BIBLIOMETRIC STUDY ON NURSING THESES AND DISSERTATIONS EMPLOYING A PHENOMENOLOGICAL APPROACH : TENDENCY AND PERSPECTIVES

This study aimed to analyze the scientific production of nursing dissertations and theses with a phenomenological approach published from 1981 to 2002. A descriptive, retrospective and bibliometric research was carried out. The material analysis, which is part of the database of the catalogue “Information on Nursing Research and Researchers”, resulted in 217 studies, 71,9% from the master’s course and 28,1% from the doctoral course. Among the obtained results, it stands out that the theoretical-philosophical reference chosen to support the data discussion found in investigations has not been used emphatically. There is a need to discuss the unveiled data, through the subjects’ discourse, in the light of the philosophical reference framework mentioned in the research trajectory.


ESTUDO BIBLIOMÉTRICO SOBRE DISSERTAÇÕES E TESES EM ENFERMAGEM COM ABORDAGEM FENOMENOLÓGICA: TENDÊNCIA E PERSPECTIVAS
Based on the presupposition that social reality is not thoroughly explained by quantitative information, qualitative research represents an indispensable strategy to perform nursing studies (1) .
Phenomenology is among the many approaches used in qualitative research.
The phenomenological movement appeared as a reaction to positivism, which states that in order to be valid, phenomena must be empirically measured and studied.Phenomenology, in contrast, aims at direct investigation and to delineate conscience-experienced phenomena, without theories concerning causal explanations and, as much as possible, free of prejudice (2) .
The phenomenological method has recently been acknowledged in qualitative research, mainly in nursing.Several studies emphasize that the phenomenological framework seeks the meaning of one's experience.Moreover, it contributes to understand men, health care subjects, and thus meets nursing purposes (3)(4)(5) .
Nursing practitioners should take notice to the meaning of experiences, the message that patients transmit, which would allow nurses to offer more effective healthcare, centered on patients' needs (6) .
A literature survey about nursing research similar to phenomenology showed that the 1980s marked the beginning of phenomenology-based nursing research.In the 1990s, there was a growing interest on using phenomenological-approach methods in research performed by nurses.This applied science has sought to understand the meaning of experiences associated with the health-disease process, in several phases of one's life cycle, in environments ranging from hospital, outpatient clinic and community care, to home care (7) .
From this perspective, the "form of health care" in nursing can be seen one way by caregivers and health care professionals, and another way by those receiving health care, clients/patients/users.

STUDY CONCERNS AND OBJECTIVES
The The phenomenological method has been broadly used in graduate-courses dissertations and theses.However, results have not been satisfactory because emphasis is on data analysis procedures and not on understanding.There are many reasons for this form of performing data analysis and discussion (8) .
The excessive amount of meaning units that appear in an interview make it difficult to perform a thorough analysis.To do that, considering the theoretical-philosophical framework in use, it would require, after many readings of the interviews, to previously limit the theme, using the stated meaning units as a background; categorization implies reducing the object and not a simple natural categorization.
Since the beginning, the phenomenological method should be used to obtain a previous categorization that would permit to make a phenomenologicallyoriented selection of the statements' most relevant meaning units; limiting and categorizing meaning units, as well as selecting those considered most important to clarify the phenomenon requires a comprehension of intentional and descriptive analyses, which the proposed procedure apparently does not take into consideration; limited time makes many students see phenomenology as a practical shorter pathway that offers a series of steps to be followed (8) .
It is worth emphasizing that this method should be refined from a deeper understanding of the method (8) .Otherwise, it tends to rapidly wear out and promote irreparable dissatisfaction among phenomenology researchers (8) .The aforementioned author states that it is essential to return to using sources, philosophical and phenomenological texts, mainly Husserl and some of his followers, including Heidegger, Merleau-Ponty, and Paul Ricouer.
It is noticed that a great part of the studies with a phenomenological approach point, regarding the method, to the use of a theoretical-philosophical framework as the guideline for data discussion.
However, the analysis shows that other authors, rather than the one pointed in the study method as the philosophical framework, are used for this procedure.
In addition, many phenomenological studies state as their framework authors who provide steps for analysis, rather than those who would support the results found in the study, that is, theoreticalphilosophical foundation.
There are concerns involving nursing knowledge production employing the phenomenological approach.
Hence, the present study was motivated by the interest in knowing how sticto-sensu graduate studies using Regarding the technique, literature reviews comprise reading, selecting, categorizing and filing the topics of interest for the research, with the aim of learning which scientific contributions have been produced for that subject (9) .
Non-systematic reviews are "work for a detective", in which articles are selected by using keywords, author names, and then reading titles (10) .
The inclusion criteria for the dissertations and theses is that they should be available in the CEPEn -ABEn After completing the selection, the full article was searched for reading and data analysis (11) .At this moment, it was analyzed if the philosophical framework, stated in the method section of the study, was used for data analysis.
The theses and dissertations previously identified by reading the abstracts were analyzed  After identifying the dissertations and theses available at the University of Sao Paulo School of Nursing library, the studies were read, analyzed, and categorized according to the items in the script.
The material was analyzed based on the articulation of the quanti-and qualitative approaches, since these two different perspectives are complementary in the search for a better approach to the investigated reality (12) .
In quantitative terms, the following variables were investigated: dissertation/thesis; year of public defense; location, and philosophical framework.
Variables were stored using MS Access, analyzed using MS Excel and later using Epi Info 6.04, by frequencies and crossings.
In qualitative terms, it was sought to analyze the results and subject discussion regarding the theoretical-philosophical framework, through the following question: Did the theoretical-philosophical framework support data analysis?Hence, the qualitative data from answers to the above question were analyzed through the following steps: identification of the theoreticalphilosophical framework in the method; reading data analysis to identify the theoretical-philosophical framework stated in the method.

