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J Adv Nurs. 2019 Apr 16. doi: 10.1111/jan.14029. [Epub ahead of print]

Patterns of parents' perspectives on protecting young children from secondhand smoke exposure: A Q-methodology study.

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Institute of Clinical Nursing, School of Nursing, National Yang-Ming University, Taipei, Taiwan.
Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan.
Department of Senior Citizen Service, Mackay Junior College of Medicine, Taipei, Taiwan.
Donghu Elementary School, Taipei, Taiwan.



To identify and describe the various patterns of parents' perspectives on avoiding secondhand smoke exposure.


Q methodology was applied to investigate the parental perspectives of 50 parents.


The study was implemented from September-December 2016. Forty-two Q-statements were constructed based on the literature related to parental attitudes and prevention practices regarding preventing young children from experiencing secondhand smoke exposure. A series of Q-sorts was performed by the participants to rank the statements into a Q-sort grid. PQMethod 2.35 software was used to perform principal component analysis to identify different patterns of parents' perspectives.


Five patterns of shared perspectives, which accounted for 62% of the total variance, were derived from the analysis: (a) lack of confidence to confront smokers in non-smoking areas; (b) awareness of health hazards but not ready to take preventive actions; (c) emphasis on parental responsibility and behavioural guidance; (d) awareness of health rights protected by legislation; and (e) strong willingness to take protective actions.


Our findings revealed the shared perspectives of five groups of parents. The exploration of clusters of parents could assist healthcare professionals in acknowledging parents' tendencies related to attitudes and responses towards secondhand smoke exposure.


Using a forced distribution through the Q-sorting technique, the particular perspective patterns of parents' experiences would be captured. These findings can serve as a useful guide for researchers and practitioners to develop tailored intervention programs for parents with the purpose of reducing secondhand smoke exposure in young children.


Q methodology; nursing care; parent; secondhand smoke exposure; young children


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