Nursing history research groups: a Brazilian reality

Abstracts

Este estudo tem por objetivo analisar as atividades dos grupos de pesquisa em história da enfermagem existentes no Brasil e sua articulação com os cursos de graduação e pós-graduação em enfermagem. É um estudo exploratório qualitativo descritivo documental, realizado no período de julho de 2008 a março de 2010. Foram identificados 34 grupos de pesquisa com pelo menos uma de suas linhas de pesquisa em história da enfermagem. Os resultados indicaram que os grupos têm produzido um vasto material bibliográfico, linhas de pesquisa e ampla participação de estudantes de graduação e pós-graduação. Verifica-se também que ainda não há uma rede de comunicação entre os grupos da mesma linha de pesquisa. Conclui-se que é necessário trabalhar na interdisciplinaridade e no fortalecimento de algumas linhas de pesquisa que sustentem o conhecimento em história da enfermagem brasileira.

Grupos de Pesquisa; História da enfermagem; Educação em enfermagem

ORIGINAL ARTICLE

Nursing history research groups: a Brazilian reality

Grupos de Investigación en Historia de la Enfermería: la realidad brasileña

Maria Itayra Padilha^I; Miriam Susskind Borenstein^II; Maria Aline Lima Carvalho^III; Aline Coelho Ferreira^IV

^IRN. Ph.D. in Nursing, Escola de Enfermagem Anna Nery, Universidade Federal do Rio de Janeiro. Post-Doctoral degree, Lawrence Bloomberg Faculty of Nursing at University of Toronto, Canada. Faculty, Nursing Department, Universidade Federal de Santa Catarina. Coordinator of the Study Group on the History of Knowledge in Nursing and Health. CNPq Researcher. Florianópolis, SC, Brazil. [e-mail]

^IIRN. Ph.D. in Nursing, Graduate Nursing Program, Universidade Federal de Santa Catarina. Associate Professor, Nursing Department, Universidade Federal de Santa Catarina. Deputy Leader of the Study Group on the History of Knowledge in Nursing and Health. CNPq Researcher. Florianópolis, SC, Brazil. [e-mail]

^IIIRN, Universidade Federal de Santa Catarina. Florianópolis Municipal Government Nurse. Member of the Study Group on the History of Knowledge in Nursing and Health. Florianópolis, SC, Brazil. [e-mail]

^IVUndergraduate Nursing Student, Universidade Federal de Santa Catarina. CNPq Scientific Initiation Grantee. Member of the Study Group on the History of Knowledge in Nursing and Health. Florianópolis, SC, Brazil. [e-mail]

ABSTRACT

The objective of this study is to examine the activities of Nursing History research groups in Brazil and their relationships with the nursing undergraduate and graduate courses. This exploratory, descriptive, qualitative documental study was performed from July 2008 to March 2010. We identified 34 research groups that had Nursing History as the focus of at least one of the lines of research. Results showed that the groups have produced a great amount of bibliographical material, research lines and broad participation of undergraduate and graduate students. It was also found that there is a communication network among groups working within the same line of research. In conclusion, there is a need to increase interdisciplinarity and also strengthen some lines of research in order to support knowledge of the history of Brazilian nursing.

Descriptors: Research Groups; Nursing history; Education, nursing

RESUMEN

Este estudio objetiva analizar las actividades de los grupos de investigación en Historia de la Enfermería existentes en Brasil y su articulación con los cursos de graduación y posgraduación en Enfermería. Es un estudio exploratorio, cualitativo, descriptivo, documental, realizado en el período de julio 2008 a marzo 2010. Fueron identificados 34 grupos de investigación con al menos una de sus líneas investigativas focalizada en Historia de la Enfermería. Los resultados indicaron que los grupos han venido produciendo una vasta cantidad de material bibliográfico, líneas investigativas y amplia participación de estudiantes de graduación y posgraduación. Se verifica también que aún no hay una red de comunicación de la misma línea de investigación. Se concluye en que es necesario una mejora en la interdisciplinaridad, así como el fortalecimiento de algunas líneas de investigación que sustentan el conocimiento histórico de la enfermería brasileña.

