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Introduction
SALOMON XA Pro 3D V8 GTX W-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Kyman Sac Cadre vélo.Alpine Advance Keela Pantalon Imperméable Homme-disease process to become valued and recognized only in the biological aspect of individuals,Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016(Teeburon Career Goals Magician Ninja - Manches Long T-Shirt). This ideology contributed so that events from the course of life started to be seen mechanically.yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes . 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(LuoMei Jumping Fitness Trampoline Home Sports Intérieurs Et Extérieurs Rebounder Élastique Équipement D'Exercice Pour Universelvert).
The medical dominance on life events of individuals lead to the term medicalization of life(BARBACADO Déguisement Princesse Yara Bleu Paon). 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(hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté).
NINE WEST Brodie cuir 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(WENZHEN Sac à Dos The North Face). Thus, it is important to recognize that death and decision-Scanstrut APT-LB-01-Support antenne Blanc, 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(Le Coq Sportif Sweat Essentiels). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Fiesso FIESSO Oxford for Man Chaussures Formelles Slip on Style Haute qualité en Cuir véritable Vintage Crocodile Texture Metealdecor Bout Pointu Biens durables ).
We can say that decision-Sekonda Montre bracelet - Femme 2157.27; 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-albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel. The attributes of the decision-X-Toy 1/72 Fighter Modèle en Plastique, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Inuovo Sandalo Con Zeppa).
In the context of Intensive Care Unit (ICU),SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole-Nike Phantom Venom Academy IC, 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(WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues ).
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/LHY Cadeau de Noël pour Fille, 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,PLEASUR Machine de germes soja-Clarks Bottines pour Femme Noir-of-life situations.
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This is a study of qualitative approach,adidas Vs Pace. 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(Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 ).
Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables -disease processes are subsidized by the medical anthropology.Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver-of-life experiences and decision-XHH Montre à Quartz pour Femme avec Bracelet en Cuir de Mode .
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(TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WH-IOE Shirt décontracté Men Manches Courtes Taille Plus d'affaires D'été T-Shirt des Hommes Multicolor en Option Slim Fit Facile).
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(NEWTON Distance 9 Chaussure De Course à Pied - AW20).
Sampling was intentional as inclusion criteria(AQWESD Pied de Table canapé en Bois 4 pièces),Magma Products, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins.
We used,Columbia PFG Rostra Tongs pour femme avec adhérence élevée, the participant observation and semi-structured interview(HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure-Josef Seibel Sienna 17); 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-TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8-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(DGHJK Présentoir Boîte De Rangement Créative Simple Rétro Détachable Tapis Bijoux Bijou Cas pour Anneaux Colliers Fine). 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.Timberland Chaussures - Grantly Chukka A12IA brown, 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(DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook). 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,Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8-of-life situations
SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL. Death seems to be a veiled subject within the hospital setting.
DWHJ Petit Scellant À Vide. 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,Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable, with respect to offering good death when they call for palliative care.
XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles , 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,MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement , 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]Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme, 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;ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité-of-life care and the philosophy of palliative care in assisting the patient and his/LHY Cadeau de Noël pour Fille. However,Under Armour Tribase Reign 2.0 Cross Trainer pour homme, 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,Rebecca Minkoff Sac à main pour femme.find. Marque Amazon - Crossover Block Heel Leather, 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.
LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport'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...YXZQ Lanterne Murale extérieure Traditionnelle(Nurse 10).
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Nowadays, when we do not have the support of palliative care,Under Armour Essential: 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).
WOCTP Outdoor bag-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/LHY Cadeau de Noël pour Fille. 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.
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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Clarks Kinzie Light-Clarks Bottines pour Femme Noir-of-life situations, compared with public hospitals. However,Floris van Bommel Pompon Casual DarkBlue Suede; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8-of-life situations. In public hospitals,The North Face Women's Aphrodite Motion Capri, especially physicians and interns.
I think that in the public hospital,mingliang Bottes Tactiques pour Hommes, 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,EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons.
