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Experience Report

Analyticalmovement -Heideggerian hermeneutics:


methodological possibility for nursing research

Movimento analtico-hermenutico heideggeriano: possibilidade metodolgica para a pesquisa em enfermagem

Movimiento analtico-hermenutico heideggeriano: posibilidad metodolgica para la investigacin


en enfermera

Cristiane Cardoso de Paula1, vis Emilia de Oliveira Souza2, Ivone Evangelista


Cabral3, Stela Maris de Mello Padoin4

ABSTRACT
The objective was to describe the analytic-hermeneutic movementapplied in investigations with the child who had Acquired Immunodefi-
ciency Syndrome by vertical transmission, and who is in transition from childhood to adolescence, sustained in the Heideggerian theoretical-
philosophical and methodological framework. The modes of conducting the stage of analysis are described, since the research question related
to the interpretative analysis of meanings, culminating in the proposition of the assistance possibilities in caring for the study population. This
framework proved to be coherent with the principles of humanistic nursing and with its object of study, and contributed to the approxima-
tion between theory and practice of care, by means of the comprehension of the phenomena that permeate the lived experience of health of
individuals, families and society.
Keywords: Qualitative research; Philosophy, nursing; Nursing research; Adolescent health, Health children (Public health); Acquired immuno-
deficiency syndrome; Infectious disease transmission, vertical

RESUMO
Objetivou-se descrever o movimento analtico-hermenutico aplicado em investigaes com a criana que tem a Sndrome da Imunodeficincia
Adquirida por transmisso vertical e que est em transio da infncia para a adolescncia, sustentada no referencial terico-filosfico-metodolgico
heideggeriano. Os modos de conduo da etapa de anlise so descritos, desde o questionamento de pesquisa at a anlise interpretativa dos
significados, culminando na proposio das possibilidades assistenciais no cuidado populao do estudo. Este referencial mostra-se coerente
com os princpios humansticos da Enfermagem e com seu objeto de estudo e contribui para aproximao entre a teoria e a prtica do cuidado,
por meio da compreenso dos fenmenos que permeiam o vivido de sade das pessoas, das famlias e da sociedade.
Descritores: Pesquisa qualitativa; Filosofia em enfermagem; Pesquisa em enfermagem; Sade do adolescente; Sade da criana; Sndrome de
imunodeficincia adquirida; Transmisso vertical de doena infecciosa

RESUMEN
Este estudio tuvo como objetivos describir el movimiento analtico-hermenutico aplicado en investigaciones con un nio que tiene el Sndrome
de la Inmunodeficiencia Adquirida por transmisin vertical y que est en transicin de la infancia hacia la adolescencia, sustentada en el refer-
encial terico-filosfico-metodolgico heideggeriano. Los modos de conduccin de la etapa de anlisis son descritos, desde el cuestionamiento
de investigacin hasta el anlisis interpretativo de los significados, culminando en la proposicin de las posibilidades asistenciales en el cuidado
a la poblacin del estudio. Este referencial se mostr coherente con los principios humansticos de la Enfermera y con su objeto de estudio y
contribuye para la aproximacin entre la teora y la prctica del cuidado, por medio de la comprensin de los fenmenos que permean lo vivido
de salud de las personas, las familias y la sociedad.
Descriptores: Investigacin cualitativa; Filosofa en enfermera; Investigacin en enfermera; Salud del adolescente; Salud del nio; Sndrome
de inmunodeficiencia adquirida; Transmisin vertical de enfermedad infecciosa

1
Adjunct Professor at the Nursing department, Federal University of Santa Maria - UFSM - Santa Maria (RS), Brazil.
2
Full professor at the Maternal-Child Nursing Department, School of Nursing Anna Nery, Federal University of Rio de Janeiro - UFRJ - Rio de Janeiro (RJ), Brazil.
3
Associate Professor at the Maternal-Child Nursing Department, School of Nursing Anna Nery, Federal University of Rio de Janeiro - UFRJ - Rio de Janeiro
(RJ), Brazil.
4
Adjunct Professor at the Nursing department, Federal University of Santa Maria - UFSM - Santa Maria (RS), Brazil.

