The use of phenomenological frameworks in Brazilian nursing research at the stricto sensu level: an overview

El uso de marcos fenomenológicos en la investigación en enfermería brasileña en el nivel stricto sensu: una visión general

ABSTRACT

Objective:

To characterize the stricto sensu scientific production of Brazilian nursing that resorts to phenomenological theoretical frameworks.

Method:

Descriptive, exploratory, and document study carried out using the CAPES catalog of theses and dissertations from January to April 2022.

Result:

The sample included 600 dissertations and theses, with a predominance of the Heideggerian framework, followed by Schütz and Merleau-Ponty. Topics discussed included nursing care in women's health, mental health, pediatric and adolescent nursing, oncology nursing, obstetric nursing, Primary Health Care, as well as family and nursing education.

Conclusion:

Phenomenology was found to be a powerful reference for the unveiling of the phenomena of interest to the field of nursing, contributing to the construction of knowledge about the being who cares, the being who is cared for, and the care itself.

Keywords:
Nursing Research. Philosophy; Nursing. Education; Nursing; Graduate

RESUMEN

Objetivo:

Caracterizar la producción científica stricto sensu de enfermeros brasileños que utiliza encuadres teóricos de la fenomenología.

Método:

Estudio descriptivo, exploratorio y documental hecho por medio de pesquisas en el catálogo de tesis y disertaciones de la CAPES, de enero a abril de 2022.

Resultado:

La muestra incluyo 600 disertaciones y tesis, con una predominancia de referencias a Heidegger, seguido por Schütz y Merleau-Ponty. Los temas discutidos incluyeran cuidados de enfermería en salud de la mujer, salud mental, enfermería pediátrica y adolescente, enfermería oncológica, enfermería obstétrica, Atención Primaria a la Salud, así como enfermería de la familia y educación en enfermería.

Conclusión:

La fenomenologíase ha mostrado una poderosa referencia para desvelar a los fenómenos de interés para el campo de la enfermería, así contribuyendo para la construcción del conocimiento sobre el ser que cuida, el ser que recibe cuidado, y el cuidado mismo.

Palabras-clave:
Investigación en Enfermería; Filosofía en Enfermería; Educación de Postgrado en Enfermería

RESUMO

Objetivo:

Caracterizar a produção científica stricto sensu da enfermagem brasileira que utilizou referencial fenomenológico.

Método:

Estudo descritivo-exploratório de caráter documental realizado a partir do Catálogo de Teses e Dissertações da CAPES no período de janeiro a abril de 2022.

Resultados:

A amostra foi constituída por 600 dissertações e teses, com predomínio do referencial heideggeriano, seguido de Schütz e Merleau-ponty. As temáticas se concentraram no cuidado de enfermagem em saúde da mulher, saúde mental, enfermagem pediátrica e do adolescente, enfermagem oncológica, enfermagem obstétrica, Atenção Primária à Saúde, família, e educação em enfermagem.

Conclusão:

A fenomenologia se apresenta como um referencial potente para o desvelamento dos fenômenos de interesse da enfermagem, contribuindo para a construção do conhecimento sobre o ser que cuida, o ser que é cuidado e o próprio cuidado em si.

Palavras-chave:
Pesquisa em enfermagem; Filosofia em enfermagem; Educação de pós-graduação em enfermagem

INTRODUCTION

All human experience can be studied, interpreted, and understood. This interpretation requires knowledge of the experience in itself, from the perspective of a being. The lived experience is what happens in the daily life of the human being, therefore, everything that happens corresponds to a phenomenon, and can be observed from a phenomenological point of view1.

The use of a phenomenological framework in qualitative nursing research enables revealing that which is experienced by the being, exposing the multiple facets of a factical existence. The clarification of a certain phenomenon and its understanding starts with a return to the things themselves, to the being-there (Dasein)2.

