DOCTORAL EDUCATI ON I N NURSI NG I N BRAZI L
Rosalin a Apar ecida Par t ezan i Rodr igu es1 Alacoqu e Lor en zin i Er dm an n2 I sília Apar ecida Silv a3 Josicélia Dum et Fer nandes4 Thelm a Leit e Ar aúj o5 Lu cila Am ar al Car n eir o Vian n a6 Rosangela da Silv a Sant os7 Mar t a Júlia Mar ques Lopes8
Rodr igues RAP, Er dm ann AL, Silva I A, Fer nandes JD, Ar aúj o TL, Vianna LAC, Sant os RS, Lopes MJM. Doct or al educat ion in nur sing in Br azil. Rev Lat ino- am Enfer m agem 2008 j ulho- agost o; 16( 4) : 665- 71.
Th is st u dy aim ed t o pr esen t t h e t r aj ect or y of doct or al edu cat ion in n u r sin g in Br azil f r om 1 9 8 1 t o 2 0 0 4 . A descr ipt ive and analyt ical st udy w as car r ied out , using docum ent s available at t he Br azilian Feder al Agency for Suppor t and Evaluat ion of Gr aduat e Educat ion, a body r esponsible for t he r ecognit ion, evaluat ion and coor dinat ion of gr adu at e st u dies in Br azil. Dat a an aly sis r ev ealed t h at t h er e ar e 1 3 doct or al cou r ses in n u r sin g, m ost of w hich ar e concent r at ed in t he Sout heast ( 69.2% ) , and t hat t eaching and scient ific pr oduct ion have been influenced by dem ogr aphic and epidem iological t r ansit ions and by hist or ical, social and polit ical m ov em ent s. Know ledge pr oduct ion is r elat ed t o Nur sing Car e, Healt h Managem ent and Pr act ices and Theor et ical Foundat ions of Car e. Doct or al pr ogr am s have pr epar ed leader s in t he fields of educat ion, r esear ch and public policy developm ent , in healt h inst it ut ions as w ell as in public policies, healt h inst it ut ions and gov er nm ent al ent it ies.
DESCRI PTORS: educat ion, nur sing; educat ion; nur sing
LA EDUCACI ÓN DEL DOCTORADO EN ENFERMERÍ A EN BRASI L
El obj et iv o de est e t r abaj o fue pr esent ar la t r ay ect or ia de la educación del doct or ado en Enfer m er ía en Br asil de 1981 a 2004. Se t r at a de un est udio descr ipt ivo y analít ico que ut ilizó dat os docum ent ados por la Coor dinación de Per feccionam ient o de Niv el Super ior ( CAPES/ MEC) , ór gano r esponsable por el r econocim ient o, ev aluación y coor dinación de est udios de post gr ado en Br asil. El análisis de los dat os puso en ev idencia que ex ist en t r ece cur sos de doct or ado en Enfer m er ía, con concent r ación en la r egión sur est e ( 69,2% ) , y que la enseñanza y la pr oducción cient ífica han sido influenciadas por la t r ansición dem ogr áfica, epidem iológica y por los m ovim ient os hist ór icos, sociales y polít icos. La pr oducción del conocim ient o est á r elacionada a la asist encia de Enfer m er ía, Gestión y Prácticas de Salud y Fundam entos Teóricos del Cuidar. El program a de Doctorado ha preparado líderes en educación, investigación y desarrollo de políticas públicas, en instituciones de la salud y órganos gubernam entales.
DESCRI PTORES: edu cación en en f er m er ía; edu cación ; en f er m er ía
EDUCAÇÃO DO DOUTORADO EM EN FERMAGEM N O BRASI L
O obj et ivo do t r abalho foi apr esent ar a t r aj et ór ia da educação do dout or ado em Enfer m agem no Br asil de 1981 a 2 0 0 4 . Est u do descr it iv o, an alít ico qu e u t ilizou dados docu m en t ados pela Coor den ação de Aper feiçoam en t o de Nív el Super ior ( CAPES/ MEC) , ór gão r esponsáv el pelo r econhecim ent o, av aliação e coor denação de est udos de pós- gr aduação no Br asil. A análise dos dados evidenciou que há t r eze cur sos de dout or ado em Enfer m agem , com concent r ação na r egião sudest e ( 69 , 2 % ) , e que o ensino e a pr odução cient ífica t em sido influenciados pela t r ansição dem ogr áfica, epidem iológica e pelos m ov im ent os hist ór icos, sociais e polít icos. A pr odução do con h ecim en t o est á r elacion ad a à assist ên cia d e En f er m ag em , Gest ão e Pr át icas d e Saú d e e Fu n d am en t os Teór icos do Cuidar . O pr ogr am a de Dout or ado t em pr epar ado líder es em educação, pesquisa e desenvolvim ent o de polít icas públicas, em inst it uições de saúde e ór gãos gov er nam ent ais.
