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Enfermería: Cuidados Humanizados

versión impresa ISSN 1688-8375versión On-line ISSN 2393-6606

Enfermería (Montevideo) vol.6 no.spe Montevideo oct. 2017

https://doi.org/10.22235/ech.v6iespecial.1453 

Articles

Narratives and Biographical approach. Uses, scope and challenges for Interdisciplinary Research

Gabriela Rubilar Donoso1 

1Universidad de Chile. Santiago de Chile


RESUMEN

Resumen: Este artículo revisa los alcances y potencialidades de la investigación con enfoque biográfico y el papel que adoptan, dentro de este enfoque, las narrativas que dan cuenta de los procesos vividos por los sujetos. Pone especial énfasis en el uso de las narrativas para la construcción de relatos, historias de vida y testimonios, aportando elementos para una discusión acerca de su uso y revalorización como enfoque de investigación e intervención. El artículo se escribe desde una perspectiva interdisciplinaria, ya que se reconocen los aportes de este enfoque a distintas disciplinas de las ciencias sociales, humanas y ciencias de la salud. Se analizan las corrientes que han influido en los estudios de enfoque biográfico, considerando aspectos históricos y epistemológicos. Lo anterior es especialmente relevante en el caso de aquellas disciplinas que están relacionadas con los cuidados, como la Enfermería o el Trabajo Social, que trabajan con relatos de sujetos que enfrentan situaciones de dolor o enfermedad. El enfoque biográfico narrativo permite rescatar sus historias y contribuir a la memoria de aquellas personas dispuestas a narrar sus experiencias. El artículo finaliza mostrando los usos contemporáneos de este enfoque tanto en el campo de la investigación como en la intervención social. Discute acerca de los desafíos actuales de este enfoque y en sus posibilidades de combinación con dispositivos multimedia y el uso de tecnologías de información

Palabras clave: Biografía; Narrativas Personales; Investigación Cualitativa; Investigación Interdisciplinaria; Profesionalismo

ABSTRACT

Abstract: This article reviews the scope and potential of research done using a biographical approach and the role that this approach adopts in giving voice to experiences lived by the subjects. Special emphasis is placed on the use of narratives to construct life stories, histories and testimonies, incorporating elements for a discussion about their use and enhancement as an approach for research and intervention. This article is written from an interdisciplinary perspective, recognizing the strengths of this approach that can be applied to diverse disciplines within social sciences, humanities and health sciences. This paper analyzes the trends that have influenced in studies from a biographical approach, considering historical and epistemological aspects. This is particularly relevant for disciplines related to human care, such as Nursing or Social Work that deal with narratives of participants who have faced situations of pain or illness. The narrative-biographical approach allows us to retrieve these histories and to contribute to the memories of people willing to narrate their experiences. The article concludes by examining the contemporary uses of this approach both in research and in social interventions. Current challenges related to this approach are discussed and also the possibility of combining it with multimedia devices and the use of information technology

Keywords: Biography; Personal Narratives; Qualitative Research; Interdisciplinary Research; Professionalism

RESUMO

Resumen: Este artigo discorre sobre o potencial da pesquisa a partir de uma abordagem biográfica e do rol que adoptam dentro deste enfoque as narrativas que dão conta dos processos vivenciados pelos sujeitos. Enfatiza, especialmente, no uso das narrativas na construção de relatos, histórias de vida e testemunhas, fornecendo elementos para uma discussão sobre seu uso e sua apreciação como enfoque de pesquisa e intervenção. O artigo está escrito a partir de uma perspectiva Interdisciplinar, visto que reconhece os aportes desse enfoque, aplicado a diferentes disciplinas das ciências sociais, humanidades e ciências da saúde. São revisadas as correntes que influenciaram os estudos de tipo biográfico, no que tange a quesitos históricos e epistemológicos. Isso é especialmente relevante no caso de aquelas disciplinas, relacionadas com os cuidados, entre os quais: Enfermagem ou Trabalho social, que trabalham com histórias de indivíduos que enfrentam situações de dor ou doença. A abordagem biográfica narrativa permite resgatar suas histórias e contribuir para a memória de aqueles dispostos a relatar suas experiências. O artigo termina mostrando os usos contemporâneos dessa abordagem, tanto na pesquisa quanto na intervenção social. Discute os desafios atuais desta abordagem e suas possibilidades de combinação com dispositivos de multimídia e uso de tecnologias da informação.