Phenomenology attempts to understand phenomena in depth, and, as a result, it has been gaining space and notoriety in qualitative research, especially due to the fact that it presents, in its conceptual framework, the possibility of going beyond what is seen in its investigations. Its focus lies in bringing forth what is shown by the senses through consciousness, which manifests itself as an intentional act of social subjects3.

Nursing research has significantly incorporated references from phenomenology, seeking to better understand phenomena and clarify dilemmas surrounding settings and contexts inherent to the practice. These are important studies, which may give support to reflective processes about the need for change, initiatives, and improvements in nursing care4^-6.

As a philosophical current, phenomenology is formed by contributions from many different theoreticians, whose premises originated the different currents of phenomenological thought. Some of these theoreticians stand out, such as Edmund Husserl, who believed that phenomena are understood by the way in which the consciousness represents the world7, and developed phenomenology as a method of apprehending things in their essence; Martin Heidegger, with his thesis of ontological phenomenology that highlights the being of the human entity; Maurice Merleau-Ponty, who presented discussions on corporeity; and Alfred Schütz, whose approach to sociological phenomenology was inspired by Husserl and Max Webber5.

As a research method, phenomenology is a way, or an attitude of the researcher to access the essence of things5. Regarding the use of phenomenological research in nursing, nurses must consider the phenomenon as something experienced, which appears in the world and to which meaning is attributed. Thus, they must recognize that it is important to support the use of phenomenology is a research method. Doing so requires consistency in the formulation of projects in this discipline, so these projects allow continuous and well-supported development, in order to preserve the essence of going to the things themselves and understanding the being that is ingrained in the process of caring1.

Nevertheless, there are still shortcomings to the incorporation of philosophical references, such as phenomenology, to subsidize the practice of nurses. This reflection makes the potential of this study clear, since by presenting an overview of the national stricto sensu nursing production, it gives support to the management of strategic areas within nursing that are more capable of benefiting from phenomenological insights to improve care. In addition, it has the potential to suggest paths yet to be discovered, which can be explored by a comprehensive approach.

Considering the above, the main question of this study emerges: What are the characteristics of the Brazilian stricto sensu research in nursing that uses phenomenological frameworks? Our objective was to characterize the stricto sensu scientific production of Brazilian nursing that uses phenomenological frameworks.

METHOD

This is a descriptive, exploratory, document study, created to show the characteristics of Brazilian phenomenological stricto sensu research in nursing. Its stages included searches in the selected catalog, the selection of theses and dissertations that formed the sample, the creation of a database with information from these research reports, and an analysis of said reports. The CAPES (the Coordination for the Improvement of Higher Education Personnel)catalog of theses and dissertations, which houses all research reports produced in higher education institutions (HEIs) in the country, was used as a data source.

Data collection took place from January to April 2022 and was carried out by two independent researchers. For this purpose, the names of the following authors, from various phenomenological currents, were used as search terms: Alfred Schütz, Edmund Husserl, Jean-Paul Sartre, Judith Stein, Martin Buber, Martin Heidegger, Joel Martins and Maria Aparecida Bicudo, Maurice Merleau-Ponty, Max Van Manen, Michel Henry, Michel Maffesoli, Paul Ricoeur, Viktor Frankl, and Pierre Vermersch. The term “phenomenology” was also used to search studies that could not be found by the strategy of using the names of the theoreticians, since the titles and abstracts of the studies did not always identify the authors and/or theoretical currents used. Thus, searches were performed using each isolated key term, except for those using the names of Joel Martins and Maria Aparecida Bicudo, in which case the combination (“Martins and Bicudo”) AND (Phenomenology) was used.

Filters available on the platform were used to specify the search, namely: academic degree (MS, PhD, and professional MS - the latter being a specific type of MS targeted at practical application in the job market) and area of knowledge (nursing). The sample included research reports (theses and dissertations) with no specific time frame, available for access in full on the platform. It also included those that, despite having had their titles and abstracts retrieved in the catalog through the search strategy, were extracted directly from institutional repositories, since the catalog does not include studies before 2012 (year of creation of the portal Plataforma Sucupira). Also, in some cases, the catalog could not find studies published after that year. Theses and dissertations that could not be retrieved were excluded.

