Van Kaam's phenomenology: theoretical-methodological contributions to nursing research

La fenomenología de van Kaam: aportes teórico-metodológicos a la investigación en enfermería

ABSTRACT

Objective

To discuss the theoretical-methodological contribution of van Kaam's phenomenology to nursing research.

Methods

Theoretical reflection based on scientific literature.

Results and discussion

Intentionality emerges as a central concept and the 7 steps of the van Kaam's method modified by Moustakas were developed: horizontalization; reduction and elimination; categorization and thematization of invariant constituents; application and validation; construction of the individual textural description; construction of the individual structural description; and composite description.

Final considerations

van Kaam's theoretical-methodological framework allows a different look at the phenomenon, since the knowledge produced comes from the textural and structural essence of the lived experience, in a composite description, considering its different perceptive dimensions.

Keywords
Qualitative research; Nursing research; Nursing care; Philosophy

RESUMEN

Objetivo

Discutir la contribución teórico-metodológica de la fenomenología de van Kaam a la investigación en enfermería.

Métodos

Reflexión teórica basada en la literatura científica.

Resultados y discusión

Emerge la intencionalidad como concepto central y se desarrollan los 7 pasos del método van Kaam modificado por Moustakas: horizontalización; reducción y eliminación; categorización y tematización de constituyentes invariantes; aplicación y validación; construcción de la descripción textural individual; construcción de la descripción estructural individual; y descripción compuesta.

Consideraciones finales

El marco teórico-metodológico de van Kaam permite una mirada diferente al fenómeno, ya que el conocimiento producido proviene de la esencia textural y estructural de la experiencia vivida, en una descripción compuesta, considerando sus diferentes dimensiones perceptivas.

Palabras clave
Investigación cualitativa; Investigación en enfermería; Atención de enfermería; Filosofía

RESUMO

Objetivo

Discutir sobre o contributo teórico-metodológico da fenomenologia de van Kaam para a investigação em enfermagem.

Métodos

Reflexão teórica baseada na literatura científica.

Resultados e discussão

A intencionalidade emerge como um conceito central e foram desenvolvidas as 7 etapas do método de van Kaam modificado por Moustakas: horizontalização; redução e eliminação; categorização e tematização dos constituintes invariantes; aplicação e validação; construção da descrição textural individual; construção da descrição estrutural individual; e descrição composta.

Considerações finais

O referencial teórico-metodológico de van Kaam permite um olhar distinto sobre o fenómeno, pois o conhecimento produzido provém da essência textural e estrutural da experiência vivida, numa descrição composta, considerando as suas diversas dimensões perceptivas.

Palavras-chave
Pesquisa qualitativa; Pesquisa em enfermagem; Cuidados de enfermagem; Filosofia

INTRODUCTION

Phenomenological investigation studies, when explaining the nature and meaning of the lived experience, become relevant for the disciplinary construction of nursing1. The excellence and richness of phenomenology reside in a dialogue of different philosophical approaches, guided by different reflective understandings on phenomenology.

Researchers are faced with methodological decisions based on their unique nature, which need reflection and elucidation for the development of the methodological path2. Each researcher has a particular attitude and phenomenological orientation directly linked to the philosophical domain that they have, which they bring to the investigation and which, in the final analysis, conditions the results of their investigation. van Kaam3adopts an approach anchored in the descriptive phenomenology of the Duquesne school to apprehend the lived experience.

In a study of identification of published studies, over a period of twenty years, with a phenomenological-descriptive methodology4, only 3% of the studies were conducted under the theoretical framework proposed by van Kaam, being the less used approach. In a study carried out in Brazil5⁾ and another one carried out in Portugal6, consulting nursing theses, no investigation was identified using this phenomenological approach. Elaborating a reflection on a certain phenomenological approach allows the researcher to deepen the person’s experience in the phenomenon of care immersed in the nurse-patient relationship7. Considering the small number of studies identified, it is considered important to discuss the potential theoretical-methodological contribution of van Kaam’s phenomenology to nursing, providing clues to elucidate and encourage research.

METHOD

Study of theoretical and conceptual reflection on the contribution of van Kaam in phenomenological research in nursing, describing the design of the study addressed in this phenomenological-descriptive methodology. The concepts and processes of understanding the lived experience central to van Kaam’s phenomenological research3, were clarified and systematized, through the deepening of its genesis and methodological nature, anchored in the procedural steps of the van Kaam method Modified by Moustakas⁽⁸⁾. Due to the nature of the study, ethical issues are safeguarded.