Palavras-chave: Biografia; Narrativas Pessoais; Pesquisa Qualitativa; Pesquisa Interdisciplinar; Profissionalismo

Introduction

This article reviews the scope and potential of research that uses a biographical approach. The uses and possibilities that this perspective offers interdisciplinary research are considered and analyzed. We place special emphasis on the relationship between the biographical approach and the use within this perspective of narrative and narration that the subjects of research themselves can construct.

Some of the contents of this article were presented at the Summer Institute for Qualitative Methodologies for Social Transformation along Border Zones, conducted during the month of January, 2017, at the University of Tarapacá. The objective of this activity was to develop and share knowledge about qualitative methodologies from diverse moments and approximations. In this context, we presented the results from a research project that reflected on the use of narratives to construct life stories, histories and testimonies, providing information for a discussion about their use and value as an approach for research and intervention HYPERLINK "#mkp_ref_001".

We begin with the assumption that the biographical approach has a long tradition in the social sciences; however, its use and deployment as a research perspective has not always been recognized across disciplines. Its renovated use and incorporation of information and communication technologies can contribute to new perspectives on analyses, while nourishing other disciplines within social sciences and humanities.

In this article, we pay special attention to possibilities of development of this approach within disciplines that entail caretaking, such as Social Work and Nursing. These disciplines can give voice to the histories and narratives of subjects with whom these professionals work, who often are confronted with painful situations or suffering that deserves to be narrated and analyzed from this perspective.

METHODOLOGY

This study consists of a literature and document review of the currents that have influenced research conducted using the biographical approach, examining historical and epistemological trends.

People often question whether the biographical perspective is an approach, method, or technique. In this article, we consider the biographical perspective to be an approach that enters into the territory of qualitative research. As an approach, the biographical perspective considers theoretical, epistemological, and methodological aspects in its development.

One of these unique elements from this perspective is that the biographical approach is constructed from the personal narratives of the subjects themselves, who tell their experiences to the researchers. These narratives can highlight the person's entire life, or can consist of briefer narratives about specific events of interest to the researchers.

We start with biographical studies from the classic work of William Thomas and Floridan Znanieck HYPERLINK "#mkp_ref_002". This study, which was published almost 100 years ago, allows us to affirm that biographical studies have a long tradition in social sciences, that regains traction with the beginning of the Chicago School of Sociology HYPERLINK "#mkp_ref_003")(HYPERLINK "#mkp_ref_004")(HYPERLINK "#mkp_ref_005". The timeliness of this work reminds us of the influence that remains currently of biographies as a research approach and of the diverse adaptations that this perspective has had not only in the Chicago School, but also in more contemporary visions like those developed by the Polish School at the University of Łódź.

During the foundational period of studies developed under this perspective, different researchers from the Sociology Department at the Chicago School, directed by Park, examined social reality in their time, with an analysis schema that questioned structural elements and connected social problems with vital life experiences and these, in turn, with social structures, articulating theory and data HYPERLINK "#mkp_ref_006".

Subsequently, reflections emerged from the pioneers of Social Work regarding a genealogy of the professional identity. This allowed us to better understand the influence and relationships that, in this period, developed among the exponents of the Chicago School and the collective of women who professionalized Social Work in the United States at the end of the 19th Century and beginning of the 20th (HYPERLINK "#mkp_ref_007")(HYPERLINK "#mkp_ref_008".

The Hull House became a privileged space for research and intervention, incorporating the biographical perspective as one of its main work tools. We can observe how early the women of the Hull House actively used this approach in combination with other techniques like mapping or cartography, that up to the present have remained a valuable contribution in studying migrant communities and their social conditions HYPERLINK "#mkp_ref_009".

