THE USE OF FILMIC SOURCES IN SOCIO-HISTORICAL RESEARCH IN THE HEALTHCARE AREA

Objective: to reflect on the methodological perspectives for the development of film analysis in socio-historical researches in the healthcare area. Method: critical-reflexive analysis organized in three sections which was based on texts from recognized researchers in the areas of cinema, history, sociology and semiotics. The study critically addresses the main characteristics, challenges and potentialities inherent in the use of film sources. Results: elements for the composition of matrices for methodological treatment of these sources were indicated, considering aspects related to description, decomposition, criticism and historical-sociological, content and discourse analysis. Conclusion: in the contemporary process of audiovisual visualization of the social world, film analysis is proposed as a potential method for approaching issues inherent to the healthcare field and to the phenomena of care in its evolutionary, historical and cultural processes. DESCRIPTORS: Research. Methodology. Health. Sociology. History. History of nursing. Cinema as subject. Cinematographic documentaries. http://dx.doi.org/10.1590/0104-07072017000320017


INTRODUCTION
In contemporary times, cinematographic works are considered sources that may possess significant value of indirect and involuntary testimony of an event or historical process.Nevertheless, prior to the revolution promoted by the School of the Annales, historical science used only textual documents, especially those considered official, from which the researcher directed his entire study toward what had actually happened in search of "historical truth." On the one hand, more conservative researchers defended the idea that the use of artistic sources as a research instrument could generate noises in the transmission of truthful history, since they considered that the process of translation of socio-historical facts would be interfered with by the artist's own interpretation.On the other hand, some researchers have come to question such a position, in the defense that textual documents, as well as other sources, also suffer interference, edits and, adjustments.
Given this, it is based on the premise that cinematic-art can be an effective research instrument; and that art can help bridge the gap between the past and the present, as upon studying it, new light is shed on the two periods.5][6] Thus, movies are of great importance to socio-historical studies as challenging sources, whether they are an image or not of reality.
To think in this sense is to understand that the most fanciful fiction film expresses only the possibilities of a given historical reality.In this way, it is possible to say that fiction, however imaginative and creative it may be, will always allow a powerful reading of the socio-historical reality; that is, who analyzes the film source can always aim at something from the society that produced the film, its relations of power, worldviews and cultural options.
It is necessary to pay attention to the singularity of each cinematographic genre -be it the experimental film, animation, documentary, fiction with historical ambience or not.][9] The point is to understand the filmic sources in their internal language structures and their mechanisms of representation of reality, from their internal codes.Thus, it is less important to know if this or that film was faithful to the dialogues, the physical characterization of the characters or reproductions of clothes and customs of a certain time and place.The most relevant is to understand why adaptations, omissions and forgeries are presented in a film.Undoubtedly, it is always praiseworthy when a film source is able to truly represent the past; however, this aspect cannot be taken as a given in its analysis. 2urrently, films are considered a primordial and inexhaustible instrument for historiographic work, a true way of preserving "time capsules" to learn about other moments, places and situations.They have the capacity to monumentalize certain historical problems, to create a memory of their own, a kind of collective memory, of social and political struggles, where experiences, ideologies and languages are (re) affirmed. 2,7,10rom this perspective, cinema -as a form of cultural expression -provides significant elements for socio-historical research on the very context in which it was produced.This provides a differentiated perspective of phenomena; that is to say, they offer explanations, readings, and speeches which, at the time they were produced, were not recognized or explained in any other way.This situation confers a different approach to research and highlights the need of the cinematographic source analyst to be prepared in order to capture such aspects and integrate them into the object of his analysis. 7,10ence, film sources are essential documentation for Cultural History, as they can reveal representations, imageries, mentalities, worldviews, habit systems, behavior patterns, social hierarchies stagnated in discursive formatting and many other aspects related to a given society.However, as the film industry contemplates power relations in all these instances -whether in relation to its inclusion in the universe of cultural industry or to its appropriation by private and public powers -it is natural that socio-historical research on films are also interested in Political, Social and Economic History.Consequently, cinema assumes a significant role in cultural, political, social and economic life, which should not be ignored. 7,11n addition, films are capable of bearing witness to what articulates the present to the past, real and symbolic, lived and imagined, and emphasize both the established movements of dominant groups and the contemporary movements of traditionally subordinated/subjugated / excluded groups. 4,124] Indeed, they generate a kind of multisensory stimulation, in perfect combination with the stimuli of a world increasingly dictated by informational and imaging technology.Such ideation makes cinema a rich experience, for no other form of art allows such a powerful connection between itself and its spectator.