RESULTS AND DISCUSSION

Adrian L. van Kaam (1920-2007) was a Dutch-born Catholic priest who founded the doctoral course at the Department of Psychology at the University of Duquesne, in the USA, in 19629. His work, containing about thirty books and hundreds of articles, focuses on phenomenological-existential psychology with a focus on eidetic description. This author dialogues with Husserl, who adopts a perspective primarily focused on uncovering the essence of the phenomenon under study, defending the intentionality of consciousness, the “self”, as responsible for research in the first line, both for the researcher and study participants10. van Kaam’s descriptive approach seeks to capture the essence of consciousness, finding the deepest layers of common human existence3, before the individual’s theoretical conception of experience. As with Husserlian phenomenology, van Kaam3⁾ defends, above all, the Being and human existence as framed in a pure description of the data of the intuition of essences, promoting reflection and elucidation of the processes that appeal to the unveiling of the phenomenon.

The human experience is a dynamic, complex and continuously moving entity11. Intentionality is a central concept in Husserlian phenomenology insofar as the way in which the consciousness of the Being is in the world is intentionally directed to phenomena10. van Kaam also reflects on the importance of intentionality when he mentions that human consciousness is being with the world, an encounter with an orientation, a direction and an intentionality11. This object-directed intention builds the conscious internal experience of the Being of the world, characterizing it as a Being immersed in a reality and social web, which ultimately also defines and shapes it in its existence, being apprehended as the one that springs from intentionality of the awareness focused on the phenomenon3.

Through the method developed by van Kaam, he seeks the explicit meaning of a phenomenon in the narratives, seeking to extract data that are produced, according to the author, by the soul11. Thus, in the 1950s, he defined six procedural steps of phenomenological analysis, which despite being specific, commonly overlap without a fixed order, giving dynamism to his method: 1st and 2nd Step-Listing and rough preliminary grouping; 3rd and 4th Step - Reduction and Elimination; 5th Step - Attempt to identify the descriptive constituents; 6th Step - Final identification of descriptive constituents through the Application3.

In the 1980s, van Kaam12revisited his method, introducing four new steps (Analysis; Translation; Transposition and Phenomenological Reflection) and naming it the Psychophenomenological Method. By revisiting his method, the author proceeded to deconstruct some of its constituent steps and added others in order to enhance reflection in the research process, while helping to structure the method and make it accessible to researchers.

About a decade later, his method was revisited again, in a research method with four phases and twelve steps, and this restructuring, according to the authors, was supervised by van Kaam himself, who considered it a reliable adaptation to his work13. This method presents a high set of data analysis steps, where once again the reflective nature of the process is highlighted, and this aspect, in particular, is valued and referenced in several steps.

Clark Moustakas, founder of the Center for Humanistic Studies in the USA, also modified the method of phenomenological analysis initially proposed by van Kaam3^,11, adapting it to a set of seven specific steps (Chart 1), which can occur in parallel, allowing a global understanding of the phenomenon, entitled Van Kaam Method Modified by Moustakas8.

Chart 1 -
Steps of the van Kaam method modified by Moustakas. Thousand Oaks, California, United States of America, 1994

Steps	Methodological procedures
1st Step	Horizontalization: Listing and Preliminary Grouping
2nd Step	Reduction and Elimination: Determination of Invariant Constituents
3rd Step	Categorization and Thematization of Invariant Constituents
4th Step	Application and Validation: Final Identification of Invariant Constituents and Themes
5th Step	Construction of Individual Textural Description
6th Step	Construction of Individual Structural Description
7th Step	Composite Description: Construction of Structural-Textural Description

• Source: Moustakas8.