The connections between Hull House and Thomas and Zananiecki's work are strong, since they both share Charles Hull and his cousin Helen Culver as benefactors. Thomas maintained considerable correspondence with them that sheds light on the backstage of his research. This correspondence shows the form in which this perspective installs itself early-on within the emerging disciplines of social sciences HYPERLINK "#mkp_ref_010".

After World War II, biographical studies declined notoriously, both in sociology and anthropology. For Bertaux, World War II shifted the focus of research toward Parsonian functionalism and survey analysis, reducing other forms of observation and theorizing HYPERLINK "#mkp_ref_011".

This type of "abandonment" in biographical studies remains registered in the works of Norman Denzin and Juan Francisco Marsal who, several decades later, resumed these studies in parallel to the boom that qualitative approaches experienced from the end of the 70s on HYPERLINK "#mkp_ref_012")(HYPERLINK "#mkp_ref_013".

It is from this context that Daniel Bertaux's article emerged as one of the most referenced for the biographical method. It is perhaps Bertaux who best represents the renovated impulse in this period and who ended up erasing the boundaries between sociology, anthropology, and history HYPERLINK "#mkp_ref_014".

This author argued that the research approach based on life histories and biographical narratives has an analytic potential that goes beyond its already-known exploratory abilities. This is affirmed by its subsequent inclusion in a proposal for comprehensive analyses, which permits not only descriptions of microsocial functioning, but also extracts conclusions that go beyond specifics.

His vision of the biographical approach as a wide research perspective, connected beyond one pure discipline, is that allows us to present the evolution of this approach and its additions to nursing. It is in this discipline that we can examine the work pioneered by Janice Morse in her Master's thesis in the middle of the 1970s in her use of the biographical approach in healthcare HYPERLINK "#mkp_ref_015".

As mentioned in the previous paragraph, the biographical approach is an imminently interdisciplinary proposal that is developed from narratives that are contained in the testimonies gathered from the subjects themselves, and in turn are connected with oral histories and stories. Bertaux himself supports this argument, that is strengthened later on through the research of Franco Ferrarotti; Phillipe Lejeune and Vicent de Gaulejac (16, 17, 18).

Towards the end of the seventies, the biographical perspective started to be used more frequently in studies about community power, as developed by Schütze; and in the works of Gabriele Rosenthal and Wolfram Fisher-Rosenthal HYPERLINK "#mkp_ref_019")(HYPERLINK "#mkp_ref_020")(HYPERLINK "#mkp_ref_021" related to memories of victims of human rights violations. We emphasize this period, given that the following decades see the consolidation of this perspective as a research approach, both in academic research and in professional research.

In the nineties, there was a turn toward biographies, not only in terms of methodologies, but also as a theoretical perspective, forming part of the movement toward reflexivity HYPERLINK "#mkp_ref_022". Consequently, the biographical approach has become a methodological-theoretical approach that underlies the research presented in this article, which was essentially constructed from the work of Daniel Bertaux that attempted to give voice and visibility to the participants of his research through their testimonies and coordinated historical-biographies.

It is therefore an epistemological, theoretical and methodological approach that considers the singularity and heterogeneity of individuals' situations. This allows the progressive appearance of common themes from analysis that structure and organize specific collectives, as occurs in the case of this research on Social Work and Nursing.

RESULTS: Combined uses of biographical materials and current trends

From research out of the Chicago School and the Polish School, this article incorporates two core elements for analysis of the biographical perspective as an interdisciplinary approach: First, the diversification of analysis materials, where narratives are constructed not only from oral tales, but rather from diverse life documents, including personal letters, travel logs, personal diaries and photographs. The ability of informational technologies to penetrate our lives has led to a more active use of personal materials in social research, including those that people diffuse on social media HYPERLINK "#mkp_ref_023". This perspective of combined uses can also be traced to research that connects personal experiences of creativity and appreciation for art with studies from healthcare HYPERLINK "#mkp_ref_024".