DESCRI TORES: edu cação em en f er m agem ; edu cação; en f er m agem
Mem ber s of t he Com m ission for t he I m pr ov em ent of Higher Educat ion Per sonnel, Minist r y of Educat ion, Brazil: 1 Full Pr ofessor, Univer sit y of Sao Paulo at
Ribeir ao Pr et o, School of Nur sing, WHO Collaborat ing Cent er for Nur sing Resear ch Developm ent , Brazil, e- m ail: r osalina@eer p.usp.br ; 2 Full Pr ofessor,
Federal Univer sit y of Sant a Cat ar ina, Brazil, e- m ail: alacoque@new sit e.com .br ; 3 Full Pr ofessor, Univer sit y of São Paulo College of Nur sing, Brazil, e- m ail:
isasilva@usp.br ; 4 Full Pr ofessor, Federal Univer sit y of Bahia, Brazil, e- m ail: dum et @ufba.br ; 5 Adj unct Pr ofessor, Federal Univer sit y of Cear á, Brazil, e- m ail:
t helm aarauj o2003@yahoo.com .br ; 6 Full Pr ofessor, Federal Univer sit y of São Paulo, Brazil, e- m ail: lvianna@denf.epm .br ; 7 Full Pr ofessor, Federal Univer sit y
of Rio de Janeir o College of Nur sing, Brazil, e- m ail: r oiva@super ig.com .br ; 8 Full Pr ofessor, Federal Univer sit y of Rio Gr ande do Sul College of Nur sing, Brazil,
e- m ail: m ar t a@enf.ufr gs.br.
I NTRODUCTI ON
G
r adu at e edu cat ion is a basic con dit ion t o g r a n t a h i g h e r e d u ca t i o n i n st i t u t i o n t h e co l l e g e ch ar act er t h at t u r n s it in t o a scien ce an d cu lt u r e-pr oducing cent er. Besides const r uct ing t he fram ew or k for r esear ch dev elopm en t , gr adu at e edu cat ion play s a social r ole, an d it s p er f or m an ce d ep en d s on t h e m o b i l i z a t i o n o f t h e a c a d e m i c c o m m u n i t y a n d int egr at ion bet w een t he Br azilian Feder al Agency for S u p p o r t a n d Ev a l u a t i o n o f Gr a d u a t e Ed u c a t i o n ( CAPES) an d t h e Nat ion al Cou n cil f or Scien t if ic an d Tech n olog ical Dev elop m en t ( CNPq ) .I n t h i s c o u n t r y, t h e N a t i o n a l Gr a d u a t e Edu cat ion Sy st em ( SNPG) , appr ov ed by t h e Feder al Ed u cat i o n Co u n ci l t h r o u g h a d o cu m en t f r eq u en t l y r efer r ed t o as t he Sucupir a Decr ee, w as est ablished b y t h e Un i v e r si t y Re f o r m o f 1 9 6 8 . I t s e x p a n si o n st ar t ed in t he 1990’s and involved all know ledge areas, w hich looked for answ ers t hat w ould indicat e t he need t o t r a i n q u a l i f i e d t e a ch i n g st a f f t o a t t e n d t o t h e cou n t r y ’s h ig h er ed u cat ion d em an d s, as w ell as t o br oaden colleges’ r esear ch capacit y. This w ould only be possible by t r aining new r esear cher s( 1).
Th e SNPG is coor din at ed by t h e Min ist r y of Ed u ca t i o n ( MEC) t h r o u g h CAPES. Th i s f o u n d a t i o n su p p o r t s t h e MEC i n t h e f o r m u l a t i o n o f g r a d u a t e p olicies an d in t h e coor d in at ion an d st im u lat ion t o con ced e f ellow sh ip s, g r an t s an d ot h er m ech an ism s d i r e ct e d a t h u m a n r e so u r ce f o r m a t i o n f o r h i g h e r educat ion and t eaching.