1^st Step: Horizontalization: Listing and Preliminary Grouping - Process of reading all texts, individually, to understand the global meaning of the narratives. van Kaam12 recommends these readings to be carried out through a random selection of the reading order of the narratives. This distinctive aspect prevents longer narratives full of description of the phenomenon from taking precedence in the final result of data analysis. Thus, at this step, the researcher's intuition is also strengthened and stimulated for the analysis of the descriptions present in all the narratives, allowing him to gain an initial "insight" about the phenomenon and its essential structure, that is, an intuitive apprehension, associated with the capacity for reflection and self-knowledge, allowing the subject to understand and discover the phenomenon. After this initial reading, all the expressions considered significant for understanding the essence of the experience are listed, and a preliminary grouping of these same expressions, numbered according to the respective narrative, begins in parallel. The concept of horizontalization of descriptions appears in the search for the horizon of the phenomenon as a more intuitive process as all descriptions are leveled by the researcher, since each participant will have a personal perspective of the common phenomenon8.In this comparative process, in which initially the expressions may all have the same value, horizons that have invariant qualities of experience gradually stand out. Thus, in the first step, the researcher tries to obtain the core of common experiences, and for this purpose he prepares a list where he groups the descriptive expressions of the participants, in a so-called preliminary sketch3. This process aims to contribute to the rigor of the investigation, including, if justified, the mutual agreement of independent judges and also the presentation of the quantification of expressions in percentage.

2^nd Step: Reduction and Elimination: Determination of Invariant Constituents - Process of re-reading and analyzing each narrative, identifying expressions or phrases that describe some constituent aspect of the experience. The invariant constituent elements of the experience are abstract statements that converge on a theme, which appear implicitly or explicitly in most narratives3. Moustakas8 suggests that the researcher ask the following questions: Does this expression contain a moment of experience that is both necessary and sufficient for its understanding? and further: Is the expression capable of categorization and ultimately abstraction? This last question is related to the so-called horizon of experience described by van Kaam3, in which descriptive expressions have to be mentally positioned at the same level of analysis. The answer must be positive to both questions to be considered as potentially significant. On the other hand, during this process, those elements that depart, both in content and in form, from the phenomenon were identified, such as vague and repetitive expressions. These data, after selection, are listed separately in expressions considered irrelevant to the understanding of the essence of the phenomenon, being eliminated, and the remaining ones considered horizons of the invariant constituents of the experience.

Although the Reduction process is present in most data analysis methods in the descriptive phenomenological approach, such as the method of van Kaam, Colaizzi, Fischer and Giorgi2, the way it is applied in both is different4. For van Kaam, the process of reduction and epoché requires, at first, a process of awareness and of a receptive presence to the phenomenon, described in his work as “enlightened awareness”, and this process of perception of knowledge of the consciousness regarding the fact or situation guides the researcher so they restrict their explanation to the expression of what is given in the enlightened conscience11. Thus, in the reduction process, van Kaam predicts that the researcher converts the vague and repetitive expressions of the participants into more precise descriptive terms11. In the process of Elimination, van Kaam3 emphasizes the importance of the researcher being able to identify influences of other phenomena on the phenomenon under study, either because they usually occur simultaneously, or because of the contamination of this phenomenon with what is being studied. In this process, the agreement can again be appealed via consultation of independent judges.

3^rd Step: Categorization and Thematization of Invariant Constituents - Process of analysis of expressions considered horizons of invariant constituents of the experience, being grouped and classified, in this step, those that support closed interactions in relation to each other. At this step, the original descriptions, referring to the elements that constitute the essence of the phenomenon, allow us to start designing structural hypotheses essential to the description of the phenomenon. Thus, the themes of the phenomenon emerge, considering its universal qualities, such as time, space, the relationship with the “self”, causality and even corporeity. In this categorization and thematization step, the researcher must reduce and eliminate expressions based on two requirements: Does the expression contain a moment of experience that can be a necessary and sufficient constituent of it? If so, is it possible to abstract this expression and label it preserving the meaning given by the participant? Is a necessary constituent of a certain experience a moment of the experience that, although expressed explicitly or implicitly in a significant majority of explanations by a random sample of subjects, is also compatible with those descriptions that do not express it3? Therefore, all themes that do not coincide with the requirements must be eliminated.

