Edinburgh Napier University

  Objective: To transparently describe the development of a Q-set for a Q-method study about midwives’ perspectives of woman-centered care.

Research design: Q-methodology is a relevant study approach to identify key viewpoints that are relevant for practitioners and for educational purposes. The development of a set of statements (Q-sample) is the first phase of this study’s methodology, forming the research instrument – and being the focus of this paper.

Methods: Q-set development and construction included four steps: (1) Collections of items, (2) Q sample selection, (3) Formulating the Q statements, (4) Validation of the Q sample. Methods to collect items included a systematic review, a scoping review and personal narratives.

Results: We used scientific literature, Dutch midwifery journals, international governmental and healthcare professional reports and guidelines, practising midwives, midwifery lecturers, media, fiction and art as sources to collect items. A collection of 45 Q-statements was formulated according the Attitude, Social influence & self-Efficacy (ASE) model. The statements were pre-tested among student midwives and pilot-tested by midwifery Master students and two individual midwives, resulting in a final Q-set of 39 statements.

Conclusion: We systematically, thoroughly and transparently developed a valid and robust Q-set. Albeit a time consuming process and granting that the Q-statements might not represent thoughts of midwives in other countries than the Netherlands, we have constructed a concourse based on rich and detailed information that is appropriate for a Q-method study among Dutch midwives about their perspectives of woman-centered care.