Creation of a nursing research group on women's health and gender

Abstracts

Trata-se do relato da experiência sobre a formação de um grupo de pesquisa por meio da estratégia metodológica participativa e emancipatória da oficina de trabalho. Concebida no âmago da epistemologia feminista, esta opção encerra a possibilidade efetiva da construção de um produto compartilhado e reconhecido como pertencente a todas as participantes, dentre outros inúmeros qualificativos. Foram estabelecidos eixos estruturantes em torno dos quais se desenvolveram os conteúdos e as atividades. Os resultados mostram que, a despeito da diversidade de visões de mundo e experiências, de dificuldades pessoais e institucionais, as participantes tinham uma perspectiva bastante positiva em relação à formação de um grupo de pesquisa para incrementar e difundir o conhecimento de gênero na saúde da mulher. A oficina as instrumentalizou para o empreendimento num clima agradável, leve e prazeroso, nem por isso, menos compromissado com uma inovadora forma de fazer ciência.

Enfermagem; Conhecimento; Gênero; Feminismo

EXPERIMENT REPORTS

Creation of a nursing research group on women's health and gender

Formación de un grupo de investigación en enfermería en el area de salud de las mujeres y de género

Rosa Maria Godoy Serpa da Fonseca^I; Kleyde Ventura de Souza^II; Clara de Jesus Marques Andrade^III; Marta Araújo Amaral^IV; Vânia de Souza^V; Laíse Conceição Caetano^VI

^IFull professor, Collective Health Nursing Department, University of São Paulo. CNPq Fellowship. E-mail: [e-mail]

^IIPh.D. in Nursing. Associate Professor, Child and Maternal Health and Public Health Department, Federal University of Minas Gerais (UFMG). E-mail: [e-mail]

^IIIPh.D. in Nursing. Associate Professor, Child and Maternal Health and Public Health Department, Federal University of Minas Gerais (UFMG). E-mail: [e-mail]

^IVPh.D. in Nursing. Associate Professor, Child and Maternal Health and Public Health Department, Federal University of Minas Gerais (UFMG). E-mail: [e-mail]

^VPh.D. in Nursing. Associate Professor, Child and Maternal Health and Public Health Department, Federal University of Minas Gerais (UFMG). E-mail: [e-mail]

^VIPh.D. in Nursing. Associate Professor, Child and Maternal Health and Public Health Department, Federal University of Minas Gerais (UFMG). E-mail: [e-mail]

Correspondence

ABSTRACT

This is an experience report concerning the establishment of a research group through the participatory and emancipating methodology of workshopping. It was conceived within a feminist epistemology. Such an option provides the effective possibility of building a product that is shared and recognized as belonging to all the participants, among other attributes. Structuring axes were defined, around which the content and activities were developed. The results show that despite the diversity of world perceptions and experiences, of personal and institutional difficulties, the participants had a fairly positive perspective in relation to creating a research group to improve and disseminate gender knowledge on women's health. The workshop enabled the participants to enjoy a pleasant and gentle environment and yet be very committed to an innovative way of making science.

Descriptors: Nursing. Knowledge. Gender. Feminism.

RESUMEN

Es el relato de una experiencia de formación de un grupo de investigación utilizando como estrategia la metodología participativa y emancipadora durante talleres de trabajo. Idealizada a partir de la epistemología feminista; esta opción posibilita, efectivamente la construcción de un producto donde existe cooperación y pertenencia, entre otras descripciones expresadas por las propias participantes. Fueron establecidos ejes estructurales alrededor de los cuales se desarrollaron los contenidos y las actividades. Los resultados demuestran que, sobre la diversidad de visiones de mundo, experiencias, dificultades personales e institucionales; las participantes tenían una perspectiva muy positiva en relación a la formación de un grupo de investigación para incrementar y difundir el conocimiento de género en la salud de la mujer. El taller las instrumentalizó para el emprendimiento en un clima agradable, leve y placentero, pero no por ello fue asumido con menos compromiso esta nueva forma innovadora de generar ciencia.

Descriptores: Enfermería. Conocimiento. Género. Feminismo.

