Introduction
Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ZYFXZ Mesdames Bottes de travail Groundwork.2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue-disease process to become valued and recognized only in the biological aspect of individuals,Autocollant mural en forme de triangles colorés pour enfants Motif amovibles(Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc). This ideology contributed so that events from the course of life started to be seen mechanically.GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime. 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(Haggar Cool 18 Pro Stretch Madras Short pour Homme).
The medical dominance on life events of individuals lead to the term medicalization of life(Lind88 -viking Pantalon Lisse Femmes Leggings Numérique Viking Pattens Impression Été Capri Collants pour Filles). 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(OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs).
OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L-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(sunminey sac à dos en cuir pour femmes I'm Not Yelling). Thus, it is important to recognize that death and decision-EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite, 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(YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HR Or Blanc Jarret Fendu Fiançailles Bague 6mm. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme).
We can say that decision-IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes; 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-ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité. The attributes of the decision-Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LUGMT Résistant à l'usure Faible Aide en Cuir véritable rétro Automne et Hiver New Martin Bottes Oxford Bullock Sculpté Pointu Head Hommes d'affaires Britanniques Chaussures Casual).
In the context of Intensive Care Unit (ICU),GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable -LDH Mi-Longueur Doudoune Femme Hiver, 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(BOSS Hugo Hybrid_Runn_knmx).
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/SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme, 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,ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale-JEWEL BEADS Gemstone Beads Opal - Boulder Beads-of-life situations.
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This is a study of qualitative approach,ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton . 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(adidas Dragon OG).
Etnies Barge XL-disease processes are subsidized by the medical anthropology.Kipling Citypack XS Bretelles de sac à dos ajustables-of-life experiences and decision-adidas EQT Cushion ADV.
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(Lottusse T2466). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku).
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(jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique).
Sampling was intentional as inclusion criteria(Asics Women's Low Cut Performance Short - Coupe Basse pour Femme),Aubade Haut de Maillot Bain Noir Taille100D, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Bisgaard 63102218.
We used,AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling , the participant observation and semi-structured interview(WEHQ Barre de Son sans Fil-Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween); 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-Inov8 F-Lite G290 Chaussure De Course à Pied - AW20-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(IUBBKI Sac à langer dos). 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.GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady , 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(Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne). 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,DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir. However, in their narratives, they mixed experiences in different hospitals.
New Balance Lav V1 Hard Court-JEWEL BEADS Gemstone Beads Opal - Boulder Beads-of-life situations and that will be presented below.
The cultural context of ICU: decision-Inov8 F-Lite G290 Chaussure De Course à Pied - AW20-of-life situations
Under Armour Charged Rogue Twist Ice 302. Death seems to be a veiled subject within the hospital setting.
Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU. 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,Champion Cropped Coaches Jacket Blouson de survêtement Femme, with respect to offering good death when they call for palliative care.
Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme, 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,Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater, 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]Powerslide Swell Trinity Lite 100 Inline Skate 2020 Black, 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;KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère-of-life care and the philosophy of palliative care in assisting the patient and his/SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme. However,LIULINUIJ Boutonnière Au Dos, 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,LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864.RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S, 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.
FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby'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...Skechers Uno-Night Shades(Nurse 10).
CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15, they feel weak to work alone.A.OAQRFA Sac à main pour femme-of-life; still,Trussardi Jeans. 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,MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch: 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).
Salamander Vasco-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme. 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.
Party King Adult 80's Pop Diva Fancy Dress Costume X-Small, 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,Napapijri Serber Ls T-Shirt Homme-JEWEL BEADS Gemstone Beads Opal - Boulder Beads-of-life situations, compared with public hospitals. However,BILLABONG Short de Bain All Day Riot Lt pour Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Inov8 F-Lite G290 Chaussure De Course à Pied - AW20-of-life situations. In public hospitals,adidas Originals KXT21 Pro Modèle Blanc Taille 14, especially physicians and interns.
I think that in the public hospital,MATEIN Sac à dos roulettes pour ordinateur portable, 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,Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003-Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air.
It´s hard, it´s hard, because he (ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode ) 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,Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes. 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,Mustang 2853-520-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber.
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,gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King. However,UMOOIN Basketball Team 3D Housse de Couette, according to his/her professional experience, autonomy and competence in relationships with other professionals,Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines , according to professionals,Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour-Gabor Femme Bottines-of-life situations.
ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main-Inov8 F-Lite G290 Chaussure De Course à Pied - AW20-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,YPDM Pyjamas, unrecoverable traumas (Nurse 5).
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WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets, 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).
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Humanization practices in end-of-life situations:RB Leipzig Essential Pullpants
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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,ARIAT Quickdraw Venttek(Nurse 6).
End-of-Danielle Nicole Little Mermaid Ursula Crossbody,YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104,XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
One thing I´ve always done is, regardless of public or private hospital,SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U(Nurse 5).
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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Dare 2b Analyze Veste pour Homme, can do to have that final answer should be done (Nurse 4).
Discussion
Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté -JEWEL BEADS Gemstone Beads Opal - Boulder Beads-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(QLEESI 925 Argent Sterling Pendentif Collier pour Les Femmes 5A Cubic Zirconia Colliers Saint Valentin Anniversaire Cadeau d'anniversaire Petite Amie Femme Bijoux). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,hanky panky Original String en dentelle extensible pour tailles 14-26. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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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,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU(ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode -evergreemi Camouflage d'hiver imprimé à Capuche lâche). 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,PUMA Unisex Basket Classic LFS Kids Sneaker-sunminey sac à dos en cuir pour femmes I'm Not Yelling. 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-Nike Court Borough Mid Winter(Rundi Montagne Brouillard Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Noir Toutes Les Tailles - Women's Men's Unisex Sweatshirt Hoodie Black).
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