Public viewpoints on new non-invasive prenatal genetic tests.

types: Journal ArticlePrenatal screening programmes have been critiqued for their routine implementation according to clinical rationale without public debate. A new approach, non-invasive prenatal diagnosis (NIPD), promises diagnosis of fetal genetic disorders from a sample of maternal blood without the miscarriage risk of current invasive prenatal tests (e.g. amniocentesis). Little research has investigated the attitudes of wider publics to NIPD. This study used Q-methodology, which combines factor analysis with qualitative comments, to identify four distinct "viewpoints" amongst 71 UK men and women: 1. NIPD as a new tool in the ongoing societal discrimination against the disabled; 2. NIPD as a positive clinical application offering peace of mind in pregnancy; 3. NIPD as a medical option justified for severe disorders only; and 4. NIPD as a valid expansion of personal choice. Concerns included the "trivialisation of testing" and the implications of commercial/direct-to-consumer tests. Q-methodology has considerable potential to identify viewpoints and frame public debate about new technologies.Economic and Social Research Counci

Q methodology and a Delphi poll: a useful approach to researching a narrative approach to therapy

Q methodology and a Delphi poll combined qualitative and quantitative methods to explore definitions of White and Epston's (1990) narrative approach to therapy among a group of UK practitioners. A Delphi poll was used to generate statements about narrative therapy. The piloting of statements by the Delphi panel identified agreement about theoretical ideas underpinning narrative therapy and certain key practices. A wider group of practitioners ranked the statements in a Q sort and made qualitative comments about their sorting. Quantitative methods (principal components analysis) were used to extract eight accounts of narrative therapy, five of which are qualitatively analysed in this paper. Agreement and differences were identified across a range of issues, including the social construction of narratives, privileging a political stance or narrative techniques and the relationship with other therapies, specifically systemic psychotherapy. Q methodology, combined with the Delphi poll, was a unique and innovative feature of this study

The Social Construction of Conspiracy Beliefs: A Q-Methodology Study of How Ordinary People DefineThem and Judge Their Plausibility

Little is known about ordinary people’s understandings of conspiracy beliefs and how these understandings relate to the perspectives of researchers and scholars. Working within a social constructionist epistemological framework, we conducted a Q-methodology study aiming to identify a range of lay perspectives on two key topics: the defining features of conspiracy beliefs; and aspects considered important in judging their plausibility. Fifty-six people (32 men and 24 women), recruited via regional UK Facebook groups, sorted their agreement with a set of statements on each of the two topics. A principal component analysis, followed by varimax rotation, was performed on each data set. Five accounts about the defining features of conspiracy beliefs were identified: that they are false, illogical and harmful; that they are forms of political critique; that there are varied types; that they are entertaining but ineffectual; and that they are held by a self-reinforcing minority. Four accounts about their evaluation were identified: conventional realist criteria; the importance of personal judgement; skeptical realism; and the assessment of critical thinking. The findings are discussed in the context of the literature and limitations of the study are considered. Implications for research and educational and policy interventions are outlined

Exploring the psychological rewards of a familiar semirural landscape: connecting to local nature through a mindful approach

This study analyses a 53,000 word diary of a year engaging with nature through over 200 trips to a semi-rural landscape. Thematic analysis revealed two themes; the transition from observer to nature connectedness and the ways in which the natural environment was experienced once a connection was made. These themes are discussed in relation to theories that seek to explain the positive effect of nature and nature connectedness. The findings are important as they suggest that repeated engagement with local semi-rural countryside can lead to a mindful approach and psychological rewards that do not require travel into the wilderness. The work informs further research into outcomes and processes of nature based interventions such as: trip frequency, duration and diary keeping

Self-management of chronic low back pain: Four viewpoints from patients and healthcare providers

A move towards self-management is central to health strategy around chronic low back pain, but its concept and meaning for those involved are poorly understood. In the reported study, four distinct and shared viewpoints on self-management were identified among people with pain and healthcare providers using Q methodology. Each construes self-management in a distinctive manner and articulates a different vision of change. Identification of similarities and differences among the viewpoints holds potential for enhancing communication between patients and healthcare providers and for better understanding the complexities of self-management in practice

