Aim: to characterize the dissertations and theses available in the Brazilian Nursing Association (ABEn) Catalog of Thesis and Dissertations (CEPEn) regarding the path taken by Brazilian Nursing in teaching, research, management and care practice. Method: a documentary and quantitative study, whose material were the Thesis and Dissertation Catalog, available on ABEn's website, from Volume XIX to XXXII. The following data collection indicators were used: academic level, educational institution, year, place, object of study, methodological design and final implications and recommendations for Nursing. Results: 8,720 abstracts were found, of which 7,141 (81.89%) composed the final sample. Of these, 627 (8.78%) were associated with teaching, 329 (4.61%) with management, 2,564 (35.91%) with care practice and 3,621 (50.71%) with research. Conclusion: it was observed that there was a substantial increase in the quantity and quality of the publications produced by Brazilian nursing personnel in the last 20 years (1994-2014).
Descriptors: Nursing Research; Practical Nursing; Teaching.
Nursing is expanding its scope in the field of research, especially regarding the technical, scientific and methodological evolution of the studies carried out by nurses in the Brazilian scenario in recent years.
It is pointed out that Nursing knowledge production is in the process of an extremely significant development, related to the post graduate growth in the area, and this reality contributes to repercussions on its national and international visibility(1).
In this scenario, it is clear that the research is consolidated in the praxis of nurses as a reflection of the emergence of new research groups, the structuring of new graduate programs and the growing interest of Nursing professionals in complementing their training with a Master's degree and/or PhD in Higher Education Institutions (IES - from the Portuguese Instituições de Ensino Superior). This reality contributes to the quality of care, expands knowledge, and favors the efficiency of Nursing actions in search of scientificity for evidence-based assistance(2).
In this sense, it can be said that the training of Masters and Doctors in Nursing contributes to the configuration of the profession as a discipline in the field of science, with the responsibility for generating results capable of supporting a field of knowledge based on solid, technically competent and morally acceptable outcomes in the process of caring in its three basic dimensions, namely: caring for individuals and groups; administering/managing Nursing work and assistencial spaces; educating and researching(3-4).
In this way, scientific production contributes to the quality training of new human resources, in order to multiply and replicate the knowledge produced for the scientific community(5).
In view of the above, the justification for the execution of this study was based on the need to know what Brazilian Nursing personnel have published over the last 20 years (1994-2014), looking at the path taken in this trajectory.
To guide the research, the following questions were elaborated: What are the characteristics of dissertations and theses available in the Catalog of Theses and Dissertations (CEPEn – from Portuguese Catálogo de Teses e Dissertações) of the Brazilian Nursing Association (ABEn – from the Portuguese Associação Brasileira de Enfermagem)? What is the path taken by Brazilian Nursing in teaching, research, management and assitencial practice?
With the purpose of answering these research questions, the objective was to characterize the dissertations and theses available in the Catalog of Theses and Dissertations (CEPEn) of the Brazilian Nursing Association (ABEn) regarding the path taken by Brazilian Nursing in the field of teaching, research, management and assistencial practice.
This is a retrospective, descriptive research with a quantitative and documentary approach, characterized as a source of data collection restricted to documents, constituting what are called primary sources(6). In addition, documentary research aims to extract information using appropriate techniques for its treatment and analysis, according to scientific principles(7).
The data were collected by two Master's students, two Doctoral students and a registered nurse, from April to May 2015, using the Catalog of Theses and Dissertations of the Center of Studies and Research of the Brazilian Nursing Association as a data source, which is a collection that provides theses and dissertations produced by nursing graduate programs in Brazil.
In order to direct the data collection, a "Documentary Research Protocol" was previously constructed, which had been used in previous researches of the same nature. This protocol was composed of: subject, study objective, guiding questions, search strategies, eligibility criteria of the studies, strategies for data collection and critical evaluation of studies and data synthesis.
Data collection was carried out using the catalogs of theses and dissertations from Volume XIX to XXXII, available on ABEn's website. For the studies selection process the inclusion criteria were: dissertations and theses, components of CEPEn of ABEn, produced by nurses. The exclusion criteria were dissertations and theses with incomplete abstracts that did not respond to the data collection indicators in its entirety.