These elements and objects connected to memories encourage the protagonists to write and narrate their experiences about different events, commemorating what happened and updating their content. In parallel, we are reminded of the epistemological demand of biographical research, in that it contributes to memory and the connection of the individual, structure and history.

The second core element focuses on the life experiences of the subjects as a field of research. This is particularly relevant for the disciplines of Nursing and Social Work that have the privilege of having incorporated listening to narratives of subjects as a primary source of information HYPERLINK "#mkp_ref_025".

We collect the symbolic strength of language and narratives from this perspective as the most important dimension of constructing and expressing our identities. This is particularly relevant when we consider that, in disciplines like Social Work and Nursing, narratives form part of our daily professional duties HYPERLINK "#mkp_ref_026".

Furthermore, this constitutes research oriented toward developing certain traits in nursing students as part of their clinical lessons. In these studies, students make it known, through their narratives, how they construct meaning as they develop their clinical skills in healthcare centers and how these have impacted their daily activities HYPERLINK "#mkp_ref_027".

Accustomed to interview and ask others, in this research perspective we inverted the normal roles and asked those who conduct interviews to take on the role of interviewee and narrate their experiences. In doing so, a space was created to activate memory and invite reflection about their professional experiences and their own tasks, as occurs for example in work that exposes social representations of organ donation, published in this journal at the end of 2016 HYPERLINK "#mkp_ref_028".

Consequently, one can begin to see how narrative practices, and particularly the biographical approach, have experienced an unexpected surge of success and prospective studies over the course of the last few decades of the previous century. In this period, as a result of the surge of particularity and subjectivity, there has been a development and acknowledgement of experiential writing and self-reflective narratives. This has led to an alteration in the ways of perceiving the generation of knowledge in social sciences.

Biographical subjectivity has been observed to contribute to knowledge generation not from an a priori understanding, but rather from a shift that has implied moving toward an order of different ideas that understands and encompasses the contemporary surge of narratives, where identity is observed as flexible and dynamic, simultaneously collective and individual.

In this article, narratives are defined as such by Guerrero, when affirming that they have multiple perspectives and theoretical underpinnings; nonetheless: "Researchers recognize certain common elements throughout. Narratives are characterized as possessing an order and sequence of events and facts (...) the narrators create arguments about an unorganized experience, leading it to become reality and coherent. Related to this, narrators structure their narratives temporally and spatially" HYPERLINK "#mkp_ref_029".

The biographical-narrative perspective has helped us to retrieve visions that actors have about a determined topic and the way in which services can be better adapted to meet the patients' needs. From here research emerges that compiles contributions from doctors, pharmacists, specialists, midwives, nurses, patients, and clients of health systems. Their experiences are key to understanding how health care systems function and paths for improvement. The biographical-narrative perspective lets us retrieve the visions that these actors have about a specific topic or issue and helps us understand how to adjust and adapt services to better meet the patients' needs.

In this regard, Ortiz states that the contents of these approximations: "are directly related to the experiences of the people interviewed: the reasoning behind their decisions, attitudes, feelings or expectations of certain situations, the processes of searching for health care assistance and the construction of their professional identities. Some of them approach a topic from the double perspective of being both a patient and professional, resulting in a multi-dimensional vision that is of particular historiographical interest" HYPERLINK "#mkp_ref_030". Keeping this in mind, we argue that the results of this study pertain to the multi-dimensional stage of biographical studies and their consolidation as an approach. Within this approach, we can recognize different currents or research traditions, such as the American, French, Italian, and German currents HYPERLINK "#mkp_ref_031".

Within the North American current-and also Mexican-it is possible to recognize some approximations to the notion of trajectory from life course studies (32). Given that this perspective analyzes people's transitions across their lifespans, it centers on movements of individuals and on temporal models that can impact these transitions. This current has studied educational and work trajectories of social actors in depth; and, consequently, is notable when analyzing transitions that people make over the course of their lives.