Corresponding Author: Cristiane Cardoso de Paula Received article 06/12/2011 and accepted 14/04/2012
Universidade Federal de Santa Maria. Departamento de Enfermagem
Av. Roraima, s/n, prdio 26, 3 andar, sala 1336 Cidade Universitria, Camobi
CEP 97105-900 Santa Maria, RS, Brasil Acta Paul Enferm. 2012;25(6):984-9.
Analyticalmovement -Heideggerian hermeneutics: methodological possibility for nursing research 985

INTRODUCTION comprehensive dimension of Heideggerian philosophical


thought, which seeks the how and not what of the ob-
Phenomenology, as aline of thought, focuses on the jects of research. Its concern is the display of the object of
meaning of life experiences for people, by meaningful- study in the movement of veiling and unveiling.
lyfulfilling aknown object (1). As a method, it enables us The Heideggerianmethodological reference presents
to capture, understand and interpret the phenomena of two instances: Onticaland ontological. The onticalseeks the
reality manifested itself (2). description of the fact and refers to the entities, a known
It is concerned with the understanding of the what, that we can determine and conceptualize. Entity is
investigated phenomena, which develop based on everything we talk about, understand, behave, and it is
uniqueness, which is from humans in their lived world what and how ourselves are (17).
and their entire existentiality(3). The ontological seeks to understand the phenomenon
The impetus for research emerges not fromtheory or and refers to a being, an unknown being. This is the relational
method itself, butfrom problems or even things them- instance between subjects, based on empathy and intersub-
selves in the way they are daily shown. The investigator jectivity, through the reduction of assumptions.
has the intention of questioning towards an object to The relationship between the being and world seems to
grasp their meaning. It shows that consciousness is clarify that there is no distance between them, as the being
always consciousness of something, and the object is is adherent to the world, proposing the expression: being-
always the object-to-one-subject. This correlation has in-the-world, presenting the phenomenon of unity and
overcome the dichotomy reason-experience in knowl- totality (17). Thus, the investigation started from being-in-
edge construction (2.3). the-world(the child being infected by vertical transmission
Nursing investigations of phenomenological of HIV) on the horizon of everyday life (to be growing
nature have unveiled obscurities of care to enlarge up and to have AIDS).
possibilities ofthe view for being human, transposing Humankind is a questioning entity, who speaks to the
the Cartesian, reductionist and fragmented model world. The questioning unfolds in three Poles: questioned:
of the human being. By unveiling the experienced theDasein; asked: thebeing; interrogated: the entity. Therefore,
phenomenon, it enables the understanding of human the questioned was the teenager-being who has AIDS, the
beings in theirmultiple facets, in their experiences and asked was the possibility of self-care, and the interrogated
relationships in everyday world (4-9). was the child who has AIDS through vertical transmission
The knowledge resulting from investigations which- and who is growing up.
have as deponents professionals, family members and To develop the questioning, Heidegger considers a
children/teenagers have unveiled facets of existential move in the investigation since the previous position, consti-
dimension of everyday life experienced by children and tuting a prior vision and articulating a preconception(17) (Figure 1).
teenagers who have Acquired Immunodeficiency Syn- The previous position refers to the scientific tradition and
drome (AIDS) (10-16). it was developed based on the constitution of the study
In this article, we present the hermeneutic analytical object of the state of art.
movement developed ina Doctoral Thesis research with The construction of prior vision occurred in an
children who have AIDS through vertical transmission analytical movement of understanding the meanings (first
and who are in transition from childhood to adolescence, Heideggerian methodical moment called vague and
sustained in Heideggerianphilosophical theoretical and median comprehension) and interpretation of the being
methodological referential. After the approval by the (called second moment of interpretive comprehension
Research Ethics Committees of three hospitals in Rio de or hermeneutic)(17).
Janeiro-RJ (approved protocols EEAN/UFRJ 096/06; This analysis was developed based on what was
IPPMG/UFRJ 09/07; HUGG/UNIRIO 36/07), eleven expressed in the statements: speeches, silences and
children from 12 to 14 years, who knew their diagnosis, behaviors. Comprehend is to capture the meanings as a way-
were interviewed (14-16). of-being in everyday life. Interpret is the phenomenon show
up in itself. That is, meanings leading to the beings. The meaning
The applied hermeneutic analytical movement is what sustains the comprehension, an existential that
demonstrates to be more accessible in everyday life, located
The research carried out in the Doctoral Thesis created on the ontical dimension of facts. The being is what sustains
opportunities for interviewees to reflect on their experience, the interpretation, is an existential that is behind, located on
with the possibility to understand the dimensions of their the ontological dimension of the phenomenon (17).
being that were veiled and open themselves to changes in To this end, it is necessary a trajectory from the ques-
self-care having AIDS and being growing up. This linguis- tioning of the whom, comprehension of the meanings, to
tic game of being, to be and to have lies the study in the then, reach hermeneutics, through being interpretation.