Before the abstracts were read, the curricula lattes of the authors of the thesis or dissertation were searched, in order to guarantee that only works produced by registered nurses were included in the research. After this step, the studies were selected based on the reading of the available abstracts, according to the eligibility criteria listed. From that, 7,141 summaries were selected to make up the final sample of the study, as described in Table 1.
Table 1 - Distribution of abstracts found and selected according to the eligibility criteria, 2016, Natal/RN.
SOURCE: Own research.
The data collected was entered into a Microsoft Excel 2010® spreadsheet according to the following indicators:
The information was then exported to a statistical program, where it was analyzed by descriptive statistics and presented in chart, tables and figures with their respective absolute and relative frequencies.
It should be emphasized that prior approval was not required by the Research Ethics Committee, since the present study did not involve human beings and had, as a source of data collection, public domain documents.
Initially, a sample of 8,720 abstracts of theses and dissertations were obtained, allocated in ABEn catalogs from Volume XIX to XXXII. Among them, 7,141 abstracts met the inclusion criteria and, therefore, composed the final sample of this study. In this sense, the losses represented 18.11% (n=1,579) of the studies that had their abstracts published in the ABEn catalogs from 2001 to 2013.
It was observed that was highlited the dissertation researches from academic Master's degree (n=5,475; 76,67%), followed by Doctoral theses (n=1,666; 23,33%), and there was no publication of related studies to the professional Master's degree in the studied period.
Figure 1 represents the annual distribution of research published and developed by registered nurses. It was found that the number of studies increased over the years, with the largest number of publications in 2012, representing 16.47% of the sample (n=1,176), followed by the year 2011 (n=618; 8.65%).
Figure 1 – Distribution of cientific production of Nursing according with year of publication, 2016, Natal/RN.
Source: Own elaboration.
In relation to higher education institutions (IES) to which the theses and dissertations are linked, there was emphasis on the University of São Paulo - USP (n=2,508; 35.12%), followed by the Federal University of Rio de Janeiro - UFRJ (n=784; 10.98%), the Federal University of Santa Catarina - UFSC (n=610; 8.54%) and the Federal University of Ceará - UFC (n=493; 6.90%) respectively.
As for the location of the studies categorized by region of Brazil, it was verified that the Southeast represented the largest quantitative (n=3,416; 47.84%), followed by the Northeast (n=1,185; 16.59%), South (n=1069; 14.97%), Central West (n=219; 3.07%) and North (n=50; 0.70%). It was observed that eight (0.11%) of the studies were at the national level and ten (0.14%) resulted from stricto sensu graduate studies made totally or partially outside Brazil (internationalization). In addition, a large number of abstracts did not report where the study had been performed (n=1,188; 16.64%).
When grouping the study site by Brazilian federal states, it was verified that the largest quantitative was from São Paulo (n=2,027; 28.39%), followed by Rio de Janeiro (n=830; 11.62%), Minas Gerais (n=535; 7.49%), Ceará (n=432; 6.05%) and Santa Catarina (n=382; 5.35%).
Among the 7,141 summaries of theses and dissertations analyzed, descriptive research predominated (n=6,389; 89.47%), followed by exploratory studies (n=345; 4.83%), bibliographical studies (n=231; 3.23%) and experimental studies (n=176; 2.46%). Thus, Table 2 shows the association between the year of publication and the type of study performed by registered nurses in the last 20 years (1994-2014).
Table 2 – Distribution of the year of publication associated to the type of study of the researches produced by Brazilian registered nurses in the last 20 years, 2016, Natal/RN.
SOURCE: own research
According to Table 2, there has been an increase in the number of studies over the years, with an emphasis on descriptive type surveys, which reached an apex in 2012 (n=955; 13.37%), as well as exploratory (n=110; 1.54%), experimental (n=56; 0.78%) and bibliographic studies (n=55; 0.77%). However, between 1994 and 1998, it was observed that the scientific production in Brazilian Nursing was incipient.
Regarding the methodological approach, qualitative surveys predominated (n=3,921; 54.91%), followed by quantitative surveys (n=2,405; 33.68%) and, finally, mixed surveys (n=439; 6.15%). It was found that 376 (5.27%) abstracts did not carry the kind of methodological approach used in the research, as explained in Table 3.
Table 3 – Distribution of the year of publication associated to the methodological approach used in the researches produced by Brazilian registered nurses in the last 20 years, 2016, Natal/RN.
