What matters most: A Q-methodology study of the viewpoints of women diagnosed with a BRCA gene mutation on person-centred care
Women diagnosed with BRCA mutations face elevated risks of breast and ovarian cancer. Managing inherited risk involves complex, value-laden decisions, yet health services frequently overlook the distinct challenges these women encounter. Person-centred care (PCC) may complement medical management by addressing what matters most to patients. To inform PCC delivery for women diagnosed with BRCA, this study examined which care aspects women themselves prioritize in their trajectory and how perspectives vary within this population. We applied Q-methodology to investigate the perspectives of 23 cancer-unaffected, female BRCA carriers in the Netherlands. Participants ranked statements reflecting PCC principles by personal importance, and elaborated on their choices in interviews. Factor analysis with varimax rotation identified shared viewpoints, which were interpreted using factor arrays and enriched with qualitative data. Three distinct viewpoints were identified, explaining 51 % of the data variance: (1) 'The Informed Journey' in which women prioritized comprehensive information to enable decision-making; (2) 'Care Rooted in Compassion' whereby women emphasized the importance of empathic, respectful interactions in building trust; and (3) 'Acknowledging Intimacy and Loss' in which women prioritized clinicians' attention to the embodied impacts of their care trajectory, including reproductive and post-surgical or menopausal challenges. Our findings support the relevance of person-centred approaches in care for women living with genetic cancer risk. Women with BRCA mutations differ in what they value most in their care, yet shared priorities emerge. Understanding whether a woman emphasises information, compassion, or bodily concerns can guide clinicians in tailoring communication and counselling. Such alignment helps ensure that risk management strategies are inherently responsive to women's lived experiences and support their broader well-being.