The SNPG is being im plem ent ed on t he basis of fiv e Nat ional Gr aduat e Educat ion Plans ( PNPG)( 2). The I PNPG ( 1 9 7 5 - 1 9 7 9 ) indicat ed t he ex pansion of gr aduat e educat ion as a public obj ect iv e, int egr at ed w it h social an d econ om ic dev elopm en t policies. Th e cent r al obj ect ive of PNPG I I ( 1982- 1985) w as hum an r e s o u r c e f o r m a t i o n f o r t e a c h i n g , r e s e a r c h a n d t e c h n i c a l a c t i v i t i e s , g i v i n g r i s e t o t h e n e e d t o i n s t i t u t i o n a l i z e a n d i m p r o v e e v a l u a t i o n , w i t h com m u n it y par t icipat ion . Th e I I I PNPG ( 1 9 8 6 - 1 9 8 9 ) ev alu at ed t h at t h e qu an t it y of r esear ch er s in Br azil w as insufficient for t he count ry t o achieve a favorable l e v e l o f s c i e n t i f i c a n d t e c h n o l o g i c a l t r a i n i n g , em p h asizin g t h e n eed f or r esear ch d ev elop m en t at univ er sit y lev el and for int egr at ion bet w een gr aduat e edu cat ion an d t h e Br azilian scien ce an d t ech n ology sy st em . Th e m ain p oin t s of PNPG I V ( 1 9 9 6 ) w er e: ev olu t ion of gr adu at e edu cat ion or gan izat ion for m s;
h u m a n r e s o u r c e f o r m a t i o n a n d l a b o r m a r k e t ; i n t e g r a t i o n b e t w e e n u n d e r g r a d u a t e a n d g r a d u a t e e d u c a t i o n , a c a d e m i c c a r e e r a n d q u a l i f i c a t i o n o f t e a ch i n g st a f f ; g r a d u a t e e d u ca t i o n e v a l u a t i o n b y CAPES; ex p an sion of g r ad u at e ed u cat ion , r eg ion al disequilibr ia and gr aduat e educat ion funding and cost s. The aim s of PNPG V ( 2005- 2010) ar e: st abilizing and inducing Br azilian gr aduat e educat ion; st r at egies for im pr oving t he per for m ance of t he gr aduat e educat ion syst em , t hat is, cr eat ing specific pr ogr am s and gr eat er ar t icu lat ion b et w een f ed er al an d st at e ag en cies f or p r o g r am an d r esear ch su p p o r t ; r esear ch f u n d i n g ; i n t r o d u c i n g n e w g r a d u a t e e d u c a t i o n m o d e l s t o st r en g t h en all ed u cat ion lev els; f or m at ion of n on -academ ic st aff; st im ulat ing nat ional and int er nat ional c o o p e r a t i o n a n d , f i n a l l y, p r e s e r v i n g q u a l i t y a n d p e r i o d i c i t y o f g r a d u a t e e d u c a t i o n s y s t e m evaluat ions( 2). I n t his sense, t he SNPG evidences t hree asp ect s: 1 - ad o p t i o n o f ev al u at i o n cr i t er i a b y t h e s c i e n t i f i c a n d a c a d e m i c c o m m u n i t y, u n d e r t h e co o r d i n a t i o n o f CAPES; 2 - e x p a n si o n o f r e se a r ch d e v e l o p m e n t f u n d i n g b y CAPES, CNPq a n d St a t e Foundat ions; 3 - per m anent par t icipat ion of scient ific com m unit y in t he evaluat ion and r eevaluat ion pr ocess of Br azilian gr adu at e edu cat ion .
I n it s search for qualit y, t he Brazilian syst em has elect ed scient ific pr oduct ion as one of t he m ain e v a l u a t i o n p a r a m e t e r s f o r Ma st e r ’ s a n d D o ct o r a l Gr adu at e Edu cat ion Pr ogr am s.
I n ev aluat ing t he qualit y of t hese pr ogr am s, CAPES assu m es t h r ee m ain com m it m en t s: f ir st , t o d o w e l l w h a t i s b e i n g b a d l y d o n e , w h i ch m e a n s
int r oducing sy st em s for diagnosing t he funct ioning of differ ent sect or s and ident ifying t heir st r ong and w eak point s; second, t o do bet t er w hat is being done w ell, w h ich r ef er s t o a st r at egic in st it u t ion al qu alif icat ion and developm ent plan t hat is capable of consolidat ing and sust aining achievem ent s; and, finally, doing w hat i s n o t b e i n g d o n e a n d d o i n g i t w e l l , t h a t i s ,
i n co r p o r at i n g d ev i ces t h at f aci l i t at e an d al l o w f o r sy st em at ic innov at ions and gr ow t h pr ocesses( 3 ).
I n r esponse t o t his inquir y, our st udy depar t s fr om t h e pr em ise t h at doct or al edu cat ion sh ou ld be founded on t he lim it s and possibilit ies of it s hist orical an d cu lt u r al space w h ich , in t u r n , is n ot st at ic, bu t subj ect t o cont inuous t ransform at ions. Hence, nursing doct or al edu cat ion is dy n am ically adj u st ed t o social evolut ions and obeys t o pr ofessional and healt h sect or dem ands. Thus, it is t he pr oduct of a m ult iplicit y of social pr ocesses, hist or ically const it ut ed on t he basis o f h e a l t h p r o f e s s i o n a l p r a c t i c e s a n d t h e s o c i a l en v ir on m en t s t h ese pr act ices ar e dev eloped in .
I n t h i s p e r sp e ct i v e , w e f o cu s o n n u r si n g doct or al for m at ion in Br azil, not as an idealized and abst r act phenom enon, but as a par t and pr oduct of n u r sin g k n ow ledge con st r u ct ion .
Based on t h ese con sid er at ion s, w e p r esen t t h e t r a j ect o r y a n d t en d en ci es o f n u r si n g d o ct o r a l educat ion in Br azil bet w een 1981 and 2005, not only w i t h a v i ew t o co n st r u ct i n g k n o w l ed g e a b o u t t h e n u r si n g f o r m a t i o n p r o cess, b u t a l so t o su p p o r t a st r at egic plan t hat sust ains gr aduat e policies for t he n u r sin g ar ea.
