completed the Q sort based on respective subjective perceptions and self-references. Data was processed utilizing the open-source Web-based Ken-Q Analysis software in detecting the main factorial structure. RESULTS: Five distinct factor (persona) exemplars were identified illustrating different pragmatic, cognitive and attitudinal approaches to smartphone engagement. They were labeled mainstream users, disciplined conventionalists, casual fun-seekers, inquisitive nerds, and sentient pragmatists in response to their respective psycho-behavioral traits. There were clear patterns of similarity and divergence among the five personas. CONCLUSION: The typological diversity points to the multiplicate nature of human-smartphone attachment. Clusters of cognitive, behavioral and habitual patterns in smartphone engagement driving each persona may be a productive area of exploration in future research in exploring their respective emotional and other outcomes. The concurrent agency of nomophobia and anthropomorphic attribution is an intriguing line of academic inquiry.

Subjective Perceptions of South Korean Parents Regarding the Effectiveness of Taekwondo Education for Adolescents and Its Characteristics: The Q Methodology Application.

This study aims to determine why Korean parents provide adolescent children with continuous physical education through Taekwondo. The Q methodology was applied. The final 25 Q-samples were selected by composing the Q-population. Twenty parents who provided their children with Taekwondo education for more than 10 years were designated as the P-sample. Q-sorting was performed on the P-sample. Centroid factor analysis and varimax rotation were performed using version 2.35 of PQ method program. The study observed four factors with a total explanatory variance of 69%. Types 1 to 4 (N = 5, 7, 5, and 3) pertained to a powerful means of enhancing mental health, the driving force behind stable school life and social development, improvement in psychological and social areas for a successful transition to adulthood, and increased awareness of the values of Taekwondo and importance of physical activity, with eigenvalues of 4.59, 6.42, 3.16, and 1.18 and explanatory variances of 0.16, 0.32, 0.12, and 0.09, respectively. Furthermore, consensus statements for each type were investigated as Q18 and Q17. These findings supported the academic foundation of proper Taekwondo education in adolescence and confirmed it as a powerful means of exerting a positive impact on adulthood.

Childhood Personality Assessment Q-Sort (CPAP-Q): A Clinically and Empirically Procedure for Assessing Traits and Emerging Patterns of Personality in Childhood.

BACKGROUND: Despite increasing research confirming the existence of childhood personalities, which are recognizable from a developmental perspective, controversies over the possibility to assess personality in childhood have continued. The purpose of this study was to provide initial data on the validation of the Childhood Personality Assessment Q-Sort (CPAP-Q), a clinician report instrument that can be employed to evaluate children's personalities and address the gap in the field of emerging personality in children classification. METHOD: A sample of 135 clinicians completed the CPAP-Q to assess the personality features of 135 children (ages 4-11) who had been in their care between two and 12 months. The clinicians completed a clinical questionnaire to collect information on them, the children, and their families, as well as the Child Behavior Checklist (CBCL), to evaluate the children's behavioral problems and social competencies. RESULTS: Q-factor analysis identified seven specific emerging personality patterns: psychological health, borderline/impulsive, borderline/dysregulated, schizoid, inhibited/self-critical, obsessive, and dysphoric/dependent. These patterns revealed good levels of validity and reliability. CONCLUSIONS: These findings are preliminary, but seem to support the possibility of evaluating emerging personality patterns in childhood and their developmental pathways that may lead to personality disorders in adolescence and adulthood. The CPAP-Q promises to significantly contribute to less explored research areas and encourage systematic studies of children assessment, promoting best practices for individualized diagnoses.

Visualising natural attractions within national parks: Preferences of tourists for photographs with different visual characteristics.

