Application of Q-methodology in chronic disease research: a scoping review

As the global population ages, the burden of chronic disease management continues to intensify. Guided by a patient-centered medical philosophy, there is an urgent need to develop research methods capable of capturing in depth the complex subjective experiences of patients, caregivers, and healthcare providers. This approach aims to address the limitations of current homogeneous intervention strategies. Q-methodology, a research method for exploring the complexities of human subjectivity, demonstrates significant potential across multiple fields, including the management of chronic diseases. This study aims to examine the characteristics of existing Q-methodology research on chronic diseases, including research questions, methodological variations, and implications for research in this field.

This study followed the updated scope review methodology of the Joanna Briggs Institute, as well as the PRISMA-ScR guidelines (Preferred Reporting Items for Systematic Reviews and Scoping Reviews). Literature searches were conducted from inception to November 1, 2025, across four databases: PubMed, Web of Science Core Collection, Embase, and Cochrane Library. The search was limited to English-language publications. Data extraction primarily utilized the Q-methodology evaluation and review tool.

Fifteen studies from six countries were included. Participants were individuals with chronic diseases, caregivers, and healthcare providers. Sample sizes ranged from 23 to 60 in the Q Sample and 13 to 136 in the P Sample. Research questions fell into three areas: identifying needs and preferences for support and interventions (N = 9), comparing differences in viewpoints (N = 4), and understanding patients' intrinsic cognition and experiences (N = 2). Each study reported 3 to 8 unique perspectives. Q-methodology use is increasing in chronic disease research; however, methodological variations persist. Notable differences appear in determining the Q sample, selecting P-samples, conducting Q-sorting, and data analysis. Its application in chronic disease studies facilitates the exploration of group perspectives and the comparative analysis of differences in viewpoints, enabling a deeper capture of complex subjective experiences within populations.

Preliminary evidence suggests that Q-methodology has clinical utility and scientific rigor in chronic disease research. However, given the limited number of studies and methodological heterogeneity, more research is needed to confirm these findings. Future efforts should focus on developing more scientifically comprehensive reporting checklists to standardize their use.

As the research did not directly involve animals or humans, no ethical review was conducted.