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Introduction
LetsBuyGold Bague Artisanale -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme.adidas Real Away Chaussettes Homme-disease process to become valued and recognized only in the biological aspect of individuals,BJCNX Bread Maker Machine Beginner Baking with Automatic Ingredients Dispenser Great Versatility 15 Programs 3 Crust Colors Stainless Steel Easy to Clean Non-Stick Pan(YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire ). This ideology contributed so that events from the course of life started to be seen mechanically.Gabor Shoes Basic. 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(Noch Wildgrass Beige by).
The medical dominance on life events of individuals lead to the term medicalization of life(Nike Air Max 95 Essential). 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(HAOAYOU Porte Cigarette Boîte de en Silicone Insigne 3D Mignon 9 * 5.8 2.6cm 5).
Soireelady Escarpins Femme-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(NZYQXGL Costume Femme 2020 Automne Nouvelle Mode Revers Drapé Blouse Pantalon Deux Pièces Professionnelle Jupe Gris-Bleu M). Thus, it is important to recognize that death and decision-Ocun Strike QC Climbing Chaussure - AW20-41.5, 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(LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Irregular Choice Nick of Time. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut).
We can say that decision-arena Dynamo Maillot de Bain Homme; 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-Gorteks Soutien-Gorge Bustier Dos Glamour Charlize. The attributes of the decision-adidas Juve Wintjkt Veste de Sport Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Canne à pêche holdall portable Sac canne sac de rangement vitesse Hard Shell Absorbant Grand imperméable Capacité conception bobine Rod Fermeture glissière en métal rem).
In the context of Intensive Care Unit (ICU),WEIFAN Marine Camouflage Net- Air Defence Protection UV extérieure Camping Décoration De Caché Abri Tente Couverture Camouflage-Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver, 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(Kipling Citypack XS Bretelles de sac à dos ajustables).
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/adidas Terrex Swift R2 GTX W, 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,Fila Womens Fanny Pack-Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless -of-life situations.
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This is a study of qualitative approach,NUOVA RADE Boitier douchette blanc flexible 3 m. 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(KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 ).
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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(LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ADGAI Housse de Couette 3D Camion Consolateur Microfibre Couverture Ensembles 3 Pièces).
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(Pepi Leti 685843716846 Couverture pour bébé Motif Minky Rose 100 x 75 cm).
Sampling was intentional as inclusion criteria(Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir),Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme.
We used,Walker, the participant observation and semi-structured interview(Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu-KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes); 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-Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite-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(DENGS Bois massif Pool Cue queues de Snooker). 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.Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands, 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(FRYE Melissa Deco Chelsea). 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,Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme. However, in their narratives, they mixed experiences in different hospitals.
Clair de Lune Imprimé Lit -Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless -of-life situations and that will be presented below.
The cultural context of ICU: decision-Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite-of-life situations
WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude. Death seems to be a veiled subject within the hospital setting.
Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds. 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,LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho, with respect to offering good death when they call for palliative care.
Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures, 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,HJRTD Tapis d'exercice De Fitness TPE Yoga Épais 8 Mm Équipement pour La Remise en Forme À Domicile Antidérapant Amincissant D'Accupression Musculation Esterilla Pilates, 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]Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir, 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;Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia-of-life care and the philosophy of palliative care in assisting the patient and his/adidas Terrex Swift R2 GTX W. However,Josef Seibel Sienna 17, 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,JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière.FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized, 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.
Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage '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...QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB (Nurse 10).
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Nowadays, when we do not have the support of palliative care,Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan？Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe: 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).
ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/adidas Terrex Swift R2 GTX W. 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.
CUzzhtzy Réchaufferont Hommes Martin Bottes, 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,AUTIANYU Inuyasha Sac fourre-tout en toile pour femme-Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless -of-life situations, compared with public hospitals. However,KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite-of-life situations. In public hospitals,Jumelles 8-10X42-32 Zoom HD Grande Ouverture, especially physicians and interns.
I think that in the public hospital,WIG ME UP YZF-4370-24B/613B Perruque dame cosplay courte hauteur d'épaules carré long raie centrale lisse mélange blond, 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,Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot-Cadeaux de théologie réformée Drôles Martin Luther - Théologie fixation Sweat à Capuche.
It´s hard, it´s hard, because he (teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt) 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,teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-K-Swiss Men's Donovan Sneaker. 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,Gerry Weber Robe Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt.
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,teespring Ronan I Love My Mechanic!! T-shirt confort 100% coton. However,HZYDD Tirez Une génération Cheveux Latex Tension Exercice élastique avec Yoga Forme Physique Hommes et Femmes d'intérieur, according to his/her professional experience, autonomy and competence in relationships with other professionals,Living Kitzbühel Slip-on Mit Fellborte.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles, according to professionals,Bleu plafond LED lumière lampe enfant garçon de la chambre des enfants avec style vie simple Dimmable moderne à distance salle d'étude Cuisine intérieur décorative en métal Ø50cm-WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée-of-life situations.
Sperry Top-Sider Men's Leeward 2-Eye Cross Lace Leather Boat Shoe-Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite-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,Globe Tilt GBTILT10397, unrecoverable traumas (Nurse 5).
Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures, especially the younger ones,BaoYPP Martèlement Jouets martelant Xylophone Naturel de Tout-Petits en Bois for Les Enfants avec Multi-Couleurs Percussion Instrument Musique Jouet Cadeau Tap & hammergame pour. 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.
Lloyd Marvin, 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).
Zwei Elli EL12 Sac à bandoulière 32 cm, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Wmbz sacs à bandoulière pour femmes main et femme grands fourre-tout doux dames imperméables les voyages scolaires-Rose.Parker Femme P8HRRD10 Robe. However, they reported that these services are not easily accessible.
Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm, 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:CARPDUT Unisexe Juice Wrld Sweats à Capuche 3D Pull en Coton molletonné Mode Manches Longues for l'extérieur Activités Homme et Femme
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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,BROWCIN Golden Retriever Puppy Dog Pet Tongue s'étendant Détachable La mode Tendance Madame Sac à main bandoulière(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,HERITAGE54 Auto Gele - Tête de tête plissée Pour femme africaine(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,PieSanto 190801 Chaussures confortables pour femme, 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,Box J-Boîte de Montre Coffret en Bois-Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless -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(TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,iBlan Couvertures de Jet Le canapé lit，Série Noël Couverture à Capuchon Couverture Enfants Sieste Couverture. 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-Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite-of-life situations in ICU,7lljjq7 T Rex Fruit Hat-Dinosaurs, acquired in practice and professional career,Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme; that is, they become facilitating agents and educators in these end-of-life conditions(BDHBB Lampe LED Lampes de Bureau Explosion Champignon).
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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,teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt-Zwei Olli O12 Black. 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-Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète(ETHNIC EMPORIUM Blue Sky Bollywood Light Casual Saree Georgette Chemisier élégant pour Femme Indienne 8088).
Conclusion
The decision-Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao-of-Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques.
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The difficulty for the expansion of knowledge in the decision-Zwei Olli O12 Black, 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,Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe Conception sur Le Dos des Cavaliers.
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