To explore what types of photographs are more helpful means to interpret natural attractions within national parks, this study focused on the relationship between the photographs with different visual characteristics and their perceived visual appeal. A photograph-based Q method was adopted. Results confirmed the visual quality of a photograph was the most important characteristic that determined its perceived attractiveness; those photographs with a high visual quality could successfully attract tourists' attention. The subject also significantly affected the preferences of observers, suggesting an interest-dependent pattern. Using photographs of birds as examples, the participants who were interested in birds were attracted by the photographs of birds rather than those of other subjects. This study provides a better understanding of the effectiveness of photographs for communication. Findings may help researchers, communicators and national park marketers better understand and select appropriate photographs for interpretation within national parks.

Nursing Students' Perceptions of Menstrual Distress during Clinical Practice: A Q-Methodology Study.

This study aimed to explore the cluster patterns of female nursing students' perceptions of the effects of menstrual distress during clinical practice. This study adopted the Q-methodology study design. We recruited female nursing students from a college in northern Taiwan. Forty-seven Q-statements were constructed to explore participants' experiences of the impact of menstrual distress on clinical learning. In total, 58 participants subjectively ranked Q-statements concerning menstrual distress experiences during clinical practice and were classified. After Q-sorting, the subjective ranking process PQ Method (version 2.35, Schmolck, Emmendingen, Germany) was employed for factor analysis. Four patterns of shared perspectives, accounting for 46.6% of the total variance, were identified: (a) influencing clinical learning and making good use of painkillers; (b) responsible attitudes and diversified relief of discomfort; (c) seeking peer support and effect on mood; (d) negative impact on learning ability and conservative self-care. Clinical practice is a major component of nursing education; menstrual distress affects female nursing students' clinical learning and performance. The exploration of clustering different nursing students' perceptions may facilitate customized strategies to enable more appropriate assistance.

Client-Centered Breastfeeding-Promotion Strategies: Q Methodology.

Fewer Korean women are choosing the 6 months of exclusive breastfeeding that are recommended for obtaining its maximal benefits despite an increasing effort to promote breastfeeding. Successful breastfeeding education and counseling need to be segmentally designed on the basis of client characteristics. This study explored the perceptions of breastfeeding in pregnant and 6 month postpartum Korean women using the Q methodology, a useful research approach to examine personal perceptions, feelings, and values about a concept or phenomenon of interest and identify typologies of perspectives. The Q sample consisted of 38 statements representing the universe of viewpoints on breastfeeding. The P sample (N = 49) included women who shared their perceptions of breastfeeding and filled each grid with a statement in the Q sorting table. Data were analyzed using the PC-QUANL program. Varimax (orthogonal) rotation revealed four factors that explained 53.0% of variance: maternal privilege (Factor 1), option based on emotion (Factor 2), option if efficient (Factor 3), and option if I have sufficient problem-solving skills (Factor 4). Korean women have changed their attitudes toward breastfeeding, with all participants viewing breastfeeding as optional. Breastfeeding-promotion campaigns and education need to consider societal norms and changes in women's beliefs and perceptions.

[Family's Perception of Proxy Decision Making to Authorize Do Not Resuscitate Order of Elderly Patients in Long Term Care Facility: A Q-Methodological Study].

PURPOSE: This study aimed to distinguish and describe the types of perceptions of do not resuscitate (DNR) proxy decisions among families of elderly patients in a long-term care facility. METHODS: This exploratory study applied Q-methodology, which focuses on individual subjectivity. Thirty-four Q-statements were selected from 130 Q-populations formed based on the results of in-depth interviews and literature reviews. The P-samples were 34 families of elderly patients in a long-term care hospital in Busan, Korea. They categorized the Q-statements using a 9-point scale. Using the PC-QUANL program, factor analysis was performed with the P-samples along an axis. RESULTS: The families' perceptions of the DNR proxy decision were categorized into three types. Type I, rational acceptance, valued consensus among family members based on comprehensive support from medical staff. Type II, psychological burden, involved hesitance in making a DNR proxy decision because of negative emotions and psychological conflict. Type III, discreet decisions, valued the patients' right to self-determination and desire for a legitimate proxy decision. Type I included 18 participants, which was the most common type, and types II and III each included eight participants. CONCLUSION: Families' perceptions of DNR proxy decisions vary, requiring tailored care and intervention. We suggest developing and providing interventions that may psychologically support families.