Within healthcare, trajectory studies tend to follow the processes of formation for healthcare professionals, as well as the trajectories of patients in different phases or stages of their lives HYPERLINK "#mkp_ref_033".

For its part, in France, the concepts of trajectory and journeys were further developed and used as a specific line of research within the biographical approach. The French current focuses less on the relationships between different trajectories and life cycles, and more on the divisions or inflection points within biographies HYPERLINK "#mkp_ref_034". As such, trajectories are understood as a chain of events that can be thought of as an articulation of various histories or sub-histories: social and political history, residential history, and family history, among others.

On this same line of thought, the current of French studies has developed an important perspective regarding the unexpected. These events can originate within the actors themselves or externally, or can even encompass generational or wider collective dimensions HYPERLINK "#mkp_ref_035". Within the area of nursing and care, it is possible to observe the presence of trajectories that have been altered or modified as a result of illness, accidents, or catastrophes that affect individual or collective subjects. Access to new treatments or access to loans that had not been considered before now can also be analyzed as "events."

The collective dimension is more connected to the principles underlying the Italian current, whose main exponent is Franco Ferrarotti, for whom the biographical approach allows access to universality and generality (society) that emerges from individuals HYPERLINK "#mkp_ref_036". Understanding the context from which life stories or experiences of the subjects emerge is fundamental for this author, in order to give voice and address them, even longitudinally, as a means of illustrating how common problems are articulated across time.

Studies of health and accidents within the workplace can also be analyzed from this lens, addressing micro and macro-social elements that can explain specific phenomena and their prevalence over time.

Finally, in Germany the notions of histories of work life and biographical work projects were expanded, in the context of studies of workplace culture HYPERLINK "#mkp_ref_037" as a way of referencing these trajectories. These were conceptualized as sequences of experiences that were structured in two dimensions: the dimension of biographical time that establishes typical sequences in accordance with life cycles, and the dimension of historical time that offers different limits and opportunities to define different social spaces for diverse generations.

Emerging from this lens, the biographical perspective has allowed for the reconstruction of trajectories from individual and collective subjects that results from the intersection of three specific dimensions: i) The multiplicity of elements present in autobiographical narratives and the importance that each one of these brings; ii) the variability of time in the configuration of the articulation of elements present in life histories; and iii) the specific articulation of elements in these same histories.

DISCUSSION: Achievements and challenges for interdisciplinary research.

As we discussed in the previous section, the biographical approach and its use of narratives in social research can be considered a genre of enunciation, action and representation that is susceptible to study and can constitute a field of interdisciplinary research.

This is particularly relevant given that the biographical approach has possessed an interdisciplinary architecture from its origin; this has led to its adoption and contribution within social science disciplines, urban studies, and socio-historical perspectives HYPERLINK "#mkp_ref_038".

Its achievements have been presented in this article as a product of social expression that is constructed mainly by biographical-narrative meetings (interviews) that are characterized by their flexible structure, repetition and genuineness, and can provide a space for life stories and biographical narratives to emerge. In contrast to life stories, life narratives are brief biographical narratives that tend to be the object of study of the researcher. While they are able to encompass the ample life experiences of a person, starting from one's birth, they tend to focus on one particular aspect of an experience.

Without going into depth on the debate about which methodology best constructs these biographical narratives, it is important to recognize that in this particular type of narrative production, the principle of the reflexive interview is the main thing that is activated, in which interviewer and interviewee actively participate as subjects in interactions and dialogue HYPERLINK "#mkp_ref_039". Therefore we assume a perspective that presents similarities with what other authors have found, in the development of a reflexive practice that questions and critiques the tasks of diverse professional and disciplinary fields HYPERLINK "#mkp_ref_040")(HYPERLINK "#mkp_ref_041".

