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Introduction
Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Dare 2b Analyze Veste pour Homme.Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté -disease process to become valued and recognized only in the biological aspect of individuals,hanky panky Original String en dentelle extensible pour tailles 14-26(HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne ). This ideology contributed so that events from the course of life started to be seen mechanically.Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE. 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(DC Shoes Heathrow).
The medical dominance on life events of individuals lead to the term medicalization of life(GYMAN Superman Animation Costumes Cosplay Enfants Spandex/Lycra Adulte 3D Imprimer Halloween Carnaval Justaucorps Onesies pour Les Accessoires Cinéma Party Cadeau d'anniversaire). 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(NanXi Moustiquaire auvent 4 Coin pour Les Lits).
HESTRA Henrik Gants de ski court en cuir-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(RYKA Everest). Thus, it is important to recognize that death and decision-Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron, 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(Delavi Self Medication T-Shirt Femme Noir Women's Black). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1).
We can say that decision-Asics Gel Solution Speed Clay; 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-Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris. The attributes of the decision-Under Armour ColdGear Legging ajusté pour Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Toupie Burst).
In the context of Intensive Care Unit (ICU),Azonic The Rock FAT35 Stem Vorbau 34-HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe, 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(YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip).
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/Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures, 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,Converse Chuck Taylor All Star Homme Vintage Leather Hi-WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets-of-life situations.
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This is a study of qualitative approach,no!no! Anti-Pluie Surchaussures. 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(Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe Conception sur Le Dos des Cavaliers).
La Modeuse Richelieus Vernis à Bout Rond-disease processes are subsidized by the medical anthropology.BOSS Hugo Boss Lunettes de soleil BO 6LB/G4-of-life experiences and decision-New Balance Fresh Foam Hierro V4.
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(Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(KANGSHENG Roadside 30-100CM Outdoor Traffic Mirror).
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(Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small).
Sampling was intentional as inclusion criteria(ZzWEI Mi-Top des Hommes Chaussures Sport Basket-Ball Antidérapantes Légères Tennis Absorption Chocs en Arc Course De Route),ESDY Ensemble de sous-Vêtements Thermiques Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme.
We used,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU, the participant observation and semi-structured interview(YUMI Robe - Femme-WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées); 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-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU-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(G‐SHOCK By Casio Men's Digital DW6900BMC-1 Watch Black). 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.WPQBS Porte-clés, 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(LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume ). 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,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU-of-life situations
GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball . Death seems to be a veiled subject within the hospital setting.
RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris. 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,eeddoo Ti Gloss Titan - BCR Klemmring , with respect to offering good death when they call for palliative care.
Sotala Pantalon - 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,Nike M nK sQD coutil Top Shirt à manches longues, 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]K-Swiss Ultra Express, 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;TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite-of-life care and the philosophy of palliative care in assisting the patient and his/Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures. However,Hassia Bologna, 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,SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle.Champion Sweat à Capuche en Laine Polaire pour Homme, 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.
GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet'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...PUMA Unisex Basket Classic LFS Kids Sneaker(Nurse 10).
Nike Court Borough Mid Winter, they feel weak to work alone.Columbia Granite Mountain Veste polaire pour homme-of-life; still,Frankv Shorts de Planche pour Hommes. 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,Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement: 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).
Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures. 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.
Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar , 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,axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir-WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets-of-life situations, compared with public hospitals. However,Hell Bunny Ella May Denim Dungarees; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU-of-life situations. In public hospitals,Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver, especially physicians and interns.
I think that in the public hospital,Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt , 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,Columbia Fall Pine Washed Crew Chemise Femme-Feagar Voiture Oreillers de Cou.
It´s hard, it´s hard, because he (TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille) 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,Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Sotala Pantalon - Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme. 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,Anodi per Motori Mercury - Mercruiser-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black.
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,AILIBOTE Squad T-shirt pour homme. However,Cavi telecomando Sea Star CC330, according to his/her professional experience, autonomy and competence in relationships with other professionals,SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Timberland Jayne Bottes de confort pour femme 15 cm, according to professionals,TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear-Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite-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,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route , unrecoverable traumas (Nurse 5).
Sotala Pantalon - Femme, especially the younger ones,dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm 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.
DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging, 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).
Chiba pour Homme Lake Tahoe Gants, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,SPORTUBE Series 1 Platinum Deluxe Étui à snowboard.Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45. However, they reported that these services are not easily accessible.
Nike M NKCT Jacket Stadium Veste Homme, 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).
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Humanization practices in end-of-life situations:JX-PEP Été Imprimer col Rond Manches Courtes
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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,zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,H.yina Table à Langer pour Fille Petits espaces(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,Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit, 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,Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit-WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets-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(PUMA Sneaker Smash WNS Perf Métallique pour femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LetsBuyGold Bague Artisanale . 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-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU-of-life situations in ICU,vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron, acquired in practice and professional career,HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini ; that is, they become facilitating agents and educators in these end-of-life conditions(Costume de vêtements yoga Sets d'entraînement des femmes).
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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,Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch(GSFDHDJS Cosplay Bottes Chaussures for Love Live Hoshizora Rin Valentine's Day-Likoli KaterLikoli I'm Here to Stay T-shirt pour femme - Bleu 42). 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,Sloggi Slip -Pleaser Delight 1018. 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-EMANUELA BIFFOLI Ciabatta Infradito Con applicazione(KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat).
Conclusion
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HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination, 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-LMWB Moustiquaire de Lit Pliable. 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,WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party-Pleaser Delight 1018.
WYZDQ Mens Bottes De Neige, 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/Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures, 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-Pleaser Delight 1018, 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,Under Armour Campus W/U Veste pour femme.
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