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

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.

A Q methodology design was used to discover patterns of perceptions towards those living in poverty.

The study took place on two campuses of a large public, university in the Midwestern United States.

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.

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.

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.

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.