In view of this, it seems opportune to take into account the inherent aspects of the uses of film sources in health research for the revelation of phenomena related to healthcare in its evolutionary process, considering that care itself has never been absent in any period of evolution and enters into the definition of the social being as existence-in-theworld-with-others, open to the totality of being, to the future and to death.
The health disciplines of the twenty-first century require the increasing incorporation of technologies and their products in spaces of reflection in which the concepts underlying the phenomena of care are explored.Nowadays, film sources can offer pedagogical-didactic possibilities and debate and knowledge production, as the inherent problems in the field of healthcare are used in a wide and recurrent way by the cinema, which justified the production of this text.
The objective of this study was to reflect on the methodological perspectives for the development of film analysis in socio-historical research in Healthcare.Without intending to exhaust the subject, the study proposal was also due to the scarce material available on the subject.with details on the analysis of data obtained from film sources and the growing interest of researchers in the use of films as a methodological resource.
The analysis corpus of this study included the use of printed books and online materials available from renowned authors from the fields of cinema, history, sociology and semiotics, which, after in-depth reading, were selected based on the possibility of an effective contribution.The criticalreflexive analysis was organized into three sections, highlighting the main characteristics, challenges and potentialities inherent in the uses of film sources as a methodological resource in the healthcare area.Elements for the composition of matrices for methodological treatment of these sources were also considered, considering aspects related to description, decomposition, criticism and historical-sociological, content and discourse analysis.

FILMIC SOURCES IN SOCIO-HISTORICAL RESEARCH IN THE HEALTHCARE AREA
The methodological procedures in the scientific research developed in the health area are designed in accordance with the construction of its objects of study, whose form of approach is shaped by means of delineations, observations, surveys, (re)readings, evaluations, measurements and systematic tests.
1] As it is an interpretative methodology, which does not have a single formula to be followed, one must create one's own path and structure categorizations ,which will support, so that the analysis is not empty, skewed or vicious interpretation.4/10 In health research, film sources are a resource whose readings can help to account not only for the epistemology of care, but also to inform how this care has evolved, was understood and represented in other times and scenarios.Moreover, they can support the discussion about the evidence of the human being, his body and his mind, the environment in which he lives, the experiences related to health care, in order to lead to phenomenological perspectives of the historicity of care.
5][26][27] In the latter case, what is at stake is the systematic construction of favorable representations in the cultural, social, political and professional fields, in order to amplify the vision about who were and what the subjects of care did yesterday, but also today.
In fact, cinema is not only a form of artistic expression, but also a means of representation.It is through the movies that perceived and interpreted realities are represented, marks of the imaginary worlds freely created by their authors.This particularity of the cinema as a means of representation allows to understand it, even as an instrument for the teaching of the History of Health itself, when several productions emphasize thematic situations of this field of knowledge. 7,28hus, cinematographic art can be seen as one of the most contributing as a sociocultural factor in the construction of a professional image.The scope of the projection of this image becomes greater when the film that projects it goes beyond the cinemas and extends to the homes by its reproduction in televising apparatuses or on mobile/ portable devices.