Descriptores: Grupos de Investigación; História de la enfermería; Educación em enfermería

INTRODUCTION

History serves to clarify the context experienced and to provide the meanings of this context. Knowledge about the socioeconomic, cultural and political currents that influenced the long course of history about care practice allow nurses to break free from past heritages. In fact, to the extent that one knows the history of a profession, like in our case that of nursing, it is perceived how much and how nursing can be distinguished from other activities in life, from the health world and its social commitments. With this look, history adheres to the possibility of outlining and identifying who nurses are, what they think, what they feel, how they act and, also, what lies ahead for them as a contextualized professional group⁽¹⁾. In its history, nursing necessarily appropriates itself of and approaches interdisciplinary territories, not only of historians, but also anthropologists, sociologists, psychologists, philosophers, to mention but a few, because there is no way to understand the processes through which the history of the profession was constructed without them. This was indeed influenced by the New History, which broadened the historian's look to other subject areas, establishing good-neighbor relations between them. Each discipline comes with its particularities and recovers the past through interdisciplinary bridges, as a kaleidoscope with countless facets^(2-4).

The development of graduate programs in Brazil as from the 1980's was undeniable accompanied by the expansion of scientific production in nursing, including theses, dissertations and books as well as papers published in indexed journals, among others. Stricto sensu graduate programs represent a consolidated segment in the Brazilian and international educational context and have decisively contributed to qualified human resource training and to national scientific-technological development, clearly revealing their strategic role in the country^(1,5).

The analysis of knowledge production in Nursing History in Brazil, resulting from dissertations and theses, revealed only 126 studies between 1972 and 2004 about themes like professional identity, institutionalization of Nursing in Brazil, organizational entities, nursing specialties and studies about the creation of Brazilian nursing schools⁽¹⁾. In these studies, as from the 1980's, nursing experts' concerns with nursing studies in a historiografic perspective were enhanced, especially to understand nursing as part of a historical, social, cultural, political, educational and gender perspective⁽⁶⁾. As there are still few documentation centers in Brazil, Nursing has moved on without adequately preserving its history, both due to its recognition and the limitation and non-organization of files used for research, besides the non-importance of recovering and preserving written, oral and iconographic sources of existing and future files⁽⁷⁾.

The Brazilian Nursing Association's (ABEn) Nursing Study and Research Center - CEPEn plays a relevant role in changing this paradigm, as well as the papers published in Brazilian journals like Revista da Escola Anna Nery, Revista Brasileira de Enfermagem and Revista Texto & Contexto Enfermagem, whose policy is to publish nursing history papers. Internationally, the journal Nursing History Review can be mentioned, issued by the American Association for the History of Nursing and especially created to disseminate research about Nursing History; and the Nursing Inquiry, whose final issue of the year exclusively publishes Nursing History texts⁽⁸⁾.

In this sense, in the attempt to deepen discussions about the theme and contribute for Brazilian nursing to preserve its memory and identity, to support faculty, students, researchers and anyone interested in Nursing History, we believe it is extremely important to study existing Nursing History research groups and centers and their articulation with undergraduate and graduate Nursing programs.

METHOD

An exploratory, descriptive and qualitative documentary research⁽⁹⁾ was developed between July 2008 and March 2010. To construct the panorama of research groups on Nursing History, two databases were used: (1) The Brazilian Council for Scientific and Technological Development - CNPq's Directory of Research Groups in Brazil, version 5.0⁽¹⁰⁾, updated in March 2010; (2) researchers' individual curriculum as available on the Lattes Platform. Departing from the directory database, there are various ways of outlining the installed research capacity in Nursing History. To give an example, a database search that used the keyword nursing history in the fields group name, title of the line and key words of the line resulted in 40 groups. When adding the main area of the group as health sciences, this dropped to 37 groups, and further to 34 when selecting the nursing area. As the presentation of these research results aims to give visibility to the research groups whose research lines include Nursing History, in the first phase, we chose to analyze the following items: specificity of the group area; year of creation; initials; identification of leaders and baseline education; CNPq researchers; other researchers; students at all levels and technicians. In addition, we identified the institutions they belong to, the region of the country where the group is located; the number and characteristics of each group's research lines. To facilitate data organization, we elaborated worksheets in Microsoft Excel^® 2007 software, containing all data for analysis.

The second research phase, related to the research group participants, involved individual consultations of each participant's curriculum on the CNPq Lattes Platform. With regard to education and degrees, data were collected and organized in tables, charts and graphs, also organized in Microsoft Excel^® 2007 software. We also consulted the site of the Coordination for the Improvement of Higher Education Personnel (CAPES), to search for and identify graduate Nursing programs in Brazil. This study did not need Institutional Review Board approval from Universidade Federal de Santa Catarina, as this is a documentary research that only used sources in the public domain. The researchers, however, strictly followed ethical criteria in the search, analysis and discussion of results.