After initial search and filter application, duplicated works were excluded. Then, titles and abstracts were read to select the studies of interest. In the next step, the full text was skimmed, to verify whether it was in line with the goals of this study. Studies that were not were excluded. All steps were carried out manually by the researchers, and spreadsheets were created to operationalize and verify whether the studies included were adequate. Later, after the sample was determined, the following variables were extracted for descriptive statistical analysis, using the software Microsoft Excel 2013^®: year of defense, academic level, educational institution where the author studied, and phenomenological framework used. The presentation of the data was descriptive (frequency distribution), using tables and charts.

The keywords from the studies that formed the sample were used to form a text corpus which, then, underwent textual statistical analysis using the software Iramuteq^® (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires), to carry out exploratory analyses of the topics addressed in the studies. The results of these analysis were presented using a descriptive synthesis and word clouds.

Regarding ethical aspects, it was not necessary to submit this study to a Research Ethics Committee, due to the fact that the data used was open access, as prescribed by resolution 510/2016, from the Brazilian National Health Council.

RESULTS

Our sample was formed by 600 theses and dissertations. Figure 1 shows the selection process of the studies and the number of works found by using each term.

Figure 1 -
Steps to form the sample of the study. Natal, Rio Grande do Norte, Brazil, 2022

Most studies (64.8% - n = 389) were MS dissertations, followed by PhD dissertations, with 33% (n = 198). Few studies developed in professional MS degrees used phenomenological references, representing only 2.2% (n = 13) of the total. In regard to the references used, Heidegger was the most commonly mentioned author, followed by Schütz and Merleau-Ponty. The chart 1 below includes a thematic synthesis of the thoughts of each theoretician carried out from the dissertations and theses of the sample and presents the number of studies per author used as reference, distributed according to type, firstyear (that is, the year in which a study in the sample used that author as a reference for the first time), and final year (year in which the author was used as a reference for the last time).

Chart 1 -
Characterization of documents according with educational level (MS, PhD, and professional MS), first and final year, and theoretical premises of the authors in a specific phenomenological current. Natal, Rio Grande do Norte, Brazil, 2022

