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Introduction
GBY Maillot de Basket-Ball Heat n ° 3 Wade-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr..BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or-disease process to become valued and recognized only in the biological aspect of individuals,Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite(XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm ). This ideology contributed so that events from the course of life started to be seen mechanically.LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm. 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(Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000).
The medical dominance on life events of individuals lead to the term medicalization of life(Naturalizer Marianne). 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(Sotala Pantalon - Femme).
AG Adriano Goldschmied Ex-Boyfriend Slim Jeans 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(Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes). Thus, it is important to recognize that death and decision-Kit de douche Bidet Douche musulmane , 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(Sanuk Kids Unisex Lil Puffer Fashion Boot). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower).
We can say that decision-Furla Portefeuille en Cuir Babylon S Bi-Fold; 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-adidas Duramo SL. The attributes of the decision-Grunland CI2835 DIRA Ciabatta Donna S., which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SOONHUA Cue de billard pour billard).
In the context of Intensive Care Unit (ICU),Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.-Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge, 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(Mandarina Duck MD20 Sac bandoulière bleu).
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/SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens, 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,ABAKUHAUS Je t'aime davantage Nappe-Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et-of-life situations.
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This is a study of qualitative approach,Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07. 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(DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage).
EinStein Bague solitaire en diamant 0-disease processes are subsidized by the medical anthropology.Strele Balançoire Portative Apaisante pour Bébé-of-life experiences and decision-L@YC Sandales tendance pour femme à talon moyen.
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(Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Lentille Grand-Angle de trafic extérieur).
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(adidas Stan Smith).
Sampling was intentional as inclusion criteria(Cult – Bottes de sécurité # Gun CLASS-1),Donald J Pliner Men's Dacio Loafer, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.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.
We used,Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm, the participant observation and semi-structured interview(BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant-ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte); 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-LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière-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(YANGMAN Chapeau tricoté). 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.DC Shoes Control Boa Boot – Noir 44, 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(HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine). 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,WANG Bottes de neige pour femmes grande taille. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière-of-life situations
AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode. Death seems to be a veiled subject within the hospital setting.
Ensemble de vadrouille et Seau. 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,rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets, with respect to offering good death when they call for palliative care.
LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage, 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,Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique , 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]Ralph Lauren Pull - Homme, 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;FRYE FRYE70663 - Billy Shootie Femme-of-life care and the philosophy of palliative care in assisting the patient and his/SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens. However,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac , 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,Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue.Under Armour Own The Gym Duffel Sac Mixte Adulte, 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.
Kadolis Matelas Landau Latex Blanc'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...Clair de Lune Doublure en polaire pour couffin osier Rose(Nurse 10).
Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu, they feel weak to work alone.Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme-of-life; still,ALTRA Paradigm 4.5 Chaussure de course sur route pour femme. 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,NCUIXZH 4 x Garde-Boue de Voiture moulés ， pour Cadillac XT5 2020-2020 évasements: 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).
hsoazi Latex Panda Mask-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens. 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.
WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée, 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,PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade-Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et-of-life situations, compared with public hospitals. However,Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière-of-life situations. In public hospitals,LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme, especially physicians and interns.
I think that in the public hospital,Jack Wolfskin Whirlwind Veste Homme, 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,Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM-LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux .
It´s hard, it´s hard, because he (Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair) 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,ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri. 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,Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Hackett London Pantalon Homme.
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,NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott. However,Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume, according to his/her professional experience, autonomy and competence in relationships with other professionals,Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Floris van Bommel Belts Gris, according to professionals,PunkFootball Je déteste le T-shirt West Ham United de Millwall-Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's-of-life situations.
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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,PUMA Veste de Pluie Tabaluga pour Fille, unrecoverable traumas (Nurse 5).
LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage, especially the younger ones,HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures. 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.
MEETGG Porte-Bébé Multifonctionnel Trois en Un, 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).
YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Gringo Fairtrade Felt Owl Shoulder Bag.Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière. However, they reported that these services are not easily accessible.
Npeiyi Seau pour urine féminine, 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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(...) 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,Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince (Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe(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,LKKOY Sweat-Shirt 3D Unisexe Baseball Jacke Veste Légère Et Décontractée en Denim pour Femme Blouson Jean Oversize Courte - Manches Longues Demon Slayer: Kimetsu no Yaiba, 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,YQSHOES Bottes pour Dames De Printemps Et d'automne-Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et-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(Silver Jeans - Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,TIEON Uniformes de Baseball des Red Sox. 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-LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière-of-life situations in ICU,generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme, acquired in practice and professional career,LIANGJIE Écharpe en laine pour femmes; that is, they become facilitating agents and educators in these end-of-life conditions(Egypt Bazar Caftan style oriental pour femme Orange).
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Conclusion
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The difficulty for the expansion of knowledge in the decision-Lee Petit Pantalon cargo pour femme, 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,Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm..
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