To r e a c h t h e s e o b j e c t i v e s , w e a n a l y z e d r e p o r t s o n Gr a d u a t e Pr o g r a m s i n N u r s i n g a n d d o c u m e n t s a v a i l a b l e i n CAPES’ s t a t i s t i c a l b a s e s CAPES/ MEC( 4). Dat a w er e collect ed fr om Mast er ’s and D o c t o r a l Gr a d u a t e Pr o g r a m s b y a p p l y i n g a n i n st r u m en t w i t h t h e f o l l o w i n g v a r i a b l es: Pr o g r a m h ist or y, g eog r ap h ic locat ion , n u m b er of g r ad u at es, d o ct o r al ed u cat i on p r o j ect , d i sser t at i on s p r od u ced bet w een 1 9 8 1 and 2 0 0 4 , r esear ch lines in gr aduat e pr ogr am s an d ev alu at ion pr ocess.
G R A D U A T E N U R S I N G E D U CA T I O N
-EMPHASI S ON DOCTORAL FORMATI ON
At fir st , gr aduat e educat ion policies in Br azil f ocu sed on f acu lt y t r ain in g ; n ex t , t h e f ocu s m ov ed t ow ar ds t h e per f or m an ce of t h e gr adu at e edu cat ion syst em and t he SNPG, as w ell as t o t he developm ent of scient ific and t echnological research at college level, w it h a view t o at t ending t o nat ional priorit ies.
St ill in t he fr am ew or k of t he I PNPG, CAPES sy st em a t i ca l l y a cco m p a n i ed t h e en t i r e p r o cess o f im plant ing t he gr aduat e pr ogr am ev aluat ion sy st em , aim ed at g u ar an t eein g t h e acad em ic q u alit y of t h e SNPG.
Th e gen er al SNPG ex pan ded in 2 0 0 3 , w h en 1, 819 pr ogr am s w er e offer ed, r epr esent ing a gr ow t h b y 1 5 . 9 % in r elat ion t o t h e t r ien n iu m 1 9 9 8 - 2 0 0 0 . How ever, not all geographic r egions gr ew at t he sam e pace: t he Sout heast concent r at es 66.57% of doct or al c o u r s e s , f o l l o w e d b y So u t h ( 1 7 . 6 % ) , N o r t h e a s t ( 10.4% ) , Cent ral- West ( 4.11% ) and Nor t h ( 1.76% )( 4). I n t he 1970’s, t he fir st doct or al gr aduat es in Nu r sin g w er e t r ain ed in t h e Sou t h east , in cou r ses a f f i l i a t e d w i t h t h e Fa cu l t y o f Me d i ci n e . Af t e r t h e f or m at ion of n u r sin g d oct or al g r ad u at es, t h e An n a Ner y Sch ool of Nu r sin g at t h e Feder al Un iv er sit y of Ri o d e Ja n ei r o cr ea t ed t h e f i r st Br a zi l i a n Ma st er s cour se in 1972. Aft er it s im plem ent at ion, ot her cour ses w er e est ablished in differ ent r egions.
Due t o scient ific and t echnological adv ances and t he ur gent need t o t r ain doct or al gr aduat es, t he Un iv er sit y of São Pau lo College of Nu r sin g an d t h e Un iv er sit y of São Pau lo at Ribeir ão Pr et o College of N u r si n g j o i n e d f o r ce s a n d cr e a t e d t h e I n t e r u n i t D o ct o r a l co u r se . Th e d o ct o r a l co u r se i n Nu r si n g im plan t ed at t h ese in st it u t ion s, w h ich w as t h e f ir st ( 1981) in Br azil and in Lat in Am er ica, st ar t ed a new age in nursing, offering t he possibilit y t o t rain doct oral gr aduat es in nur sing w ho w ould develop r esear ch t hat at t ended t o nat ional pr ior it ies.
Fr om t his m om ent onw ar ds, t he scenar io of Br a zi l i a n g r a d u a t e e d u ca t i o n h a s b e e n g r a d u a l l y t ak in g for m an d ex pan din g, per m an en t ly seek in g t o m aint ain academ ic excellence. I n t his sense, research is bein g dev eloped t h at at t en ds t o t h e popu lat ion ’s and t he nat ional healt h sy st em ’s int er est s. Alt hough t his ex pansion m ov em ent is dir ect ed by qualit y and r eg ion al d iseq u ilib r ia, Br azilian g r ad u at e ed u cat ion bodies are w or ried about t he dist r ibut ion of t he cour ses offer ed and t he flexibilizat ion of t he nur sing gr aduat e educat ion m odel, as new cour ses ar e being cr eat ed, m ainly in m or e dest it ut e r egions.
As f r om 1 9 9 3 , CAPES/ MEC con sid er ed t h e t im ing w as r ight t o or ganize gr aduat e educat ion int o k n ow ledge ar eas, w h ich w er e: Mu lt idisciplin ar y an d Te a c h i n g , A p p l i e d S o c i a l S c i e n c e s , A g r i c u l t u r a l S c i e n c e s , H u m a n S c i e n c e s , B i o l o g i c a l S c i e n c e s , En gin eer in g; Lin gu ist ics, Lan gu ages an d Ar t s, Ex act and Ear t h Sciences and Healt h Sciences. The Healt h Sci e n ce a r e a co n si st e d o f : Me d i ci n e I ( cl i n i ca l ) , Med i ci n e I I ( Psy ch i a t r y, Ped i a t r i cs a n d Nu t r i t i o n ) , Medicine I I I ( Sur ger y ) , Dent ist r y, Phar m acy, Nur sing, Collect iv e Healt h , Ph y sical Edu cat ion , Ph y siot h er apy and Occupat ional Therapy. Each ar ea com ponent had a r epr esen t at iv e, r espon sible f or act in g in dif f er en t CAPES/ MEC co m m i ssi o n s. I n t e r m s o f g r o w t h i n doct or al cour ses bet w een 1996 and 2004, t he Healt h Science ( 22.7) ar ea ex per ienced t he lar gest incr ease am o n g al l k n o w l ed g e ar eas. 4 . 3 % g r o w t h r at e i n Nu r sin g d oct or al cou r ses in com p ar ison w it h ot h er Healt h Scien ce ar eas.