RESULTS AND DISCUSSION

The Directory of Research Groups in Brazil is a project the CNPq has developed since 1992 and consists of databases with information about active research groups in the country. The directory maintains a current database, whose information group leaders, students and research managers at participating institutions update continuously. CNPq also accomplishes biannual census, which are photographs of this current database. Thus, to situate this research in the general context of health research in Brazil, we detected, since the first census in 1993 and until 2008, the number of registered Health Science Research Groups grew exponentially, from 4,402 to 22,797⁽⁹⁾. The number of research lines in human health also increased from 13,841 lines in 2002 to 21,862 in 2008. Specifically considering the group distribution per predominant area, we selected the Nursing area and found a rise from 59 to 373 groups in 2008, with 1059 research lines.

The data revealed that the first research group to develop studies from a historical perspective was created in 1988 and called the Research Group on Health Policies and Practices (GRUPPS), at Universidade Federal do Ceará (UFC). The second group was created in 1989. In the 1990's, nine groups were created, and 23 others as from the year 2000. Only ten out of these 34 groups include the word history in their title. We consider Nursing History in teaching and research as a sedimentation and expansion process. Its visible limitations in Brazilian scientific production in Nursing should be acknowledged, which is going through an accelerated development process of sociohistorical research, creating possibilities to reconstruct the knowledge that constitutes specific historical and cultural contexts^(8,11).

A comparative analysis with other Brazilian research groups reveals that, in a study on the scientific development of epidemiology in Brazil, the authors found that, in the 1990's, collective health research groups increased by 4.09% in comparison with the first decade of the 20th century⁽¹²⁾. This increase in the number of research groups was also verified in another study, which analyzed the growth in education and nursing research groups in the South of Brazil, identifying that, out of 18 existing groups in 2006, five got structured in the 1990's⁽¹³⁾. The main research for the enhanced knowledge production in all areas is definitely due to the increase in graduate programs in Brazil and, consequently, to the establishment of research groups⁽¹⁴⁾.

The visibility of the knowledge produced in graduate programs and research groups is evidenced when participating researchers, faculty and students' research results are published. The graduate system needs to expand to respond to new needs. This means greater investment in financial resources at graduate levels, particularly to prepare teaching staff the universities will absorb, where health research needs support⁽⁷⁾. Stricto sensu graduate programs in Nursing in Brazil started in 1972, at the Federal University of Rio de Janeiro Anny Nery School of Nursing, which founded the Master's Program in Fundamental Nursing. In 1973, the University of São Paulo School of Nursing (EEUSP) started the Master's Program in Nursing Fundamentals^(7-8). There were 14 graduate Nursing programs in 1998, which increased to 39 in 2010, which corresponds to a 278.57% growth, which is extremely relevant for the development of the nursing profession in terms of professional qualification⁽¹⁵⁾. Besides, when comparing the number of Nursing History group with the 433 Nursing groups registered in the CNPq Current Database, these represent only 7.8% of the total number⁽⁹⁾. However, taking into account that this is an expanding area and that a large number of groups guarantees neither consolidation nor research quality, we consider that the production of nursing history research groups in terms of projects and publications is what can guarantee their maintenance and strengthening⁽¹⁶⁾. According to CAPES data, in Brazil, today, 39 stricto sensu graduate Nursing programs exist. Thirty-five of these offer a Master's program, three professional Master's programs and 20 Ph.D. programs. The programs are distributed as follows: 19 in the Southeast, three in the Central-West, nine in the Northeast and eight in the South⁽¹⁵⁾. It can be inferred that graduate programs and research groups are closely related, as greater consolidation and stimuli for research groups' work exist where graduate programs are located, and these groups, as a counterpart, strengthen graduate programs, as they represent spaces that comprise researchers' scientific core. In this sense, 60.70% of groups are concentrated in the Southeast, which is related with the number of graduate Nursing programs in this region. It is also interesting to observe that approximately 17.64% belongs to the Northeast, 11.76% to the South and only 5.88% to the North, which clearly demonstrates a disequilibrium in group distribution and, consequently, in Brazilian scientific production.

In line with this information, we compared the development of other Brazilian research groups and identified that research groups in the Epidemiology sub-area are also concentrated in the Southeast, responsible for 61% of groups, a peculiar difference when compared with the South, corresponding to 9.7% of groups in this knowledge sub-area, while the Northeast displays 21.6% of the groups⁽¹²⁾. The same information is present in a study on human aging research in Brazil, when the authors identified that the geographical distribution shows a larger number of research groups - about 59.7% of groups in the human aging area - in the Southeast. Next comes the South with 21.5%, the Northeast with 13.9%, the Central-West with 4.9 % and the North with 0%⁽¹⁷⁾.

