A Q methodology study of perceptions of poverty among midwestern nursing students

Objectives: Providing patient-centered care involves understanding how social factors, including poverty, affect health outcomes. The purpose of this study was to explore nursing students' beliefs surrounding the poor. Design: A Q methodology design was used to discover patterns of perceptions towards those living in poverty. Setting: The study took place on two campuses of a large public, university in the Midwestern United States. Participants: The purposeful sample of 23 Q participants was drawn from students enrolled in the second, third, and final year of study in a baccalaureate nursing program. Methods: Participants rank-ordered their level of agreement with a set of 30 statements regarding poverty. Data were analyzed by a three-step process that included correlating participant profiles, performing factor analysis, and generating factor scores. A factor array and narrative were used to explain the findings. Results: Three viewpoints were identified: judges who tended to feel that poverty was linked to individual behavior; Allies who mostly saw societal reasons for poverty and felt a strong need to assist the poor, and Observers who did not blame individual for their circumstances, but were not as compelled to champion their cause. Conclusions: Given these different perspectives, educators may need to use variety of teaching approaches to help students achieve patient-centered care competencies with their poorest patients. (C) 2014 Elsevier Ltd. All rights reserved.