Acta Paul Enferm. 2012;25(6):984-9.


986 Paula CC, Souza IEO, Cabral IE, Padoin SMM

Figure 1. Heideggerian hermeneutic-analytic movement: methodological possibility for nursing research

Therefore, the prior vision unveiled the everyday life configuration (age and educational level) and biological
of teenager-beings, who have AIDS, and their ability (inception and ART situation and diagnosis revelation).
to care for themselves. The historicity analysis announces the phenomenal
A preconception consists in grasping this set of previous dimension when considering the living human in their
positions and visions (17) and allowed the Heideggerian daily lives, revealing subjectivities and expressingthe in-
hermeneutics, based on what we think onwelfare possi- tersubjectivity of the meeting. It began with the listening
bilities to teenager-beings who have AIDS. ofthe statements in its entirety and without interruptions,
In this trajectory of questioning, there are three sus- to recall the meeting in its totality. After, were transmitted
pensions. Suspension is the philosophical act of reducing what was said and the behaviors expressed by interviewees:
assumptions, prejudice and pre-judgments.It opens the silences, pauses in speech, looks, tears, laughter. The way
possibility to show the phenomenon essence, putting the of talking to each interviewee was held, with grammatical
natural and immediate consciousness in parentheses (1). errors, slang and incompleteness, seekingthe allegiance of
The first suspension of assumptions, happens in the each response as part of its uniqueness.
datasproduction, in the listening of recording audios of All interviews were transcribed by the researcher
the statements and in the attentional reading of the tran- considering an important moment to relive the meeting
scripts. The second suspension is called phenomenological towards analysis.An attention listening was developed to
reduction or epoch and it happens at the first methodical accompany the reading and review what had been tran-
moment of meanings analysis. The third suspension is scribed, making necessary corrections and additions. The
called eidetic reduction and it happens in the second me- researcher prioritized transcribes which wereasclosest to
thodical moment of senses analysis. its event as possible; to make the writing more faithful to
The first analytic moment - vague and median compre- what had been experienced. Some interviews mobilized
hension - seeks to understand daily facts, what beings show feelings; in these situations, a time offwas needed.
directly and most often for all (17). It started with careful A preliminary analysis was intended to assess the ade-
listening and reading of the statements. It developed the quacy or adjustments needs in guiding questions: Tell me
highlight of meanings contained in the testimonials, which how it is to become teenager. The question - How is your
began in historiography and historicity. daily routine with this disease? - mentioned only when the
Historiography is composed by the ontical dimension interviewee spoke abouttheir serologic condition. It was
of events that contextualize the whom of the growing used the term disease because AIDS was mentioned in
up-being: family composition (parents conjugal status, interviews in this way, being referred, but not nominated.
orphan hood and responsible caregiver); development This preliminary analysis also assessed the construction of

Acta Paul Enferm. 2012;25(6):984-9.


