Reflection on the phenomenology of Merleau-Ponty and its contributions to nursing research

Reflexão sobre a fenomenologia do Merleau-Ponty e suas contribuições para a pesquisa em enfermagem

ABSTRACT

Objective:

To elaborate a reflection on the phenomenology of Merleau-Ponty and her contributions to nursing research.

Methods:

This is a reflective theoretical study based on one of Merleau-Ponty's works and recent scientific literature on the subject.

Results and discussion:

Three themes were developed that combine the contribution of Merleau-Ponty's phenomenology, starting from the central concepts of philosophy and nursing care. The approach to the body not only from a biological expression, but from the phenomenology of the lived body provides an existentialist vision of the understanding of the human being immersed in the world and its relations with holistic care.

Final considerations:

Merleau-Ponty's philosophical reference is very useful in the generation of nursing knowledge, constituting a support for phenomenological research since it allows the understanding of the subjective phenomena of care through the body.

Keywords:
Phenomenology; Nursing research; Nursing care; Philosophy

RESUMO

Objetivo:

Elaborar uma reflexão sobre a fenomenologia de Merleau-Ponty e suas contribuições para a pesquisa em enfermagem.

Métodos:

Trata-se de um estudo teórico reflexivo baseado em uma das obras de Merleau-Ponty e na literatura científica recente sobre o assunto.

Resultados e discussão:

Foram desenvolvidos três temas que trazem a contribuição da fenomenologia de Merleau-Ponty, partindo dos conceitos centrais da filosofia e do cuidado de enfermagem. A abordagem do corpo não apenas a partir de uma expressão biológica, mas da fenomenologia do corpo vivido proporciona uma visão existencialista da compreensão do ser humano imerso no mundo e suas relações com o cuidado holístico.

Considerações finais:

O referencial filosófico de Merleau-Ponty é muito útil na produção do conhecimento em enfermagem, sendo suporte para a pesquisa fenomenológica, pois permite a compreensão dos fenômenos subjetivos do cuidado por meio do corpo.

Palavras-chave:
Fenomenologia; Pesquisa em enfermagem; Cuidados de enfermagem; Filosofia

RESUMEN

Objetivo:

Elaborar una reflexión sobre la fenomenología de Merleau-Ponty y sus aportes a la investigación de enfermería.

Método:

Se trata de un estudio teórico reflexivo, basado en una de las obras de Merleau-Ponty y en la literatura científica reciente sobre el tema.

Resultados y Discusión:

Se desarrollaron tres temas que conjugan el aporte de la fenomenología de Merleau-Ponty, partiendo de los conceptos centrales de la filosofía y el cuidado enfermero, el abordaje del cuerpo no sólo desde una expresión biológica, sino desde la fenomenología del cuerpo vivido aporta una visión existencialista de la comprensión del ser humano inmerso en el mundo y sus relaciones con el cuidado holístico.

Consideraciones finales:

El referente filosófico de Merleau-Ponty es de gran utilidad en la generación de conocimiento de enfermería constituyendo un sustento para la investigación fenomenológica pues permite comprender los fenómenos subjetivos del cuidado a través del cuerpo.

Palabras clave:
Fenomenología; Investigación en enfermería; Atención de enfermería; Filosofía

INTRODUCTION

The history of nursing as a science is recent, formerly speaking of nursing care as a professional exercise was unthinkable, the scientific study of nursing began in the mid-nineteenth century with the contributions of Florence Nigthingale. Since this time, the development of the nursing discipline has faced various challenges in its intention to consolidate itself as a science, one of them, perhaps the priority, is the development of its own theoretical base that supports the practice of its professionals. To face this problem, for several decades, the generation of scientific knowledge has been established as one of the main demands on nursing professionals, mainly under the cover of the quantitative approach.

However, it was increasingly evident the need to adopt the qualitative paradigm as a means to explore the phenomena of care itself and provide scientific information to the disciplinary field, understanding the relationship of care between the nurse and the patient as a subjective relationship1 susceptible to be studied by phenomenology. The study of these phenomena related to nursing care must be based on the understanding of people's thoughts and feelings before the various health and disease processes that existence itself supposes.

Nursing can be understood as the study of care from the experiences or living of human health and the way in which they are interpreted by those who live them2, which requires a humanistic paradigm that allows understanding the subjective phenomena of care, finding in qualitative research, especially in phenomenology, the opportunity to study lived experience, as well as to describe the meanings of the phenomena of your interest3.

Among the most recognized phenomenologists is Maurice Merleau-Ponty, who in his work Phenomenology of Perception proposes the corporal theory of perception where it is assumed as a function of the body4. This phenomenological approach presents similar features to those of existentialist phenomenology, since it exposes as main themes concrete configurations of human existence such as the body, perception, freedom and language5.

