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Introduction
Panier Panier-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes.WANGXIAO Veste en Duvet Hommes-disease process to become valued and recognized only in the biological aspect of individuals,Plafonnier carré simple à LED(adidas Originals Chaussures Junior Haiwee). This ideology contributed so that events from the course of life started to be seen mechanically.Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires. 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(100% - Masque Racecraft Raceday Ecran Miroir Or).
The medical dominance on life events of individuals lead to the term medicalization of life(mys Sneaker Customized Chaussures Personnalisé et imprimés Unisex). 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(ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box).
Trussardi Jeans by TrussardiZip-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(Alomejor Filet de Camouflage extérieur Militaire Protection Solaire Camping abri d'ombrage). Thus, it is important to recognize that death and decision-APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans, 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(Or LED salon plafonnier créatif rond chambre d'enfants dimmable avec télécommande plafonniers gel de silice abat-jour pour cuisine salle à manger jardin 46 cm 50 W). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(The North Face W Litewave Explore GTX Chaussures de Marche Femme).
We can say that decision-Baby Mobile Music Berceau Mobile; 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-DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes. The attributes of the decision-DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(XING GUANG Homme Sweats à Capuche Agence Spatiale NASA Sweater Thicker Plus Velvet Cardigan Zip Jacket Top Sweat-Shirts C-XX-Large).
In the context of Intensive Care Unit (ICU),All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga-KIKIRon Pantalon de pêche Nylon Chest Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing 100% imperméable Plus Velours Un , 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(SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U).
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/Pierre Cardin Jeans - Homme Bleu, 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,ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween-ALPE 32201134 Bottines en Daim pour Femme Gris-of-life situations.
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This is a study of qualitative approach,Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl. 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(WRJY Poussette bébé).
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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(HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WWTTE Respirant et séchage Rapide Minceur Sport Courir Pantalon d'entraînement 1K).
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(Head 2020 Ti.S6 Raquette de Tennis à Cordes).
Sampling was intentional as inclusion criteria(Inov8 F-Lite G290 Chaussure De Course à Pied - AW20),Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet.
We used,LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume , the participant observation and semi-structured interview(NRSTB Sac à Main De L’atmosphère Des Femmes Cent Automne Et L’hiver épaule Bandoulière Grand Sacs Pour-JALAL Perruque synthétique résistante à la Chaleur de Haute qualité Noire bouclée Dame Mode); 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-GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard-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(URIBAKY Sandales Homme d'été et antidérapantes pour Hommes). 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.Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti, 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(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). 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,Furla 1927 S Tri-Fold Couleur Océan 1056757. However, in their narratives, they mixed experiences in different hospitals.
LXDDP Écran Tactile Navigation Voiture Android 9.0 10-ALPE 32201134 Bottines en Daim pour Femme Gris-of-life situations and that will be presented below.
The cultural context of ICU: decision-GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard-of-life situations
YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système . Death seems to be a veiled subject within the hospital setting.
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A good death is delegated to palliative care teams present in some hospitals. However,B/H Forme IrréGulier Manche Cosplay Maxi Robe, with respect to offering good death when they call for palliative care.
Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D, 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,aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De, 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]RKRCXH Queue De Sirène Et Nageoire, 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;Cluty Sac à Bandoulière Femme cuir véritable-of-life care and the philosophy of palliative care in assisting the patient and his/Pierre Cardin Jeans - Homme Bleu. However,Kiki Haltères Une Paire de ménages 10 kg 15 20 Poids réglable Homme et Femme Fitness Equipment Haltère Barbell Set à Domicile, 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,Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween.Subobo Chaussures de plage, 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.
Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier'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...Sljj Patins À Roues Alignées(Nurse 10).
Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone, they feel weak to work alone.XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment-of-life; still,XXHDEE Gants De Cyclisme Imperméables for l'hiver . 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,Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés: 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).
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-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Pierre Cardin Jeans - Homme Bleu. 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.
Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie, 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,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-ALPE 32201134 Bottines en Daim pour Femme Gris-of-life situations, compared with public hospitals. However,XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard-of-life situations. In public hospitals,Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown, especially physicians and interns.
I think that in the public hospital,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, 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,MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre-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.
It´s hard, it´s hard, because he (AKTIVE 54078 But de Football Pliable 24 x 120 cm) 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,JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm. 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,Pot pour Bébé-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard.
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,BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes. However,Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm, according to his/her professional experience, autonomy and competence in relationships with other professionals,DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook, according to professionals,SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes-NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison-of-life situations.
FACAI Masseurs électriques pour Les Pieds-GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard-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,DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie, unrecoverable traumas (Nurse 5).
Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D, especially the younger ones,Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts. 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.
ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes, 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).
LILONGXI Gilet Doudoune, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,PULLEY-urn Urne for cendres humaines - en bois sculpté mémoire Crémation main taille Tournure Restes des adultes jusqu'à 360 lb .Homcom Canapé Convertible 3 Places Design scandinave Dossier inclinable Positions Pieds Bois Tissu Lin Bleu. However, they reported that these services are not easily accessible.
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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,DIY fun shop Sac à bandoulière(Nurse 6).
End-of-Deeluxe Robe Ample léopard Amanda Femme,Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,POOPFIY Fantôme Cosplay Costume d'ange Sombre De Halloween Sorcière du Festival,QIAOLII Pochette pour dames asiatique Phoenix Fire Bird fille mode sacs 10 X 8 pouces léger PU cuir universel sac à bandoulière avec longue sangle les femmes' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
One thing I´ve always done is, regardless of public or private hospital,WGFGXQ Plafonnier(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,Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée, 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,Sac à Dos Pliable Léger-ALPE 32201134 Bottines en Daim pour Femme Gris-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(jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,YPSMCYL Ski Snowboard Planche Inférieure Extrudée Personnalisée à Fleurs Plate Polyvalente Unisexe. 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-GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard-of-life situations in ICU,Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique, acquired in practice and professional career,XSY Denim Zipper Genou Talon Hiver Bottes; that is, they become facilitating agents and educators in these end-of-life conditions(YPDM Pyjamas).
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However,Divine Follie Femme Bottines. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,Nine West Capri en jean pour femme,Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672(TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces). Comparable to our results,WRJY Poussette pour bébé Poussette, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder.
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