Based on t he above infor m at ion, w e analyzed nur sing gr aduat e pr ogr am s’ r epor t s on t heir act ivit ies in 2 0 0 5 , specif ically pr ogr am s t h at of f er ed doct or al cour ses, and found t he follow ing r esult s: in 2005, 27 m ast er and doct or al nur sing gr aduat e pr ogr am s w er e r ecogn ized in Br azil, r epr esen t in g a 3 1 . 2 5 % gr ow t h i n r e l a t i o n t o t h e p r e v i o u s t r i e n n i u m 1 9 9 8 - 2 0 0 0 . How ever, t his gr ow t h only occur r ed in t he Sout h and S o u t h e a s t ; t h e s a m e n u m b e r o f p r o g r a m s w a s m aint ained in t he Nor t heast .
I n t er m s of locat ion, 15 ( 55.5 % ) m ast er and doct or al n u r sin g gr adu at e pr ogr am s w er e offer ed in t he Sout heast ; 5 ( 18.5% ) in t he Sout h; 5 ( 18.5% ) in t h e Nor t h east , t w o ( 7 . 5 % ) in t h e Cen t r al- West an d none in t he Nort h( 4).
I n t er m s of gr aduat e educat ion, accor ding t o CAPES d a t a , g r a d u a t e p r o g r a m s i n a l l k n o w l ed g e ar eas conceded 35,724 degr ees in t he t r iennium 2001-2003; 8,094 of t hese at doct or al level ( Br asil, 2005b) . Mor e specifically in nur sing, 343 doct or al cer t ificat es w er e gr ant ed in t he sam e per iod, 76.40% of w hich in t he Sout heast ; 11. 07% in t he Sout h and 12. 53% in t he Nor t heast( 4).
Th e n u m b er of n u r sin g g r ad u at e p r og r am s and doct or al cour ses has ex per ienced a consider able in cr ease in r ecen t y ear s; h ow ev er, in sp it e of t h e m odels pr oposed by public policies t o develop Br azilian graduat e educat ion, regional inequalit ies persist in t he num ber of doct or al gr aduat es as w ell as in t he num ber of gr aduat e pr ogr am s offer ed in t his know ledge ar ea.
I nit ially, t he nur sing doct oral m odel in Br azil f o c u s e d o n p r e p a r i n g s t u d e n t s t h r o u g h i n - c l a s s s u b j e c t s ( d u r a t i o n o f a p p r o x i m a t e l y o n e y e a r ) , follow ed by a qu alificat ion ex am an d cu lm in at in g in t he defense of a disser t at ion. This appr oach aim ed at t r a i n i n g r e se a r ch e r s t o t e st a n d d e v e l o p n u r si n g k n ow led g e. How ev er, it sh ou ld b e h ig h lig h t ed t h at B r a z i l i a n n u r s i n g l e a d e r s a r e d i s c u s s i n g t h e p e r sp e ct i v e o f ch a n g i n g d o ct o r a l e d u ca t i o n . Th e cur r ent focus of t heir discussions is t he adher ence t o l ear n i n g ex p er i en ces, i n co m p l i an ce w i t h d o ct o r al co u r se s’ p e d a g o g i ca l p r o j e ct , a l w a y s p r i o r i t i zi n g p op u lat ion h ealt h an d h ealt h ser v ice m an ag em en t needs. I n t his sense, Br azilian univer sit ies have been st im u lat in g t h eir n u r sin g d oct or al st u d en t s t o p ass b e t w e e n o n e a n d t w o se m e st e r s a t h i g h - q u a l i t y foreign universit ies, w it h a view t o great er int eract ion w it h r efer ence cent er s in t he ar ea.
1 d l e i F / a e r
A Area/Field2 Area/Field3
l a n o i s s e f o r
P Care Organizational
d n a h tl a e H f o s n o it a d n u o f l a c i h p o s o li h p -l a c it e r o e h T 1 . 1 e r a c g n i s r u
N 2.1CareprocessinHeatlhandNursing 3.1HeatlhandNursingpoilciesandpracitces g n i s r u N d n a h tl a e H n i y g o l o n h c e T 2 .
1 2.2Heatlhandquailtyofilfe 3.2EducaitonandNursingpoilciesandpracitces g n i s r u N d n a h tl a e H n i s c i h t E 3 .
