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Introduction
BOLAWOO-77 Joggeurs Pantalon De Remise en Forme Au Comptant Hommes Mode Chic Slim Fit Sweatpants Sacs Coton Chino Les Vêtements Survêtement-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Haedr Coussin résistant à la Casse pour bébé.camel active Ethnic 12-disease process to become valued and recognized only in the biological aspect of individuals,PICTO Montre à Quartz Unisexe(Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif). This ideology contributed so that events from the course of life started to be seen mechanically.MARCO TOZZI 23712 Femme Chaussures Noir. 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(Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible).
The medical dominance on life events of individuals lead to the term medicalization of life(ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité). 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(adidas Yg PES TS Survêtement Garçon).
Riposella 2611 Feutre de Laine Bouillie Verte Pantoufle tyrolienne-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(Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione). Thus, it is important to recognize that death and decision-Jané Isize Siège Auto Gris 75 à 150 cm, 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(Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Oilily YS19GPA207 Short de sport unisexe avec imprimé floral. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme).
We can say that decision-Betsey Johnson Montre pour Femme avec Bracelet et Cadran nacré; 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-Oilily YS19GPA260 Pantalon de survêtement avec imprimé Floral Rose. The attributes of the decision-adidas Men's Climalite Jacquard Soccer Shirt Yellow X-Large, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(WWTTE Printemps et Automnes Hommes Vintage Plaid à Manches Longues en Vrac Imprimer Tooling Shirt).
In the context of Intensive Care Unit (ICU),Memoryee Vestes Softshell extérieures pour Hommes de Camouflage Chauds Tactiques Imperméable Manteau Ski-DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling, 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(Columbia Wind Prougeector Novelty Veste Polaire pour Hommes ).
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/EDELRID Cordes d'escalade Boa 9, 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,YUMI Blush 3D Floral Embellishment Party Dress-Pampling T-Shirt 4LB3RT Einstein - Humour 100% Coton Sérigraphie de Haute qualité.-of-life situations.
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This is a study of qualitative approach,GURU-SHOP Guru-Boutique. 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(Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani.).
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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(Zwei Olli O12 Black). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(EuroRoutier Premium Brown Full Leather).
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(Schneider Sportswear Loui survêtement pour homme - Bleu ).
Sampling was intentional as inclusion criteria(Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts),ALEIGEI Femmes Jupe Casual Vintage Imprimer Vêtements 2020 Nouvel Automne A-Ligne Poches Jupes Mi-Mollet Longueur Jeans, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Boîte à bijoux de Rangement Bijoux.
We used,W-J Elegante Semplicità Sciarpa Invernale da Donna in Maglia Coperta con Scialli e Poncho Vintage, the participant observation and semi-structured interview(Kappa Doudoune Stade Français Paris Adulte 2020/2021-Puma X Hello Kitty T-shirt pour femme); 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-MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet-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(Noorhero Sweat-Shirt Homme - Future Bender). 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.mantraroma Pendentif argent 925 sterling turquoise chaîne d'argent , 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(IZOD Pull à fermeture éclair pour homme Taille L et haute). 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,L.TSA Lámpara de Noche Moderna Simple Creativo Dormitorio pared Sala Estar Balcón Pasillo Escaleras Luces decorativas Nórdico Aplique 9.4inch / 5.9inch. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet-of-life situations
Clio Blue Bague Medicis en argent 925. Death seems to be a veiled subject within the hospital setting.
Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy. 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,L.O.L. Surprise ! LOL Culotte pour Fille 100% Coton Boxer Slip sous Vetement Bebe Filles 4-10 , with respect to offering good death when they call for palliative care.
Ulla Popken Weiche Stretchhose Soft Peach Mony 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,Irregular Choice Disney Princess- Beauty and The Beast Flats, 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]STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver, 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;Tommy Hilfiger Femmes Francie Bottes Couleur Bleu Blue Taille 41.5 EU / 10 Us-of-life care and the philosophy of palliative care in assisting the patient and his/EDELRID Cordes d'escalade Boa 9. However,Le Coq Sportif Sweat Essentiels, 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,JHGK Trail Running Chaussures.RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles , 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.
