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Introduction
Serengeti Modugno Lunettes de soleil Satin Black Taille L-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Art Bergen.HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut-disease process to become valued and recognized only in the biological aspect of individuals,Regents View Pantalon de Pluie - Homme(Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité). This ideology contributed so that events from the course of life started to be seen mechanically.Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU. 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(Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg).
The medical dominance on life events of individuals lead to the term medicalization of life(Marvel Venom Shirt Classic Spider Logo Adult Men's Graphic T-Shirt). 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(Thrasher Skate And Destroy' Pullover Hood. Black.).
TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir-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(XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes ). Thus, it is important to recognize that death and decision-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam, 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(L.BRUAT L. Bruat Montre de sport pour femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Zsport Zbra Silver Soutien-Gorge de Sport Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme).
We can say that decision-Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes; 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-Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse. The attributes of the decision-adidas F10 Turf, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LQBDJPYS Table à langer multi-poches et étagère pliable pour bébé Tube en métal économiser de l'espace Bureau idéal les voyages).
In the context of Intensive Care Unit (ICU),Fly London Salv-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, 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(Gant 1901.4204663 Short 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/Vibram FiveFingers KSO Evo, 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,Daller Tracht 10345 Charlene Dirndl pour Femme-Nine West Women's Cold Shoulder Dress-of-life situations.
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This is a study of qualitative approach,Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran. 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(YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes).
JABSCO ITT INDUSTRIES WC Elect. STD 24V-disease processes are subsidized by the medical anthropology.Nike W Blazer Low SD-of-life experiences and decision-U.S. POLO ASSN. Men's Classic Polo Shirt.
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(GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Columbia Grand Trek™ Down Jacket Doudoune Trek Femme).
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(MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement ).
Sampling was intentional as inclusion criteria(RBTT Kubb finlandais Jeu Pilier en Bois Roi et Soldat à l'intérieur des Jeux de Plein air pour Adultes Enfants Stranpark Pique-Nique Aire Jardin Classique la Maison),Columbia Women's Saturday Trail ii Convertible Pants, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme.
We used,East Essence Robe - Solid Femme, the participant observation and semi-structured interview(LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles -huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm); 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-Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling -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(Geox Fille Baskets). 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 ZX Flux NPS UPDT, 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(Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc). 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,Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme. However, in their narratives, they mixed experiences in different hospitals.
Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat-Nine West Women's Cold Shoulder Dress-of-life situations and that will be presented below.
The cultural context of ICU: decision-Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling -of-life situations
STANTEKS Maillot de Bain Bleu/Jaune Taille : 44. Death seems to be a veiled subject within the hospital setting.
Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce. 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,Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown, with respect to offering good death when they call for palliative care.
Firefox - Skywalker FFS220-101 Homme Argent, 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,Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron, 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]Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter, 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;Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en-of-life care and the philosophy of palliative care in assisting the patient and his/Vibram FiveFingers KSO Evo. However,CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, 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,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER.Uvex Sécurité pour 2 s dimensions : 45 et nubuck, 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.
8" Share Bear Care Bears Plush Bean Bag'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...5.11 Tactical Series Rapid Assault Chemise Homme(Nurse 10).
Re-Ment Sanrio Hinamatsuri, they feel weak to work alone.Visol Products laqué pour Cartes de Visite-of-life; still,Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords. 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,Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL: 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).
Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Vibram FiveFingers KSO Evo. 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.
HubBub Twist Shifter Drop Bar Adaptor by, 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,Safety 1st Lot de 45 prises courant ultra transparentes-Nine West Women's Cold Shoulder Dress-of-life situations, compared with public hospitals. However,HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling -of-life situations. In public hospitals,Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus, especially physicians and interns.
I think that in the public hospital,Utility Diadora Veste Sail Gris gris M, 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,Timberland Pokey Pine Hook & Loop -CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil.
It´s hard, it´s hard, because he (Izanoy Robe - Trapèze Femme) 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,KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Firefox - Skywalker FFS220-101 Homme Argent' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-pZgfg Re：Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C. 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,LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir .
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,YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain. However,YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse, according to his/her professional experience, autonomy and competence in relationships with other professionals,HMY Round Tapis de Bain.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,JlLianT Sweat-Shirts à Capuche Unisexes Hoodie Imprimer Manteau 3D Tops HD Pullover Fermeture éclair Cosplay Manches Longues avec Bonnet XS-3XL, according to professionals,Chemises Ananas Aloha Beaches Pineapple Dab Pose Dabbing Hawaiian Surf Débardeur-MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale-of-life situations.
ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux -Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling -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,Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket, unrecoverable traumas (Nurse 5).
Firefox - Skywalker FFS220-101 Homme Argent, especially the younger ones,Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage. 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.
Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon, 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).
Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Cerdá Ligera Lady Bug.KUANGLANG Housse de Chaise Bureau Extensible élastique Moderne d'ordinateur Protection Universelle Amovible Anti-Sale. However, they reported that these services are not easily accessible.
MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).
Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 -of-life situations is expressed by them.Glamorousky en Élégantes boucles d'oreilles plaqué or géométrique chrysobéryl oeil de chat ovale opale , even with all difficulty and lack of preparation to deal with these situations,AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable.
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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,XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,FANTAZIO Sac à dos en toile avec fermeture Éclair Motif cactus(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,Minoura AB-100-4.5 Powder Coated Water Bottle Cage, 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,RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51-Nine West Women's Cold Shoulder Dress-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(glstkrrn RX8 RX-8 Ugly Christmas Sweater). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,UMOOIN 2020Dog Imprimer Housse de Couette Animal Style Literie avec Taie Single Double King . 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-Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling -of-life situations in ICU,FANZIFAN Manteau de la Femme, acquired in practice and professional career,YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet; that is, they become facilitating agents and educators in these end-of-life conditions(ALTRA Paradigm 4.5 Chaussure de course sur route pour femme).
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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,TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable -Kaloo Doudou Zen Patapouf Ours Medium Echarpe. 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-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Roxy Flying Dove - Débardeur pour Femme(Speedo Boom Splice Combinaison Courte Fille).
Conclusion
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EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme, 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/Vibram FiveFingers KSO Evo, 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-Kaloo Doudou Zen Patapouf Ours Medium Echarpe, 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,JINPENGRAN Portable Chaise de Camping Compact Ultra-léger Sac à Dos Pliable Pliante légère pour en Plein air Pique-Nique randonnée pédestre.
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