This aspect needs to be emphasized, as nowadays one lives in a world dominated by images and sounds obtained directly from reality, by means of increasingly sophisticated technical and portable devices.And everything can be seen/accessed/ shared in moments by the media, in an increasingly democratic way.Everything is given to seeing and hearing, relevant or banal facts, public and influential or anonymous and ordinary people. 2 In this way, film sources have the power to give quick access to information and to retrieve episodes, experiences, contexts that explain care in each culture, region and time, which tends to contribute to the dissemination and historiography of healthcare.In this case, the need to exercise a more specific perspective according to the disciplines and professions of the Health area is reiterated, and to its own competence -as an example, the identification of elements that come into play in the phenomena of care, such as air, lighting, hygiene, food, safety, sustainability, health practices, epidemic control, among others. 1,10hus, filmic sources can be a way of narrating a phenomenon, that self declares the events in health and care.Obviously, in order to be defined as testimonial evidence, these sources must pass through a credible process of socio-historical research, in which each step seeks to recognize agents, circumstances and elements to visualize the network of interconnections that structures and gives meaning to the discourse, the image and the very phenomenon that the image protects. 10

PARTICULARITIES OF FILM SOURCE ANALYSIS
Although there is no universally accepted methodology for film analysis, it is common to accept the existence of two important steps.The first deals with the decomposition, when the film is described and sectioned in its aspects related especially to the image and sound and, after, when its interpretation is sought, with a view to establishing and understanding the relationships between the decomposed elements.The second stage consists of criticism, in which the film is evaluated and judged, as well as its contribution to the discussion of a specific theme, its cinematography, context, content, discourse, aesthetics, representation and truth. 8y the very nature of their images, movies provide viewers with only a minimum of information about the characters, thoughts, emotions, motives and atmosphere that prevails in a particular scene.They are the spectators who, moved by the images and sounds, must arrive at their own conclusions, i.e., they must interpret the film with the aid of the visual and sound signa that the photographer, the musician, the writer, the director, the editor, the actors come to them in a given action scene or in a dialogue. 4hen interpreting a film source, one seeks to understand the internal structures of language and its forms of representation of the socio-historical reality contained in these sources (its narrative content) from its intrinsic codes and functioning.31] The internal aspects refer to the elements of the audiovisual language that will give shape to the product.For the internal analysis, it is necessary to decompose the constituent elements of the source.It is to shatter, disentangle, extract, highlight and denominate materials that are not perceived in isolation "with the naked eye", because the film is usually taken in its totality.In the sequence, links are established between these isolated elements, in order to understand how they associate and become accomplices to bring about a significant whole.
However, external aspects are related to temporalities.It is necessary to consider the time that the film source portrays, the social, cultural, political, economic, aesthetic and technological period in which it was produced; and the history of the art related to the movement of the cinema of which the film forms part.
A key point in the analysis is for the researcher to ask himself: what will it serve to understand, what directs the analysis, in what context and for what purpose?] In short, the "deconstruction" of the film is equivalent to the description of the sequences, scenes, planes, angles, sounds, and then "reconstituted" by means of the understanding of decomposed elements, a fact which is equivalent to interpretation.This process allows a view of the parts in relation to the whole, which makes a difference at the time of analyzing and interpreting.
In this context, the internal analysis focuses on the audiovisual work as an individual and singular production; and the external one takes the film as the result of a set of relationships and constraints in which its production and realization took place, such as its context. 32For this reason, external analysis usually relies on other methods, such as documentary and bibliographic research, in order to surround the object, to remove distortions and to complement the analysis. 21Contextual information, located outside the film is important but only to the extent that the specific source demands and suggests questions and problems for the researcher to answer. 2 Often people working in the production of a film have no direct knowledge of the influences they have received from the past; many are not aware of what triggers their creative impulses.Consequently, any critical approach that starts from traditional academic research and that can lead to a problematization of content must pay attention to the fact that what is modernly called "intertextuality" becomes increasingly fascinating and difficult to analyze. 4 Deeper again, the work of analysis should privilege an approach that seeks to see in the double life between the artist and the world in the film.The artist is influenced, stimulated by the world and, in turn, produces a work, an expression of his vision of the world and the marks that it leaves on him ; the work is returned to that world, thus restarting a cycle.The product of the artist's work, the work carries a dialogue that sets the world and expresses the general forces of existence.Such an approach in cinema seeks to provide man with a rapprochement with the world and with reality. 33ence, the tensions between subjectivity and objectivity, counter-history and official history, fiction and reality, manipulation/adulteration and truth/authenticity of fact, representation and evidence, imagination and proof, art and science.These tensions end up demarcating the nature and challenge the analysis of film sources. 2,8fter all, cinema is manipulation, but not necessarily creating falsehood or empathy.Therefore, it is a warning that, if it is not possible to identify the discourse that the cinematographic work builds on the society in which it is included, pointing to its ambiguities, uncertainties and conflicts, cinema loses its effective dimension of socio-historical fact. 4,34In fact, it is one of the most powerful contemporary instruments of monumentalization of the past, but also a vehicle for deconstructing myths and official versions of History. 2 Therefore, one must pay attention to the possibility of false transparency of film source content , as the moving image is, at the same time, a transmitter of enunciated messages used to seduce, persuade and to convince, as well as being a translator of shared covenants which allow it to be understood, received, and decipherable. 35t should be noted that, according to the research design, one can work in a trans-sectional way, from which the films are treated in a timely manner, at one time; or longitudinally, in which are considered several points in time, the evolution of the theme, images and problems in different con-texts and periods, observing changes in relation to habits, languages and practices.
