REVI EW OF SCI ENTI FI C LI TERATURE ON THE USE OF GROUP
ACTI VI TI ES I N NURSI NG W ORK I N BRAZI L: 1980 TO 2003
1Mar ia Ter eza Hagen de Godoy2 Denize Bout t elet Munar i3
Godoy MTH, Munar i DB. Review of scient ific lit er at ur e on t he use of gr oup act ivit ies in nur sing w or k in Br azil: 1980 t o 2003. Rev Lat ino- am Enfer m agem 2006 set em br o- out ubr o; 14( 5) : 796- 802.
Am ong t he m any and div er se act iv it ies car r ied out by nur ses, m any ar e or ganized w it hin t he cont ex t of a gr oup appr oach. The r ealizat ion t hat t her e w er e no sy st em at ized st udies in Br azil, capable of pr ov iding param et ers t hat would help t o underst and how nurses use t his resource, m ot ivat ed t he aut hors t o develop t his st udy, whose obj ect ive was t o review scient ific lit erat ure on t he use of group act ivit y, as it relat es t o t he work carried out by nurses, bet ween 1980 and 2003. This was a descript ive/ explorat ory research developed t hrough a bibliogr aphic r ev iew in Br azilian j our nals, on t he basis of a specific pr ot ocol. We w er e able t o ident ify 151 art icles t hat were reviewed in t erm s of t he expansion of t his knowledge and t he different sit uat ions in which a gr oup is used by nur ses. The qualit at iv e analy sis done on pr e- est ablished cat egor ies enabled t he aut hor s t o v er ify t hat nur ses hav e been using t his t echnique w hile deliv er ing car e, pr oducing k now ledge and dev eloping hum an resources. This invest igat ion allow ed us t o out line a panoram ic view of t his lit erat ure and t o develop a cat alogue, ident ify ing im por t ant aspect s in t he const r uct ion of t his know ledge by Br azilian nur sing per sonnel.
DESCRI PTORS: nur sing; focus gr oups; nur sing r esear ch
ANÁLI SI S DE LA PRODUCCI ÓN CI ENTÍ FI CA SOBRE LA UTI LI ZACI ÓN DE ACTI VI DADES
GRUPALES EN EL TRABAJO DEL ENFERMERO EN BRASI L: 1 9 8 0 A 2 0 0 3
Ent re las act ividades del enferm ero, m uchas est án organizadas en el cont ext o del t rabaj o en grupo. La const at ación de que no había est udio sist em at izado, en Br asil, que per m it iese un par ám et r o par a com pr ender com o el en f er m er o u t iliza ese r ecu r so, m ot iv ó el d esar r ollo d e est e est u d io, cu y o ob j et iv o f u e an alizar la pr oducción cient ífica sobr e la ut ilización de la act iv idad en gr upo r elacionada al t r abaj o del enfer m er o ent r e 1980/ 2003. I nvest igación descr ipt iva/ explor at or ia r ealizada a t r avés de invest igación bibliogr áfica en per iódicos nacionales, t eniendo com o base un pr ot ocolo específico. I dent ificam os 151 ar t ículos que fuer on analizados en cu an t o a la ex pan sión de ese con ocim ien t o y las dist in t as sit u acion es en qu e el gr u po es u t ilizado en las act iv idades del en fer m er o. En el an álisis cu alit at iv o, r ealizado a par t ir de cat egor ías pr ev iam en t e defin idas, iden t ificam os qu e el en fer m er o v ien e u t ilizan do ese r ecu r so en la asist en cia, pr odu cción de con ocim ien t o y form ación de recursos hum anos. La invest igación nos perm it ió t razar un panoram a de esa producción y elaborar u n cat álogo qu e iden t if ica aspect os im por t an t es en la con st r u cción de ese con ocim ien t o por la en f er m er ía b r asileñ a.
DESCRI PTORES: en fer m er ía; gr u pos focais; in v est igacíon em en fer m er ía
ANÁLI SE DA PRODUÇÃO CI ENTÍ FI CA SOBRE A UTI LI ZAÇÃO DE ATI VI DADES
GRUPAI S NO TRABALHO DO ENFERMEI RO NO BRASI L: 1 9 8 0 A 2 0 0 3
Dent r e as at iv idades do enfer m eir o, m uit as est ão or ganizadas no cont ex t o gr upal. A const at ação de que não havia est udo sist em at izado, no Brasil, que oferecesse parâm et ro para com preender com o o enferm eiro ut iliza esse r ecur so, m ot iv ou o desenv olv im ent o dest e est udo, cuj o obj et iv o foi analisar a pr odução cient ífica sob r e a u t ilização d a at iv id ad e g r u p al, r elacion ad a ao t r ab alh o d o en f er m eir o en t r e 1 9 8 0 / 2 0 0 3 . Pesq u isa descr it iv a/ ex plor at ór ia, r ealizada por m eio de inv est igação bibliogr áfica em per iódicos nacionais, t endo com o b ase u m p r ot ocolo esp ecíf ico. I d en t if icou - se 1 5 1 ar t ig os q u e f or am an alisad os q u an t o à ex p an são d esse con h ecim en t o e às div er sas sit u ações em qu e o gr u po é u t ilizado n as at iv idades do en fer m eir o. Na an álise qualit at iv a, r ealizada a par t ir de cat egor ias pr é- definidas, ident ificou- se que o enfer m eir o t em ut ilizado esse r ecur so na assist ência, pr odução de conhecim ent o e for m ação de r ecur sos hum anos. A inv est igação per m it iu t raçar um panoram a dessa produção e elaborar um cat álogo que ident ifica aspect os im port ant es na const rução desse con h ecim en t o pela en f er m agem br asileir a.
