Historical and Dialectical Materialism as a Theoretical-Philosophical Referential for Qualitative Researches in Health - an experience report
In the early decades of the 20th century, qualitative research was overshadowed by positivist practice since qualitative methods were not considered as capable of analyzing and assessing social problems in depth. In the 1960s, a new phase began, when questions emerged about the capacity and exhaustion of positivist studies to describe and understand the reality of that time (Minayo, 2016). Likewise, from the 19th century on, Historical and Dialectical Materialism (HDM) was remarkably introduced by the work of Marx and Engels due to strong criticisms the authors made on the positivist approaches (Perna & Chaves, 2008). Such criticisms were based on the fact that the HDM admits the possibility of an objective reason, arising as a result of the socio-historical organization of the society that is in permanent change. By contrast, positivism conceives a reason of subjective nature that is taken, in general, as finished in its own logical-rational structure (Perna & Chaves, 2008). This study is an experience report that aims to reflect on the productions of a research group, the Center for Studies in Collective Health (NESC, in Portuguese) of the Federal University of Paraná, Brazil, which uses HDM as a theoretical-philosophical reference for qualitative studies on health. In the HDM perspective, the health-disease process is historically and socially determined, since social transformations generate changes that are expressed in health patterns, both in individuals and in population groups. Studies conducted by NESC researchers in the last decade have shown that the health of an individual is directly related to the production mode of a given society in a certain historical period of time. In order to deepen the researches, theoretical and methodological references used in these studies are anchored in the HDM, in qualitative and quantitative methods, and seek to reflect on historicity, relations, representations and perceptions of the subject over particular and collective conditions and over the health and disease process that occur in contexts historically determined by the established production mode. This perspective allows those studies to highlight a critical reflection about the realities observed, and thus to think about how it is possible to transform undesirable situations for health. The group’s production using qualitative approach is enabling the elaboration of critical-reflective views on the objective reality of the phenomena studied, but at the same time, its discourse finds difficulty to be diffused in scientific journals. These publications, for the most part, have affinity with positivist discourses, which bring generalized results that can be reproduced in other scenarios for possible comparisons.