SOURCE: Own research
Regarding Table 3, it was verified that the qualitative research was highlighted among the publications. It was observed that the largest number of qualitative studies (n=578; 8.09%), quantitative (n=469; 6.57%) and mixed (n=82; 1.15%) occurred in 2012. However, in 2000, there was a high proportion (n=174; 2.44%) of abstracts whose approach was not possible to identify.
Chart 1 summarizes the recommendations and implications of the abstracts analyzed according to the categories attributed to the objects of study - teaching, research, management and care practice.
Chart 1 - Synthesis of the final recommendations and the implications presented in the abstracts analyzed according to the categories attributed to the objects of study, 2016, Natal/RN.
SOURCE: Own research
According to the categories attributed to the objects of study of theses and dissertations produced by registered nurses between 1994 and 2014, it was found that 627 (8.78%) contributed directly to Nursing teaching, 329 (4.61%) brought implications for management, 2,564 (35.91%) established a relationship with the practice of care and 3,621 (50.71%) applied to the research.
The growing number of publications in the ABEn catalogs over the last 20 years (1994-2014) show the evolution of Nursing as a science. The findings indicate that registered nurses are increasingly interested in seeking better qualifications, possibly with the objective of providing quality care and based on scientific evidence.
Thus, stricto sensu postgraduate courses have emerged as a need to guarantee the continuity of training for Nursing professionals, as Masters and researchers, providing the expansion and deepening of health research, with the consequent production of knowledge and specific technological innovations(9).
A study carried out in the CEPEN online catalogs between 2001 and 2009 showed a predominance of Master's dissertations (74%), and only 26% of the sample was composed of Doctoral theses. These data are in agreement with those found in the present research and are justified by the greater number of Masters courses available in Brazil, at the expense of Doctoral programs(10). This results from the fewer requirements by the Coordination of Improvement of Higher Education Personnel (CAPES - from Portuguese "Coordenação de Aperfeiçoamento de Pessoal de Nível Superior") to open Masters courses in comparison to Doctoral courses.
The purpose of the professional Masters is to strengthen the bonds between academy and practice, breaking with the dichotomy of thinking and doing(11). However, in the present research, there was no abstract related to the professional Master's dissertation. It is believed that the implementation of professional Masters courses is a challenge that is imposed on Nursing(11), since this training requires a reform in the conception of stricto sensu, since there must be an interrelationship with the dynamics of health services in order to seek solutions to problems encountered in everyday care and care management, contributing to the soundness of health institutions to conform, also, in the fields of research and knowledge production.
The progressive growth of research production over the years is detrimental to the progress made in the creation of postgraduate programs in Brazil. This reality is capable of consequently generating a larger quantity of publications which results in the expansion of Nursing as a science, which has been gradually gaining a firm foundation in terms of scientific knowledge(12). Corroborating this fact, from the beginning of 2013 until the end of 2014, a total of 447 theses and dissertations were published in the ABEn catalogs, and this figure compose 6.26% of the stricto sensu Brazilian production of the last 20 years (1994-2014 ).
Authors(1) corroborate the results achieved by showing that, in 2012, Nursing had its number of publications booming, reaching 6th place in the world ranking in the SCImagoJournal & Country Rank (SCImago). The area also grew in relation to its contribution to Brazilian scientific production, since it represented 0.2% of the knowledge published in the said database in 2005, increasing to 1.9% in 2012, which reflects a relative growth of 713%.
Given this scenario, the impact of postgraduate growth on the international visibility of Brazilian Nursing knowledge production is verified by the indices of the number of articles in the Scopus/SCImago database, which ranked 25th place in the world production of the area in 2000 and climbed to 7th place in 2013, overtaken by the United States of America, United Kingdom, Australia, France, Canada and Germany(13).
In this study, there has been an emphasis on scientific production in the Southeast, which corroborates the results of historical research(4) which found that the Southeast was the first region in postgraduate education in Nursing stricto sensu, initially deployed at the Federal University of Rio de Janeiro and then at the University of São Paulo.
The postgraduate degree in Nursing is in notable expansion in Brazil, a fact evidenced by the considerable increase in the number of courses and postgraduate programs, graduates and scientific productivity, with publication of articles in periodicals with a relevant impact factor. However, in the North and Central-West regions there is still a deficit in supply for this level of education, with the quality demanded by CAPES, data that are in line with those presented in this research (14).