DESCRI TORES: enfer m agem ; gr upos de est udo; pesquisa em enfer m agem
1
Art icle ext ract ed from t he Mast er’s Thesis, part of an int egrat ed proj ect wit h CNPq support ; 2 M.Sc. Assist ant Professor, e- m ail: m ait ehagen@brt urbo.com .br; 3
Ph.D. Full Professor, CNPq Researcher, e- m ail: denize@fen.ufg.br. Goiás Federal Universit y Facult y of Nursing
I NTRODUCTI ON
N
u r sin g act iv it ies oft en occu r in t h e gr ou p co n t ex t , as a st r at eg y i n d i f f er en t act i v i t y ar eas, research act ivit ies and professional t raining. I n Brazil,Public Healt h Nursing was a pioneer in t he publicat ion of scient ific st udies focusing on t his cont ext( 1).
St udy and pract ice allow us t o affirm t hat , in g e n e r a l , n u r s e s u s e g r o u p a c t i v i t i e s a s a c a r e
“ t echnique”, doing what t hey believe is correct wit hout , h ow ev er, seek in g specif ic t h eor et ical f ou n dat ion s t o
sust ain t he use of t his w or k inst r um ent . We believ e
t hat t his fact is due, am ong ot her aspect s, t o a lack of know ledge about specific t heoret ical support for t heir
act ions, as t his cont ent s has not been syst em at ically offer ed in under gr aduat e nur sing cour ses( 2- 3).
The use of gr oups in hum an car e essent ially requires knowledge about t his inst rum ent wit h a view
to better professional perform ance. Hence, nurses need specific training to expand their knowledge in this area,
offering a base for m ore assert ive and efficient act ion. Th e t er m g r ou p r ef er s t o a set of p er son s
j oin ed in t h e sam e p lace, w it h t h e sam e ob j ect iv e and at t it ude and wit h a com m on goal t hat condit ions
it s m em ber s’ cohesion( 4- 5).
What det erm ines t he exist ence of a group is t he int eract ion am ong it s m em bers, t hat is, t hat t hey
ex per ien ce t h e sam e em ot ion s, an d t h at t h ese ar e s u f f i c i e n t l y i n t e n s e t o c o n s t i t u t e a g r o u p( 6 ). As
i m p o r t an t as i t s d ef i n i t i on i s k n ow l ed g e ab ou t i t s nat ure and charact erist ics, especially when we int end
t o u n d er st an d g r o u p s as a sp ace f o r p r o f essi o n al
act ion , lik e in t h e case of n u r sin g, w h er e t h ey ar e used for differ ent act iv it ies.
One way of characterizing groups is on the basis of t heir pur pose. They can be classified as oper at iv e
and t herapeut ic. Operat ive gr oups ar e t ask- cent er ed
and t heir concept is w ide- r anging, due t o count less
possibilit ies for pr act ical applicat ions. Many consider t h ese as a con t in en t of all ot h er g r ou p s, in clu d in g
teaching- learning, institutional and com m unity groups( 5).
Ther apeut ic gr oups ar e divided int o self- help groups, w hich cover t he m edical area in general, t he
psy chiat r ic ar ea and t he so- called psy chot her apeut ic
gr oups, st r ict ly designat ed for t hose t y pes of gr oups aim ed at acquir ing insight( 5,7).
I n n u r sin g w or k , for ex am ple, an oper at iv e
group focus is adequat e, in view of t he relat ive ease
of t r ain in g pr ofession als t o per for m t h is act iv it y, as w ell as t o w or k w it h pr egnant w om en, adolescent s,
hospit alized pat ient s, am ong ot her s( 5, 8).
Gr ou p w or k of f er s oppor t u n it ies f or gr ow t h and change in relat ion t o ourselves and t he w orld. A group’s life can and m ust be observed from different per spect iv es, in or der t o u n der st an d it s com plex it y,
vit alit y and pot ent ial( 9).
