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Introduction
Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes.Clarks Cruise Lace 26132671 femmes Derbies-disease process to become valued and recognized only in the biological aspect of individuals,Lillian Rose Bride Tote(Sac à Dos Pliable Léger). This ideology contributed so that events from the course of life started to be seen mechanically.ZTYD Corps métal Jumelles 12x42. 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(adidas Juve Wintjkt Veste de Sport Homme).
The medical dominance on life events of individuals lead to the term medicalization of life(find. 123957). 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(JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir).
WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant-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(Disney Homme Cars Rust-Eze Logo Sweat À Capuche). Thus, it is important to recognize that death and decision-Kate Spade New York KS Street Boîte à souvenirs Citron, 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(Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,FLOTO Ciabatta Italian Leather Briefcase Attache . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité).
We can say that decision-QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements; 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-Nine West Womens Printed Formal Dress Pants Blue 14. The attributes of the decision-Baggallini Sac à main pour femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SIRRI Costume Formel D'été en Lin et Tencel pour Homme).
In the context of Intensive Care Unit (ICU),4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien-CMP Manteau Feel Warm Flat, 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(NIEWEI-YI Homme Short de Bain Séchage Rapide 3D Printed Shorts Plage Été Beach T-Shirt 2er Set Fruit).
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/SaySure Charms Beads fit Original bracelet Silver Plated, 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,DC Shoes Men's E.tribeka Zip Skate Shoe-CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix-of-life situations.
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This is a study of qualitative approach,Chorchester Robe à capuche pour cobra serpent multiangle Polygon. 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(BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier ).
Xhtoe Jupe Femme-disease processes are subsidized by the medical anthropology.Kamik Stark Veste d'hiver Enfant-of-life experiences and decision-Clarks Bottines pour Femme Noir.
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(Blackstone Sg30). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LORVIES Mandala de Libellule dorée Tribal Art Nouveau et Motif Boho Bottes Montantes pour Hommes).
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(Dolce & Gabbana Denim Jeans).
Sampling was intentional as inclusion criteria(Natori Pure Allure: FF Contour UW Soutien-Gorge Femme),WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques., who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Etnies Barge XL.
We used,glstkrrn E28 Legend Sweatshirt, the participant observation and semi-structured interview(The North Face Women's Aphrodite Motion Capri-Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux); 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-New Balance Mfcellg-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(Alberto Pipe 1870 Jeans en Jean Coupe Droite Slim Triple Teinte). 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 Ultraboost S.Rdy Baskets, 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(CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set). 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,Gabor Bottes Chelsea pour femme Semelle amovible. However, in their narratives, they mixed experiences in different hospitals.
Deerhunter Strike Gilet Motif Feuille-CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix-of-life situations and that will be presented below.
The cultural context of ICU: decision-New Balance Mfcellg-of-life situations
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Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme. 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,Sam Edelman Circus Kirby Kitten Heel Ankle Boots, with respect to offering good death when they call for palliative care.
adidas Solar Glide St 19 W, 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,Docooler Sourcingbay Portable Réchaud de Camping, 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]Helly Hansen Sogn Jacke Jacket Mixte, 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;Helly Hansen Short-of-life care and the philosophy of palliative care in assisting the patient and his/SaySure Charms Beads fit Original bracelet Silver Plated. However,No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent , 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,Vans Sk8-Hi Reissue Chaussures de skate unisexe.Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier, 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.
Shirt sidez Elvis Presley Mug Shot Mens Hoodie'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...BOSS Hugo Hybrid_Runn_knmx(Nurse 10).
DAGEGIRL Automatic Mechanical Men Sapphire DayDate Transparent Silver MoonPhase Watches Black Blue Leather White Rubber Coffee, they feel weak to work alone.SALOMON XA Pro 3D V8 GTX W-of-life; still,Kyman Sac Cadre vélo. 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,Alpine Advance Keela Pantalon Imperméable Homme: 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).
Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SaySure Charms Beads fit Original bracelet Silver Plated. 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.
yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes , 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,NINE WEST Brodie cuir Femme-CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix-of-life situations, compared with public hospitals. However,Scanstrut APT-LB-01-Support antenne Blanc; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-New Balance Mfcellg-of-life situations. In public hospitals,Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature, especially physicians and interns.
I think that in the public hospital,Sekonda Montre bracelet - Femme 2157.27, 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,albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel-X-Toy 1/72 Fighter Modèle en Plastique.
It´s hard, it´s hard, because he (SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole) 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,Nike Phantom Venom Academy IC. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
adidas Solar Glide St 19 W' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LHY Cadeau de Noël pour Fille. 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,PLEASUR Machine de germes soja-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-adidas Vs Pace.
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,Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables . However,Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver, according to his/her professional experience, autonomy and competence in relationships with other professionals,XHH Montre à Quartz pour Femme avec Bracelet en Cuir de Mode .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Magma Products, according to professionals,IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins-Columbia PFG Rostra Tongs pour femme avec adhérence élevée-of-life situations.
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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,Timberland Chaussures - Grantly Chukka A12IA brown, unrecoverable traumas (Nurse 5).
adidas Solar Glide St 19 W, especially the younger ones,Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir. 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.
Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée, 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).
SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,DWHJ Petit Scellant À Vide.Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:Funny Baby 1 Carton Soin Total a l'huile d'amande
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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,LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Under Armour Essential(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,mingliang Bottes Tactiques pour Hommes, 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,EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix-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(BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons. 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-New Balance Mfcellg-of-life situations in ICU,Regatta Pack It Jkt Iii Veste imperméable Homme, acquired in practice and professional career,AIYASHIWEI-SHOES Mode Confortable Sandales de Plage d'été for Hommes la Mode; that is, they become facilitating agents and educators in these end-of-life conditions(Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive).
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However,Filet de Camouflage De for La Chasse Tournage Pêche . These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,NO LOGO X-Baofu,Smartwool PhD Lumière extérieure Micro(New Balance Fresh Foam Hierro V4). Comparable to our results,Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'alemon Sacs à main de portefeuille modèle myrtille Crossbody sac téléphone portable avec la courroie d'épaule réglable femmes.
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,Filet de sécurité pour enfants(kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL-O'NEILL Femme Blouse). 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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Jouailla Bracelet PERLAS LATINAS perles de verre rouge-Centered Care (IPFCC) provides directions to advance in understanding,One Man Show Bracelet tressé en Cuir de bovin Bleu et Fermoir à Crochet Acier doré-Rose . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Illex Squirrel 61 Jackall Series).
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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,LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes-ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil. 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-XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet(Tent Sac de Couchage Backpacking Camping en Plein air Lightweight Personne Seule avec des à Dos Ultra-léger Net).
Conclusion
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