This highlights the articulate character of research and intervention processes, as well as the idea of reflective practice. Reflective practice has now been extended from the field of research to part of typical professional duties HYPERLINK "#mkp_ref_042". Therefore, there is an emphasis in this article on processes of reflection and epistemological vigilance, considered an exercise of disciplinary self-reflection that recognizes the importance of re-thinking and examining one's own duties, constantly revising and reflecting on them, as well as analyzing and questioning them HYPERLINK "#mkp_ref_043".

Simultaneously, it is important to pay special attention to the background of these narratives, to what has not been registered and remains in a private sphere, as well as decisions, what has not been said, and to the processes that the researchers and/or professionals leave hidden upon developing their work. Bringing these to the light and making these background processes visible is one of the tasks that this research approach undertakes HYPERLINK "#mkp_ref_044".

As such, the research that this article develops and promotes adds to a reflective current that has integrated other disciplines for some time and with other researchers such as the reflections on her own professional development that Beatrice Webb made out of England, recognized today as a precursor to social work, sociology and economy HYPERLINK "#mkp_ref_045".

However, there are multiple challenges of the biographical approach within qualitative research. Particularly within the disciplines of Social Work and Nursing, the first challenge they have is related to its recognition or validation as a research perspective, either in combination with other techniques or approaches, or in its use as a main perspective in research that analyzes and reflects on disciplinary tasks and duties.

A second challenge is related to the possibilities provided by this approach, both regarding analysis and comprehension of phenomena related to who conducts research, such as the therapeutic use of reflection for those who participate in these processes. The therapeutic qualities of narratives constitute a dimension that has not yet been fully explored in these approximations. Whyte and Epston's work contributes some to this dimension, but needs to be more fully explored, especially when considering the reparative nature of these types of narratives and the possibility of re-signifying traumatic or painful events in people's lives, as approximations on this topic have already done in clinical psychology and psychotherapy HYPERLINK "#mkp_ref_046".

From the point of view of social work practice, and essentially from the relationship constructed between subjects, biographical narratives are constitutive and modeled on the lives of people, including professionals and clients in social services and healthcare settings. "People's narratives are discursive realities, historically and sociocultural anchored (...) Narratives are a fundamental way human beings have of giving meaning to an experience" HYPERLINK "#mkp_ref_047".

In this sense, biographical-narrative perspectives also bring a third challenge when they are revised. The options that we have today with information technologies to think of audio-visual products or multi-methods have led some authors to plant the notion of an "audiovisual qualitative methodology" HYPERLINK "#mkp_ref_048". In this perspective, it is possible to consider that oral narratives can be combined with the use of electronic resources such as documents and mail, images, photographs, and audio archives, while simultaneously incorporating other forms of representation via the use of drawings, maps, and other graphic representations.

Finally, there is a challenge of registering this research approach as a recurrent practice within profession duties, and the possibility of adapting it to daily practices within disciplines like Nursing and Social Work. In both of these professions it is common to find systems of personal charts such as clinical and social folders, case reports, logs, home visits, data and institutional memory, that highlight narrative processes. All of these documents contain narrative-reflective potential that could be considered valuable to analyze and to put in the perspective of research and generation of knowledge.

Conclusions

The process of this study has provided us with a clearer vision of the uses and options that the biographical approach as a research perspective in social science and health can give us. The use of biographical materials in combination and often as complements to other research approaches offers an ample field of analysis for interdisciplinary research projects.

The biographical approach contains different currents and perspectives within it, from which different lines of research and analysis emerge. Each current contains a seal that identifies it by its mode of understanding the notion of trajectory and the way in which narratives are structured by the subjects themselves.

Research as a biographical approach is currently facing a challenge of adapting its procedures and traditional ways of analysis to incorporate new information technologies, while also recuperating traditional elements from this approach such as oral narration and subjects' memories. These can be retrieved today to be stored in digital archives containing images, data and voices.

We suggest studying and practicing this research approach in studies within Nursing and Human Care, since this perspective offers new dimensions for analysis, while also contributing to processes of reflexivity within the researchers and/or the professionals' own tasks.

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Received: June 15, 2017; Accepted: September 09, 2017

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