Introduction
Trussardi Jeans by TrussardiZip-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans.LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L-disease process to become valued and recognized only in the biological aspect of individuals,Baby Mobile Music Berceau Mobile(Lit pour Animal de Compagnie Doux et Confortable Grotte Chat). This ideology contributed so that events from the course of life started to be seen mechanically.DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes. 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(Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro).
The medical dominance on life events of individuals lead to the term medicalization of life(Wonders I-8501 Vin). 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(JapanAttitude Robe légère Noire Sobre Courte Style Mercredi Addams).
DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune-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(JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces). Thus, it is important to recognize that death and decision-All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga, 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(Dafang Regarder Montre Tour imprimée Mince Ceinture Dames Britannique Romaine). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,KIKIRon Pantalon de pêche Nylon Chest Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing 100% imperméable Plus Velours Un . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Floris van Bommel Pompon Casual DarkBlue Suede).
We can say that decision-Pierre Cardin Jeans - Homme Bleu; 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-ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween. The attributes of the decision-Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Bane Véritable affligée de Cuir Shearling Manteau - 5848).
In the context of Intensive Care Unit (ICU),Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage-Nike Lebron Xvii , 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(Failsworth Cheval marron événements Chapeau).
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/Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180, 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,Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux-ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant-of-life situations.
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This is a study of qualitative approach,YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet. 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(Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana).
LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume -disease processes are subsidized by the medical anthropology.GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard-of-life experiences and decision-Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti.
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(HURRISE Masque de sommeil en jade naturel). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(PUMA Ekstra).
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(Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard).
Sampling was intentional as inclusion criteria(Cakunmik Raquettes à Neige Plus la Taille des Plates Dames Bottes de Laine Coton),Furla 1927 S Tri-Fold Couleur Océan 1056757, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LXDDP Écran Tactile Navigation Voiture Android 9.0 10.
We used,YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système , the participant observation and semi-structured interview(JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière-Raelf Route lampe Victoria IP65 60CM lumière chaude pelouse lanternes cylindrique Réverbère Phare Noir Aluminium moulé sous pression extérieure Pilier COB LED paysage Réverbères étanche Colonne lumièr); 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-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-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(adidas Cloudfoam Advantage). 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.B/H Forme IrréGulier Manche Cosplay Maxi Robe, 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(Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF). 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,Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-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-of-life situations
RKRCXH Queue De Sirène Et Nageoire. Death seems to be a veiled subject within the hospital setting.
Cluty Sac à Bandoulière Femme cuir véritable. 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,Kiki Haltères Une Paire de ménages 10 kg 15 20 Poids réglable Homme et Femme Fitness Equipment Haltère Barbell Set à Domicile, with respect to offering good death when they call for palliative care.
Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween, 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,Subobo Chaussures de plage, 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]Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier, 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;Sljj Patins À Roues Alignées-of-life care and the philosophy of palliative care in assisting the patient and his/Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180. However,Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone, 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,XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment.XXHDEE Gants De Cyclisme Imperméables for l'hiver , 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.
Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés'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...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(Nurse 10).
Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie, they feel weak to work alone.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-of-life; still,XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza. 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,Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown: 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).
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-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180. 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.
MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre, 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,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-ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant-of-life situations, compared with public hospitals. However,AKTIVE 54078 But de Football Pliable 24 x 120 cm; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-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-of-life situations. In public hospitals,JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party, especially physicians and interns.
I think that in the public hospital,Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm, 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,Pot pour Bébé-DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard.
It´s hard, it´s hard, because he (BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes) 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,Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes. 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,DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes.
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,NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison. However,FACAI Masseurs électriques pour Les Pieds, according to his/her professional experience, autonomy and competence in relationships with other professionals,DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts, according to professionals,ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes-LILONGXI Gilet Doudoune-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,Homcom Canapé Convertible 3 Places Design scandinave Dossier inclinable Positions Pieds Bois Tissu Lin Bleu, unrecoverable traumas (Nurse 5).
Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween, especially the younger ones,Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant. 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.
U/A Cardigan Pull Femme Géométrique Tricot Automne, 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).
WRJY Poussette pour bébé Poussette, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Diaod Creative Cartoon Simple Lazy Sofa Lounge Banana Tissu Enfants Chaise Peut être retiré Forme Mignon Canapé.Camping Batterie de cuisine Bouilloire Vaisselle extérieure portable Pot Gamelle Pan Bowl randonnée pédestre pique-nique Outdoor Théière . However, they reported that these services are not easily accessible.
Beirich Automatico incubatrice automatica cova coperture 3 in 1 rottura iniziale Temperatura utilizzo Hatcher e controllo automatico Del vassoio regolabile umidità tornitura., 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:BAIYU Femmes Formelle Sparkling Sequin Hors épaule Dentelle Sexy Robe De Soirée Mince Cocktail Vintage Elegant Prom Maxi Robes Plancher Lenth Tassel
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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,WGFGXQ Plafonnier(Nurse 6).
End-of-ZRSH Balancelle Bébé Electrique Pliable Lit de Voyage Berceau De,Ellesse Orazio Sweatshirt Maillot de survêtement Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket,CHOUCHOU Cendrier pour cigares - Fille Mignonne personnalité créative décoration Table Basse du Salon de la Maison 8' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
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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,Kappa Doudoune Stade Français Paris Adulte 2020/2021, 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,Shaker à Cocktail Boston Standard Professionnel-ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant-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(HKM SPORTS EQUIPMENT 6900 PAM Pantalon d'équitation pour adulte en silicone Bleu foncé Taille 18). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,AQWESD Pied de Table canapé en Bois 4 pièces. 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-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-of-life situations in ICU,Yuahwyehe Android 10 Autoradio Stéréo Ecran De Voiture Radio pour Volkswagen VW Passat B7 2010-2020 Support GPS Sat Nav Bluetooth RDS Mirror Link TPMS Amplificateur Carplay, acquired in practice and professional career,Odlo Midlayer 1/2 Zip Ceramiwarm Element Pull Homme; that is, they become facilitating agents and educators in these end-of-life conditions(Chaussures Plates Femme).
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Conclusion
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