Pesquisa qualitativa em saúde: desafios atuais e futuros

Abstract

qualItatIve ReseaRch In health caRe. cuRRent and futuRe challenges For many years now one notes the growing and generalized acceptance of Qualitative Research in Health Care (QRHC) among the majority of Latin American countries, especailly in its largest country, Brazil. Proof of this are the publications to be found under this theme in Text&Context Nursing Journal (Revista Texto & Contexto Enfermagem). But, parallel to the aforementioned acceptance is a series of critiques which have been made concerning some of the problems and challenges faced within this same knowledge production. Based on a recently published literature review, 1 I reference three subjects which are found at the heart of the debate concerning the contributions and challenges that qualitative Latin American Health Care Research faces. They are: its theoretical perspective, the impact of the production generated, and its proposals. Its theoretical foundation-the radical adoption and dependence upon pragmatic and empirical postures, especially the Grounded Theory-seems to be a constant within regionally produced QRHC. This predominance is found in various forms: as it is the most employed reference, its respective authors the most cited (Strauss, Glasser, Corbin, etc.), as well as its designs and strategies the most utilized, beyond the reoccuring use of computational programs sustained within the same methodology as Atlas-ti or Nud+ist. The subject should not be the subject of any criticism at all, at first glance. However, the manner in which it is being used within the región has resulted not only in production that has little concern for theory, but also a lack of knowledge and incorrect knowledge on behalf of other amply used perspectives utilized in latin american countries, such as those inserted in critical and instigating, not to mention interpretative, paradigms. In a region characterized by persistence and social inequality, growing social exclusion processes such as the voices of large social sectors whose exclusion in the field of health care rights occurs for economic, political, and social motives, the use of the Grounded Theory and other pragmatic postures seems to constitute in yet another limitation rather than advance, due to the historical disinterest in the conditions and circumstances which surround the lives of the population under study, among many other things. The impact of the production generated-until the present moment one cannot find a single study within the region concerning the impact of qualitative investigation on its health care systems, organization, or practices. However, some evidence is available about such impact in academics, especially through the number of times in which studies have been cited by other researchers. Based on the findings of the aforementioned literature review, it is an unequal and periphery impact. It is periphery in the sense that regionally produced qualitative research in health care is not cited much. It is unequal because the most cited studies are those published in high impac...