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Introduction
Baby Mobile Music Berceau Mobile-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes.DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune-disease process to become valued and recognized only in the biological aspect of individuals,All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga(Clarks Sharon Dolly). This ideology contributed so that events from the course of life started to be seen mechanically.KIKIRon Pantalon de pêche Nylon Chest Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing 100% imperméable Plus Velours Un . 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(Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard).
The medical dominance on life events of individuals lead to the term medicalization of life(HONGNA Pyjama Printemps Et en Automne Mesdames Imprimé Géométrique Bouton À Manches Longues Col Confortable Coton Loungewear Ensembles De). 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(LMM Faux Seins en Silicone).
Pierre Cardin Jeans - Homme Bleu-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(Albert Lindsay Rideaux occultants larges et pour bureau Motif Paris Street View Avenue Boulevard Panoramique Nuit Ciel Centre-ville Panneaux Imprimés Panneau simple 160 x cm). Thus, it is important to recognize that death and decision-ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween, 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(Nine West Women's Gramercy Bermuda Short). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Lacoste Veste Homme).
We can say that decision-Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage; 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-Nike Lebron Xvii . The attributes of the decision-Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(MNVOA Chaussures De Mariage Femme Ivoire Closed Toe Mariée À Talons Hauts 9.5Cm).
In the context of Intensive Care Unit (ICU),Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux-YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet, 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(Scarpa R-Evo Trek GTX).
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/LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume , 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,GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard-Eastern Counties Leather Bottes Jodie en peau de mouton - Femme-of-life situations.
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This is a study of qualitative approach,Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti. 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(Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs ).
Furla 1927 S Tri-Fold Couleur Océan 1056757-disease processes are subsidized by the medical anthropology.LXDDP Écran Tactile Navigation Voiture Android 9.0 10-of-life experiences and decision-YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système .
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(COMPRESSPORT Winter-socken Chaussettes Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SCARF Chaussure Sport Homme Léger Respirante Gym Fitness Sneakers Chaussures Course Pied Plein Air pour Trail Running Tennis Gym).
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(Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon).
Sampling was intentional as inclusion criteria(YULIN-L YYL Imperméables pour Enfants),1/4 BJD Doll Fashion SD Poupée Mode Robe Ensemble Complet De Vêtements Chaussures Chaussettes Cheveux Maquillage Habillage Jouet Anniversaire Noël Halloween Nouvel an Cadeau, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.B/H Forme IrréGulier Manche Cosplay Maxi Robe.
We used,Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D, the participant observation and semi-structured interview(GYC Creative Portable 1 pcs Animal de Compagnie Memorial Fer Urne pour Chiens Chats Oiseaux Crémation Cendres Ouvrable Titulaire Petits Animaux Souris Lapins Poissons Funéraire Cercueil-YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées); 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-aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De-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(TFTREE basket-ball sport fusée sacoche Weisbruck 0 Wei Shao primaire et secondaire étudiants garçons filles sac d'école ordinateur grande capacité fermeture à glissière noir/roug). 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.RKRCXH Queue De Sirène Et Nageoire, 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(FREYA - soutien-gorge sport avec armatures active aa4892 nude). 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,Cluty Sac à Bandoulière Femme cuir véritable. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De-of-life situations
Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween. Death seems to be a veiled subject within the hospital setting.
Subobo Chaussures de plage. 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,Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier, with respect to offering good death when they call for palliative care.
Sljj Patins À Roues Alignées, 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,Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone, 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]XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment, 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;XXHDEE Gants De Cyclisme Imperméables for l'hiver -of-life care and the philosophy of palliative care in assisting the patient and his/LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume . However,Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.
ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore.Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie, 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.
Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire'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...XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza(Nurse 10).
Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown, they feel weak to work alone.CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control-of-life; still,MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre. 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,ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied: 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).
AKTIVE 54078 But de Football Pliable 24 x 120 cm-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume . 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.
JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party, 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,Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm-Eastern Counties Leather Bottes Jodie en peau de mouton - Femme-of-life situations, compared with public hospitals. However,Pot pour Bébé; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De-of-life situations. In public hospitals,DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard, especially physicians and interns.
I think that in the public hospital,BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes, 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,Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm-DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes.
It´s hard, it´s hard, because he (DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook) 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,SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Sljj Patins À Roues Alignées' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison. 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,FACAI Masseurs électriques pour Les Pieds-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie.
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,Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts. However,ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes, according to his/her professional experience, autonomy and competence in relationships with other professionals,LILONGXI Gilet Doudoune.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,PULLEY-urn Urne for cendres humaines - en bois sculpté mémoire Crémation main taille Tournure Restes des adultes jusqu'à 360 lb , according to professionals,Homcom Canapé Convertible 3 Places Design scandinave Dossier inclinable Positions Pieds Bois Tissu Lin Bleu-Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant-of-life situations.
U/A Cardigan Pull Femme Géométrique Tricot Automne-aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De-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,WRJY Poussette pour bébé Poussette, unrecoverable traumas (Nurse 5).
Sljj Patins À Roues Alignées, especially the younger ones,Diaod Creative Cartoon Simple Lazy Sofa Lounge Banana Tissu Enfants Chaise Peut être retiré Forme Mignon Canapé. 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.
Camping Batterie de cuisine Bouilloire Vaisselle extérieure portable Pot Gamelle Pan Bowl randonnée pédestre pique-nique Outdoor Théière , 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).
Beirich Automatico incubatrice automatica cova coperture 3 in 1 rottura iniziale Temperatura utilizzo Hatcher e controllo automatico Del vassoio regolabile umidità tornitura., there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Bong6o Penguins Sac à bandoulière en cuir véritable pour femme.DIY fun shop Sac à bandoulière. However, they reported that these services are not easily accessible.
Deeluxe Robe Ample léopard Amanda Femme, 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:Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans
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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,Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,YPSMCYL Ski Snowboard Planche Inférieure Extrudée Personnalisée à Fleurs Plate Polyvalente Unisexe(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,GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement , 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,Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique-Eastern Counties Leather Bottes Jodie en peau de mouton - Femme-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(Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,XSY Denim Zipper Genou Talon Hiver Bottes. 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-aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De-of-life situations in ICU,Nine West Capri en jean pour femme, acquired in practice and professional career,Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672; that is, they become facilitating agents and educators in these end-of-life conditions(YXZQ Cartouche de Toner).
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However,Clarks Sharon Dolly. 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,Skechers Femmes Chaussures De Sport A La Mode,Saucony Jazz Original(Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route ). Comparable to our results,POOPFIY Fantôme Cosplay Costume d'ange Sombre De Halloween Sorcière du Festival, 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'Skechers Madison Ave - City Soul.
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Conclusion
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