INVITED EDITORIAL

The Purpose of Healthcare Sciences

Enéas Rangel Teixeira¹

¹Fluminense Federal University

ABSTRACT
This editorial is a reflection on healthcare sciences as a means of generating a critical mass of technical and scientific material. We highlight the understandings involved as they relate to the caring sciences and their ethical dimensions in a historical overview, and the creation and contribution of the Academic Graduate Program in Healthcare Sciences (Masters level in 2008 and Doctorate level in 2013), at the Aurora de Afonso Costa Nursing School, of the Fluminense Federal University.
Descriptors: Nursing; Science; Education, Nursing, Graduate; Interdisciplinary Studies; Scientific Domains.

The proximity of the year 2014 makes us rethink some historical events that, besides not being apparently strictly related, or not even having any obvious relevance to the lives of ordinary people, all contain elements that are linked in the field of nursing and healthcare.

In 2014, we will celebrate 100 years since the beginning of the First World War, a historical event of both social and political importance, the consequences of which were devastating to human kind and to many aspects of human well-being. It was so important that it led thinkers to write about the civilizing process and the tension between life and death. In other words, the order and disorder⁽¹⁾ implicit in the materiality of things, and in the symbolism of life.

In an observed correlation, it is possible to understand time in a more dynamic way, as being slippery and relative. In fact, the choice of a historical day or fact is a condensed conjunction of contents and mainstream longitudinal echoes. This condensing process reunites the asymmetric cuts: past, present and future, and their overlaps and interfaces.

Desire can be expressed based on symbolic apparatus, and can mobilize the emergency of concepts and ways of acting. This woven history fabricated by the symbology filled with emotionality on the level of human languages⁽²⁾, is generated and produces an understanding, and its materialization with the capacity to transform.

Based on this perspective, we try here to briefly debate the purpose of healthcare sciences as a means of generating a critical mass of technical and scientific resources, generated by the staff and students of the Aurora de Afonso Costa Nursing School (EEAAC, in Portuguese), from Fluminense Federal University (UFF, in Portuguese).

It is important to think about a certain level of institutional reality, and about the impossibility of understanding the totality of different levels of reality that interact in a certain context. Thus, the criteria of perception of the reality observed is the one that exists with regard to the author of this article, which captures the recursive and referential forms, aiming to describe nursing and its interfaces.

During 2013, the UFF’s Nursing School started its preparations to celebrate its 70 years of history, the anniversary of which will be in 2014.   The school was founded in 1944 as the result of an enormous contribution from Professor Aurora de Afonso Costa. This institution was created during the Second World War, when there was the use of violence and scientific technologies to solve a major conflict.

During the Second World War, the contemporary philosopher Edgar Morin fought in the French resistance against Nazi occupation. In the period after WWII, he helped to rebuild Germany, which led him to write his first book “The Year Zero of Germany”⁽³⁾.

This historical context permits an association with the origins of nursing institutions to teach caring and, at the same time, to remember the two World Wars. Those events were significant in the history of nursing, the role of which is, among other aspects, to take care of ill or wounded people because of the effects of war and social conflict. Caring is directed to cure and regeneration of individuals based on a curative and combatative biomedical model in terms of endemic diseases.

However, during the last decades of the 20th Century, the process of the production of information and education has shifted the paradigmatic tendencies, with a consequent impact on health. Thus, caring has emerged as the necessary support to life⁽⁴⁾, from recovery to the promotion of life quality⁽⁵⁾, moving the curative or combatative focus to the illnesses. As a consequence, caring can repair, reconstruct and regenerate life on a worldwide spectrum⁽⁶⁾.

In terms of this new perspective, considering the mistakes of the past and the movements aimed at overcoming such errors, science and its technological products are not seen as neutral, and depend on the intention for which they are intended. This demands an ethical approach when it comes to producing knowledge and in dealing with life in a research context⁽⁷⁾. The legislation that deals with ethics in research and with regard to genetic heritage is already legitimated.

Morin⁽⁸⁾ discusses the point that civilization prepares  people for war, that education is filled with warfare values, even in the case of healthcare. On the other hand, he says it is necessary to educate for peace and for cooperation, and that peace is better than war. In addition, we need to mention that it is necessary to educate people in order to promote health, rather than focusing exclusively on illness⁽⁹⁾.

With the intention of overcoming fragmented understanding, a transdiciplinary attitude⁽¹⁰⁾ has emerged, dealing with the distinct levels of reality, of complexity, and of the paradigm of connection; this last one is the opposite to dissociation, which was Flexner’s standard in the area of health.

The caring sciences require the interconnection of knowledge in education, in research and in innovation. This is processed in a particularly strict format in the life sciences, human sciences and in nursing, which characterizes caring by its epistemology, once it has a genealogy⁽¹¹⁾ of understandings and practices, produced as part of the history of nursing. In terms of nursing, we must also include ontology, an essential link to the one being cared for ⁽⁶⁾ and its references.