The methodological options also depend on previously defining: 1) how many films will be treated; 2) whether the films that are going to be analyzed will be the central object of the research, or whether they will be used as an accessory to the analysis; 3) whether the entire film will be treated or only a few sequences; and 4) what types of film -from which times or periods, constructed in what manner and according to available technologieswill be considered. 4or more complete documentary criticism, the aspects of languages (aesthetics, dialogues, techniques, image and sound codes), contents (theme, physical, psychological and ideological characteristics of characters and represented situations, verbal channels and codes, etc.) and the recording technologies comprise a tripod that will ultimately support the informative potential of the film document. 2inally, it must be considered that the researcher will always offer a personal reading of the film, not definitive, a provisional version of the work based on his vision and position in the social world and accumulated cultural capital. 33,36y itself, the use of film sources in the field of socio-historical methodologies does not intend to reconstruct any past, as the task would be almost impossible by itself; Rather, it seeks to promote a (re) reading due to documentary evidence, through interpretive strategies of theoretical, sociological, anthropological, philosophical and humanistic bias, and to contextualize the phenomenon of interest to its actors and to the elements involved around an event of interest. 10,31

ELEMENTS FOR ANALYSIS MATRIXES OF FILMIC SOURCES
A set of useful elements for the development of analysis matrixes of filmic sources, which can support studies from the historical-sociological perspective, is presented in the tables below.,21,[32][33] However, there no mention of any author or theoretical school in particular.
This proposal is presented as additional guidance, but without any intention to exhaust, since, as said, there is no single format for effective film analysis.Therefore, it is up to the researcher to make the adaptations due to the objectives of his study.The elements are organized by category and into three tables: the first for the initial description; the second focused on the decomposition of the film structure; and the third focused on criticism and analysis of (narrative) filmic content.
• Origin (studio and country of production).
• Technical sheet (production, direction script, photography, editing, special effects cast etc.) and author biography/filmography.• Registration Technology (type of film process, format).
• Support and Financial support agencies.
• Production period and release date .
• Duration time (film or scenes).
• Official synopsis of the movie or summary of the selected scenes.Visual aspects Decomposition of the largest unit to the smallest of the film in sequences, scenes and shots with identification of the number and duration of these units of analysis.Explore in units: framing; composition; color; depth of field (visible / sharp points); objective and filters used; camera angle (front, side); shots (medium, American, close up, very first shot); takes (single, double, group); scales (camera positions relative to the subject); mobility of the image; privileged scenes and shots and more important; visual effects (zoom, panoramic, fusions, darkening, slow motion, cropping); editing "shocks" in the passage from one shot to another; (photo, written text, costumes, costumes, set design, architecture, location, icon, symbol, etc.).

Sound aspects
Decomposition in soundtracks / songs, noises and narrative / words.Explore: track / song styles; moments in which they are heard; stereotyped music; transitions and sound ruptures; distinction of objective sounds (environmental noise) from subjective (a voice of a hallucination of the character); noise characteristics; types of sound (in, off, off-field); intensity; synchronism between sounds and images; characteristics of the languages (dialogues, techniques, channels, verbal codes, etc.).From the presented tables, the first two present fundamental topics for the initial description and for the decomposition of what one sees and what one hears in the film.The degree of precision of the final analysis (interpretation) depends on these first steps.When interpreting a film without proper description and decomposition, an unfavorable or even inappropriate interpretation may result.The degree of accuracy of the observation of the elements in table 3 (related to the criticism and analysis of the film in its historical-sociological, content and discourse aspects) will depend on the objectives sought by the researcher.