Analyticalmovement -Heideggerian hermeneutics: methodological possibility for nursing research 987

empathic questions (those that the researcher constructed as essential to answer the objective of this research.It was
based on the speech of adolescents themselves, in order to sought, then, what teenager shows as being him/her and
seek a deepening of the statements). Besides analyzing the how he/she understands his/her being as first of all and
understanding of these issues by the deponents, it allowed most of the time (17). Who does that meaning is the teenag-
to expand the testimony and attended to the object and erhimself/herself; he/sheis the one who points out in his/
purpose of the research. It was possible to notice that the her living what is essential. Then, the researcher dedicated
questions were appropriate. There was also the intention to extract these significant structures from the testimonials.
of analyzing if the statements revealed facets of the A chromatics coding was used to highlight the expres-
phenomenon and essential structures in order to sustain sions of the way-of-being in daily teenagers-beings who have
the focus of existential perspective, the framework of the AIDS and their possibilities to care for themselves. When
Phenomenology and the Heideggeriantheoretical-meth- speaking about themselves: the pronoun I was highlighted
odological referential. in bold; of their relations, purple; their daily chores, brown;
The process of comprehensive analysis involves a logical, among other colors which indicated other essential struc-
intellectual and objective knowledge, as well as personal, tures. These structures indicated meanings.
experiential, subjective and intuitive knowledge (18). Con- The constitution of the conducting thread of analysis
sidering that the researcher should not always impose the was developed as follows: adding meanings; agglutinating, and
presence outlined categories for the first idea (17), the re- synthesizing (Table 1). The synthesis is that culminates in
searcher seeks essential structures, not on the previous position Units of Meaning (UM)themselves. The caput (uttered) of the
or based on it, but in what emerges from its own statements. UM is elaborated with parts of the deponent`s ownspeech
In this movement in search of meaning, it is indicated as significant structures to understand the object of study.
that the routine should not draw occasional and accidental Based on the caput of the UM, the conducting
structures, but essential structures [...]that remain ontologi- thread with the development of the concept of being
cally determinants in the way of being of attendance (17:44). is conquered(17), which shows how the teenager-being
The exercise of distinction was made in which manifested who has AIDS understood himself/herself: the teenag-
Table 1 Analytical Framework: composition movement ofconducting thread
1o conductingthread 2o conductingthread 3o conductingthread Conductingthread of Thesis

additions agglutinationssynthesis
The teenager-being who has AIDS...
show up and show up and announces whotheyare announce who they are and recognize (UM1) announces themselves,
announces recognize themselves as teenagers: in the themselves as teenagers, but sometimes, they recognize themselves as
themselves waytheyact, behave, look or in their mood they still want to be children teenagers and, sometimes, they
relateto people relate to people in the family, school, still want to be children
still want to bechildren
around them hospital (UM2) relate to family and
relate to people around them: family, friends, consider school as
recognize school, hospital describes how their daily routine is
themselves as and express their leisure important and they have daily
teenagers describe how their daily routine is: at activities and recreation
home, at school and in the hospital think about: dating, studying,
describe their tasks working and having children (UM3) reveal that they have
and leisure express their leisure a virus and that it is bad to
know that they have a problem, have this problem, and think
know the diagnosis think about: dating, studying, working, which acquired from their mother about: study, work and dating
andthatit should not choosing a career and having children
have relatives who are sick or that (UM4) know that acquired it from
be discussed with know that they have the same problem have died, which is bad, difficult and
anyone their mother; having relatives
as their mother reason for sadness who are sick or who have died is
knowits a disease having relatives who are sick is bad and understand themselves as being difficult and cause for sadness
that has prejudice difficult, specially if someone has already died normal despite the virus (UM5) recall how they knew
know that they have recall how they knew they had the virus recall how they found out the disease and how it was said that they
the same mothers should not tell anyone because
illness few people know the diagnosis and they a few people know, it was said that of prejudice
know that they cannot tell anyone they can not tell anyone because of
establishes a help prejudice (UM6) understand themselves
relationship with the know that people turn away from those as being normal despite the
mother who have this disease take care of their health is something virus
must want their own good they have to do, and need to want to
think about dating do because its for their own good (UM7) take care of their health
and studying have to go to hospital is something they have to do
due to the disease, they must go to and need to want to do; because
speaks about taking medications is important for hospital and take medicine
medications, exams of the disease they have to
their health, so they need to commit to go to the hospital and take
and hospital treatment, but maintaining it, is difficult need to commit to treatment, but
keeping it is difficult and sometimes medicine, but it is difficult and
and sometimes they need help they need the help of someone
they need help from someone

Acta Paul Enferm. 2012;25(6):984-9.