It is also possible to notice a significant concentration in the Southeast Region of Brazil, which may be related to the substantial investment in the areas of research and technology, as well as to the pioneering in the implementation of postgraduate programs(15). This reality refers to the need to promote a better geographic distribution of stricto sensu postgraduate programs in the country(16).
Although the present research demonstrates that only 0.14% of the sample was related to internationalization, the opportunity to participate in an international academic mobility program promotes gains of several orders, namely: scientific production, especially in relation to the advancement of knowledge which refers to research methods and theoretical references; professional training; for the possibility of discussing ideas and contact with theoretical and methodological perspectives of centers of excellence; and, finally, exchanges of cultural experiences (17).
Even in view of the incipient insertion of Nursing in terms of internationalization, it has been gaining an important place in the national and international scenario through academic exchanges, research networks and joint international publications. It is recognized that some limitations still need to be overcome, especially in the domain of a second language(18).
Regarding the type of study, it is necessary to expand the experimental research in Nursing, since this type of study confers a higher level of scientific evidence for its applicability in practice, at the expense of descriptive studies (preponderant in the present research).
As for the methodological approach used, there was a predominance of qualitative studies that, in general, is the chosen method, with the purpose of understanding the subjectivity of the subjects, since Nursing is a science oriented in the holistic view of the human being, destined to consider it in all its aspects(19).
Thus, for not dwelling on isolated factors, qualitative research is widely used in Nursing, thus providing the exploration of the different dimensions of the individual, so as to consider it in its singularity and complexity(19).
In this context, the stricto sensu postgraduate course is of fundamental importance for the training of qualified and productive Masters and PhDs in Nursing in order to improve teaching in existing undergraduate courses and the practice of Nursing in Brazil and in the world(20). However, despite the advances in the development of postgraduate programs, the consolidation needs of Nursing as a science in Brazil are still great and challenging(14).
The present research sought to bring to the knowledge of society the paths that Brazilian Nursing has been going through in terms of research, teaching, care practice and management, with a view to unveil the development of this area as a discipline and as a science.
In this sense, in the last 20 years (1994-2014), there has been a substantial increase in the quantity and quality of the scientific productions coming from academic Masters and Doctorates in Brazil performed by registered nurses.
However, there is a great amount of descriptive research, thus demonstrating the need to produce experimental studies with a view to contributing to evidence-based nursing. This is justified by the fact that the experimental study presents more scientific evidence and greater reliability in order to be applied in practice.
The large amount of qualitative research demonstrates how much Nursing is concerned with knowing the human being in its singularity and complexity, since this methodological approach allows the subject to be understood through subjective expressions such as emotions, feelings and perceptions.
The limitations of this study concern the non-standardization and incompleteness of the abstracts analyzed. In addition, the sample consisted only of abstracts published in the ABEn catalogs. In addition, this research portrays only the Brazilian scenario, making it necessary to broaden the knowledge about the subject treated in terms of the international scenario.
Therefore, it is suggested to carry out new studies that include the analysis of theses and dissertations in full, as well as the knowledge produced outside Brazil.
All authors participated in the phases of this publication in one or more of the following steps, in according to the recommendations of the International Committee of Medical Journal Editors (ICMJE, 2013): (a) substantial involvement in the planning or preparation of the manuscript or in the collection, analysis or interpretation of data; (b) preparation of the manuscript or conducting critical revision of intellectual content; (c) approval of the version submitted of this manuscript. All authors declare for the appropriate purposes that the responsibilities related to all aspects of the manuscript submitted to OBJN are yours. They ensure that issues related to the accuracy or integrity of any part of the article were properly investigated and resolved. Therefore, they exempt the OBJN of any participation whatsoever in any imbroglios concerning the content under consideration. All authors declare that they have no conflict of interest of financial or personal nature concerning this manuscript which may influence the writing and/or interpretation of the findings. This statement has been digitally signed by all authors as recommended by the ICMJE, whose model is available in http://www.objnursing.uff.br/normas/DUDE_eng_13-06-2013.pdf
Received: 01/08/2016 Revised: 01/09/2017 Approved: 01/23/2017