Another important data when assessing the expansion of scientific production about the History of Nursing and Health is the number of Research Group participants (Table 1).

The large majority of the groups (13) contain between 11 and 20 participants, comprising researchers, students and technicians. Although there is no definition for the ideal number of research group members, we consider that extremes are undesirable. In other words, a group with few participants can, but does not necessarily imply hardly significant production. A very large group, on the other hand, like more than 25 members for example, can imply difficulties to organize the group, the studies developed and to plan group activities. This data is in line with a study developed to assess Brazilian Nursing research group characteristics between 2005 and 2007, in which the authors identified that most groups comprised between one and 17 members⁽¹⁸⁾.

One important aspect to be taken into account is the research groups' infrastructure, with a view to guaranteeing a space for integration, collective production and activity organization, in this sense, the more participants a group contains, the greater will be the need for adequate infrastructure to guarantee affective and knowledge sharing, besides enhancing the visibility of the groups' integrative activities⁽¹³⁾.

According to CNPq Research Directory information, the Research Line (RL) represents binding themes of scientific studies that are based on a research tradition, which give rise to projects whose results display mutual affinities⁽⁹⁾. All of the researchers, students and technicians' intellectual production in research groups joins around the research lines, which the group has established based on ongoing projects. According to CNPq, research project (RP) is a research with a defined start and end, based on specific aims, aiming to achieve cause-and-effect results or to evidence new facts⁽⁹⁾. Researchers with a Ph.D. degree are responsible for creating and maintaining the research lines. In the assessment of the research groups' RL, the below list shows the distribution of the number of RL among the 34 identified groups that develop research on the History of Nursing and Health, according to their title, research lines or projects.

In Chart 1, we decided to analyze only those 31 groups with one or more RL on the History of Nursing and Health. In the three groups excluded from the figure, Nursing History is not the central focus of their studies. We verified that only eight groups present specific lines on the History of Nursing and Health. This means that the remaining 25 groups do not explicitly include the word history in the description of their research groups or lines. Seven groups present two research lines and the remainder (23) three to five research lines, which represents significant knowledge production in the area in a diversified way.

A great victory Brazilian Nursing History researchers achieved was the fact that the Research Line was acknowledged at the National Forum of Nursing Graduate Program coordinators, which CAPES organized in the year 2000 during the 52^nd Brazilian Nursing Congress in Belém, PA. This legitimizes the line as an important research area and also permits increased funding for Nursing History research and researchers. The acceptance of this line still is not unanymous in Brazil though, as illustrated by the limited number of funding for historical research in comparison with other areas. That is the case because research funding entities privilege studies with more pragmatic problems, which threatens Nursing History as a domain area, as it is at the heart of the scientific community that these spaces are constituted⁽¹⁹⁾. Thus, one of the positive strategies to be used is the strengthening of this research line in graduate Nursing programs.

To verify the inclusion of Nursing History RL in graduate Nursing programs, we analyzed the data available in the 2008 Coleta CAPES report on graduate programs. A primary search to define the research line revealed only two programs whose identification contained the word history - UFRJ, UFSC. Then, we moved on the description of the research line, which revealed six more programs - UNIRIO; UFRGS; UFSM; USP/SP; USP/SP interdisciplinary and USP/RP - whose research line descriptions contained the word history. In this sense, we consider that a discrepancy exists between the data informed in the CNPq directory and those in Coleta CAPES⁽¹⁵⁾. This finding demonstrates that graduate Nursing programs still have not assumed the research line Nursing History as something essential in their production, or at least in the definition of their projects.

To identify the research group members' qualification, we analyzed both the CNPq Research Directory and the Lattes Platform, which raised several challenges, including registration differences between data in the Directory of the CNPq Current Database and group members' Lattes Curriculum, i.e. in the Group Directory, one person was identified as a Ph.D. student, while the same person was registered as a Ph.D. graduate on the Lattes platform. Another problem was the group members' distribution in the categories of researcher and technician. Some groups identified Ph.D.'s, M.Sc.'s and Specialists as researchers; others only the Ph.D.'s and so forth. In this sense, with a view to homogenizing our assessment, we considered the qualification informed in the CNPq Research Directory, as follows:

