Use of webQDA to analyze the route of construction of the Theory of Wanda de Aguiar Horta

Abstract

Wanda de Aguiar Horta is a Brazilian nursing theorist of the best known in her country and other Portuguese-speaking countries. Her theory was created and disseminated in the mid-1970s (Horta, 1974b). More than the theory itself, Horta was responsible for a proposal of systematization of nursing care that still prevails in Brazil today. In the course of theoretical construction, concepts and ideas were divulged in scientific journals existing at the time, especially in the Journal of the Nursing School of the University of São Paulo (REEUSP) given the author's connection as a teacher and researcher of this School. The Brazilian Journal of Nursing (REBEn) was another important vehicle for disseminating Horta's thinking. Bousso, Poles, & Da Cruz (2014), in the study titled Concepts and Theories in Nursing, affirm that, given their dynamic nature, concepts vary according to their use and the contexts or structural dimensions in which they are put into practice. Thus, it is necessary to recover the historicity of the construction of the theory, to understand the underlying theoretical-philosophical framework and to visualize the limits and the potentiality of its current use (Egry, 1996). This is a qualitative study, part of a larger project that aims to reconstruct the path of elaboration of Horta’s Theory. The clipping for this article is the use of webQDA to answer the question: What concepts, principles and codes were developed historically in the construction of the Nursing Process of Horta? Objectives: to identify the articles published in REEUSP and REBEn that address Horta Theory clippings; to identify the influence of authors who provided the basis for the theory; to understand the importance of qualitative research in the study of theories. Method: a documentary study based on the Scientific Electronic Library Online (SciELO) through electronic access to REEUSP and REBEn journals. Data collection was performed in April and May 2019. The search descriptors used were: "Wanda de Aguiar Horta" and "Basic Human Needs". From the total of 60 articles selected, 57 were included in the first stage of the study according to the criterion of inclusion: Basic Human Needs Theory approach proposed by Wanda de Aguiar Horta. Data extraction was performed using the webQDA qualitative analysis software. Data were initially extracted based on titles and abstracts. The full articles were then accessed to additional eligibility. The articles selected through the titles in SciELO were inserted in the reference manager (Mendeley) and imported as metadata for webQDA in the format of .xml files. They were automatically coded according to type and year of publication, authors and keywords. Duplicate metadata were automatically identified by webQDA and excluded from the sample (three references). There was also the exclusion of two articles dealing exclusively with the Basic Human Needs proposed by Maslow. Thus, 52 articles were included, saved in the Internal Document System of the webQDA in the Portable Document format. Specific notes were attributed to the 52 publications, which were then codified through the Tree Codes system in the analytical categories: Theoretical and Philosophical Bases and Scientific Principles. The software also allowed the elaboration of questions, in order to establish relations between the descriptive and empirical codifications. Results: 52 articles made up the documentary database; 21 were published by Horta between 1968 and 1979, 13 in REEUSP and eight in REBEn.

Theorist presented a regular scientific production during these 11 years, with the exception of 1971 and 1977. The articles published in REEUSP were associated with the construction of the Theory, while those published in REBEn were related to the research developed in his professional career. Most of the authors cited by Horta were Nursing theorists (Eugene Levine, Faye G. Abdellah, Florence Nightingale, Ida J. Orlando, Martha E. Rogers, Margo McCaffery and Virginia Henderson), followed by authors from the field of Psychology (Maslow, Burrhus F. Skinner, Charles E. Osgood and Silvia TM Lane), Anthropology (Mark Zborowski), Administration (Cyril J. O'Donnell and Harold D. Koontz) and Pedagogy (Victor G. Hoz). The first study published by Horta deal with the proposition of a dynamic concept of Nursing (Horta, 1968), addressing the nurse's responsibility in identifying patients' unmet needs. In addition, she published studies indicating the experimental character of the steps that would come to compose the method in his Theory (Horta, 1969b, 1973, 1974a). In other texts she presented the challenges and perspectives of the profession, emphasizing the importance of the development of scientific theories (Horta, 1969a) and the instrumentalization of professionals through knowledge and skills (Horta, 1970, Horta, Kamiyama, & Paula, 1970). In the articles it is possible to observe the concern of the author with the satisfaction of the needs of the users and the qualified training to the nursing professionals. In 1974 the article related to the proposal of theory and its principles and to the nursing process, at the time structured in six phases (Horta, 1974b), was published. In the following years, Horta sought to systematize the nursing consultation, involving the physical and psychological aspects of the patients, as well as understanding the perception of professionals, teachers and students regarding nursing care. In her last article, when she was very sick, we can verify the preoccupation with the subjectivity of the care, associated with the meanings attributed to pain, health and illness. Conclusions: REEUSP was an expressive vehicle for the dissemination of Horta's theory, highlighting the number of articles published by the theorist herself. The North American nursing theorists were the ones that most influenced the theoretical construction. Psychologists, anthropologists, administrators and pedagogues have contributed to the elaboration of concepts and ideas. The main contribution was made by the psychologist Maslow, whose Theory of Basic Human Needs was the basis used by Horta to guide nursing care. The qualitative methodology was adequate for the study of the theory and webQDA proved to be an essential tool for the organization, extension and deepening of data analysis. However, the software had limitations on reading part of the internal fonts due to the publication time, there was the creation of notes for the publications for the coding.