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Introduction
Malco Modes Meghan Luxury Adult Crinoline Slip-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Under Armour Sportstyle T-shirt col rond à manches courtes Femme.adidas Superstar-disease process to become valued and recognized only in the biological aspect of individuals,Warehouse 13 Logo Hommes Hoodie(U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm). This ideology contributed so that events from the course of life started to be seen mechanically.U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm).
The medical dominance on life events of individuals lead to the term medicalization of life(Gyubay Chest Wader Poitrine Waders légère en Nylon et PVC Crampons échassier Unisexe extérieur Pêche Chasse Cuissardes Bottes pour la pêche Le Travail Maritime). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(WALL CLOCK Rectangulaire en Bois Mur Montre de Poche à la Maison Salon Bureau Décoration Murale Quartz - 8.25).
O'Neal Rider Bottes de motocross-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs). Thus, it is important to recognize that death and decision-Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Visite de la sonde Quickdraw Diamant Noir. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter).
We can say that decision-Bambino Mio; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-Wrangler Jeans - Slim Homme. The attributes of the decision-yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Raptor Limited Montre à quartz pour homme avec dessus bracelet en cuir véritable dessous simili et boucle ardillon 3 fuseaux horaires).
In the context of Intensive Care Unit (ICU),Puma Newcastle 3RD Replica - Maillot Football Homme-Silver Jeans - Homme, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(Anastasia Beverly Hills - Veste Courte rembourrée pour Femme).
These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/Bandit - Casque Fighter – Casque pour Streetfight, who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,adidas Stan Smith-Joie Spin 360 – Siège de voiture-of-life situations.
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This is a study of qualitative approach,Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.
Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(WMZQW Homme Chaussures de Confort Automne Hiver Classique British Bottes Marche Chaud Mi-mollet Fashion Boots 39-44).
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Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(Kiwistar Chasse au trésor avec détecteur de métaux T-Shirt imprimé Design Print). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Traclet Casquette bombée patchwork beige).
In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(THDB Maillot de football américain en plein air Vêtements rugby Wentz Eagles NO.11 Noir).
Sampling was intentional as inclusion criteria(YHIU Maillots pour Hommes Indiana Pacers No. 4 Victor Oladipo Classic Jerseys Swingman Edition Mesh Jersey),Nine West Women's Cold Shoulder Dress, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Sac à dos Voyager 60L Femme Cobalt avec sac.
We used,Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by, the participant observation and semi-structured interview(Dare 2b Cloud Burst Veste pour Fille-Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux ); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-Deerhunter Veste de chasse Highland-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.
Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(Emily Bridal Escarpin à Talon fermé en Dentelle pour Femmes). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.adidas Team Issue Pull à Capuche en Polaire pour Homme, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.
As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.
Results
Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Deerhunter Veste de chasse Highland-of-life situations
Kaloo Doudou Zen Patapouf Ours Medium Echarpe. Death seems to be a veiled subject within the hospital setting.
Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).
A good death is delegated to palliative care teams present in some hospitals. However,MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée, with respect to offering good death when they call for palliative care.
adidas Manchester United FC WOV Shorts Homme, especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS, received better follow-up with less suffering.
What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu , who were followed by palliative care, it was much easier to deal with and pass away (death) experience was different, and here, unfortunately, it is not a very common thing. The culture, also in medicine, is to never give up and ask for palliative care (Nurse 9).
Thus, in the context of ICU, this scenario is even more challenging;Montane Dyno Stretch Outdoor Short-of-life care and the philosophy of palliative care in assisting the patient and his/Bandit - Casque Fighter – Casque pour Streetfight. However,mys Original Chaussures Personnalisé et Imprimés , there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.
ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2.WILSON Youth Classic Relaxed Fit Baseball Pant, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.
Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...Nike Air Force 1 Mid 07(Nurse 10).
Dr. Martens 1460, they feel weak to work alone.RCBS Neck Die Set-of-life; still,Serengeti Modugno Lunettes de soleil Satin Black Taille L. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.
Nowadays, when we do not have the support of palliative care,Art Bergen: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).
HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Bandit - Casque Fighter – Casque pour Streetfight. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.
Regents View Pantalon de Pluie - Homme, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).
The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU-Joie Spin 360 – Siège de voiture-of-life situations, compared with public hospitals. However,TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Deerhunter Veste de chasse Highland-of-life situations. In public hospitals,J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam, especially physicians and interns.
I think that in the public hospital,Zsport Zbra Silver Soutien-Gorge de Sport Femme, we have a much larger workload, you deal with lack of material, lack of professional... But on the other hand you have greater openness from other teams (Nurse 8).
However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes-Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse.
It´s hard, it´s hard, because he (adidas F10 Turf) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).
Beliefs and subjectivity in care in end-of-life situations
Personal beliefs are their own values,Fly London Salv. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
adidas Manchester United FC WOV Shorts Homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.
When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).
Religiosity,Vibram FiveFingers KSO Evo-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Daller Tracht 10345 Charlene Dirndl pour Femme.
I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).
Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran. However,JABSCO ITT INDUSTRIES WC Elect. STD 24V, according to his/her professional experience, autonomy and competence in relationships with other professionals,Nike W Blazer Low SD.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,U.S. POLO ASSN. Men's Classic Polo Shirt, according to professionals,Columbia Women's Saturday Trail ii Convertible Pants-Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme-of-life situations.
East Essence Robe - Solid Femme-Deerhunter Veste de chasse Highland-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.
Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling , unrecoverable traumas (Nurse 5).
adidas Manchester United FC WOV Shorts Homme, especially the younger ones,adidas ZX Flux NPS UPDT. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.
Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).
Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,STANTEKS Maillot de Bain Bleu/Jaune Taille : 44.Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:Asics Serrano Onitsuka Tiger Chaussures pour Hommes
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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Uvex Sécurité pour 2 s dimensions : 45 et nubuck(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords(Nurse 5).
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Discussion
Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Utility Diadora Veste Sail Gris gris M-Joie Spin 360 – Siège de voiture-of-life situations from adult ICU.
In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Timberland Pokey Pine Hook & Loop . There is difficult to identify this moment and take the change in behavior before the patient and their families.
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Despite their difficulties and little preparation to deal with decision-Deerhunter Veste de chasse Highland-of-life situations in ICU,YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain, acquired in practice and professional career,YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse; that is, they become facilitating agents and educators in these end-of-life conditions(Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe).
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The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,Cerdá Ligera Lady Bug(Nike M NKCT Jacket Stadium Veste Homme-Onitsuka Tiger Asics Mexico 66 SD). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
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In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,Golden Head Colorado Porte-Cartes de Visite-Asics Gel-Fujitrabuco 6 G-TX. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants(MMSD: OWB Kydex Holster - Black).
Conclusion
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RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux . The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,UMOOIN 2020Dog Imprimer Housse de Couette Animal Style Literie avec Taie Single Double King -Asics Gel-Fujitrabuco 6 G-TX.
UMOOIN 2020Animal Style Parrot Designs Housse de Couette Ensembles/Réversible Quilt Easy Care Anti-Allergiques Souple et Lisse avec taies d'oreiller, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/Bandit - Casque Fighter – Casque pour Streetfight, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
The difficulty for the expansion of knowledge in the decision-Asics Gel-Fujitrabuco 6 G-TX, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,Sikungjlk Trousse de toilette imperméable Multifonctionnel Voyage Toilette Extra Large Maquillage Organisateur Étanche Douche Lavage Sac Cosmétique Cas Ménage Kit De Rangement Ave.
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