INTRODUCTION

Gender as analytical category has been used to explain biological differences and the social construction of femininity and masculinity internalized by women and men. It means that being a man or a woman is constituted in the relationships between both genders, in a given context and time. The category gender was developed in the heart of feminist theories with the purpose to understand inequality that exists between the sexes, the context in which it unfolds and the purpose of interfering in the set of social relationships. ^1-2

The differences between the sexes have been historically naturalized in the health field as a result of the hegemony of biological models, in which the supremacy of biological aspects is the universal model. Men and women are seen as bodies with a function predetermined by genetic inheritance, which may be altered by events belonging predominantly to the natural world. If anything, the social system is considered one of the factors that, together with the biopsychological factor, can interfere in good physical-body functioning and in the masculine and feminine functions and characteristics.

The use of the analytical category gender assumes that body functioning and, therefore, the differences between men and women, take place among individuals inserted into a social world that attributes markedly sociocultural functions and characteristics to sex, which are re-signified by the way these individuals are inserted into society. These are determined by relationships of power (between women and men, men and men, and between women and women), shifting the focus from issues related to women and social relations. Hence, the varied mechanisms of the subordination of women by men and, consequently, the way social relations are organized, have gained visibility and been extended to the legal political system, legislation, the State, labor relations, and to social representations and symbolic fields.^3-4

In the science and scientific literature addressing gender, the concerns over the consequences of inequality resulting from an imbalance of power between men and women have a positive effect in the development of studies designed to understand phenomena and establish interventions related to the development of public policies. In the health and nursing fields, these works are included in the areas of healthcare, management, planning and teaching.

Publications addressing gender began appearing regularly in the 1990s and their occurrence is booming, especially in the fields of reproduction and contraception, gender violence, and other related fields such as domestic, family, marital and sexual violence, STD/AIDS, occupation and health. Other themes, however, such as social vulnerability, mental health, aging, and management have been poorly explored.⁵

The nursing field has followed pari passu the advancement of such studies and has contributed to transforming and redirecting teaching, healthcare and research. When men and women are seen as social subjects, vested with power in social relationships they establish between each other and with the society, they aim to transform them. ⁶

Reducing social inequalities and urgently seeking to overcome the paradigm of freedom and power for men and obedience and subordination for women are commitments also assumed by the Brazilian nursing field through the Brazilian Association of Nursing (ABEn), which represents the nursing profession. These commitments have strongly reflected on the profession so that broadened collective awareness and acknowledgement of the transversality of this connection has been incorporated in all its fields of practice/healthcare, teaching and research.⁷

Taking into account the previous discussion, those participating in the course Women and Newborn Health administered by the Maternal Child and Public Health Department, School of Nursing, Federal University of Minas Gerais (EE/UFMG) proposed a workshop entitled "Structuring axes and the configuration of research groups on women's health and gender" to support the creation of a research group to research, teach and support the field of women's health with a focus on the connections among gender, health and education.

Specific objectives were established to achieve this goal: a) reflect upon the use of gender as an analytical category to understand phenomena related to health and nursing with an emphasis on women's health; b) reflect upon general and specific issues concerning the production of knowledge through research and its connection with the process of providing care and teaching in the nursing and health fields; c) reflect upon the concept of a research group, as well as the relevance of its creation and the process of establishing and adopting lines of research; and d) devise possibilities of constructing interdisciplinary and inter-institutional projects with a focus on gender-health-education.

It is worth mentioning that the implementation of this workshop was a desire of the professors responsible for the Woman and Newborn Health course. Recognizing the transversality of gender with professional qualification and understanding the intrinsic relationship between undergraduate and graduate education, these professors made an effort to make the workshop possible, aiming to create a research group focused on topics not yet explicitly addressed in the institution's lines of research.

This paper describes the process of implementing this workshop and its results, providing comments about the content that emerged concerning the proposed themes and its prospects for advancing the production of knowledge.