'Using Q-methodology to Explore What is Valued from Child Sexual Exploitation Services: The Importance of Safety'.

Child Sexual Exploitation (CSE) is a complex international issue requiring specialist multi-agency support. There is evidence that survivors of CSE are likely to experience mental health difficulties and have long-term psychological needs in response to trauma. However evidence regarding services and interventions for these difficulties is limited. This study explored viewpoints of key stakeholders, such as young people and frontline staff, about CSE services. Participants were recruited from services that support young people who have experienced CSE. The sample consisted of 18 participants; nine young people and nine professionals. Q-methodology was used to investigate subjective viewpoints regarding this topic. Statements about CSE interventions and services were collected from the existing literature and validated to form a Q-set. Participants sorted the Q-set from most to least important. Q-sorts were subjected to factor analysis using Q-methodology software. Three factors were identified: (1) The importance of safety and attunement, (2) Managing trauma and mental health difficulties and (3) Family, normality, and a relaxed approach. All factors emphasized the importance of safety and trust between young people and professionals. Key areas that may benefit service design were identified. Primarily, young people are likely to benefit from specialist support promoting a trauma-informed and relational approach.

[Types of Perception Toward Quarantine Measures among Patients Infected with COVID-19].

PURPOSE: This study was conducted to identify the types of perception toward quarantine measures at hospitals or community treatment centers among patients infected with COVID-19. METHODS: This study applied Q-methodology. Two hundred and nineteen Q populations were constructed based on related literature and in-depth interviews with 5 adults infected with COVID-19 and who experienced quarantine and hospitalization. Interviews were performed from November 14 to 29, 2020. A total of 45 Q samples were extracted and Q sorting was performed using a 9-point scale for 30 adult subjects who experienced quarantine at hospitals and community treatment centers. The data were analyzed using the PC-QUANL program. RESULTS: The perception of subjects toward quarantine measures was classified into the following six types: 'passive acceptance', 'social stigma perception', 'appreciation of daily life through awareness of the realities of illness', 'why me?', 'fearful perception', and 'positive meaning'. CONCLUSION: The perception of quarantine measure among patients with COVID-19 is identified as six types with positive and negative emotional characteristics. This result will contribute to the development of individualized strategies to address psychosocial health problems among patients with infectious diseases.

Using the attachment network Q-sort for profiling one's attachment style with different attachment-figures.

Attachment instruments vary substantially in practicability of administration, employment of categorical versus dimensional scoring, quality of scales, and applicability to different attachment figures. The Attachment Network Q-sort (ANQ) is a self-report, quasi-qualitative instrument that discriminates relationship-specific attachment styles for multiple attachment figures. The current study assesses the properties of the ANQ in psychotherapy patients and in non-patient respondents, using mother, father and romantic partner as possible attachment figures. Analyzing the ANQ-data with latent class analysis, we found four types or classes of participants: a group with an overall secure profile, a group only insecure for father, a group only insecure for mother, and a group insecure for mother as well as father but not for partner (if available). These profiles proved to have good concurrent, discriminant and construct validity. We conclude that the ANQ is potentially a useful alternative clinical self-report instrument to assess combinations of attachment styles for a range of attachment figures such as parents and a romantic partner.

Listening to parents to understand their priorities for autism research.

Involving the autism community in research increases the real-world translation and impact of findings. The current study explored the research priorities of parents of school-aged children on the autism spectrum across the home, school, and community settings. A combination of content analysis of an online questionnaire (n = 134) and Q-sort methodology (n = 9) was used. The most commonly identified research priorities in the online questionnaire were child health and well-being (home setting), socialisation and social support (school), and community awareness and understanding of autism (community). The Q-sort method highlighted different top priorities, with understanding the parent, sibling, child and family impact and stress the highest ranked priority for home, teacher/staff education and support for the school, and recognizing and supporting anxiety for the community. The implications of the findings are discussed in relation to shifting the framework of autism research to align research agendas with parental priorities.