To ap p ly t h is r esou r ce in d if f er en t n u r sin g w or k dim ensions, w e defined t he t er m gr oup act ivit y as act ion s t h is p r of ession al p er f or m s in t h e g r ou p
cont ext . This definit ion will be used in t his paper. The st udy of t hese act ivit ies, t heir nat ure and applicat ion in nursing led t o t he observat ion t hat t here w a s n o sy st e m i ze d st u d y o f f e r i n g p a r a m e t e r s t o
underst and how nurses have used t his resource. This f act m ot iv at ed u s t o st u d y t h e su b j ect in Br azilian lit er at ur e, specifically in nur sing j our nals, in v iew of our involvem ent in t he developm ent of t his t echnology
and it s possible cont ribut ion t o people want ing t o work bet t er wit h t his t ool in nursing.
The decision t o focus on Brazilian product ion is j ust ified by t he fact t hat t his t hem e is st ill developing,
out lined by im por t ant sociocult ur al peculiar it ies t hat need t o be know n in a Brazilian cont ext . The st udy’s relevance exact ly derives from t he possibilit y t o draw a nat ional panoram a about t his knowledge product ion,
w hich does not exist yet .
Thus, our aim is t o charact erize and analyze scient ific product ion about t he use of group act ivit ies r elat ed t o nur sing w or k , bet w een 1980 and 2003, in
Br azilian nur sing j our nals.
METHOD
We car r ied out a descr ipt ive and explorat or y bibliographic st udy, i.e. t he invest igat ion of all writ t en an d p u b lish ed m at er ial t o su r v ey an d an aly ze t h e pr odu ct ion abou t a par t icu lar su bj ect , ch ar act er ized as t he research t hem e( 10- 11).
Bibliogr aphic r esear ch allow s r esear cher s t o have direct cont act wit h what has already been writ t en about t he subj ect . I t s m ain advant age is t o allow for a w ider cov er age of t he r esear ch phenom ena, w hich
w ou ld n ot be possible if t h e r esear ch w er e r ealized direct ly at t he source( 10- 11).
We decided t o work only wit h Brazilian nursing j o u r n a l s, a s t h e i r r e g u l a r p u b l i ca t i o n p e r m i t s a n an aly sis of Br azilian n u r se r esear ch er s’ p r od u ct ion about t he st udy t hem e.
Th e r esear ch per iod w as delim it ed bet w een 1980 and 2003, since an earlier st udy( 1) indicat ed t he 1 9 8 0 ’s as t he st ar t of r esear ch dissem inat ion about
The m at er ial w as select ed in t he collect ions
fr om t he Ribeir ão Pr et o Cam pus Cent r al Libr ar y and t he Glet e de Alcânt ara Reading Room at t he Ribeirão
Pr et o College of Nu r sin g, bot h of w h ich ar e par t of t he Univ er sit y of São Paulo.
We adopt ed a n u m ber of in clu sion cr it er ia: index ed j our nals; r egular ly published w it h per iodical
cir culat ion, t o allow for an analy sis acr oss t he st udy period; and availabilit y at t he research sit es bet ween
July and Decem ber 2003.
The following j ournals at t ended t o t he inclusion
cr it er ia: Rev ist a Br asileir a de En f er m agem ; Rev ist a
da Escola de En f er m agem da USP; Rev ist a Gaú ch a d e En f er m ag em ; Rev ist a Pau list a d e En f er m ag em ;
Act a Pa u l i st a d e En f e r m a g e m ; Te x t o & Co n t e x t o En f e r m a g e m ; Re v i s t a La t i n o - A m e r i c a n a d e
En f e r m a g e m ; Re v i st a d e En f e r m a g e m d a UERJ; Co g i t a r e En f e r m a g e m ; Re v i s t a d a Es c o l a d e
En f er m agem An n a Ner y.
To select t he ar t icles, w e r ealized an act iv e
search in t hese j ournals, per volum e and issue. I f t he previous reading of t he t it le, abst ract and m et hodology
indicat ed t hat group act ivit ies were used in som e way in t he cont ent s, t he art icle w as select ed.
The selected articles were com piled, separated
per publicat ion year, subm it t ed t o careful reading and registered by m eans of a protocol, elaborated to identify
r elevant aspect s for t his st udy, such as: publicat ions p er j ou r n al an d y ear ; t y p e of ar t icle ( sy n t h esis of
m ast er ’s t h esis or d oct or al d isser t at ion , r esear ch , experience report, case study or others) ; authors’ region
of origin; descriptors; them e area; focus of group activity
and specific t heoret ical fram ework about groups. Dat a about aut hors’ origin and profession were
collect ed from t he foot not es present ed in each art icle. I nit ially, w e per for m ed a descr ipt iv e analy sis
o f t h e d a t a i n c l u d e d i n t h e p r o t o c o l , a i m e d a t
charact erizing t he above m ent ioned aspect . This gave
us a panoram a of t he sit uat ion of knowledge product ion in t his area.