1 --- 3.3SocialproducitonandworkinHeatlhandNursing y r o t s i h g n i s r u N 4 .
1 --- 3.4HeatlhandNursingservicemanagement
-- --- 3.5Informaiton/communicaitoninHeatlhandNursing
Table 1 - Descr ipt ion of Resear ch Lines in Gr aduat e Nur sing Pr ogr am s / CAPES – Flor ianópolis, 2001
Car valho, 2002
Bet w een 1983 and 2001, 448 nur sing doct or al d i sser t at i o n s w er e d ef en d ed i n Br azi l i an g r ad u at e pr ogr am s. Their r esult s show t hat m ost st udies w er e pr oduced in t he car e ( 171 or 38.1% ) and or ganizat ional ar ea/ field ( 164 or 36.6% ) , follow ed by t he pr ofessional ar ea ( 86 or 19.1% ) . The m ost fr equent r esear ch lines
w er e: Healt h and qualit y of life, Car e Pr ocess in Healt h and Nur sing, in Car e; Educat ion and Nur sing Policies
a n d Pr a c t i c e s , H e a l t h a n d N u r s i n g S e r v i c e
M a n a g e m e n t , i n t h e O r g a n i z a t i o n a l a r e a ; a n d
Th eor et ical- Ph ilosop h ical Fou n d at ion s of Healt h an d
Nur sing Car e, in t he pr ofessional ar ea( 7).
Th e m o s t f r e q u e n t t h e m e a r e a s w e r e : Wom en ’s Healt h , Nu r sin g an d Healt h Man ag em en t ,
Collect ive Healt h and Child Healt h, am ong ot her s. This
pr edom in an ce m ay be du e t o t h e fact t h at t h e fir st r esear ch lines, adopt ed in gr aduat e pr ogr am s cr eat ed i n t h e 1 9 7 0 ’s, r ef er r ed t o Wo m en ’s Hea l t h , Ch i l d H e a l t h , Co l l e c t i v e H e a l t h / Pu b l i c H e a l t h a n d Adm in ist r at ion / Man agem en t .
Th e l a r g e n u m b e r o f st u d i e s o n w o m e n ’ s healt h and service m anagem ent r eveals t hat , in Br azil, w om en’s healt h is one of t he m ain social and polit ical ch allen g es.
I n t er m s of r esear ch lines and m et hods, st udy o r r e s e a r c h t y p e , m o s t s t u d i e s w e r e e i t h e r
explor at or y w it h a qualit at ive appr oach or st udies t hat sou gh t k n ow ledge abou t r ealit y or u n der st an din g of
social ph en om en a, in dicat in g a par adigm ch an ge in t h e n u r sin g k n ow led g e con st r u ct ion p r ocess, w h ich ev idences a t endency t ow ar ds qualit at iv e st udies. I n t h i s s e n s e , p h e n o m e n o l o g i c a l - h e r m e n e u t i c a l , e t h n o g r a p h i c, h i st o r i c a n d so ci a l st u d i e s, a m o n g o t h e r s, r e v e a l e d p o ssi b i l i t i e s t o o b t a i n a d e e p e r k n o w l e d g e o r u n d e r s t a n d i n g a b o u t t h e s o c i a l ph en om en a t h at per m eat e n u r sin g pr act ice.
The use of differ ent m et hods and t heor et ical ap p r o ach es h as r eq u i r ed co n t en t s an d t h eo r et i cal foundat ions from ot her ar eas, offer ing a w ider chance
o f k n o w l e d g e c o n s t r u c t i o n a n d p r o f e s s i o n a l im pr ov em en t f r om a scien t if ic an d cu lt u r al poin t of v iew .
Ou r an aly sis h as clear ly sh ow n an in cr ease in t h e n u m b er of cou r ses an d d oct or al g r ad u at es. Mor eov er, com m unicat ion vehicles ar e allow ing for a m or e int ense and agile infor m at ion ex change am ong r esear ch er s, f av or in g t h e d ev elop m en t of r esear ch and Nur sing it self.
Th e scien t if ic p r od u ct ion or ig in at ed b y t h e t heses considered here indicat es t he legit im acy of t he r esear ch lines defined by t he nur sing ar ea at CAPES in t er m s of r ange, m ak ing it possible t o accom pany n u r s i n g r e s e a r c h t e n d e n c i e s a s w e l l a s t h e i r con solidat ion an d con sist en cy.
Th e con solid at ion of n u r sin g r esear ch lin es a n d j o i n t r e se a r ch i n i t i a t i v e s i n p a r t n e r sh i p w i t h r esear ch g r ou p s f r om d if f er en t r eg ion s in Br azil as w ell as abr oad offer s possibilit ies t o ident ify r esear ch p r ior it ies an d p r od u ce less f r ag m en t ed k n ow led g e. These fact ors favor gr eat er ar t iculat ion and int egr at ion in m u lt idisciplin ar y k n ow ledge.
Th e r an g e o f su b j ect s f r o m d i v er se ar eas in v olv ed in in t er d iscip lin ar y t r ain in g an d t h e ab ov e m en t i o n ed p ar t n er sh i p s p o i n t t o w ar d s a t en d en cy aim ed at im pr ov ing nur sing educat ion.