988 Paula CC, Souza IEO, Cabral IE, Padoin SMM

er-being recognize himself/herself as a teenager, and, methodical moment: hermeneutics, which is developed
sometimes, still want to be a child; relates to family and by the interpretive comprehension.
friends, considers the school important and has daily The interpretive comprehensionseeks to reveal
activities and recreation; reveals that he/she has a virus the phenomenon (ontological dimension) - which is not
and that is bad to have this problem, and thinks about: shown directly in fact, but it is veiled, pointing to the
studying, working and dating; acknowledge that he/she need for factual deconstruction to bring at light the
acquired his/her mothers illness; have relatives who is meaning of being.
sick or have died and it is difficult and cause for sadness; From the clarity of the concept and ways of un-
recalls how he/she knew and how it was said that he/ derstanding explicit inherent in it, it must be decided
sheshould not tell anyone because of prejudice; take what is this comprehension of theobscure being and
care of your health is something he/she has to do and still unclear (17). To this end, it was developed the
need to want to do; because of the disease he/she has analytic movement of meanings contained in the fac-
to go to the hospital and take medicine, but it is difficult tual dimension, without seeking the explanation, but,
and he/she needs the help of someone. inaugurating the unveiling of meaning located in the
The concept shows facets of everyday life and makes phenomenon dimension. This movement corresponds
up the conducting thread of the second Heideggerian- to Heideggerian hermeneutics (Table 2).
Table 2 Table of the analytic movement of comprehension to hermeneutic

(meanings) (sense)
ONTICAL ONTOLOGICAL
The teenager-being who has AIDS...
(UM1) announce themselves, they recognize themselves as teenagers and, sometimes, they still want to being-there
bechildren coming-to-be
facticity
impersonality
(UM2) relateto family and friends, consider the school as important and they have daily activities and recreation public world
being-with-others
occupation
(UM3) reveal that they have a virus and that is bad to have this problem, and think about: studying, working ownworld
and dating being-with-themselves
authenticity
being-of-possibilities
(UM4) know that acquired their mother's illness; have relatives who are sick or who have died and it is difficult and fear
cause for sadness
(UM5) recall how they knew and how it was said that they should not tell anyone because of prejudice authenticity
inauthenticity
(UM6) understand themselves as beingnormaldespite of the virus ambiguity
gabble
(UM7) take care of their health is something they have to do and need to want to do; because of the facticity
diseasethey have to go to the hospital and take medicine, but it is difficult and they need the help of someone occupation
solicitude
pre-occupation
being-of-possibilities

A Heideggerian hermeneutic has enabled the interpre- CONCLUSION


tation of the being, revealing that teenagers-beings who
have AIDS experience in their daily an existential movement A description of the experience with the phenom-
which part of inauthenticity, manifested by fear and ambiguity, enological investigation with application of the Heide-
toward authenticity, mediated by anguish.Projectthemselvesas ggerianhermeneutic analytic movement showed one
being-of-possibilities, not limited by the double-facticity: to be possibility for methodological research in Nursing. This
growing up and to have AIDS. It reveals the movement to is a reflexive and also theoretical movement, which begins
be-cared-by to be-cared-with, because in childhood family care on the construction of the research project, when the
was required full time, already in the transition from child- need for locating the object of research and the pursuit
hood to adolescence there is a comprehension of the need for a theoretical-methodological reference converge.
to care for themselves, by the responsibility with-himself and The development of Heideggerian referential of
with-familiar and with-professional help (14-16). onticaldimension enables the understanding of the

Acta Paul Enferm. 2012;25(6):984-9.


Analyticalmovement -Heideggerian hermeneutics: methodological possibility for nursing research 989

meanings indicated by the deponents in their daily liv- their eyes to subjective situations of human beings and
ing. Culminating in the ontological dimension, which care.Contribute to rapprochement between theory and
allowed us to unveil the meanings of lived and expand practice of care through the understanding of the phe-
the possibilities of healthcare and nursing. nomena that underlie the impact of individuals, families
The Heideggerian philosophical theoretical and and society health status. Herein, are located, especially
methodological referential have shown to be consis- the emerging population of children who have AIDS
tent with the humanistic principles of nursing and its through vertical transmission and that are transitioning
object of study, by the tendency of researchers to turn from childhood to adolescence.

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