Q sample construction: a novel approach incorporating a Delphi technique to explore opinions about codeine dependence

Abstract

Background Q methodology is an evidenced approach to researching subjectivity, involving a combination of qualitative and quantitative techniques. The methodology has been used successfully in healthcare research to explore the opinions of patients and healthcare providers about topics such as the illness experience, healthcare services, clinical practice and professional training. Q methodology studies require the generation of a Q sample, a set of opinion statements representing the phenomenon of interest. This paper describes a novel and rigorous approach to develop a Q sample for a study exploring misusers’ opinions about over-the-counter (OTC) codeine dependence and critically examines the associated methodological issues. Methods Development of the Q sample in this study involved three steps; (1) identification of opinion statements via a comprehensive literature search, (2) application of a theoretical framework, the Capability, Opportunity, Motivation - Behaviour (COM-B) model of behaviour, to group and then reduce the number of statements and (3) use of a Delphi technique to achieve expert consensus on the final selection of statements. The Delphi component involved a multidisciplinary panel of 15 addiction experts comprised of doctors, nurses, pharmacists, psychologists and researchers, who were recruited purposively. Experts rated each statement using a 5-point scale of perceived importance. Two Delphi rounds were undertaken and consensus for inclusion of a statement was set at a median score of ≥4 and an interquartile range of ≤1. Results A total of 842 statements representing codeine misusers’ opinions about OTC codeine dependence were identified from the literature. Statements were grouped thematically using the COM-B framework and representative statements were selected, reducing the number to 111. After two Delphi rounds, addiction experts achieved consensus on 46 statements which formed the final Q sample. Conclusions This paper describes a new and systematic approach to Q sample construction and explores associated methodological issues that could be useful for those considering Q methodology and for furthering the rigour of this research technique.

Bridging the Gap: Using Consensus to Explore Entrustment Decisions and Feedback Receptivity in Competency-Based Emergency Medicine Residency Programs Through the Construction of a Q-Sample Incorporating a Delphi Technique

“…Apart from using the two types of concourses (i.e., naturalistic and ready-made), the strength of this study lies at the use of three conceptual models to inform the thematic analysis of the statements. Using established theoretical models structures the construction of a Q-sample and ensures that statements represent different facets of the Research Topic ( 33 , 38 , 45 ). Although the statements extracted primarily originated from international literature, a Delphi technique was incorporated in our study to obtain validation from Taiwanese experts for relevance to the broader East Asian healthcare setting.…”

“…Similar to the framework set by Kirschbaum et al ( 38 ), construction of the Q-samples consisted of four steps and four points of refinement ( Figure 1 ).…”

Experiences of over‐the‐counter codeine misusers and accounts of recovery: A qualitative study in Tasmania, Australia

“…The cross‐sectional qualitative interview data presented in this manuscript constitute the second phase of a larger study of OTC codeine misuse in Tasmania, Australia. The first phase involved an online survey of OTC codeine misusers using Q methodology and is reported elsewhere [29–30]. Ethical approval was provided by the Human Research Ethics Committee of the University of Tasmania, Australia (Reference number H0015843).…”

Assessing the Sustainability of Alternative Structural Solutions of a Building: A Case Study

“…The Delphi study is an iterative process, based on the principle that decisions from a structured group of experts are more accurate than from individual or unstructured assessment. The Delphi technique has been used in many professional fields, such as facilities management [42], road engineering [54], healthcare [55], energy [56], manufacturing [57] and education [58].…”