REFERENCE	LEVEL			YEAR		Theoretical premises
	M*	MP†	D‡	Earliest	End
Buber	01	00	01	1998	2007	This author is fundamentally concerned with the idea that reflection and action, experienced and lived, logos and praxis, are co-responsible; he focuses on the meaning of human existence in all its manifestations, in a dialogical relationship permeated by ethical responsibility, in an attempt to reflect about reflection and generate a new commitment with life and lived experiences.
Frankl	14	00	06	1992	2016	This author focuses on logotherapy, a multifaceted, phenomenological, existential, and humanistic psychology school of thought that seeks to find existential meaning for each individual in their context, in their existence, understanding that the search for meaning guides the lives of beings. This school believes that the finiteness of life is one of the main aspects of human existence.
Heidegger	144	00	78	1990	2022	This author sees phenomenology as both concept and method. The question of the being represents the essence and transcends the entity, that is, transcends that which is seen when a person is looked at. He presents the Dasein, the being-there, indicating that a being only is in the ways it manifests itself, in the ways it actualizes its being-in-the-world. This characterizes the condition of a being that exists as it is conscious of its presence in the world and in time. Heidegger analyzes how the being experiences its own experiences as it becomes conscious of its state of a being-thrown-into-the-world. Nonetheless, time is a central concept in Heidegger's phenomenology, since temporality is an ontological condition required for one to understand what "being" is.
Husserl	03	00	01	2004	2014	Considered to be the main precursor of phenomenology. He advocated the elaboration of a science of lived experiences, an analysis of essence starting with a "return to things themselves", in order to reach a visualization of phenomena in their own reality, their original state. To do so, a temporary suspension (epoché) would be necessary, a suppression of convictions, judgment, and pre-conceived concepts. He believed that anything that appears to consciousness was a phenomenon, and that all consciousness was the consciousness of something.
Maffesoli	17	00	08	1995	2012	The author proposes an existentialist logic that encompasses the entire, daily, constant unveiling of daily-life history, not only that of a single moment, focusing on recurring phenomena never dealt with in their essence and uniqueness. Maffesoli highlighted the premises of a comprehensive psychology that values lived experiences that are dynamically built day after day, seeking intelligibility and understanding as intrinsic aspects of social phenomena, which are separated from natural phenomena by the concepts of intentionality and meaning.
Martins and Bicudo	10	02	01	1995	2021	The authors focus their analysis on the structure of situated phenomena, whose essence would be in descriptions (in which essences and intentionalities are located) from the subjects, which refer to lived experiences. This involves idiographic analyses, where the ideology that goes beyond ingenuous descriptions of the subject is analyzed using symbols that represent ideas; and nomothecnical, that is, related to the elaboration of laws, therefore allowing to go from a specific element to a more general one.
Max Scheler	01	00	00	2008	2008	Phenomenology is a focus for this author (not a method). It is a procedure to be used for thinking and contemplation, making its use less rigorous than Husserl's. The author emphasizes that phenomenology seeks the apprehension of phenomena through the apprehension of essences and their essential correlations in the world, stating that these are different from the contingent and empirical facts of the world.
Merleau-Ponty	62	11	27	1992	2021	Merleau-Ponty understands consciousness as perception related with the attitude of one's body, which creates senses and is the vessel of a being in the world. In addition, the author creates an interface between the concept of beingintheworld and the expression of the experiences of the body in the world, considering the body as the place where the sensible becomes something knowable, as well as a place where subjectivity manifests itself.
Patricia Benner	01	00	01	2019	2020	This author advocates for an interpretive phenomenology, representing an understanding of the practices, abilities, and daily experiences, creating a portrait of an individual in a situation, and preserving the context and meanings of the life world. The phenomena and the context where they are inserted suggest a project to interpret the world of beings. This context can be accessed by creating a dialogic relationship between experiences and practical preoccupations.
Ricoeur	10	00	02	1997	2018	The premises of studies that follow this author’stheoriesrevolve around hermeneutic ontology, hermeneutics being understood as the science of all linguistic understanding. Thus, this framework seeks to understand the meaning of the being considering their expression in the world, and the interpretation of phenomenatakes place between lived experiences and language (considered both what it says and what it hides).
Sartre	01	00	00	2008	2008	Sartre believes that the phenomenal relation between world and man is important, as areman’s actions situated in the world. The author is attentive to data that is factical in the world andbelieves that essence is preceded by existence.
Schütz	125	00	69	1993	2021	The author lays the groundwork for a sociological phenomenology, a comprehensive approach to social fact. The constitution of the daily world would be the setting where subjects live, where men continuously transform and change social structure. It encompasses the actions of subjects in the social world, based on intersubjective relations built from daily experiences.
Stein	00	00	02	2009	2009	The author attempts to analyze the experience of being as the origin of knowledge about the self, considering that the concrete existence of men is the source of their experience and recognizing that there is a spiritual individual in human beings that connects them to the world. The author addresses intersections between philosophy and religion, discussing theological issues philosophically.
Van Manen	00	00	02	2015	2019	This author discusses a phenomenology of practice, focused on the way in which human beings act and relate with people who are in the world, considering the lived experience as the starting and ending point of phenomenological research. The author brings together phenomenological, hermeneutic, and descriptive elements.

• Source: Elaborated by the authors, 2022.
• ^*
  ^MS; ^†Technical MS; ^‡PhD.

Regarding the topics addressed in the phenomenological studies, they were quite varied. Still, considering the keywords analyzed, some topics stood out, including nursing care in women's health (saúde_da_mulher), mental health (saúde_mental), pediatric (enfermagem_pediátrica) and adolescent nursing (adolescente), oncology nursing (enfermagem_oncológica) and palliative care (cuidados_paliativos), Primary Health Care (PHC) (aps), and family health (família). This is shown in Figure 2.