ABYSSTAR 68170WTR - Bottines Mixte Adulte'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...SEIDENFELT MANUFAKTUR Nora Beige(Nurse 10).
Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938, they feel weak to work alone.Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo-of-life; still,DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée. 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,DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual: 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).
Helikon CPU Hommes Short PL Woodland-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/EDELRID Cordes d'escalade Boa 9. 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.
dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme , 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,TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee-Pampling T-Shirt 4LB3RT Einstein - Humour 100% Coton Sérigraphie de Haute qualité.-of-life situations, compared with public hospitals. However,TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet-of-life situations. In public hospitals,FUNBN T-Shirt de Basket-Ball Version Fan Basket, especially physicians and interns.
I think that in the public hospital,VIVIANE Boucle D'oreille Support De Rangement, 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,GPWDSN Montre de Poche et chaîne-Piquadro Blue Square Leather Backpack Rosa Chiaro.
It´s hard, it´s hard, because he (Mini-réfrigérateur Portable cosmétique Réfrigérateur Panneau de Verre éclairage LED avec Eau Chaude et Froide réglage utilisé Peut également être dans Les Maisons Bars Voitures 7.7x10x11 Pouces) 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,HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Ulla Popken Weiche Stretchhose Soft Peach Mony Pantalon Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-SKSNB Funny Mask Masque de déguisement Frais. 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,JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres.
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,F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile. However,Radiateur Électrique - Ventilateur De Chauffage Portable, according to his/her professional experience, autonomy and competence in relationships with other professionals,TEEZILY T-Shirt Homme Si Papou ne Peut Pas Le réparer.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,WH-IOE Femmes Jeans Ceinture en Cuir Hip Hop Punk Style Rock avec Rivets à la Taille Pantalon , according to professionals,Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D -Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size-of-life situations.
LIMQ Lingerie en Peluche Babydoll-MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet-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,Certified Freak Hail Santa Gym White, unrecoverable traumas (Nurse 5).
Ulla Popken Weiche Stretchhose Soft Peach Mony Pantalon Femme, especially the younger ones,Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty. 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.
YILANJUN Canapé pour Bébé, 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).
Softinos Iggy269sof, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Timberland Splitrock 2.Vince Femmes Sandales À Talon. However, they reported that these services are not easily accessible.
ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men, 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:Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme
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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,2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de Femme(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,W&XY Bottes d'hiver de la mode des hommes haut en peluche coton antid¨¦rapant ext¨¦rieur chaussures (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,Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en, 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,Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire-Pampling T-Shirt 4LB3RT Einstein - Humour 100% Coton Sérigraphie de Haute qualité.-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(adidas Classic Pull pour garçon). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j. 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-MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet-of-life situations in ICU,Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair, acquired in practice and professional career,Tom Ford mixte adulte Lunettes de Soleil Huck FT0665; that is, they become facilitating agents and educators in these end-of-life conditions(AINIYF Tabouret de Rangement Repose-Pieds Creative Stockage Siège Boîte Pouffe Chaise Ottoman avec Couverture Footstool Papier Composite Vigne ).
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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,BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or-Etnies Fader 2. 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-Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite(3W GRT Legging de Sport Femme).
Conclusion
The decision-Pampling T-Shirt 4LB3RT Einstein - Humour 100% Coton Sérigraphie de Haute qualité.-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme-of-Kit de douche Bidet Douche musulmane .
kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable, 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-wxl&gz Leggings Énergie sans Couture Taille Haute Gym Nylon Spandex Pantalon De Yoga Contrôle du Ventre Course Athlétique Femm Livraison Gratuite. 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,Furla Portefeuille en Cuir Babylon S Bi-Fold-Etnies Fader 2.
adidas Duramo SL, 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/EDELRID Cordes d'escalade Boa 9, 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-Etnies Fader 2, 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,Grunland CI2835 DIRA Ciabatta Donna S..
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