The relevance of the present document lies in analyzing the Merleau-Ponty’s philosophy as a reference aligned with the disciplinary principles of nursing in its essence, in a way that allows guiding scientific research in the quest to understand the experiences of people in the health and disease processes inherent to care. Therefore, the objective of this article is to elaborate a reflection on Merleau-Ponty's phenomenology and its contributions to nursing research.

METHOD

It is a reflective theoretical study on the contribution of phenomenology to nursing research from the Merleau-Ponty’s reference, it starts from the most popular work of the philosopher Phenomenology of Perception from which the concepts of perception and body are retaken, in addition to the integration of some of the philosopher’s contributions to research and the development of nursing knowledge; Therefore, this reflection was elaborated from the mentioned literature and the authors’ contribution.

The epistemological constructions were organized in themes seeking at all times to respond to the proposed objective. Due to the nature of the study, the need for ethical procedures was excluded.

RESULTS AND DISCUSSION

Three themes were developed that combine the contribution of phenomenology to nursing research from the Merleau-Ponty's reference, tracing a path that goes from the central concepts of philosophy and its relationship with nursing care to nursing research approaches under the lens of the referent in question. These topics were considered essential for understanding the contribution of Merleau-Ponty's ideas to nursing research.

Merleau-Ponty: phenomenology, perception, and corporeality

Merleau-Ponty's phenomenology bases its thinking with an emphasis on the concept of being in the world and seeks to understand the experience of the lived world and its expression by the body itself4. The philosopher manages to relate the essences with existence, that is, he undertakes a search for meaning, supported by the facts of existence, hence the movement of return to ourselves is displaced by a reverse movement of leaving from ourselves6.

The intention of the Merleau-Ponty is to correctly problematize the various aspects of existence in order to understand the Being, which is clearly stated in his theory where perception is essential since it allows the body, as subject and object, to navigate the environment and interact on it6.

It considers perception as a spontaneous act of direct capture of meaning and never of the materiality that sustains it, it is at first perception of elements and not of things, it is a bodily behavior; our perception is cultural and historical in such a way that the perception of each one depends on that of others and their interrelations in the total configuration5.

Perception is not the result of an intellectual or linguistic process that would be applied to a sensitive material: on the one hand, it is not possible to isolate a pure sensation devoid of meaning; on the other, it is not necessary to postulate the operation of tacit judgments, categories of understanding or computational or inferential processes to account for what is perceived4.

The phenomenology of perception states that perception depends fundamentally, not on an intellectual process, nor on a merely physiological one, but on bodily behavior and more precisely on the motor dispositions settled by habit.

On the other hand, Ponty assures that the body is more than a set of parts, it is corporeality and spirituality at the same time, it is an animated body that accounts for the integrity of the human experience: perception, emotion, reasoning, language, etc. The body is the means of knowing and being, therefore, it is not possible to separate it from the soul, nor for it to transmigrate to another body, since a body without a soul would become a machine5.

As a philosopher of the body, he considers this as the object that ensures the existence of other objects for the human being, therefore, my body is not just any object, but is the means of communication between the world and me: the medium through which I perceive.

The body is the necessary and sufficient subject of perception, with the inescapable condition of seeing the body beyond the fragmented definition provided by the biomedical model, which is daily present in nursing work, in this sense, the philosopher does not accept the vision of the body as a set of parts with fixed functions, but rather proposes returning to things themselves through lived experience to achieve the rediscovery of the body.

The phenomenological research by nursing requires the researcher’s ability to isolate predetermined concepts about the phenomenon in question and base the understanding process solely on the lived experiences of each subject7.

Merleau-Ponty and nursing care

The nursing practice whose reason for being is care, assumes the premise of holism as the fundamental basis of this, with this the discipline is aware of the important but not absolute role that the physical body represents in the process of caring8. Coinciding with the Merleupontyan theory, nursing avoids reducing the human body to a set of organs and systems that are related to its functioning and seeks to integrate the environment and the experiences lived as triggers of health and disease processes.

Merleau-Ponty's phenomenological proposal stands out in nursing for the subjective nature of the essence of the human being, which allows the discipline to have access to the most intimate and less commonly explored experiences of being cared for, being a caregiver and the interaction of both with the environment9.

For the nurse, this approach probably means the path to the humanization of care, since it allows the understanding of human complexity and the various phenomena that emanate from it, which is extremely necessary to achieve holism in nursing care and position the be cared for as a being in the world with experiences, meanings and perceptions of oneself, of others and of the world they inhabit3.