4^th Step: Application and Validation: Final Identification of Invariant Constituents and Themes - Process of carrying out a new reading in order to refine and verify the analysis previously conducted. The themes produced are confronted with the original descriptions in the narratives. At this step, in the face of significant incompatibilities, the essential structure of the elements can be discussed by independent judges. The researcher also reflects on whether the themes are necessary and/or sufficient for the description of the essential structure of the phenomenon, this process being initially designated as application by van Kaam11 and application and validation by Moustakas, suggesting the following questions for reflection by the researcher: Do the identified invariant constituents appear explicitly in the transcript? Are they compatible with the whole despite not appearing explicitly in the transcript? If they do not appear explicitly and are not compatible with the whole, how do they produce meaning for the phenomenon8? At the end of this step, the invariant constituent themes become carriers of meaning for the experience, being explicit in the original transcripts and compatible with the totality of the phenomenon.

5^th Step: Construction of Individual Textural Description - In this step, the researcher seeks to compose an Individual Textural Description, using the expressions “verbatim” from the transcript. The Individual Texture Descriptions are a descriptive integration of the invariant textural constituents of each participant's themes8. The Individual Textural Description constructed portrays. Therefore, the focus is the nature of the phenomenon, being a more objective construction element in view of the invariant constituents and themes that submerged from the analysis of the previous step.

6^th Step: Construction of Individual Structural Description - In this step, the researcher builds an individual abstract structural description of the experience, mobilizing his professional and personal experience in this process. This has a more subjective component, based on the individual textural description under the action of imaginative variation. “Imaginative variation” is an intentional mental process of the researcher that, through imagination, allows analyzing possible meanings, adopting different perspectives of the phenomenon, freely and intuitively considering possible structural qualities, evoking textural characteristics. Therefore, this process requires the researcher to be able to look at the data in a unique way, forcing him to review the various human senses of apprehension of the world and to excel in the imaginative analysis of the data. At this level, art and its various expressions are a recurring source of inspiration in the appropriation of meanings. It is important to reflect, as a researcher, that this process entails an emotional, social and cultural interpretive component of the data, in line with some critical voices, such as van Manen14, who advocates that any description implies an interpretation of the phenomenon. The objective of the analysis is to find the necessary and sufficient constituents of the experience, first in a textural and then structural way, starting from the assumption that the “core” of the experiences is common to different individuals3. van Kaam also defends the importance of the researcher putting in written form the descriptive hypotheses of the phenomenon (Hypothetical Identification), because the explanation is based on raw data, instead of the researcher's own personal experience of the phenomenon11, which is a process that intends to contribute to the rigor in the researcher's judgment. In the process of formulating hypotheses, the author also mentions that he tends from a global analysis of the human situation in its immediate individual gift, clarifying that it is the abstract manifestation of the individual's initial interest for the explanation of the phenomenon as a natural totality3. This process is quite dynamic, requiring an analysis in a movement of several attempts to confront the narratives.

7^th Step: Composite Description: Construction of Structural-Textural Description - Finally, the researcher compiled the meanings and essences of the lived experience in the so-called Structural-Textural Description, combining the Individual Textural Description with the Individual Structural Description. To carry out this process, Moustakas8 suggests the construction of a table or a graph to better identify existing connections in the data. The final presentation of the data analysis is carried out through a Composite Description representative of the totality of the phenomenon, commonly using a geometric figure, where the individual descriptions initially started are blurred, emerging commonalities in the essence of the structure of the experience of the phenomenon. van Kaam described the final product resulting from the data analysis as being partially a set of ordered abstractions of what the person experiences as a natural totality3. The Composite Description of the lived experience is the result of the reflexive and intuitive integration of all the Individual Structural-Structural Descriptions in a universal description, representative of the narratives8, synthesizing the essence and structure of the phenomenon. Thus, in the last step, the researcher must try to randomly apply the explanatory hypotheses to different cases of the participants, that is, according to van Kaam, the procedure consists of checking the constituents provisionally identified against random cases in the sample to see if they meet the conditions3. This process called Application, which begins in the fourth step, allows the review of the hypothetical description, and after the initial review, the researcher must also carry out a new application to the cases in a process of formation of the explanation. Although this concept of explanation, through the final composite description, only emerges later in his work as a concrete step in the method, the truth is that already in his initial work, van Kaam referred to the importance of seeking the implicit and vague awareness of a complex subjective phenomenon that is transformed by the process of expression and formulation into explicit knowledge of its components, designating the process of explanation3. Thus, in the final step, the researcher finally identifies the structural-textural descriptive constituents through the application process, that is, he verifies the identified constituents against the cases. For this purpose, the researcher must ensure that each constituent: Is expressed explicitly in the description; that is, it is expressed explicitly or implicitly in some or most of the descriptions; And if absent, it is consistent with the overall description of the experience. The author states that it must be compatible with the expression in which he did not express himself11. If in the last step a significant expression is identified, but incompatible with a constituent, it must be considered whether this is descriptive of the essence of the experience or of another phenomenon associated with the experience, which in turn only influences or contaminates it.

