The Theory of Social Representations in Brazilian Health Researches : a Bibliometric Profile

The study aimed to characterizing the production of national articles on health, the time frame of the past 10 years, available in the database LILACS and MEDLINE Virtual Health Library that used the Theory of Social Representations in its searches, using as descriptors the words: social representations and health. It is a descriptive study, developed in the context of bibliometrics. Of the 158 units found, 122 were considered and analyzed after removal of those that did not include the stablished inclusion criteria: articles in Portuguese, available in full and that mentioned the expression "social representations", either in the title or abstract. The journal that most published researches about the Theory of Social Representations was Science & Public Health; being the largest number of articles published in 2011. The most frequent area of knowledge covering about the Theory of Social Representations was the Public Health, with the participant group most cited health professionals. Among the data collection instruments used, the semi-structured interview was the most frequent and the kind of qualitative analysis the content analysis was the most common. Noteworthy is the growing interest for the theory and the need for greater criteria in the preparation of abstracts, considering its importance in the spread of scientific production. The Theory of Social Representations in Brazilian Health Researches: a Bibliometric Profile RevIew


Introduction
The bibliometric research and the use of indicators of scientific production have been the target work and research of several authors.Numerous discussions have been proposed among the global scienti-fic community and undoubtedly they motivate and contribute to the research carried out in Brazil.It is a type of research that presents itself as an important method to analyze and evaluate the processes related to scientific activity because it enables the bringing of more appropriate indicators to measure national scientific productivity from the application of a set of techniques that quantify the scientific communication process stored information sources, based on studies conducted in bibliographic databases, indexes and abstracts, directories and periodicals titles books, references and citations.[1,2] With regard to the Theory of Social Representations (TSR), it was introduced by Serge Moscovici in 1961, in France, in his work entitled "Psychoanalysis, its image and its audience."And from this development, many researches have been subsidized, over these 54 years, as a form of knowledge and practice that act as mediators between subject and object.In Brazil, it was transmited from the 80s, with the emergence of the first studies master's and doctorate and has been found useful in the analysis of different objects of study, particularly in the health field.[3,4] Being defined as a set of concepts, propositions and explanations created in everyday life in the course of inter-communication, this theory has funded many studies showing the methodological plurality, thematic and conceptual, which favors the understanding of complex psychosocial phenomena, beyond sense common, where knowledge, concepts and explanations on a particular event or theme is built and shared by a group in their interpersonal conversations in everyday life.[3,5] There are identified numerous publications that depict the importance of social representations in the different possibilities of health interventions, it offers theoretical support to researchers, allowing understand how people take care of their health, their attitudes, values, and meanings front to illness and therapy.Another aspect that determines the development of studies about social representations in the context of health is the desire to understand the health-disease process beyond the biomedical model, whose main focus is human biology, disease and pathophysiology.[6,7] When searching for social representations, they study human beings who think autonomously, produce and communicate representations constantly instigating this way, discussing and aiming advances on their theoretical aspects and methodological improvement, which can support other studies, including serving to strengthen evidence-based practices.[3,8] Based on the foregoing, considering the relevance of the theme for health professionals and researchers, we sought, in this investigation, answer the following guiding question: What is the trend in scientific production in health about the TSR in the last decade?From this perspective, this study aimed to identify the published Brazilian scientific production about health, in the light of the Theory of Social Representations.

Method
This is a descriptive study, with bibliometric approach, which was carried out by analyzing the abstracts of articles available in the database LILACS and MEDLINE of the Virtual Health Library (VHL), available online, in the period 2005-2014.
There was used as inclusion criteria the articles in Portuguese, available in full, which would mention the expression "social representations", either in the title or abstract.And as exclusion criteria repeated publications in databases and/or those that were not relevant to the research objectives or manuscripts like letters to the editor, theses, dissertations, monographs, books, manuals and abstracts.
The data collection period was between the months of April and May of 2015 and after the identification of the studies, the analytical reading of abstracts was performed using a script, considering for characterization studies, the variables: knowledge area, periodic / year group sampling and evaluation of the theoretical framework: collection and analysis of data, the theoretical work, publishing journal, publication year, area of expertise and/ or subarea, research participant group, instrument/ data collection technique, type of qualitative analysis.When all information surveyed was not found in the summary, if consulted, the method to complement the data.
The extracted data were recorded and organized into an instrument in table format, built from the established variables.For data analysis we used the descriptive method for variables and the discussion held with authors whose production is relevant for analyzing the object of this study.The presentation of the results considered the simple descriptive statistics: absolute and percentage frequency.
The following shows the figure 1 with the methodological design of this study.