WORKSHOPS AS A METHODOLOGICAL STRATEGY FOR INTERVENTIONS

In Brazil, workshops began within the feminist educational approach in the 1980s aiming to construct and disseminate a project for women and value the participants' experiences and knowledge, especially in the health field. The objective was to move away from the biologicist view, centered on the procreative function, and give priority to individual content, and the subjectivity and viewpoint of women as social subjects without, however, abandoning the collective support of pedagogical actions.

The workshop modality has been used by those who proposed the workshop in their professional routine, not only in teaching and healthcare but also in research activities, in the collection and preliminary analysis of data, in accordance with an ethical intervention, transforming and being transformed in this investigative process as subjects of action.^8-9 Workshopping, as methodological strategy for intervention and investigation, has some characteristics that place it among the preferred options in the field of education and the emancipation of individuals, namely:

• the organization of a process that leads to the understanding and valorization of the participants as social subjects; architects of their own identity and subjectivity in relation to other subjects, seen as being historically and socially determined by class, gender, race/ethnicity and generation situation;

• the establishment of a relationship of cooperation between the coordinators and participants permeated by trust, essential for the process and its connection with the experiences of the subjects involved;

• the establishment of an educational and emancipatory process that enables one to recognize and decode knowledge and experience, to help the participants understand the essential elements of experiences and through them recognize and proceed with the transformations required to construct the desired product;

• the reconstruction of knowledge based on the dialectics of internality and externality of phenomena in the different dimensions of objective reality, namely, of the subjects and social groups to which they belong, and the social structure as a whole;

• the construction of a final product, the authors of which are the participants themselves and that which takes place in sharing knowledge and experiences, especially in joint creation. The product is recognized by the group and is valued and collectively acknowledged.

  ^7-8

The theoretical pillars of workshops are the emotions, as the builders of knowledge,¹⁰ the development of autonomy, self-esteem, and empowering through critical-emancipatory education,¹¹ and the Praxis Intervention Theory in Collective Health Nursing.¹² Hence, the workshop was structured into four different points in time:

1. warm up: development of an activity designed to prepare the group for the subsequent activities and to strengthen interpersonal relationships. Warm up techniques should refer to the dynamics and themes connected to the subject to be developed in the session;

2. individual reflection: personal reflective process, based on the experiences or observations of the participants, represented by techniques that facilitate the process.

3. group reflection: condensation and addition of content based on individual exposure to support general discussion and synthesis;

4. synthesis: summary and analysis of the main points addressed in the previous items, followed by the introduction of new knowledge.

Each of these are important to achieving the final product, which should portray the stage of reflection achieved by the group, translating the envisioned transformations that will guide the entire intervention as the objective of the work process. We expect a participatory and emancipatory process, the product of which will be appropriated by all the participants, since it contains the group's knowledge and experiences, including its different actors.

To facilitate the expression of individual and group representations, as well as to stimulate the participants' creativity, dynamics and strategies can be used to facilitate the expression of individual and subjective content, which forms the basis on which knowledge is constructed and expanded. These strategies should take into account the group's experience, level of education, and ability to think abstractly. Such strategies are instruments and not an end in themselves.

The participant group is highly educated with a great power of thinking abstractly. For this reason, sophisticated dynamics such as reflection upon texts and exposure to scientific content, were used.

DESCRIPTION OF THE WORKSHOP

The workshop was conducted on the premises of the School of Nursing, Federal University of Minas Gerais in December 2009 with a workload of 16 hours and with the content distributed into four sessions of four hours each. The sessions were based on the delimitation of structuring axes for the activities, keeping objectives in mind. The axes served as a driving line and also guided the definition of the content and activities, as well as the selection of bibliographic material to provide support, as shown in table 1.

Strategies to facilitate individual and group expression were used in all the sessions with different purposes: to integrate the participants, to sensitize them to development of the main theme, and to conduct partial evaluations, as shown in table 2.

A partial evaluation took place at the end of each session. It was an opportunity for each participant to say a word that would represent her perceptions concerning that specific part of the intervention. A final evaluation was conducted at the end of the last session and each participant provided a free report concerning the event, its process, and product.