Figure 2 -
Word cloud of the topics of study of theses and dissertations in Brazilian Portuguese. Natal, Rio Grande do Norte, Brazil, 2022

Considering that Martin Heidegger and Alfred Schütz were the most represented authors in the studies analyzed, we decided to analyze more in depth the studies produced using the works of these authors.

Studies that used Heidegger as a reference were mostly carried out in the southeast of the country, especially in the Universidade Federal do Rio de Janeiro, followed by the Universidade de São Paulo. Most studies were for MS theses. Regarding their topic, the most common were women’s health, pediatricand oncology nursing, adolescent health, family, and palliative care. This is shown in Figure 3.

Figure 3 -
Characterization of works that used Martin Heidegger as their theoretical framework according to the region where they were developed. Natal, Rio Grande do Norte, Brazil, 2022

Regarding Schütz, most studies that used his theories as framework also came from the southeast of the country, especially from the Universidade de São Paulo and the Universidade Federal do Estado do Rio de Janeiro. In the South, Northeast, and Midwest, the institutions with the most expressive productions were, in order, the Universidade Federal do Rio Grande do Sul, the Universidade Estadual do Ceará, and the Universidade Federal de Mato Grosso. Regarding the topics discussed in this production, the word cloud below highlights nursing care as related with topics such as mental health, women and children health, PHC, family, psychiatric nursing (enfermagem_psiquiátrica), among others, as figure 4 shows.

Figure 4
Characterization of works that used Alfred Schütz as their theoretical framework according to the region where they were developed. Natal, Rio Grande do Norte, Brazil, 2022

Regarding the other authors used as references, researches supported by Buber discussed mother-child topics, revolving around what it means to be a relative of a child with AIDS and around nursing care provided to women and family during the birth of these children. Studies involving this author came from the south of the country, more specifically, from the federal universities in Santa Catarina and Rio Grande do Sul.

Researches based on Husserl's work focused on the meanings of being a cancer patient and on the experience of those who cared for an elder relative with Alzheimer's. These studies were developed in the Midwest, in the Universidade Federal de Goiás, and in the Southeast, in the Universidade Federal Fluminense.

Studies based on Maffesoli, in turn, highlighted the understanding of the experience and daily life of nurses. They addressed topics such as administrative practices, the daily life of nurses in university hospitals and surgical centers, the dynamics of family relations, the daily life of families where there are cases of violence against children and adolescents, the educational process experienced by the diabetic patient, the manifestation of sexuality in its personal, social, and professional dimensions in the daily lives of female nurses, the nursing care supported by sensible reasoning, being adequate to the culture of the patient, in addition to the imaginary of nursing technicians about health promotion, and others. These studies were mostly produced in the South, followed by the southeast of the country, focusing on the federal universities of Santa Catarina and Minas Gerais, respectively. Most studies were defended in the years 2002, 2007, and 2009.

Martins and Bicudo are leading Brazilian phenomenological researchers. Their ideas are based on many theoreticians, including Husserl and Merleau-Ponty. Studies who used these authors as reference were mainly developed in the southeast of the country, mostly in the Universidade Federal de Minas Gerais. Other institutions with research based on these authors were Universidade Federal de Feira de Santana and Universidade de São Paulo. The topics addressed by these studies included how mothers understood their children with congenital heart diseases or who had been through cancer treatment; understanding attempts of self-extermination by young adults and adolescents; the meaning of providing care to adolescents from the perspective of Primary Care; and understanding decisions made by nurses in regard to ethical conflicts experienced in the scope of welcoming patients and risk classification, for example.