FIGURE 1

In total, 643 research group members were identified, 161 of whom were Ph.D.'s, 90 M.Sc.'s, 31 held a Specialist degree and 18 were technicians. Besides, 343 were students: 151 undergraduates, 105 Master's, 51 Ph.D. and 36 Specialization students. Out of 161 Ph.D. graduates in the groups, only 26 are CNPq productivity grantees, 12 PQ 1 and 14 PQ 2, representing 16.14% of all Ph.D. graduates. The CNPq Research Directory considers researchers as research team members with an undergraduate or graduate degree, directly and creatively involved in the accomplishment of the group's projects and scientific, technological and artistic production⁽⁹⁾. In this sense, the following were considered as researchers: Ph.D.'s (135), Ph.D.-graduated CNPq researchers (26), M.Sc.'s (90), specialists (31) and graduates (6), totaling 288 members. As observed, 87.45% of the researchers are included in the Ph.D. or M.Sc. category, which guarantees an important qualificaiton level, especially in group research. This information is compared with the study about Nursing Education research groups in the South of Brazil, where 86% of researchers with M.Sc. and Ph.D. degrees were identified (35% Ph.D. and 49.7% M.Sc.)⁽¹³⁾. One important piece of information identified in this study is the number of Ph.D., M.Sc., specialization and undergraduate students with support scholarships in research development. The proportion of Ph.D.-graduated researchers in all knowledge areas present in the CNPq Directory is 56.7%. When related with Nursing History research groups, this proportion is high, as the number of Ph.D.-graduated researchers in this sub-area is 27.65%. This can be considered a very positive aspect for Nursing History knowledge production.

Out of 343 students, 83 (24.19%) receive scholarships, 33 at the scientific initiation, 10 at Ph.D. and 32 at M.Sc. level. This relatively small number of grantees in comparison with the total number indicates that most students participate in research groups as volunteers, but demonstrates the importance of research groups in student education at all levels. The predominant funding agencies that offer student scholarships are Brazilian, state and some international funding agencies. Since the mid-20^th century, these have strongly influenced the institutionalization and directions of Brazilian scientific production and the establishment of relations among researchers⁽¹⁴⁾.

Research groups can expand the production possibilities of researchers affiliated with Graduate Programs, because they have devices at their disposal that facilitate this process, including productivity and scientific initiation grants to prepare students for research⁽²⁰⁾. It is fundamental for inclusion in the research area to start at the undergraduate level, as this education strategy not only permits learning the steps of the research process, but enhances the education of a new generation of nurses, who not only accomplish their first research experiments, but also adopt a posture of incorporating the scientific methods to elaborate concepts, ideas and formulate inquiries⁽¹³⁾. One of the goals of students' participation at different training levels is to support the research group leaders and researchers; hence, they are considered the critical mass that is being prepared. This concidence of viewpoints among researchers and students with a view to research development is a stimulus the group offers for students to develop and grow in this area^(8,18).

Besides driving research production and community services, M.Sc. and Ph.D. students' permanent insertion in the job market is what strengthens the triple dimension teaching, research and community services in higher education institutions. The presence of Ph.D. students in research groups is fundamental, as they are preparing to be the group's new researchers and the number of members shows the intensity of the group's production. Through historical research, the students develop insights and a better understanding of the nursing profession, and also expand the curriculum's multiple educational needs^(4,8,21). History enhances the development of students' critical skills towards events and historical issues and explores how these events may have changed the profession. History offers not only contextual perspectives, but also clarifications, and feeds pride and self-esteem in a profession that is frequently subject to social devaluation⁽²²⁾.

CONCLUSION

The data presented here entail the possibility of knowing and analyzing the activities of existing Nursing History research groups in Brazil in qualitative terms, which indicates a developing knowledge area. Various important aspects in this research should be taken into account. These include the clear intent and importance of Research Groups' articulation with undergraduate and graduate nursing programs, in view of the number of students who participate in these groups.

This study permitted reconstructing and strengthening the historical knowledge of Nursing by enhancing new reflections and furthering the analysis of the evolution in the Nursing History research line, especially articulated with stricto sensu graduate Nursing programs in Brazil. We believe that one of the aspects that has also strengthened concerns with the development and expansion of historical studies was the increase in Nursing History research groups, considering Nursing History as a research area under development. Production was enhanced as from the 1990's, culminating in its CAPES acknowledgement as a research line in the year 2000. We consider that, in teaching and research, Nursing History is still going through a sedimentation and expansion process. Its visible limitations in sociohistorical research should be acknowledged, creating possibilities to reconstruct the knowledge that constitutes specific historical and cultural contexts.

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Correspondence addressed to:

Publication Dates

• Publication in this collection
  20 Mar 2012
• Date of issue
  Feb 2012

History

• Received
  05 July 2010
• Accepted
  07 July 2011