Caring has a professional academic dimension and another non-academic dimension that are connected in the art of caring on a daily basis. It is the caring used for reparation, which is formative and scientific, and the other related to caring with life⁽¹²⁾.

A transdisciplinary attitude has developed between the caring subjects and the plural knowledge of culture. These connections, dialogues and complexities, have materialized in certain aspects of public policies in Brazil in terms of healthcare, in Family Health Strategy and in humanization. Transdisciplinarity implies a continuous reflection with regard to what affects the subject in the form of emotion, a sign of psychoaffective implications in the process of teaching and caring.

Hence, the area of graduate studies needs to produce theories and concepts, transforming understanding into practice, generating professionals to manage the consideration of paradigmatic tendencies with regard to the conquest of health issues and the ethical and humane dimensions. More than that, there exists the challenge of contributing to the transformation of the people affected in the process.

The goal to create a differentiated proposal for graduate studies, which at the core of caring in the area of nursing and its interfaces, initially developed in the Nursing School of UFF in 2008, with the creation of the Academic Masters Program in Healthcare Sciences.  This started in March 2009, with the approval of the Brazilian National Coordination for the Improvement of Higher Education Personnel (CAPES, in Portuguese). The objective was to improve the production of knowledge in the unit, and integrate it with other existing graduate and undergraduate programs in its area of expertise. This was the result of a persisting desire to develop an academic graduation program, aimed at supporting high-level studies.

Based on actual interdisciplinary and transdisciplinary perspectives, the program prepares nurses and professionals who work in the field of healthcare sciences, with a focus on the complexity of caring in nursing and health.

From this perspective, graduates are prepared to manage, research and innovate. The dissertations and other products reflect this aim. That the program has been successful in this respect is shown by the growth of scientific publications generated by its projects. The coherence, consistency and maturity of the program has permitted an expansion to the doctorate program.

As a result of an intense, persistent and collective work effort, at the end of the triennium 2010-2012 of the Masters Program in Healthcare Sciences, the proposal to start a doctoral program was approved by the University, and then sent to CAPES.

On September 19th 2013, to the intense satisfaction of all involved, CAPES announced the approval of the Doctorate Program in Healthcare Sciences. This day was an important moment in terms of building a graduate program in the Nursing School and in the University itself, focusing on excellence. As a result, the Graduate Program in Healthcare Sciences is complete, with both a Masters and a Doctorate program.

The doctorate course is due to start in the first semester of 2014, which is a great gift for the 70th Anniversary of the EEAAC, and is also significant for the University. As a consequence, new researchers will emerge, new partnerships and exchange programs will be created, and there will be new possibilities to participate in projects and to source additional resources, with bigger challenges and higher visibility on a national and international level yet to come.

Hence, 2014 will be used to celebrate the rise of caring as a reinforcement of life, of the creation of cooperation and as a means of supporting diverse ways of dealing with the horrors of modern wars, of fundamentalism, and of the old paradigm of a dissociation of understanding.

REFERENCES

1. Morin E. O método 5: a humanidade da humanidade. Porto Alegre: Sulina; 2002.

2. Maturana H. A ontologia da Realidade. Belo Horizonte: UFMG; 1997.

3. Morin E. Ano Zero da Alemanha. Porto Alegre: Sulina; 2009.

4. Waldow VR. Cuidado humano – o resgate necessário. Porto Alegre: Sagra Luzzatto; 2001.

5. Colière MF. Promover a vida: da prática das mulheres de virtude aos cuidados de enfermagem. Lisboa: Lidel; 1999.

6. Boff L. Saber Cuidar: ética do humano - compaixão pela terra. Petrópolis: Vozes; 1999.

7. Teixeira ER, organizador. Psicossomática nos cuidados em saúde: atitude transdisciplinar. São Caetano do Sul: Yendis; 2009.

8. Morin E. Os Sete Saberes Necessários à Educação do Futuro. [S.l.]: UNESCO; 2000.

9. Daher DV, Teixeira ER, Santana RF, Fonseca TC. Rosalda Paim: a nurse before her time. Online braz j nurs [ Internet ]. 2012 Aug [ cited 2013 sep 24 ] 11 (2): 408-17. Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/3967  http://dx.doi.org/10.5935/1676-4285.20120035

10. Nicolescu B. O manifesto da transdisciplinaridade. São Paulo: Triom; 1999.

11. Foucault M. Arte, Epistemologia, Filosofia e História da Medicina. Rio de Janeiro: Forence Universitária; 2011.

12. Colière MF. Cuidar A primeira arte da vida. 2.  ed. Lisboa: Lusociência; 2003.

Received: 24/09/2013
Revised: 26/09/2013
Approved: 28/09/2013