I n a s e c o n d p h a s e , t h e m a t e r i a l w a s subm it t ed t o qualit at ive analysis( 12), based on a priori
d ef in ed cat eg or ies: a) Th e g r ou p as a r esou r ce in car e; b) Nur sing and gr oups: k now ledge pr oduct ion
an d c) Th e g r o u p i n h u m an r eso u r ce t r ai n i n g . I n defining t hese cat egories and dist ribut ing t he art icles,
w e especially con sider ed t h e obj ect iv es t h e au t h or s defined in t heir ar t icles, as som e st udies fit t ed int o
m or e t han one cat egor y.
Hence, what defined t he art icle’s inclusion int o a cat egory was t he st udy’s cent ral focus, delim it ed in
t h e ob j ect iv e. Th er ef or e, w e v alid at ed t h e ar t icles’ dist r ibut ion int o t he r espect iv e cat egor ies, based on
a ca r e f u l r e v i e w o f e a ch , i n o r d e r t o g u a r a n t e e r eliabilit y and consist ency in t he descr ipt ion of dat a
cont ent s for qualit at iv e analy sis.
RESULTS AND DI SCUSSI ON
Th e t r eat m en t of d at a t h r ou g h d escr ip t iv e analysis of t he aspect s select ed in t he collect ion prot ocol
and t he search for t he st udy obj ect ives allowed us t o reach t he result s present ed below in t erm s of general
charact erizat ion, as well as t hem at ic cont ent analysis.
Gen er al ch ar act er izat ion of ar t icles
I n t his t opic, we present a general panoram a
of t he st udied art icles, present ing t he aspect s delim it ed in t he m et hodology. Alt hough var ious ot her j our nals
w ere published during t he st udy period, t he research inclusion crit eria described above result ed in a research
universe of t en art icles, present ed in Table 1.
Table 1 - Journals selected to study production about the use of group activities related to nursing work ( 1980- 2003)
e l t i T l a n r u o
J Yearof1
t s n o i t a c i l b u
P City
t n e r r u C 4 0 0 2 / y t i c i d o i r e
P IndexationSources/2004
l a n o i t u t i t s n I n o i t a i l i f f A m e g a m r e f n E e d a r i e li s a r B . v e
R 1932 Brasíila Bimonthly Medilne/Ini;Cinaha;lLliacs;Adsaude;Laitndex; Bdenf. ABEn m e g a m r e f n E e d a l o c s E a d . v e R P S U a
d 1967 SãoPaulo Quarterly Medilne;Lliacs;Adsaude;Laitndex;Indexmedicus. EE/USP
m e g a m r e f n E e d a h c u a G . v e
R 1976 PortoAlegre Semi-annually Ini/Medilne;Lliacs;Bdenf;Laptoc; Laitndex;Index . s u c i d e
M UFRS
m e g a m r e f n E e d a t s il u a P . v e
R 1981 SãoPaulo Threeitmesayear Lliacs;Bdenf;IndexMedicus. ABEn-SP
m e g a m r e f n E e d a t s il u a P a t c
A 1988 SãoPaulo Quarterly Adsaude;Lliacs. Dept°Enf. P S E F I N U m e g a m r e f n E o t x e t n o C & o t x e
T 1992 Florianópoils ThreeitmesayearLliacs;Cinaha;lBdenf; Index. UFSC
e d a n a c i r e m A -o n it a L . v e R m e g a m r e f n
E 1993 RibeirãoPreto Bimonthly
; o f n i c y s P s t c a r t s b A b a C h tl a e H b a C ; l h a n i C ; e n il d e M / i n I ; y r o t c e r i D s l a c i d o i r e P ;l a n o it a n r e t n I s ' h c i r l U ; s c a li L n e d i u C . a c i n ô r t e l E a c e t o il b i B f n e d B P S U / P R E E J R E U a d m e g a m r e f n E e d . v e
R 1993 RiodeJaneiro Semi-annually Lliacs UERJ m e g a m r e f n E e r a t i g o
C 1996 Curiitba Semi-annually Lliacs UFP
y r e N a n n A . f n E e d a l o c s E a d . v e
On ly on e j ou r n al, t h e Rev ist a Br asileir a de
En f er m ag em , is or ig in at ed in t h e Cen t r al West . All
ot hers are issued in t he Sout h and Sout heast . Despit e
a com prehensive search, som e issues of t he select ed
j ou r n als w er e n ot locat ed in d u e t im e an d , h en ce,
w er e not analy zed.
Table 2 present s t he dist ribut ion of t he st udied
ar t icles, accor ding t o t he y ear t hey w er e published,
f o r t h e sa k e o f b e t t e r v i su a l i z a t i o n o f Br a z i l i a n
pr oduct ion in j our nals.