The use of Ricoeur's phenomenological-hermeneutic references, in turn, was focused on the understanding of care/the process of care from different perspectives, including hospital care and, particularly, intensive care units, not excluding the care for the newborn and self-care. The authors also addressed topics such as psychiatric hospitalization; understanding the world experienced by homeless children; and the meaning of graduation courses focused on public health to nursing students. Most studies were carried out in the south of Brazil, especially in the Universidade Federal do Rio Grande do Sul, and most were defended from 2003 to 2008.

Regarding Sartre, his phenomenology was used as a reference to explore the understanding of the conditions of life of alcoholic women, as well as the perceptions of these women and the phenomena related to alcoholism and the meanings of this reality. The only study identified concerning this author was an MS thesis developed at the Universidade de São Paulo and defended in 2008. As in the case of Sartre's work, Stein's phenomenology was used as a framework for a single study, about the experiences of faith and religiosity of patients with cancer, also discussing how health workers give meaning to this phenomenon. This study was a PhD dissertation, also produced in the Universidade de São Paulo and defended in 2009.

Regarding Max van Manen, two PhD dissertations were identified that used the philosophy of the author as their main theoretical framework. They were defended in 2015 and 2019, in the federal universities of Santa Catarina and Mato Grosso, respectively. The studies are related with the experience of empathy in neonate nurses and relatives, and with the understanding of the lived experience of women with complications in their puerperium during breastfeeding.

Regarding Viktor Frankl's theories, they were mostly used in the northeast of the country. Universidade da Bahia alone was responsible for 50% of the studies produced. Universidade de São Paulo also produced a significant percentage of studies using this framework. Most works using this framework took place in 2005 and 2016. Studies based on the work by Frankl explored meanings of several phenomena, especially the existential analysis and the tragic triad. Phenomena addressed included: the feeling of caring for a being with cancer; the meaning of living a nurse’s professional responsibility; the meaning of spirituality in providing integral care to the person under palliative care; nursing actions that subsidize the preservation of the mental health of persons with AIDS; the experience of nursing graduation students with the spiritual dimension of human beings; understanding the trajectory of resilience of mothers whose children developed cancer, and how these mothers found meaning; and the understanding of what it means for nursing students to become responsible for care.

Finally, Max Scheler and Patricia Benner's works were used as reference by three studies. A thesis using Scheler was defended in 2008, at the Universidade Federal da Paraíba, and addressed the understanding of nursing professors about ethical values and how present they are in nursing formation. Benner's work, in turn, appeared as the theoretical framework of a PhD dissertations defended in 2020, at the Universidade de São Paulo, and in an MS thesis, defended in 2019 at the Universidade de Brasília. These studies investigated, respectively, the moral experience of relatives of children and adolescent who received care at home via technology, and the experience of families with children and adolescents with intestine and bladder disorders, who were undergoing outpatient follow up.

DISCUSSION

For decades, nursing studies have been based on the philosophical tradition of phenomenology, as they develop and attempt to ensure the soundness of their theoretical bases and their methodology 8. In this regard, in Brazil, nursing stands out among the fields of health that seek to show the "how" of the objects and entities that are a part of life5. Therefore, the development of nursing research that attempts to get closer to a phenomenological approach has contributed for professional practice, especially for those who wish to understand the being as way to get closer to an authentic form of care9.

For phenomenology, humans are beings thrown into the world, being present and being a presence. This approach allows understanding the being in its subjectivity, as an existential being, valuing and allowing its reconstitution as a presence dealing with another, and considering them in their experience, in their particular form of existing, their being-in-itself9. From this perspective, since phenomenology deals with existential issues of human beings who receive care daily, it provides a relevant contribution for the practice and thought of nursing, since understanding the reality of daily life requires the ability to dive into subjectivity and its essence, without losing sight of the objectivity that permeates it10.

In this study, the relevance of phenomenology in nursing research was corroborated by the considerable number of dissertations and theses that used this theoretical framework. Most studies were based on the works by Heidegger, Schütz, and Merleau-Ponty, in this order. This is a tendency in nursing that has been observed since the year 200011. Incorporating several other theoreticians shows that nurses have a strong ability to articulate theoretical-philosophical knowledge and practice, signaling the search for improving care and translating the knowledge created on a stricto sensu level.