A total of 13 individuals participated in the workshop: nine professors from the EE/UFMG, one undergraduate student, two nurses from the Sofia Feldman Hospital, and one nurse from the Hospital das Clínicas at the UFMG. These are institutions where teaching concerning clinical activities and the supervised training of the courses Woman and Newborn Health and the Specialization in Obstetric Nursing of the EE/UFMG take place.

Even though the implementation of workshops is exempt from the guidelines of Resolution 196/96 provided by the National Council of Health, Brazilian Research Ethics Committee (CONEP), all guidelines were complied with. Therefore, the participants were invited and freely consented to participate in the workshop. The workshop's objectives and purpose were clarified as well as the procedure for data collection and recording. The ethical procedure concerning the public dissemination of results included extensive discussion within the group about the relevance of developing a paper to report the experience; the participants explicitly and spontaneously expressed themselves and unanimously agreed with the public dissemination of results. Many also suggested that the material be presented in other scientific venues, in addition to written publication.

RESULTS AND DISCUSSION

The results are presented according to each of the structuring axes because problems, challenges, perspectives, and actions directed to objectives within each axis were identified.

Structuring axis 1 – the concept of gender as analytical category

This axis guided the workshop's initial phase. During the group discussions, the participants showed they perceive the current importance of the concept of gender, its connection, and how it has been incorporated in academic studies in the health field, especially in the fields of women's health, collective health,¹³ and education.¹⁴ In regard to the concept of gender and its use as an analytical category, the group highlighted that its development provides different elements that need to be considered in the scope of nursing and health: interdisciplinary work, commitment to the demands of society, dialogue with health workers, consonance with current Brazilian health policies,¹⁵ and also international commitments assumed by the Brazilian state.

At this stage, the participants showed understanding concerning the struggle of women to become researchers and produce science from their own perspective, incorporating a multiplicity of meanings and views of the world, including the development of the idea of masculine and feminine, of opposition, complementarity and overcoming. The challenge is to reduce the consequences of inequality for gender, enabling the deconstruction of the hierarchical order still present in society.² Feminism in science and the presence of women in scientific production were mentioned as essential elements that can encourage visibility and the overcoming of inequalities and injustices related to gender relations.

We also identified that the concept of gender has grounded or guided studies conducted by some of the participants, particularly during doctoral education, and can be used to guide studies, both those already active and future studies.

Aspects related to the production of scientific knowledge, to the establishment of research groups, and the definition of their lines of research were discussed based on the structuring axis 2 – Conceptions of group and line of research.

Structuring axis 2 – Concepts of groups and line of research

When developing this axis, the group recognized that the current process of producing scientific knowledge within universities should follow a hierarchical process organized in the form of research groups, which requires new ways to interact¹⁶ and organize the work process among faculty members, who should increasingly engage in research practice. The creation of research groups is effective in giving visibility to studies conducted in the scopes of healthcare, teaching and university extension; expand and strengthen the scientific production of a given group of researchers; enable integration at the various levels of education aiming to advance knowledge; and develop and strengthen scientific production among peers in a multidisciplinary way.^17-19 The line of research was clearly presented by the group as a guideline for investigation processes. The gender issue, for instance, was mentioned as a topic that can lead research on health, violence and population groups such as female adolescents and women.

Structuring axis 3 – The group's scientific production and its vulnerable points

Scientific production was the topic addressed in this axis. The participants presented their research projects and ongoing projects under the category of gender. The participants listed nine studies in diverse fields. There were studies including the participation of undergraduate and graduate students and one of the studies was characterized as a multicenter study. The qualitative approach predominated and the following theoretical frameworks were identified: humanization, gender, violence, and integrality. Positivism was the predominant view of world even though some studies were conducted in light of historical and dialectical materialism. In summary, there were a diversity of themes, research designs, and theoretical-philosophical references.

The difficulties presented referred to lack of time and the limitation or absence of financial resources. In regard to the organization of the group to develop studies, the following difficulties were listed: a lack of an organized research group, of leadership to establish a research group, and of experience in fundraising. The difficulty in connecting and establishing a dialogue among professionals in the academy and obtaining assistance to jointly develop and conduct research projects was apparent.