However, the effectiveness in the analysis process is revealed through the art of manipulating and correctly relating to the object of study, associating the relevant and significant elements of criticism and analysis, and interpreting them coherently.
In film analysis, it must be considered that cinema can be examined from the position of the author (his vision of the world), the audience (with the study of the repercussion of the film on this and the possible changes of behavior that may arise) and reality (with the observation of the view of truth and knowledge in the images of the film). 37mong the possibilities of analytical approaches from the textual data derived from the films, which take account of the image / word relations, one can use classical content analysis, for the objective, systematized and quantitative description of the manifest content about the signs of communication.Another approach would be through discourse analysis, for interpretation of the internal narratives of the work and general reflection on the conditions of production and apprehension of the meaning of related texts. 38Therefore, what is important is the definition of a methodological as well as theoretical typology in order to support the interpretations of the textual codes of the film material, if the analysis fails to do so.
In the use of films, it is advisable to contemplate certain premises inherent to the researcher, such as: expectations, not to interpret what the image says by itself in advance ; reasons, to seek a foundation in health knowledge in order to locate what is and not what one wants to see; state of mind, which undoubtedly leads to interpretation in every hermeneutic act; context, which refers to the need to identify the network or network of connections underlying every situation in which a fact occurs, such as care, and which provides references for interpretation ; and frequent critical review of sources for primary or first impression cognitive represen-tation on related events, which anticipates a point of view by which the source will be interpreted. 10or the interpretation itself, it is necessary to be prudent, as, without the careful definition of objective(s) of analysis and the beacon of bibliographic knowledge on the subject and theoretical and methodological reference well within the object of study, the inefficacy of the interpretative process of film sources can occur.
However, there will never be an analysis / interpretation that captures a single truth of the text.Thus, the point is to be as explicit as possible regarding the resources that have been employed by the various modes of translation and simplification, and to open space for debate and critical judgment. 19,39fter reviewing the film and/or its selected sequences several times, all hypotheses, ideas, articulations between film elements should be recorded in the form of a free text, i.e., in a non-established or previously ordered form.Nonetheless, the wording of the final text of the analysis must point to the scenes of the film as references, in order to direct the reader to a synthesis that well translates the work, that critically checks all the parameters, channels and codes that give form. 33inally, the analysis / interpretation of the film must be legitimized by the work itself.The analyst must justify each of his interpretations and the whole system he has constructed to handle the film, highlighting the various elements that have supported his constructions.At the same time, it is a way of making the work speak and of preventing the projection of something strange or anachronistic in it.For the same reason, using the work to convey beliefs or construct theses, seems frankly wrong and reprehensible. 33he antidote to such a fallacy is to try to return to the film itself, to the materiality of its discourse, and its representative parameters all the time.The analysis / interpretation under the socio-historical perspective, although being the most common type, has its assumptions, conditions and risks. 4

CONCLUSION
According to the methodological design of researches in the healthcare area that propose to work with the analysis of film sources, different pathways can be traced.In this study, considering that there are not many references in this area that deal extensively with this process, its potentialities and the epistemological risks of this type of analysis.
We sought to present a critical review of the subject and to share some impressions about the socio-historiographic academic work with film sources.
In audiovisual times of the social world, cinematic-art can be considered a creative element for the formation and critical and constructive reflection of health professionals, referring them to socio-cultural aspects which reveal realistic situations of care-art, which, in a way, can help to mitigate the dichotomies between scientific / technical / economic and artistic / humanistic / ecological formation.

Table 3 -Elements for film criticism and analysis. Rio de Janeiro, RJ, 2017
Dialogue that the film maintains with the social world (identification of the dialogue, what the film adds to the world, its proposal and questions to the world, etc.).