Results
There were identified 158 articles from the selected descriptors and, with the use of the exclusion criteria, 36 articles were eliminated.Thus, the study sample included 122 articles for analysis.As for the newspapers, can be seen a greater distribution in the journal Science & Public Health (23.8%) and Public Health Journal (17.2%), followed by the Brazilian Journal of Nursing (10.7%).Table 1 shows the distribution, by periodic, the number of articles published in the time frame ten (10) years.
Regarding the year increased production of these articles, the year 2011 with a quantity of projecting posts 24 (19.7%),followed by 2008 (14.8%) and 2013 (13.9%) (Table 2).We also identified the areas of knowledge of these articles, in which to set them, it was held initially, analysis of descriptors, abstracts and, when necessary, the article methodology of reading, where the Community Health magazine appears more frequently (41.0%),Public Health (24.6%) and Nursing (19.7%) (Table 3).
Regarding the participant group, health professionals are among the most researched subjects in the studies (28.7%) and users (11.5%) and women (9.0%) reported with significant frequency (Table 4).Have to investigate about the most used instrument, the semi-structured interview appears with a high percentage (35.2%),followed by the free association of words technique (14.8%) (Table 5).Regarding the type of analysis content analysis is most commonly used (30.3%), also being referred to quite Lexical analysis (14.8%) and the analysis of Evocations (13.1%) (Table 6).

Discussion
The use of field theory of social representations has been expanding in various fields of knowledge, particularly in the health field.It favors the unveiling of imbued with social representations of cognitions from social objects built by groups to which the attention of health professionals and managers are focusing on the planning of their actions.
In view of this study with quantitative bibliometric indicators, there was prevalence of Science & Collective Health on the number of publications; this being quite renowned in academia, having a vast subject production that involves the field of public and collective health in Brazil.Scientific journals basic aim the debate on the internationalization and proper valuation, and this one in particular stands out in the landscape such as journal more frequently found in the publications, which involved the Theory of Social Representations.[9] It was observed the growth of publications about the theme of social representations in 2011, corroborating what was identified in a desk study, which aimed to perform an exploratory thematic analysis of the abstracts of articles related to the theme discussed, verifying also a prevalence of these publications in Brazil from 2010 to 2013.This period is more current which concentrates the amount of publications may be motivated by the spread and growing interest the theory, which increases the national scientific productivity, it has funded more research, in that TSR has shown the methodological plurality, theme and concept that promote understanding of complex psychosocial phenomena.[10] The results show the prevalence of studies published in the field of public health in order to identify and characterize the profile of Brazilian research groups that develop the theme of the theories of social representations.In other descriptive exploratory study of quantitative and qualitative character, also found a higher frequency of research related to the area of public health, involving knowledge of the "health sciences".[11] A survey of health professionals is often used by the scientific production, for this group, as a member of the research, it is important to understand the cultural values and their representations on specific topics, in addition to facilitating the understanding of the relationships they give between the actors involved in the healthcare process.Sometimes, studies also serve for the assessment of public and social policies at both the point of view of their formulation, technical application, as the users to whom it is intended.
The leading role of these professionals as protagonists of the participating groups (35), followed by users of the service (14) hints at the research in this field, it is driven primarily by who is ahead of the service administration, which is also the holder of the means of access to information sources and often, the resource provider (or principal interlocutor who is) for research.[12] Regarding the population studies, research as in Giordano et al have also described the "Nursing Team" in 58 articles and "multidisciplinary team" in 32, totaling 90 publications with these groups of health professionals, followed by "Customers "on 78 items.Thus, it can be said that the health professional is a subject widely researched and participation and opinion relevant to the scientific production in the last decade.[13] A great amount of scientific research in the health field has been developed from a qualitative approach.When little is known about a particular phenomenon, concept or experience to disclosing the evolution of ideas, from the description and interpretation of phenomena can be investigated; qualitative research tends to be the first choice of the researcher.[14] From this perspective, the use of the interview is indicated when the nature of the information is difficult to observe the phenomenon.Often the interview is recommended to seek information about opinion, views, expectations and perceptions of historical facts or not.[15] The semi-structured interview is one way to gather data that favors the description of social phenomena, why can emerge more freely information, explaining the understanding of all phenomena through basic questions that follow two parts: theoretical phenomenological where the goal is to achieve maximum clarity in the descriptions of social phenomena.This type of descriptive question is very important for the discovery of the meanings of the behaviors of people from certain cultural backgrounds.The historical and cultural aspects, the questions can be designated as explanatory or causal, in order to determine immediate or mediate reasons of social phenomena.It is worth mentioning that through the interview can only study the account of the facts.These facts corroborate our findings, where the use of semi-structured interview as data apprehension technique prevails to subsidize research that has focused on the TSR.
Especially, a technique frequently applied as a research tool in data collection is the Test of Free Association of Words (TALP) that provides information projective, that is, that relate to the mental processes of individuals surveyed.You then a technique by means of induction, can capture and receive information apparently hidden, and through an image or a word can emerge opinions and thoughts, which makes this technique one of the best to obtain meaning hitherto obscure.[16] Therefore, in scientific research, the choice of data collection technique of the objective and the possibility of the phenomenon come from investigation.Qualitative research is able to incorporate the question of meaning and intentionality as inherent relations, the acts and social structures.However, the choice of analysis technique must be connected to the type of guiding question, the type of knowledge you want to produce about the object studied.As noted in our collected material.[17] Statistical analysis of the resulting data and interview or evocations can be performed with the help of software, which has proved increasingly fre-quent.The computer program developed for lexical analysis (Alceste) combines a number of statistical procedures applied to textual databases, such as interviews, literary works, newspaper articles and magazines, among others.In the program operation of the base is the idea of relationship between linguistic context and collective representation or context between drive and typical context.It is this double reference that allows the formation of the representation of an object.The purpose of an analysis Alceste is to distinguish classes of words that represent different forms of discourse about the topic of interest.[18] Some authors of our bank chose to investigate the object from the structural approach which focuses on the cognitive dimension of representations.The differential Programs Set to Evocations Analysis (EVOC) compared to Alceste is the existence of native features in the program for conducting research on the structural approach of the RS.This approach of the Central Nucleus Theory (TNC) was proposed by Jean-Claude Abric, in 1976, in which he defended the idea that the organization of a representation presents a specific characteristic, 19 "[..] to be organized around a central core (CN) constituting one or more elements that give meaning representation".[20] The Central Core develops two functions considered major: the generator, which prepares or modifies the essential elements of representation, and through which the elements gain meaning, sense; the organizer, which unifies and stabilizes the RS.[19] In a recent survey, with respect to the use of the programs as the country of origin of the work, the Alceste was used in 40 Brazilian studies on RS six Mexicans and three Colombians, while the EVOC was used by 23 Brazilian works, one Colombian and one Argentine; confirming the Brazilian reality found in our study, the predominant use of Alceste.[21]

