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GPs and paediatric oncology palliative care: a Q methodological study
  1. Sue Neilson1,
  2. Faith Gibson2,3,
  3. Stephen Jeffares4 and
  4. Sheila M Greenfield5
  1. 1 Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
  2. 2 Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  3. 3 Faculty of Health and Medical Sciences, School of Health Sciences, University of Surrey, Surrey, UK
  4. 4 School of Government and Society, University of Birmingham, Birmingham, UK
  5. 5 Institute of Applied Health Research, University of Birmingham, Birmingham, UK
  1. Correspondence to Dr Sue Neilson, Institute of Clinical Sciences, College of Medical & Dental Sciences,University of Birmingham, Vincent Drive, Edgbaston, Birmingham, B15 2TT, UK; s.j.neilson{at}


Objective This mixed-methods study set in the West Midlands region of the UK demonstrates the effectiveness of Q methodology in examining general practitioners' (GPs') perception of their role in children's oncology palliative care.

Methods Using data obtained from the analysis of semistructured interviews with GPs who had cared for a child receiving palliative care at home and bereaved parents, 50 statements were identified as representative of the analysis findings. 32 GPs with a non-palliative child with cancer on their caseload were asked to rank the statements according to their level of agreement/disagreement on a grid. They were then asked to reflect and comment on the statements they most and least agreed with. The data were analysed using a dedicated statistical software package for Q analysis PQMethod V.2.20 (Schmolck 2012). A centroid factor analysis was undertaken initially with 7 factors then repeated for factors 1–6. Varimax and manual flagging was then completed.

Results 4 shared viewpoints were identified denoting different GP roles: the GP, the compassionate practitioner, the team player practitioner and the pragmatic practitioner. In addition consensus (time pressures, knowledge deficits, emotional toll) and disagreement (psychological support, role, experiential learning, prior relationships) between the viewpoints were identified and examined.

Conclusions Q methodology, used for the first time in this arena, identified 4 novel and distinct viewpoints reflecting a diverse range of GP perspectives. Appropriately timed and targeted GP education, training, support, in conjunction with collaborative multiprofessional working, have the potential to inform their role and practice across specialities.

  • Cancer
  • Bereavement
  • Paediatrics
  • Terminal care
  • Home care
  • General Practitioner

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  • Contributors SN designed and conducted the research. SJ provided Q methodology analytic input. SMG and FG advised during study. SN wrote the main draft of the paper and all authors contributed to the article revision and approved final version.

  • Funding NIHR/CNO CAT Clinical Lectureship (CAT CL-09–06). This report is independent research arising from a Clinical Lectureship supported by the National Institute of Health Research and Chief Nursing Officer.

  • Disclaimer The views expressed in this publication are those of the author(s) and not necessarily those of the NHD, the National Institute of Health Research or the Department of Health.

  • Competing interests None declared.

  • Ethics approval South Birmingham Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.