Table 2 - Dist ribut ion of art icles according t o year of publicat ion ( 1980 t o 2003)
P YearofPublication
0 8 9
1 19811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003Total
B
R - 02 01 01 02 02 02 01 02 - 01 - 01 02 04 - 01 02 01 01 06 - 07 02 41 E
R - - - 01 - - 01 - 01 - - - 01 02 03 02 01 12
G
R - - - 01 - - 01 - - 01 - - - 01 - 01 01 04 - 01 02 - 13
P
R - - - 01 - - - 01 - - - 02 - 01 02 07
P
A - - - 01 - 01
C
T 01 - 01 05 01 05 02 01 03 02 05 14 40
A
L - - 01 01 01 02 - 05 - 02 03 15
U
R - - 01 03 01 01 02 - 02 01 02 13
E
C 04 01 01 01 01 01 - - 08
N
A - - - 00
l a t o
T - 02 01 02 03 02 04 01 02 02 02 01 02 02 05 08 10 11 08 10 19 09 21 24 151
P - j ournals.
RB - Revist a Brasileira de Enferm agem TC - Revist a Text o e Cont ext o Enferm agem RE - Revist a da Escola de Enf. da USP LA - Revist a Lat ino- Am ericana de Enferm agem RG - Revist a Gaúcha de Enferm agem RU - Revist a de Enferm agem da UERJ RP - Revist a Paulist a de Enferm agem CE - Cogit are Enferm agem
AP - Act a Paulist a de Enferm agem AN - Rev. da Escola de Enferm agem Anna Nery
Table 2 shows a growing increase from 1994
onwards, which can indicat e bot h t he increase of group
act iv it ies in nur sing act ions and t hese pr ofessionals’
increased int erest in dissem inat ing t he result s of t heir
applicat ion .
Wit h r espect t o t h e pr odu ct ion v olu m e per
j ou r n al/ y ear, w e f ou n d t h at t h e av erage n u m ber of
art icles published, considering publicat ions st art ed unt il
2003, is m ore significant in som e j ournals, as show n
in Table 3.
Table 3 - Annual average of publicat ions per j our nal
s l a n r u o
J Startofpublications Numb.Articles Numb.ofyears Annualaverage
m e g a m r e f n E e d a r i e li s a r B a t s i v e
R 1981 41 22 1,86
m e g a m r e f n E e d a h c ú a G a t s i v e
R 1983 13 21 0,62
P S U a d . f n E e d . a l o c s E a d . v e
R 1984 12 20 0,6
m e g a m r e f n E e d a t s il u a P a t s i v e
R 1984 07 19 0,37
m e g a m r e f n E e d a t s il u a P a t c
A 1988 01 15 0,07
m e g a m r e f n E o t x e t n o C & o t x e T . v e
R 1992 40 12 3,33
. f n E e d a n a c i r e m A -o n it a L . v e
R 1995 15 09 1,67
J R E U a d . m e g a m r e f n E e d a t s i v e
R 1995 13 09 1,44
m e g a m r e f n E e r a t i g o
C 1996 09 08 1,12
y r e N a n n A . f n E e d a l o c s E a d . v e
R 1997 00 07 00
We f o u n d t h a t t h e Re v i s t a Br a s i l e i r a d e
Enferm agem published a larger volum e of publicat ions
in n u m er ical t er m s, bu t sm aller in t er m s of an n u al
av erage ( 1 . 8 6 ) , w h ile t h e Rev ist a Tex t o & Con t ex t o
En f er m ag em p r esen t s t h e l ar g est an n u al av er ag e
volum e of publicat ions ( 3.33) in t he st udy per iod.
As t o t h e a u t h o r s’ r eg i o n o f o r i g i n , m o st
ar t icles in t h is st u dy com e f r om t h e Sou t h east ( 6 0
ar t icles) , follow ed by Sou t h ( 5 7 ar t icles) , Nor t h east
and Cent ral West ( 11 art icles) and Nort h ( 1 art icle) .
Th e co n ce n t r a t i o n o f p u b l i ca t i o n s i n t h e
S o u t h e a s t a n d S o u t h c a n b e e x p l a i n e d b y t h e
con cen t r at ion of ex ist in g gr adu at e cou r ses in t h ose
r e g i o n s , w h i c h f a c i l i t a t e s a n d s t i m u l a t e s t h e
d e v e l o p m e n t o f k n o w l e d g e p r o d u c t i o n a n d ,
co n se q u e n t l y, i t s d i sse m i n a t i o n . Ni n e o f t h e t e n
j ournals we st udies are affiliat ed wit h higher educat ion
i n st i t u t i o n s l o ca t ed i n t h o se r eg i o n s a n d o f f er i n g
gr adu at e n u r sin g cou r ses.
On e si g n i f i ca n t p i e ce o f i n f o r m a t i o n t h a t
r einfor ces t his asser t ion is t he fact t hat 1 6 2 facult y
m em ber s of higher educat ion inst it ut ions, i.e. 51.4%
of t h e r esear ch au t h or s, ser v ed as au t h or s or
I n 1 5 ar t icles, 2 7 p r of ession als f r om ot h er
ar eas collabor at ed. Besides t h ese pr of ession als, 1 8
nur sing st udent s w er e par t ner s in t he publicat ion of
12 art icles, t wo of whom were t he single aut hors. This
fact indicat es fut ur e pr ofessionals’ aw ak ening t o t he
ap p licat ion of t h is t ech n olog y, w h ich w ill cer t ain ly
st r en gt h en t h e u se of t h is t ool in t h eir pr ofession al
act iv it y w it h gr oups.