Descriptive analysis was used for results
presentation with the aim to provide better clarification regarding the obtained data.In the 1980s, five phenomenological studies were presented.As of the 1990s, studies with this focus began to be developed in nursing, very modestly, but increasing considerably over the last years.This information is in line with the previous literature survey, mentioned in the introduction, which showed that in the 1990s there was an interesting increase in nurse-conducted studies employing phenomenology (7) .

RESULTS AND DISCUSSION
A study on the development of nursing graduate programs in Brazil from 1972 to 1994 reported that there was a remarkable increase of graduate courses in the 1990s (13) .The authors state that the boost was due to the reform of the Law of Education Guidelines and Foundations, approved in 1997, which determined that one-third of the faculty in superior level schools must have a masters or doctorate degree.This generated the opening of many graduate courses and, consequently, an increase in the demand for course-candidates, which explains the expressive increase in the number of dissertations and theses employing phenomenology as of the mid-1990s.
Considering the 217 analyzed abstracts, 189 studies (87%) had health care as the theme area, only 23 (11%) were focused on education, and most (71.9%)referred to masters dissertations.
There were more studies associated with adult health, women's health, and child health.Only two studies (0.9%) on collective health were developed.
It is observed that building nursing body of knowledge and associated themes reflect the differences and contradictions of its historical process (14) .In this sense, it is observed that there has been an increase to the understanding of the object of nursing practice, comprising illness and humans in the health-disease process; the many health care levels, from primary to tertiary; health promotion and disease cure and prevention; nursing and health care work organization; integral health care, focused on issues concerning health, disease, and human beings as social and historical processes (15) .
A study about nursing knowledge production in Brazil, in the 1990s, reported that there is significant prevalence of production in the health care are, mainly directed to health care issues, followed by womenand child-related issues.The organizational area appears is ranked second, followed by the professional area (14)   .
It is stated that this difference is probably associated with the focus in graduate programs, which maintain a strong connection with the biomedical model (obstetrics, pediatrics, psychiatry).Regarding educational themes, there are lacks in nursing knowledge, which confirms a general tendency for reduction in studies in the educational area over the last decade in the country (14) .
Most of the analyzed abstracts (89.9%) did not present a methodological framework for analysis.
Regarding the theoretical-philosophical framework used in the studies, stated in the abstracts, 53% were specified and 47% did not use it.The most referenced authors were Heidegger (50.4%), followed by Alfred Schultz (21.7%), and Merleau-Ponty (20%).
Of the 75 studies analyzed in full, with the aim to identify, in the method, the indication of a philosophical framework, 55% indicated their use, and the most cited philosophers were Heidegger (43.9%) and Merleau-Ponty (24.4%).
It is concluded that dissertation and thesis abstracts have not been given the appropriate importance, considering that study abstracts should include a brief statement of the purpose and its relevance, the method used, the obtained results, a statement regarding the main conclusions and additional information about the credibility of results or the article's organization (16) .