Final Notes
In a society where the sense of our relationship was grounded in biological phenomena, the study of social representations in health keeps it relevant to bring order to our relations with the social.Thus, the analysis of the collected material, this bibliometric research, there has been a growing trend to use the TSR in health research over the past decade, investigating the importance of the contribution of the same when thinking about public health.
It is perceived as limitations of this study that just reading the abstracts often had gaps in relation to the variables studied, either on sample group, collection instrument and data analysis.Thus became necessary to look for more information in the article's full, mainly in the methodology section.Therefore, it is suggested that the abstracts address all variables of a study, the most judicious journals in the selection of articles for publication.
It is expected then that the summarization of scientific literature published in the national literature found enable support knowledge in the health field, especially with regard to initiatives to design how people take care of their health and their attitudes and behaviors front the health-disease process, contemplated by the Social Representation Theory.

Contribution of the authors
ABLM, AKFJA, KLA, and SMGC worked in all phases of development, from conception, design, analysis and interpretation of the data, writing of the manuscript; ABLM and KLA prepared the database; GG performed critical review of the manuscript; JAN, AOS, MASPM, conducted orientation of the manuscript and approved the final version to be published.

Table 1 .
Journal distribution on the number of articles published in the years 2005 to 2014.

Table 4 .
Distribution of participating groups surveyed in journals published in 2005-2014.

Table 2 .
Distribution of journals published by year of publication, 2005 a 2014.

Table 3 .
Distribution of areas of expertise identified in the articles analyzed, 2005 to 2014.

Table 5 .
Distribution of collection instruments used in articles published, 2005-2014.
Source: Lilacs and Medline, 2015.Legend: TALP = Technique of Free Association of Words.

Table 6 .
Distribution of types of analysis found in the articles analyzed, published in the years 2005 to 2014.