Within the phenomenological field, the difference between feeling and knowing becomes evident, because to know a phenomenon, the sensations that we have of it are not enough4, Merleau-Ponty seeks to reveal the fundamental truth of our affiliation to a preconstituted world, for this reason it becomes essential to return to the lived world with a free gaze of objectifying thought6.

The philosopher considers that the body is much more than a passive receptor of sensations, it is the object that does not leave me, does not move away from me, therefore the importance of conceiving it as more than the means to see, feel, smell or hear, with based on the above, assuming that perception is achieved through the senses mutilates the concept itself, reducing it to knowledge and forgetting its existential background10.

The phenomenological dimension of care seeks to understand the meanings that the person gives to the experiences lived in the various health and disease processes, as well as the interaction with the environment in which they develop. The foregoing is very useful for the study of being cared for and its relationships in the caring process, care encounters also involve the nursing professional, who acts as a subject who experiences the world and at the same time relates to the world from other personnel and professionally, to provide nursing care11.

Nursing care is complex and this characteristic resides in its human nature, during the process of caring the nurse and the patient intervene in an exchange of experiences that allow them to understand the health-disease processes with which they deal through a deep dialogue that it goes beyond words. Being a caregiver focuses attention on the lived experiences of the beings he cares for, seeking the understanding of these experiences through temporality.

Merleau-Ponty's reference for nursing research

While it is true that the qualitative research approach in nursing science dates back a few years, it is also true that phenomenology as philosophy in its different references and also as a phenomenological method is the most appropriate to understand and describe the phenomena inherent to caregiving9.

The phenomenology of Husserl and Heidegger is more popular among nurses, even though Merleau-Ponty's ideas are also relevant to nursing practice8. Nursing researches under the shelter of the Merleaupontyan phenomenology are of a varied nature, recent publications show the variety in the explored phenomena, of the study subjects and from the spaces where the research is carried out8^,12^-14.

Merleau-Ponty is present in nursing studies in the community and clinical setting, with young, elderly, healthy and sick subjects, guiding studies on drug perception in young people12⁾ with the same benefit as research in institutionalized mentally ill patients8⁾ scenarios where the needs of the subjects are explored under the light of the referent with substantial results.

Thanks to the tinge of existentialism present in Merleaupontyan phenomenology, it can be incorporated into practically any phenomenon related to the human being and his relationship with others (intercorporality) and with the world5. The flexibility of the referent allows the nurse to inquire about the perceptions of professionals13, with the same benefits that it contributes to the investigation of the nurse-patient relationship14, allowing proximity with the care subjects and understanding of relative experiences to health and disease processes9.

However, it is necessary for nursing to take ownership of the philosophical and methodological elements that support research under the Merleupontyan reference in order to restructure existing knowledge and set new goals in favor of professional nursing practice.

Limitations

Due to the nature of this article, the concepts presented in the Phenomenology of Perception are only the main ones and although they allow us to know the essential ideas of the philosopher, further study is required to implement them in the research activity, for which the nursing professionals who are interested in the subject should immerse themselves in a much deeper reading of Merleau-Ponty's work.

Considerations for practice

The reflections supported in this article are intended to encourage in nurses concern for the development of research that contributes to the improvement of nursing care practice, taking up the Merleau-Ponty reference as a philosophical basis that will allow exploring people’s experiences and experiences from a perspective that focuses on the body as the origin of knowledge.

FINAL CONSIDERATIONS

Based on the reflections made, it is possible to conceive the Phenomenology of Perception as a very useful philosophical resource in the generation of nursing knowledge that allows understanding the subjective phenomena of care through the body, assuming it as a means of knowing and communicate with the world. Merleau-Ponty's proposal places the phenomenon of perception as a tool to explore the care provided for and by the body, in this sense it is interesting the similarity between the philosopher's ideas regarding the body and the principles of nursing where both converge in assuming the human body as a phenomenon of the lived body, for which the elaboration of the reflection was constituted under this perspective.

Nursing care encompasses both objective and subjective aspects that for many years have been addressed by a single paradigm, however, the complexity of care makes it necessary to face nursing phenomena with other approaches to the comprehensive paradigm. Phenomenology emerges as a methodological approach and as a philosophy that allows deepening the experience of the person in the phenomenon of care immersed in the nurse-patient relationship.

The flexibility of the reference in nursing research allows equally successful and enriching approaches in social, educational and institutional contexts, having as participants people of all ages and health conditions, as well as health professionals and students, with which it is possible to cover an extensive amount of phenomena related to nursing care.

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Publication Dates

• Publication in this collection
  26 Feb 2021
• Date of issue
  2021

History

• Received
  05 Nov 2019
• Accepted
  13 July 2020