On t h e ot h er h an d, t h e in cr ease in n u r sin g k n o w l e d g e a l l o v e r t h e w o r l d h a s co n t r i b u t e d t o im pr ov e doct or al educat ion, influencing bot h doct or al
e d u ca t i o n p r o g r a m s ( r e se a r ch d e v e l o p m e n t ) a n d p r o f e s s i o n a l p r a c t i c e . W i t h a v i e w t o a c h i e v i n g excellence, doct oral t eaching st aff has been m obilized t o exchange know ledge w it h int ernat ional researchers, w het her t hr ough post doct or al cour ses or collabor at ive r esear ch , cl osi n g i n t er - i n st i t u t i on al ag r eem en t s or pr esent ing r esear ch at int er nat ional congr esses, w it h a v iew t o pr om ot ing adv ances in t eaching m odels.
pr oblem s, w het her t hese ar e cur r ent or fut ur e, global or, at least , m ult inat ional or int ernat ional( 8), displaying n u r sin g as a p r of ession of g lob al im p or t an ce. Th is r ev eals t he r elev ant r ole of int er nat ional ar t iculat ions t o i m p r o v e d o ct o r al ed u cat i o n i n Br azi l an d o t h er cou n t r ies.
I n Eur ope, som e count r ies ar e only st ar t ing d o ct o r a l e d u ca t i o n i n n u r si n g , w h i l e o t h e r s h a v e already reached high educat ional and research levels. Th i s i n d i c a t e s t h e p o s s i b i l i t y o f e s t a b l i s h i n g a co l l a b o r a t i v e n e t w o r k a m o n g d i f f e r e n t Eu r o p e a n u n i v e r s i t i e s , t h r o u g h t h e Eu r o p e a n A c a d e m y o f Nur sing and t he Nor dic Academ y for Advanced St udy. I n Eu r o p e , t h e s t u d y a r e a o f N u r s i n g d o c t o r a l edu cat ion depen ds on each u n iv er sit y ’s pr ogr am ; in Fin lan d , f or ex am p le, r esear ch is m or e d ir ect ed at t h e clin ical ar ea, follow ed b y edu cat ion an d, fin ally, adm in ist r at ion( 8 ).
A c o m p a r i s o n b e t w e e n n u r s i n g d o c t o r a l educat ion in Br azil and in Eur ope and Nor t h Am er ica r ev eals t h at t h e pr odu ced k n ow ledge is f ou n ded on sim ilar fact ors, and t hat t here is also a need for great er i n t e r l o c u t i o n a m o n g d i f f e r e n t u n i v e r s i t i e s a n d r esear cher s w it h a v iew t o int er nat ional net w or k ing. Mor eov er, in t hese r egions, var iables lik e populat ion a g e i n g , h e a l t h p r i o r i t i e s ( a n a l y s i s o f m o r b i d i t y, d i sab i l i t y an d d eat h cau ses) , so ci al an d eco n o m i c f a ct o r s a n d h e a l t h se ct o r o r g a n i za t i o n co n st i t u t e essent ial t hem es for research developm ent( 8). I n Nort h Am erica, count ries like t he Unit ed St at es and Canada p r o m o t e t h e e x p a n si o n o f n u r si n g k n o w l e d g e b y em ph asizin g in div idu al, fam ily an d com m u n it y car e, inst ead of focusing on disease. Nur sing k now ledge in No r t h Am e r i ca h a s r a p i d l y e x p a n d e d d u e t o t h e i n cr e a se i n r e se a r ch f u n d s a v a i l a b l e f o r d o ct o r a l st u d e n t s a n d g r a d u a t e d r e se a r ch e r s. Co n t e x t u a l fact ors influencing know ledge developm ent in doct or al p r o g r a m s i n cl u d e so ci a l , e co n o m i c, p o l i t i ca l a n d dem ographic indicat ors, as w ell as t he cont ext of t he healt h sy st em it self( 8).
As a r esult of t he guidelines est ablished for d oct or al ed u cat ion in Br azil, u n iv er sit ies an d n u r se r esear cher s at t em pt t o collabor at e w it h int er nat ional univ er sit ies and r esear cher s on a m or e consolidat ed b a s e , w i t h a v i e w t o i m p l e m e n t i n g m u l t i c e n t e r r e s e a r c h w i t h a w i d e r r a n g e o f a l t e r n a t i v e m e t h o d o l o g i e s, i n cl u d i n g t r i a l s. An o t h e r r e l e v a n t aspect is r esear ch funding in Br azilian nur sing, w hich
is affect ed by t he lim it ed num ber of agencies and t he lar ge num ber of com pet it or s for t hese gr ant s.
Special at t ent ion should also be given t o t he im pact fact or s of r esear ch. This par am et er should be follow ed and m easur ed by r esear cher s; t he pr oduced k n ow ledge sh ou ld be ev alu at ed, m easu r in g w h et h er t h i s k n o w l e d g e h a s c o n t r i b u t e d t o p r o f e s s i o n a l p r a ct i ce ; st r a t e g i e s sh o u l d b e d e f i n e d t h a t a l l o w organizat ions t o im plant research result s and est ablish consort ia am ong universit ies, researchers and nursing p r of ession als. Th ese an d ot h er issu es ar e essen t ial for t he consolidat ion of Br azilian nur sing r esear ch, in v i e w o f t h e r e su l t s p r e se n t e d b y Er d m a n n e t a l . ( 2 0 0 5 ) .
