Presenting life with cystic fibrosis: a Q-methodological approach to developing balanced, experience-based prenatal screening information

Health Expect. 2015 Oct;18(5):1349-62. doi: 10.1111/hex.12113. Epub 2013 Aug 2.

Abstract

Background: Cystic fibrosis (CF) is one of the most common life-threatening genetically inherited conditions and prenatal screening for CF is available in many countries. Genetic counsellors and other health professionals are expected to provide information about the condition in a way that facilitates personal decision making. Knowing what information to deliver about complex genetic conditions to support informed screening decisions can be challenging for health professionals.

Objective: To solicit views from those with personal experience with CF on which aspects of the condition they consider most important to include in prenatal screening materials.

Methods: Q-methodology; an approach to systematically explore variations in viewpoint that combines factor analytic techniques with qualitative approaches to pattern interpretation.

Setting and participants: Twelve adults with CF and 18 parents of affected children were recruited from a regional centre in the UK.

Results: Five distinct viewpoints on the items most and least important to include in screening information were identified: Factor 1 the normality of life with CF and increasing life expectancy; Factor 2 the hardships and reduced lifespan. Factor 3 medical interventions and the importance of societal support. Factor 4 longer-term consequences of CF. Factor 5 the ability to adjust to the condition.

Discussion: The identification of five different views on what represented the most and least important information to include about CF highlights the challenge of portraying a complex genetic condition in a balanced and accurate manner. Novel ways in which Q-methodology findings can be used to meet this challenge are presented.

Keywords: Q methodology; cystic fibrosis; prenatal screening information.

MeSH terms

  • Adaptation, Psychological
  • Cystic Fibrosis / diagnosis*
  • Cystic Fibrosis / genetics
  • Disclosure
  • Female
  • Genetic Testing
  • Health Education*
  • Health Policy
  • Humans
  • Interviews as Topic
  • Pregnancy
  • Prenatal Diagnosis / methods*
  • Q-Sort
  • United Kingdom