The immediate consequence of these difficulties is the isolated design and development of research. The participants reported they feel isolated, especially when they arrive at the institution as newly hired faculty members or when they return after earning a doctorate, which continues during their academic life. Another fact that corroborates the level of individual work is the long time spent during the master's and doctoral education.

It is worth noting that, in the nursing field, due to the predominance of women, maternity as well as double or triple workdays, are elements that contribute to interrupting their academic trajectory, which consequently progresses slower than that of men. Men in general have the possibility to dedicate themselves almost entirely to extra home activities, and given gender roles and the social process in which masculinity is constructed, receive the support of women to their ventures. That does not always happen otherwise and since the workshop's participants belong to the same androcentric society as the remaining women, these considerations also apply to them.

Various strategies to overcome the evidenced difficulties were identified: alliances among peers; partnerships with institutions and professionals with recognized experience; becoming a member of a consolidated research group; and increased funding. The participants' reflection concerning what they think and how they feel about their scientific production revealed dissatisfaction and frustration as a consequence of isolation and in the face of the institution's demands. The need to achieve an individual and collective strengthening became apparent.

Given the context and what motivated the implementation of the workshop, we observed a very positive perspective concerning the possibility of new connections to overcome limitations and difficulties, such as the establishment of a research group.

Structuring axis 4 – Identity of the group to be established: scope and research themes (group's interest and reality)

At this point we identified actions designed to aid in establishing a research group as an opportunity to develop human resources in research through the participation of faculty members, undergraduate and graduate students, technical-administrative professionals from the institution itself and other national and international institutions. Many topics, whose studies could be connected and cooperation established, were mentioned as well as other topics to be explored. The gender category was once again acknowledged as being a key factor in the construction of new knowledge, capable of effectively transforming teaching, university extension activities, and investigation itself. The group also identified the need to expand specific qualification in the area of gender and in research methodology.

Structuring axis 5 – Strategies to increase and enhance the group's production

The last stage of the workshop comprised this axis, whose focus was strategies to incrementally increase the group's production. We discussed the importance of group research as a starting point to increase and enhance the scientific production of its members and those who cooperate with it. In this context, we decided to promote events directed to strengthening research practices, qualification of researchers, and the successful search for funding for research via financing agencies, among others. Other activities should be developed to encourage reflection upon the group's scientific and intellectual production to present, discuss and disseminate the results.

Finally, another strategy identified by the group to increase and enhance the group's scientific production would be to include the group members in the Graduate Program in the participants' institution, and establishing and consolidating partnerships with internal and external research groups.

FINAL CONSIDERATIONS

This workshop was an important strategy for the creation of the research group, currently consolidated and called Center for Studies and Research on Women's Health and Gender (NUPESMeG). It was created in 2010 and enrolled in the Directory of Research Groups in Brazil, the National Council for Scientific and Technological Development (CNPq).

This conception is consistent with the event's objective. Its concretization can be one of the pillars to strengthen and expand the fields of care delivery, teaching and research, connecting gender, health and education in the nursing and health fields.

The participants recognize that scientific and academic production within universities requires an organized process and new forms to interact within and among institutions. The creation of a research group was indicated as one of the requirements to increase the production and visibility of knowledge.

The workshop was considered a privileged methodological strategy since it involves the participants in a process in which the final product is acknowledged as belonging to all and, therefore, enabling real engagement and commitment. It also enabled other situations: interaction; deepening of theoretical aspects that were required to develop the task; pleasant moments, enriched by dynamic pedagogical techniques; consonance between content and the participants' needs; exchange of experiences; and personal and collective satisfaction for having the work done.

We expect that this experience report will encourage groups of researchers to organize themselves to create and strengthen research groups with a view to intensify and enhance scientific production, as well as to advance and strengthen knowledge concerning gender, nursing and health, whether it is shared in a collective experience capable of giving pleasure, building and reassigning the difficult art or by producing and disseminating women's knowledge, gendered in their process and product.

REFERENCES

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Publication Dates

• Publication in this collection
  08 Jan 2013
• Date of issue
  Dec 2012

History

• Received
  10 Mar 2011
• Accepted
  20 Apr 2012