An analy sis of t he descr ipt or s char act er izing
t h e ar t icles iden t if ied a v er y lar ge v olu m e, as t h ey
h ig h lig h t ed t h e ap p licat ion ar eas of g r ou p w or k in
n u r sin g act ion s, in st ead of f ocu sin g on t h e g r ou p
appr oach in it self. For t his r eason, w e only select ed
and analyzed 25 descr ipt or s t hat , in our per spect ive,
w er e in som e w ay r elat ed t o gr ou p act iv it ies. On ly
f i v e o f t h e se a r e a v a i l a b l e t o ch a r a ct e r i ze g r o u p
act iv it ies in t he BI REME dat abase.
We a l s o a n a l y z e d s p e c i f i c b i b l i o g r a p h i c
references about group t heories. Their occurrence was
v ar iable an d ir r egu lar acr oss dif f er en t y ear s, bein g
used in st udies published at t he st ar t of t he 1980’s,
but not in art icles published in 2003, w hich suggest s
t he need for fur t her st udy.
Sixt y- one classical t ext s on group t heory were
used, as well as group t echnique m anuals and books.
These r efer ences w er e found in 39.1% ( 59 ar t icles) ,
11 of which only referred t o books and group t echnique
and gam e m anuals.
The client s at t ended by group act ivit ies m ainly
consist of healt h ser v ice user s. This show s t hat t his
t ech n iqu e is becom in g con st an t pr act ice in n u r sin g
car e. Thus, w e can affir m t he gr oup as a big ally in
nur sing car e, inv olv ing a w ide r ange of client s w it h
different problem s. I t is also a frequent ly used t ool in
t e a c h i n g , r e s e a r c h a n d t o s u p p o r t s e r v i c e
m an ag em en t .
Analysis of Knowledge Product ion: a t hem at ic cont ent
an aly sis ap p r oach
Qualit at iv e dat a analy sis w as const r uct ed t o
show a panor am a of Br azilian pr oduct ions about t he
t h e m e , w i t h o u t l o o k i n g d e e p e r i n t o t h e a r t i cl e s’
cont ent s. We at t em pt ed t o m ap t hem on t he basis of
t hem at ic references, in order t o group t hem in a priori
defined cat egories - The group as a resource in care
- Nu r sin g an d gr ou ps: k n ow ledge pr odu ct ion - Th e
gr oup in hum an r esour ce t r aining.
Af t e r e x h a u st i v e r e a d i n g , d i st r i b u t i o n i n
cat egor ies and t he v alidat ion pr ocess, w hich defined
t he cont ent s of dat a in each cat egor y, each of t hese
cat eg or ies w as an aly zed sep arat ely, in v iew of t h e
dat a v olum e ( 151 ar t icles) .
The gr oup as a r esour ce in car e
The cat egory: t he group as a resource in care
ch a r a ct er i zes st u d i es w o r k i n g w i t h d i f f er en t ca r e
l e v e l s , r a n g i n g f r o m h e a l t h p r o m o t i o n t o
r eh ab ilit at ion . Th ir t y - sev en ar t icles w er e in clu d ed ,
corresponding t o 24.5% of t he t ot al num ber of art icles.
To f acilit at e t h e an aly sis of ar t icles in t h is
cat egory, w e used an earlier st udy( 1), so as t o divide
t hem in line wit h t he aut hor’s suggest ions, in order t o
classify group act ivit ies perform ed by nurses wit h t his
pur pose. Thus, ar t icles char act er izing car e act iv it ies
w e r e d i st r i b u t e d i n t h e f o l l o w i n g su b ca t e g o r i e s:
infor m at ion and healt h educat ion gr oups; gr oups t o
m ain t ain in d iv id u al an d f am ily car e p r og r am s an d
p r o j ect s an d r eh ab i l i t at i o n an d em o t i o n al su p p o r t
g r ou p s.
I nfor m at ion and healt h educat ion gr oups
This subcat egory included 11 art icles ( 7.3% ) ,
w h i ch d e scr i b e d sh o r t g r o u p a ct i v i t i e s w i t h l i t t l e
st ruct ure, such as wait ing room groups, surgical advice
gr oups, w or k shops and ot her educat iv e act ions.
Gr o u p s t o m a i n t a i n i n d i v i d u a l a n d f a m i l y c a r e
pr ogr am s an d pr oj ect s
This subcat egory included 13 art icles ( 8.6% ) ,
r epor t in g differ en t t y pes of car e per for m ed t h r ou gh
group act ivit ies in program s est ablished by t he Minist ry
of Healt h, or developed at inst it ut ions t o im prove t he
qualit y of indiv idual and fam ily car e.