In this theoretical-methodological approach, the imaginative free variation and the analysis of the data in the form of a narrative report with structural and textural description, appealing to the senses, based on direct quotes from the participants, building a visual and linguistic narrative in the first person that materializes the personal and subjective experience of the essential structure of the phenomenon, allowing a deeper and broader understanding of the topography of the experience of Being. In addition, van Kaam also defends, like Gadamer15, that the research question must be experienced by the researcher. In this perspective, a situation aroused interest and curiosity in him, instigating an entire investigative process. Moustakas8 even states that it is the question that chooses the researcher and it is not the researcher that determines what he intends to study. In practice, the researcher's personal and professional experience assumes relevance in the methodological process. Moustakas8⁾ considers that if the researcher has already experienced a similar phenomenon, he can more easily empathize with the participants, establishing a genuine relationship in the data collection process, as in the interview. Thus, a greater connection between interviewer and interviewees potentially leads to a deeper understanding of the phenomenon. The proximity of the researcher to the theme is considered a source of movement towards the research question and an aspect that enhances the research, the integration and understanding of the phenomenon8, so it considers the researcher as a participant and the other participants as co-researchers.

When reflecting on the influences in his work, van Kaam emphasizes the role of existentialist psychology, however, he does not discard positivism and rationalism, as most phenomenological authors do, since phenomenal-existential psychology is rooted in an original synthesis of certain principles of positivism and rationalism, and phenomenology and existentialism3. These dimensions will play a distinctive role in the methodological approach he advocates, being appreciated by some and criticized by others within the scientific community, because in the studies he carried out, the participants were in large numbers, sometimes with dozens of participants, resorting to quantitative analysis in the separation and accounting of descriptive expressions of the phenomenon4, in an attempt to make the method more rigorous and reliable. Also according to Moustaka8, there is a concern to safeguard the voices of the participants, as the continuous return to the narratives and the focus on the researcher's reflective process during the analysis process contributes to the rigor and integrity of the investigation. Commonly, the various procedures of the method occur simultaneously without being able to be framed in a time frame where the moment when they begin and end is clearly identified.

Regardless of the selected philosophical approach, phenomenology is not limited to a set of sequential and articulated procedures that, performed in a specific order, produce a certain result. Therefore, phenomenological research cannot be condensed into a set of procedural steps, as it requires from the researcher an attitude, a way of being in the investigation, an openness to the phenomenon, an attention to the subtleties of verbal and non-verbal dialogue, a genuine intuition in the data analysis.14. As a limitation of this reflection, it is important to consider that reading this article is not enough to go through a research path, using this phenomenological approach, since it is important for the researcher to deepen the concepts and their essential steps.

FINAL CONSIDERATIONS

Theoretical reflection provides guidelines for researchers who intend to resort to van Kaam’s phenomenological theoretical-methodological approach, which is distinguished by its: focus on the concept of intentionality; the quantitative nature in the initial grouping of data; the randomness in the approach of the narratives; the valorization of the role and the reflective process of the researcher, because despite advocating the importance of reductive processes in the analysis, in a next phase it values the imaginative variation of the researcher in the intuition of the essence of the experience, considering his own lived experience; the systematic return to the narratives as a way of structuring and validating the findings, basing the meanings in the participants’ discourse; and the possibility of involving experts in the discussion of the data, designated as independent judges. The van Kaam method modified by Moustakas includes a 7-step structure that allows a different look at the phenomenon, as the knowledge produced comes from the structural and textural essence of the experiences, considering the different perceptive dimensions of the phenomenon. Thus, this study serves as a call to action so that more research, using van Kaam’s theoretical-methodological approach, is carried out in the area of Nursing.

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Edited by

Associate editor

Helena Becker Issi

Editor-in-chief

Maria da Graça Oliveira Crossetti

Publication Dates

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

History

• Received
  24 May 2022
• Accepted
  06 July 2022