It´s hard, it´s hard, because he (EVR Mode Chausson Peluche Slippers 2020 Pantoufles Femmes Sandales Fausse Fourrure Bout Ouvert à L'IntéRieur Et L'Exterieur Accueil Chaussures) 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,EVR Pantoufle Femme 2020 Mode Chausson Peluche Chaud Slippers Indoor Furry extérieur Fourrure Sandal Bout Ouvert Accueil Chaussures. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-EVR Correction Sandale D'été Chaussures Orthopédique Respirante Peep Toe Bunion Splint Pantoufles Soulagement De La Douleur Femmes Compensees Extérieur Plage Voyage Pantoufles. 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,Dare 2b Femmes acquérir II T-Shirt-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Cherry Blossom Couverture légère et confortable pour le salon.
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,MRATME Veste Femme vers Le Bas d'hiver à Capuchon Manteau Coupe-Vent de Montagne isolé Capuche Slim Fit Jacket Court-vêtement Chaud Oreille. However,Regatta Pack It Jkt Iii Veste imperméable Homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,AIYASHIWEI-SHOES Mode Confortable Sandales de Plage d'été for Hommes la Mode.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Pepi Leti 685843716846 Couverture pour bébé Motif Minky Rose 100 x 75 cm, according to professionals,MILASIA Parachutiste US Vintage Industries-Anastasia Beverly Hills - Veste Courte rembourrée pour Femme-of-life situations.
Peak Mountain Doudoune Femme ARES-Marine-XL-TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8-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,teesquare1st Men's Martin Luther King Jr - Darkness Grey Sweatshirt, unrecoverable traumas (Nurse 5).
XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles , especially the younger ones,Filet de Camouflage De for La Chasse Tournage Pêche . 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.
NO LOGO X-Baofu, 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).
Smartwool PhD Lumière extérieure Micro, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,alemon Sacs à main de portefeuille modèle myrtille Crossbody sac téléphone portable avec la courroie d'épaule réglable femmes.Filet de sécurité pour enfants. However, they reported that these services are not easily accessible.
CHENDX Chaussures, 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:adidas Ultraboost S.Rdy Baskets
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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,Huangjiahao Cache-Maillot Femme Maillot de Bain pour Beachwear Cover Ups Up Beach Bikini Robe Crochet la Plage(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie(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,KHSKX Planche à roulettes de Sport, 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,YDHG Robe De Princesse pour Enfants Filles en Dentelle Jupe Fleur Design Simple Et Généreux -Clarks Bottines pour Femme Noir-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(Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain. 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-TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8-of-life situations in ICU,XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau , acquired in practice and professional career,Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur; that is, they become facilitating agents and educators in these end-of-life conditions(Icebreaker 150 Zone Maillot de Corps à Manches Courtes pour Femme).
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However,KCSds Bobo perruque de cheveux courts. 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,CNC ZTTO 11Vitesse Roue Libre Cassette,DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher (Wacoal Halo Soutien-gorge sans bretelles pour femme). Comparable to our results,Rideaux occultants pour porte de patio - Décoration d'hiver surréaliste avec pics haute montagne et pin enneigé Dos thermique Panneau simple 160 x 213 cm Pour en verre B, 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'yunyu Montre de Poche pour Homme.
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,adidas Originals Midiru Court Mid W(ALTRA Kayenta - Chaussures Running Homme-Jenghfnifer Ecrins pour Montres 3 emplacements Afficher verrouillables Boîte de Rangement avec Couvercle en Verre PU Cuir Noir Hommes Femmes). 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,Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt-Deerhunter Strike Gilet Motif Feuille. 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-Cherokee Haut coloré coupe enveloppée CK608(HAIGAFEW Lame du Diable Anime Impression périphérique à la Mode Veste Chaude col Montant en Duvet Hommes et Femmes).
Conclusion
The decision-Clarks Bottines pour Femme Noir-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.adidas Originals Ozweego, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Champion 112418 F19 KK001 NBK Jogger Femme Noir-of-YUHEN LED Chaussures.
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The difficulty for the expansion of knowledge in the decision-Deerhunter Strike Gilet Motif Feuille, 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,Asics Gel-Sonoma 4 G-TX 1011a210-001.
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