FI NAL CONSI DERATI ONS
The educat ion syst em , as one of t he st r at egic p o i n t s i n B r a z i l ’ s s o c i o e c o n o m i c a n d c u l t u r a l developm ent pr ocess, has show n t hat nur sing doct or al edu cat ion pr ov ides an im por t an t con t r ibu t ion t o t h e con st r u ct ion of social k n ow led g e in h ealt h . I n t h is p er sp ect iv e, m an y of t h e p r ed om in an t cu r r en t an d f u t u r e h ea l t h p r o b l em s w i l l b e g l o b a l , o r a t l ea st m ult inat ional or int er nat ional( 9).
REFERENCES
1 . B a l b a c h e v s k y E, V e l l o s o J. A t i v i d a d e s e d i t o r i a i s ,
c o m i t ê s e t r a j e t ó r i a s p r o f i s s i o n a i s . I n : V e l l o s o J,
o r g an i zad o r. Fo r m ação n o p aís o u n o ex t er i o r ? D o u t o r es
n a p ó s - g r a d u a ç ã o d e e x c e l ê n c i a . B r a s í l i a : Fu n d a ç ã o
CA PES ; 2 0 0 2 .
2 . Mi n i st é r i o d a Ed u ca çã o ( BR) . Pl a n o Na ci o n a l d e Pó
s-Gr a d u a ç ã o – PN PG 2 0 0 5 - 2 0 1 0 . B r a s íl i a : Mi n i s t é r i o d a
Ed u ca çã o ; CAPES; 2 0 0 5 .
3 . Z ab alza MA. O en sin o u n iv er sit ár io, seu cen ár io e seu s
pr ot agon ist as; Por t o Alegr e: Ar t m ed; 2 0 0 4 .
4 . Mi n i st ér i o d a Ed u ca çã o ( BR) . Secr et a r i a d e Ed u ca çã o
Su p er ior. Coor d en ação d e Ap er f eiçoam en t o d e Pessoal d e
Nív el Super ior [ Hom epage na I nt er net ] . 2004- 2005 [ Acesso
1 0 f e v 2 0 0 6 ] . Es t a t ís t i c a d a p ó s - g r a d u a ç ã o ; [ 1 t e l a ] .
Disponív el em : ht t p: w w w. capes. gov. br.
5 . K i m M J, W i l s o n - B a r n e t t J, Ro d r i g u e s RA P. Q u a l i t y
m on it or in g an d qu alit y cr it er ia f or doct or al pr ogr am m es: a
g l o b a l p er sp ect i v e. I n : Ket ef i a n S, McKen n a H. D o ct o r a l
Ed u cat ion in Nu r sin g : I n t er n at ion al Per sp ect iv es. Lon d on :
Recebido em : 25.1.2007 Apr ovado em : 11.11.2007
Rou t led g e; 2 0 0 5 . p . 1 4 7 - 6 1 .
6 . Ca r v a l h o V. Li n h a s d e p e s q u i s a e p r i o r i d a d e s d e
e n f e r m a g e m : p r o p o st a co m d i st i n çã o g n o se o l ó g i ca p a r a
ag r u p am en t o d a p r od u ção cien t íf ica d e p ós- g r ad u ação em
en f er m ag em . Esc An n a Ner y Rev En f er m 2 0 0 2 ; 6 ( 1 ) : 1 4 5
-5 4 .
7. Er dm ann AL, Silva I A, Rodr igues RAP, Fer nandes JD, Vianna
LAC, Lopes MJM et al. . Teses pr oduzidas nos pr ogram as de
p ó s - g r a d u a ç ã o e m e n f e r m a g e m d e 1 9 8 3 a 2 0 0 1 : u m a
a p r o x i m a ç ã o c o m a s l i n h a s d e p e s q u i s a d a á r e a d e
En f er m ag em / CAPES/ MEC. Rev Esc En f er m USP 2 0 0 5 ; 3 9
( n ú m er o esp ecial) : 4 9 7 - 5 0 5 .
8. Hinshaw AS, Leino- Kilpi H. Fut ur e dir ect ions in k now ledge
dev elopm ent and doct or al educat ion in nur sing. I n: Ket efian
S, McKenna H. Doct or al Educat ion in Nur sing: I nt er nat ional
Per spect iv es. Lon don : Rou t ledge; 2 0 0 5 . p. 2 7 - 5 5 .
9 . Wr igh t MGM, Cau f ield C, Gr ay G, Olson J. I n t er n at ion al
r esear ch capacit y - building pr ogr am s for nur ses t o st udy t he
d r u g p h e n o m e n o n i n La t i n A m e r i c a : c h a l l e n g e s a n d
per spect iv es. Rev Lat in o- am En f er m agem 2 0 0 5 ; 1 3 ( special