Rehabilit at ion and em ot ional suppor t gr oups
Th e a ct i v i t i e s d e scr i b e d i n t h i s ca t e g o r y
r efer r ed t o gr oups of pat ient s w it h t he sam e disease
or need ( hypert ensive, obese, diabet ic and colost om y
pat ient s, am ong ot her s) . I n t hese gr oups, t he for ce
of g r ou p m ot iv at ion is t h e m ain t h er ap eu t ic act ion
inst rum ent , due t o t he fact t hat pat ient s use t he sam e
l a n g u a g e a n d s h a r e t h e s a m e s u f f e r i n g a n d
difficult ies( 5,7,13).
This subcat egory included 13 art icles ( 8.6% ) ,
g r o u p a ct i v i t i e s, a i m e d a t co p i n g w i t h d i f f e r e n t
sit uat ions ex per ienced by pat ient s w ho need t o liv e
w it h chr onic healt h pr oblem s.
The adv ant age of t his k ind of w or k for t his
t y pe of clien t s is it s pot en t ial t o ch an ge beh av ior s.
Peop le in v olv ed in t h ese p r ocesses d em on st r at e a
capacit y t o help, as w ell as an incr edible t her apeut ic
capacit y, released by t he freedom t o express feelings
pr ov ided by gr oup ex per ience( 14).
Nur sing and gr oups: k now ledge pr oduct ion
Th is cat eg or y in clu d ed 8 9 ar t icles ( 5 8 . 9 % )
dev elopin g k n ow ledge abou t t h e t h em e. Th ey focu s
on t h e ex plor at ion of t h eor et ical- t ech n ical con cept s
an d asp ect s, b ased on classical t h eor ies ab ou t t h e
m ov em en t of h u m an g r ou p s an d it s ap p licat ion in
n u r sin g.
I n it self, t he im por t ance of get t ing t o k now
t hese concept s in or der t o under st and t he behav ior
of hum an groups and t he funct ioning of societ y already
j ust ifies r esear ch about t his obj ect( 15).
Th i s cat eg o r y al so i n cl u d ed ar t i cl es ab o u t
t h eo r et i cal - t ech n i cal asp ect s, ap p l i ed i n t h e d ai l y
r ealit y of car e p r act ice, r esear ch , t r ain in g an d t h e
assessm ent / validat ion process of using t his st rat egies,
a s w e l l a s a r t i cl e s i n w h i ch a u t h o r s u se d g r o u p
act iv it ies t o collect r esear ch dat a.
To facilit at e t he analysis of t his cat egory, w e
divided t he art icles int o four subcat egories: t heoret ical
st udies; group act ivit y m odels in care; hum an resource
t r aining m odels and use of gr oup act iv it ies t o collect
r esear ch dat a.
Th eor et ical st u dies
This subcat egory included 11 art icles ( 7.3% )
t h at con t r ib u t e t o t h eor et ical k n ow led g e ab ou t t h e
group and it s applicat ion in nursing work. These st udies
addr ess concept s, t heor ies and m et hodologies, as a
sour ce of infor m at ion for pr ofessionals w ho w ant t o
work wit h t his t ool.
Gr oup act iv it y m odels in car e
This subcat egor y cov er ed ar t icles pr oposing
gr oup act iv it y m odels for car e and r epor t ing on t he
act iv it ies of gr oups act iv e in car e. Ninet een ar t icles
w er e included ( 12. 6% ) .
Hum an r esour ce t r aining m odels
Th i s su b ca t e g o r y i n cl u d e d se v e n a r t i cl e s
( 4 . 6 % ) , w h i ch t h e o r e t i ca l l y d e scr i b e g r o u p w o r k
m odels f or h u m an r esou r ce t r ain in g. Th ese st u dies
dem onst rat e t he great pot ent ial of t his t echnology for
h u m a n r e s o u r c e d e v e l o p m e n t , b a s e d o n t h e
adv ancem ent of t he per sonnel m anagem ent pr ocess
in m odern t im es( 3,11).
Use of gr oup act iv it ies t o collect r esear ch dat a.
Th is su bcat egor y in clu ded ar t icles in w h ich
aut hors use group act ivit ies and t echniques t o collect
r esear ch dat a. Resear cher s hav e used t his t echnique
on a large scale in dat a collect ion, as t his is t he largest
subcat egor y, t ot aling 52 ar t icles ( 34. 4% ) .
The analysis of t his cat egory showed t hat only
a sm all n u m b er of r esear ch er s d ev elop t h eor et ical
st udies about groups ( 7.3% ) . This fact m akes it m ore
difficult for nurses t o use t his t ool, due t o t he lack of
specific r efer ences t o suppor t t heir pr act ice. On t he
o t h e r h a n d , w e p r o v e d i n t e r e st i n d i sse m i n a t i n g
m o d e l s f o r t h i s a ct i v i t y i n ca r e , h u m a n r e so u r ce
t raining and as a research st rat egy, providing valuable
cont r ibut ions t o t he dev elopm ent of t his t echnology
by nur sing.