The place with the highest number of works involving phenomenological references was the southeast of Brazil, represented especially by the Universidade de São Paulo and the Universidade Federal do Rio de Janeiro. This can be explained by the fact that other regions of the country have less stricto sensu postgraduation level courses. Also, studies that use this approach are often not as valued and difficult to find funding for, which impacts on the number of people who choose this methodology to develop MS or PhD researches12.

Regarding the theoreticians used as phenomenological references, Heidegger stands out due to the fact that his perspective is a research method often employed in the field of health, especially in nursing, as it allows for understanding many of the phenomena experienced by subjects, considering that care is a complex phenomenon that involves intersubjectivity1. Schültz phenomenology, in turn, makes it possible to think, support, and develop research, as well as nursing care. It is guided by social relations established in the world of life, also valuing the intersubjective dimension of care, which is seen by the author as the original relationship there is between human beings4.

Merleau-Ponty's phenomenology, in turn, contributes for the development of studies that seek to improve the practice of nursing assistance using, as a scientific framework, the exploration of the experiences of the subjects, in a perspective that focuses on the human body as the origin of knowledge3. A recent study determined the number stricto sensu investigations in nursing that used this theoretician as framework,13finding that most were MS theses carried out in the Southeast and South of the country, especially at the Universidade Federal Fluminense and at the Universidade Federal de Santa Catarina. The topics of the studies using this framework included perception, spirituality, family, and adolescence. It stands out that most professional MSs that used a phenomenological approach used this author as a reference.

It should be mentioned that, due to its intrinsic characteristics, academic programs are more likely to use phenomenological references. The fact that Merleau-Ponty is the most used in professional MS programs does not imply that the author provides a less complex framework; instead, it can suggest that nurses have more difficulty considering interventions targeted at practical issues (which is generally the case in professional MS) that are based on phenomenological references. It is noteworthy, however, that most research in the field of nursing has used phenomenology as a theoretical reference and as a method for several different issues14.

Maffesoli, Frankl, and Ricoeur are other theoreticians that stand out in the dissertations and theses analyzed. Maffesoli's thought contributed to construct knowledge in health and nursing, indicating pathways in the dimensions of academic and professional care and considering the daily lives of individuals. This perspective allows re-signifying care beyond technique, calling attention to the different nuances of living and coexisting, to abandon development and become involved with a type of care, which touches, and, therefore, is effective15.

Frankl references are focused on existential analysis, making it possible for nurses to recognize integral intervention processes, that is, those that consider biological, psychological, and spiritual aspects. Therefore, it enables more human forms of care, focused not only on the biological meaning of life, but also on the search for spiritual meaning16.

Ricoeur references, in turn, are based on hermeneutic phenomenology, which, in nursing, shows other paths, meanings, and perspectives in the praxis of nursing. Ricoeur's hermeneutics indicates there is an effective effort in the search for understanding the self and the reality where the self lives. This takes place in a historic and temporal time frame, and it is necessary to analyze what has been said/written in a certain period of time, in a history and culture, assuming that expressions or texts can be said or rewritten in different ways, since there will always be different interpretations17.

Regarding the topics studied using these authors, the main ones are the same from another revision study, which states that they are recurring topics in phenomenology. These are, especially, those related with women's health, children's health, and mental health, which were the most common. Topics such as violence against women, PHC, and care, also showed strong tendencies in an earlier research, a result similar to the one found here18. Another study carried out in Portugal using the phenomenological references from PhD dissertations in nursing, found that, often, cancer-related topics use these authors as framework, as well as works related with mental health and reproductive health19.

It can be inferred that the strong presence of the topic women's health, which stood out in this investigation, ratifies the position of some authors, according to whom nursing care to women, based on the contributions of objective phenomenology, seeks to understand solicitude, which is the way in which one is with another, in addition to providing visibility to the essence of forms of being and being in the world, understood here as a premature art, which aims to care for the realization of something, or even with care6 From this perspective, seeking the essence is paramount, as it allows for women to receive holistic care and be understood factically, favoring the exercise of integral care, as prescribed by the National Policy of Integral Care to Women's Health6.

