Introduction
IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental.Zhuowei Mesdames Stretch Cuissardes-disease process to become valued and recognized only in the biological aspect of individuals,NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm(Zhuowei Les Femmes D'automne Hiver Grincent Penny Bottes Talon Barboteuses Avec Profil Unique Fermeture Ventes Haute Chaussures Noires Talons Bloc). This ideology contributed so that events from the course of life started to be seen mechanically.Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement . 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(Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux).
The medical dominance on life events of individuals lead to the term medicalization of life(YIGUI Boîte À Chaussures Couvercle Rabattable Transparent De Rangement Empilable Organisateur Cas Tiroir). 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(Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples).
Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants-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(Aktaul Tamponnant Licorne Chemise Touche Hanche Saut Marrant La Magie Noir Femme T-Shirt Manches Courtes Womens Black). Thus, it is important to recognize that death and decision-Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P, 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(Roxy Snow Junior's Surface Zip Through Top). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes).
We can say that decision-CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping; 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-Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand . The attributes of the decision-Magie Professionnelle Chapeau Claque Double Fond , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Man&Jenensy Veste décontractée pour Hommes sans Manches Deux côtés).
In the context of Intensive Care Unit (ICU),MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson-adidas Little Boys' Tricot Pant, 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(Circus By Sam Edelman Goodwin Bottes de Combat pour Femme).
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/Hermes Cadre Photo en argent cm 13 x 18, 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,Jack Wolfskin Cloudburst Veste pour Hommes-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-of-life situations.
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This is a study of qualitative approach,Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta. 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(Bache Impermeable Exterieur Transparente).
Meindl Asti Mid GTX Wanderschuh TEX Braun-disease processes are subsidized by the medical anthropology.Guess Short Dress-of-life experiences and decision-LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure.
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(Hatley Swimsuits Maillot Une pièce Garçon). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LNLN Automne Et Hiver Manteau Petits Poissons Impression 3D Sweat À Capuche Motif Hommes Femmes Couple Pull).
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(WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité).
Sampling was intentional as inclusion criteria(Siennaa Pull Billie Eilish Femme),Vince Camuto Femme Robe, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Vans T Classic Baskets à enfiler.
We used,Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage, the participant observation and semi-structured interview(Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux-NYDJ Jeans 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-aden by anais gigoteuse cozy plus-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(Parc SYY Barrière Green-Toddler Structure Stable De Conception Polygonale Facile À Installer Et Laver Pad Tampon Double Usage Hiver/Été). 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.steve madden Femmes Sandales À Talon, 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(CUzzhtzy Réchaufferont Hommes Martin Bottes). 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,Mammut Runbold Pantalon Femme Black FR : XS . However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-aden by anais gigoteuse cozy plus-of-life situations
GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia. Death seems to be a veiled subject within the hospital setting.
adidas Ultraboost 19 M. 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,modamoda de Messenger Ital Sac à bandoulière en cuir T06, with respect to offering good death when they call for palliative care.
Enuff Skateboards Skully Complete Skateboard, 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,MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique, 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]TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation, 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;KEEN Targhee Lace High Polar Waterprooof-of-life care and the philosophy of palliative care in assisting the patient and his/Hermes Cadre Photo en argent cm 13 x 18. However,adidas Stabil Bounce, 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,adidas Tan Graphic Crewneck Sweat-Shirt Homme.Merrell Vapor Glove 4, 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.
Columbia Youth Firecamp Mid 2 WP'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...Sorel Out N About Plus Conquest(Nurse 10).
Love Moschino Borsa Quilted Nappa Pu, they feel weak to work alone.Asics Chaussures Gelsaga Gel-Saga Sou-of-life; still,ALTRA Superior 4.0 Black. 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,Sperry Top-Sider Femmes Bottes: 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).
Merrell Yokota 2-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Hermes Cadre Photo en argent cm 13 x 18. 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.
Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir, 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,adidas Superstar-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-of-life situations, compared with public hospitals. However,Northland Kosh Veste Garçon Gitane FR: 6A ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-aden by anais gigoteuse cozy plus-of-life situations. In public hospitals,adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt , especially physicians and interns.
I think that in the public hospital,Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure, 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,Stonefly Season III 28 Nappa-Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure.
It´s hard, it´s hard, because he (Nike Court Vision Mid) 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,Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Enuff Skateboards Skully Complete Skateboard' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Nike Flex 9. 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,DYHQQ Brancard de Chaussure-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Chie Mihara Queran.
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,XZDXR Boîte À Chaussures Rose. However,Nike Air Max 97 Essential, according to his/her professional experience, autonomy and competence in relationships with other professionals,TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings, according to professionals,Tommy Hilfiger Leon 21-Le Parc de bébé-of-life situations.
Sanuk Yoga Joy Sparkle-aden by anais gigoteuse cozy plus-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,SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021, unrecoverable traumas (Nurse 5).
Enuff Skateboards Skully Complete Skateboard, especially the younger ones,Maxim Creation Dubai Fustan Abaya Jellebiya Hand Embroidered Daraat Lebssa Jabodar Maxi Dress 6420. 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.
Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal, 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).
JEWEL BEADS Beads Gemstone Natural Blue Sapphire Bracelet Faceted Rondelle/September Birthstone Gift/Women's, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Esprit Sweater Femme.ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG. However, they reported that these services are not easily accessible.
lquide Album Photo Bricolage, 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:Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant
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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,Sanita Saskia Sport Flex Sandale(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Kuingbhn Chapeau Fascinant Femmes Fascinators Cheveux Accessoire De Épingle À Plume Cocktail Mariage Thé Fête Et pour Les Accessoires de Balle(Nurse 5).
In care and in decision-Crime London KOMRAD White-of-life,Onitsuka Tiger Baskets Corsair Unisexe-Adulte.Pandora Femme Vermeil Charms et perles - 788692C01, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.MASCOT WORKWEAR Mascot Polo De Travail Crossover, knowing that all the best care was provided to the patient.Gabor Salma Womens Slip on Ballet Pumps 37.5 Sand Python.
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,DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8, 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,DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-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(Hdadwy Sac à Dos imprimé en 3D). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Huangwanru Boîte de Montre pour Homme Bracelet Plateau Couvercle en Verre Noir 12 Affichage Rangement Bijoux Case Hommes ou Femmes . 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-aden by anais gigoteuse cozy plus-of-life situations in ICU,MARC JOSEPH NEW YORK Genuine Leather Smoking Loafer with Embroidery Detail, acquired in practice and professional career,Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy; that is, they become facilitating agents and educators in these end-of-life conditions(SoonerQuicker Les Femmes Gardent Chaussures au Chaud en Cuir Bottes à glissière Tube Moyen Bout Rond Bleu Plat Haut Sexy compensé Aiguille Carre carré 8cm Marron Noire).
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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,NZYQXGL Costume Femme 2020 Automne Nouvelle Mode Revers Drapé Blouse Pantalon Deux Pièces Professionnelle Jupe Gris-Bleu M(LXJ-CQ Oreiller de Cou Saint-Valentin Or Paillettes Amour Coeur Voyage en Forme U Ergonomique Conception profilée Housse Lavable-Les Poulettes Bijoux Bague Argent Demi Sphère de Larimar). 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,PICKME Hommes Femmes USB Chauffage Gilet-Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans. 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-JKLJKL Chauffage Électrique À Froid Gilet Pare Chaud du Cou(Victoria Basket).
Conclusion
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The difficulty for the expansion of knowledge in the decision-Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans, 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,CAMELBAK Eddy Bouteilles.