Stakeholder perspectives on shale gas fracking: A Q-method study of environmental discourses

The rapid expansion of shale gas exploration worldwide is a significant source of environmental controversy. Successful shale gas policymaking is dependent upon a clear understanding of the dynamics of competing stakeholder perspectives on these issues, and so methods are needed to delineate the areas of agreement and conflict that emerge. This empirical study, based in the United Kingdom, examines emergent perspectives on a range of environmental, health and socio-economic impacts associated with shale gas fracking using Q- methodology: a combined qualitative-quantitative approach. The analysis reveals three typologies of perspectives amongst key industry, civil society and non-affiliated citizen stakeholders; subsequently contextualised in relation to Dryzek’s typology of environmental discourses. These are labelled A) “Don’t trust the fossil fuels industry: campaign for renewables” (mediating between sustainable development and democratic pragmatism discourses); B) “Shale gas is a bridge fuel: economic growth and environmental scepticism” (mediating between economic rationalism and ecological modernisation discourses); and C) “Take place protective action and legislate in the public interest” (reflecting a discourse of administrative rationalism). The implications of these competing discourses for nascent shale gas policy in the UK are discussed in light of recent Government public consultation on changes to national planning policy

Doing fence sitting: a discursive analysis of clinical psychologists' constructions of mental health

A growing body of research indicates that the way health care professionals conceptualize mental health might have important clinical implications. We adopted a discursive psychology approach to explore clinical psychologists’ accounts of mental health and its effects. Semistructured interviews were conducted with 11 clinical psychologists in the East Midlands region of the United Kingdom. The participants constructed mental health through building up biological factors and psychosocial aspects as opposite ends of the same spectrum, and then positioned themselves as distant from these extremes to manage issues of stake and accountability. A discourse of moral concern for service users was used to negotiate the implications of having different views of mental health from service users, enabling clinicians to manage issues of accountability and demonstrate their ability to be helpful. This suggests that clinicians should be mindful of the effects of their use of language and make the contingent nature of their knowledge explicit

Reclaiming the humanity in personality Disorder.

This paper provides a commentary upon the nursing care of individuals diagnosed with personality disorder and associated education courses. The discussion focuses upon recent policy trends in the UK as a point of departure. This policy discourse is critical of mainstream mental health services in previously operating to exclude such individuals. One of the consequences has been a recent growth in interest in relevant training courses, many of which devote significant attention to staff attitudes regarding this client group. Various previous researchers and commentators have remarked upon the implications for practice of a perceived negative attitude among care staff. We reflect upon our own anecdotal experience of developing and delivering new university-based courses for practitioners working in the field of personality disorder to offer a particular critique of the UK context, in which this policy, training, and practice is framed. Social constructionist theories are drawn on to offer insights into public and practitioner discourse and the possible effects on therapeutic relationships. The available discourse constructs individuals with a diagnosis of personality disorder as essentially different from other people. We argue that staff training and practice development initiatives are likely to be more successful if such discourse is challenged, and attempts are made in therapeutic encounters to recognize shared characteristics and positive attributes as much as perceived difference and negative attributes. We refer to this as a re-engagement with common humanity. Despite the singular national context, the discursive themes explored are not necessarily restricted to the UK

An Alternative Ethics? Justice and Care as Guiding Principles for Qualitative Research

The dominant conception of social research ethics is centred on deontological and consequentialist principles. In place of this, some qualitative researchers have proposed a very different approach. This appeals to a range of commitments that transform the goal of research as well as framing how it is pursued. This new ethics demands a participatory form of inquiry, one in which the relationship between researchers and researched is equalized. In this paper we examine this alternative approach, focusing in particular on two of the principles that are central to it: justice and care. We argue that there are some significant defects and dangers associated with this new conception of research ethics