The gr oup in hum an r esour ce t r aining
This cat egor y concent r at es st udies t hat use
g r o u p a c t i v i t i e s i n h u m a n r e s o u r c e t r a i n i n g ,
s e n s i t i z a t i o n a n d p e r m a n e n t e d u c a t i o n o f c a r e
professionals, and as a didact ical- pedagogical resource
w it h n u r sin g st u den t s. Tw en t y - f iv e ar t icles ( 1 6 . 6 % )
w er e included in t his cat egor y.
Th e u s e o f g r o u p t e c h n i q u e s l e a d s t h e
i n v o l v e d i n d i v i d u a l s t o a f e e d b a c k m o v e m e n t ,
i n c r e a s i n g c o m m u n i c a t i o n a n d b e n e f i t i n g t h e
ap p ear an ce of n ew id eas, con cep t s an d d ir ect ion s,
cont ribut ing t o learning on a larger scale( 15).
Gr oup act iv it y as a didact ic- pedagogical act iv it y
Th is su bcat egor y r efer s t o ar t icles in w h ich
aut hors use group act ivit ies/ t echniques as a didact ical
r esou r ce. Th is t h em e w as in clu d ed b ecau se it is a
h u m an r eso u r ce t r ai n i n g st r at eg y p ar ex cel l en ce.
The gr oup as a r esour ce for t eam dev elopm ent and
st r engt hening of pr ofessionals’ int er per sonal r elat ions
This subcategory covers articles that worked with personal training of all professional categories, in nursing
as well as other health areas, using group activities. Twelve articles (8% ) with this approach were included.
This group cont ained st udies in which aut hors at t em pt ed t o work wit h healt h professionals’ feelings,
w it h a view t o car e hum anizat ion.
The analy sis of t his cat egor y pr ov ed nur ses’
awakening int erest in using group act ivit ies for hum an
r eso u r ce t r a i n i n g , i n n u r si n g t ea ch i n g a s w el l a s professional t raining. Group act ivit y is an efficient way
of dealing w it h t he difficult ies bot h pr ofessionals and st udent s ar e confr ont ed w it h, because it benefit s t he
e x c h a n g e o f e x p e r i e n c e s a n d p r o v i d e s s u p p o r t t hr ough t he gr oup, helping par t icipant s t o ov er com e
anguish and conflict s deriving from em ot ional overload and st ress in t his kind of work( 2- 3).
FI NAL CONSI DERATI ONS
Th e ach i ev em en t o f t h e i n i t i al l y p r o p o sed
st udy obj ect iv e allow ed us t o const r uct a panor am a of gr oup act iv it ies r elat ed t o nur sing w or k in Br azil,
bet w een 1980 and 2003. We obser ved an ex pansion in t he developm ent of t his knowledge during t he st udy
per iod, par t icular ly fr om t he 1990’s onw ar ds. We w er e able t o charact er ize t he sit uat ions
in w h ich g r ou p s h av e b een u sed in n u r sin g , w h ich
pr ov ed t he use of t his t echnology as a w or k t ool in
count less nur sing act iv it ies.
One hundred fift y- one art icles were ident ified,
which were analyzed in t erm s of knowledge expansion and t he different sit uat ions in which groups are used
in nursing act ivit ies. I n t he qualit at ive analysis based on pr edef in ed cat egor ies, w e iden t if ied t h at n u r ses
have used t his resource in care, knowledge product ion and hum an r esour ce t r aining.
This bibliographic research allows us to indicate som e advantages of this type of study. One of them is
t he possibilit y t o go back t o t he collect ed m at erial as
m a n y t i m es a s n eed ed , so l v i n g d o u b t s w h en ev er n ecessar y. I n ou r ex p er ien ce, t h e d isad v an t ag e of
bibliographic research is that, often, researchers do not find answ er s t o som e of t heir quest ions and have t o
count on t he aut hor ( s) ’ clar it y of ex pr ession and t he availabilit y of m at erial in libraries.
We also highlight t he capacit y t o creat e new w ay s o f g r o u p w o r k a s a n u r si n g ca r e st r a t e g y,
r ev ealed by nur ses’ r epor t s t hr oughout t he r esear ch. Th e o ccu r r en ce o f p r o d u ct i o n s a b o u t t h i s
t h em e in all st u d ied j ou r n als allow s u s t o af f ir m a p e r m a n e n t l y i n c r e a s i n g t e n d e n c y t o u s e a n d
sy st em ize g r ou p act iv it ies in v olv in g d if f er en t t y p es
of client s and nur sing act ions.
This st udy allowed us t o draw a panoram a of
this production and elaborate a catalogue that identifies im portant aspects in the construction of this knowledge
by Br azilian nur sing. This cat alogued and descr ipt iv e m aterial is available in the text of the thesis, as a valuable
source for bibliographic consult at ion about t he t hem e.
Recebido em : 7.3.2005 Aprovado em : 14.6.2006
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