FINAL CONSIDERATIONS
The present studied offered a view of what has been studied in nursing graduate courses in Brazil, regarding the phenomenological approach.
It is the commitment of health care professionals to consolidate the body of knowledge in nursing, developing studies that would contribute simultaneously with its increase and consolidation in the referred profession.
The present study also aimed to inform nurses about phenomenology.This method is in line with the nursing proposals in terms of proving health care form patients' perspective.
This study can help interested researchers to develop/deepen phenomenology-based studies.In database in the last two decades (1980 to 2002), considering that, as mentioned before, the 1980s marked the beginning of phenomenology-based nursing research production in Brazil.The search for dissertation and thesis abstracts was performed using printed sources available at the University of Sao Paulo School of Nursing.The first step to identify the studies was choosing the keywords: phenomenology, qualitative research, comprehensive approach/study.The next, and most accurate, step to choose studies was the analytical reading of all abstracts with the aim to identify the thematic area and the theoreticalmethodological framework.
provided they were available at the University of Sao Paulo School of Nursing library.Data were collected between August 2003 and January 2004, using a script containing the following items: place and year of public defense, focus and knowledge area, and questions regarding the methodological and theoretical-philosophical frameworks.

From
1980 to 2002, there were 217 published studies using the phenomenology method, of which 156 (71.9%) refer to master's dissertations and 61 (28.1%) to doctorate theses.The public defenses of dissertations and theses produced employing the phenomenological approach were performed in the graduate programs of the following institutions: University of Sao Paulo School of Nursing, Federal University of Rio de Janeiro, University of Sao Paulo at Ribeirao Preto College of Nursing, Federal University of Minas Gerais, University of Rio de Janeiro, Federal University of Santa Catarina, Federal University of Ceara, Federal University of Bahia, Federal University of Sao Paulo, Federal University of Rio Grande do Sul, Federal University of Para, University of Sao Paulo College of Education, Federal University of Parana, and State University of Rio de Janeiro.The three institutions that most produced phenomenological studies were the University of Sao Paulo School of Nursing (23%), the Federal University of Rio de Janeiro (17.1%), and the University of Sao Paulo at Ribeirao Preto College of Nursing (15.2%).The graduate program at the University of Sao Paulo School of Nursing presented in the referred period 27 (17.3%)masters dissertations and 23 (37.7%) doctorate theses.The graduate program at Federal University of Rio de Janeiro came next, with 24 (15.4%)masters dissertations and 13 (21.3%)doctorate theses, followed by the graduate program at the University of Sao Paulo at Ribeirao Preto College of Nursing, with 24 (15.4%)masters dissertations and 9 (14.7%)doctorate theses.The Federal University of Minas Gerais produced exclusively masters dissertations, but at a considerable amount -25 (25%).
addition, it supports the nursing knowledge area in terms of improving group discussions about research, in qualitative graduate classes and in scientific events associated to research.Results show that in the mid-1990s there was a marking increase in phenomenological dissertations and thesis, mainly in nursing graduate courses at the University of Sao Paulo, as well as at the Federal University of Rio de Janeiro and the University of Sao Paulo -Ribeirao Preto.There was a significant prevalence of scientific productions in the health care area, with themes associated with adult, women's, and child health.Most of the analyzed abstract do not present a methodological framework for analysis.Moreover, 45% of the studies analyzed in full do not have a theoretical-philosophical framework.Thus, it is concluded that studies employing this methodological approach remain ambiguous.To perform phenomenological studies, researchers should study the texts by philosophers and phenomenologists, considering their presuppositions throughout the development of the research.Researchers should justify, for reader clarification, the reasons for choosing qualitative research, phenomenology, and also why the chosen theoretical-philosophical framework meets the study proposals.