In the scope of mental health, the importance of phenomenology is in the relevant contribution it can provide to issues related with care, as it unveils facets of these issues that can help improving the development of new actions in mental health, even those with the potential of including the family in the process of care20.

In oncology nursing, phenomenology is a unique way to understand a world of care that is experienced in many ways, considered reflexively, constructed through human relations, and carried out according to human potential. The experience of the world of care is permeated with unique meanings. Capturing the essence of this experience requires resorting to the potential of understanding the other as a being-in-the-world, of listening, of dialog, of observation, sensibility, and empathy, recovering fundamental values that are necessary to provide more integral and humanized care21.

Therefore, it became clear that many fields use phenomenology as a philosophical approach. They include, in addition to those mentioned above, children's health, worker's health, family health, public health, and nursing education. This diversity of topics suggests that nursing researchers are not concerned with a single sector of professional activity, but with care in general22.

Phenomenology does not eschew theoretical premises and a rigid formula in the search for truth, as it seeks to go-to-the-thing-itself, showing it as it manifests itself. Thus, as a science focused on the care for the other, nursing finds in phenomenology a pathway to understand phenomenon that, at first, are not easy to understand, since caring for others reveals some of their profoundly subjective, authentic, and unique aspects. As a consequence, phenomenology is a pathway to increase the visibility of professional experience and of aspects of the being that is cared for, aspects that are imprisoned by daily distractions, which often prevent these beings from interacting, assuming positions, and participating in community life in an authentic way23.

Since nursing is concerned with holistic beings and values their experiences, it is, in essence, concerned with the nature of beings, with their becoming, with their reality and/or existence, all of which are subjective and intrinsic to lived experiences. Therefore, the practice of nursing and phenomenology are ontologically congruent. The descriptive and explanatory nature of phenomenology frames the meanings of the experiences of subjects, becoming aligned with their understanding of the world. The use of phenomenology in research in nursing, therefore, improves the understanding of nurses about the unique experiences of an individual, and how this individual interprets them24.

Limitations of this study include the unavailability of some dissertations and theses in institutional repositories and in the catalogue consulted, which may have influenced the precise determination of a real overview of the studies produced, also preventing an overview of the topics studied. Another issue to be mentioned is the scarcity of recent studies that articulate part of the phenomenological references with a thematic overview of nursing production.

FINAL CONSIDERATIONS

Characterizing the stricto sensu scientific production in Brazilian nursing according with the phenomenological premises it used allowed us to provide an overview about the use of phenomenology as a reference for dissertations and theses developed by nurses. The objects of study addressed in the overview of the thematic fields discussed involve complex and sensitive topics of daily life, which can be explored more deeply, beyond appearances, using a phenomenological approach.

It was found that most studies are master's theses, developed in the southeast of the country and based, mostly, on the works of Heidegger, Schütz, and Merleau-Ponty. The thematic framework of the studies was varied. Nonetheless, topics such as women's and children's health, mental health, oncology nursing, and PHC were often discussed.

Phenomenology is a relevant framework to unveil the phenomena of interest for nursing. It can contribute to the construction of knowledge about the being that cares, the being that is cared for, and care itself, based on a comprehensive epistemology that does not seek the absolute truth of things, but the revelation of these things, as it goes to the things themselves.

Therefore, considering the potential of phenomenology, it must be further disseminated throughout Brazilian nursing postgraduation programs, since, currently, its use is more present in some specific contexts.

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Edited by

Associate editor:

Cíntia Nasi

Editor-in-chief:

Maria da Graça Oliveira Crossetti

Publication Dates

• Publication in this collection
  02 Dec 2022
• Date of issue
  2022

History

• Received
  21 June 2022
• Accepted
  27 July 2022