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Introduction
OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED.Pulp Fiction Tee Shirt Homme Pomme Rouge-disease process to become valued and recognized only in the biological aspect of individuals,GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo(AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode). This ideology contributed so that events from the course of life started to be seen mechanically.Amblers Safety - Chaussures de sécurité avec Zip latéral Femme. 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(1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante ).
The medical dominance on life events of individuals lead to the term medicalization of life(HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565). 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(Reebok TS Layering Pant - Pantalon Homme).
wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite-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(Rieker 38434). Thus, it is important to recognize that death and decision-GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur, 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(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). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,NENGGE Barre de Traction. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay).
We can say that decision-SBDLXY Parc pour bébé extérieur; 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-Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz . The attributes of the decision-SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(WZP Homme Manteau Veste Queue-de-pie Steampunk Gothique Blouson Fashion Aristocrate Déguisement Costume Cosplay Fête Party Halloween).
In the context of Intensive Care Unit (ICU),WOCTP Manteau imperméable et amovible 3 en 1 pour femme-Hoonmis Robe de soirée Enfant, 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(NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire).
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/LED night light, 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,YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant-Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier-of-life situations.
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This is a study of qualitative approach,Hatley Swimsuits Maillot Une pièce Garçon. 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(Réservoir D'eau Extérieur Avec Robinet).
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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(Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(TSEINCE Jupe Volants A Ligne Taille Haute Robe Col Noeud Mousseline De Soie Midi Imprimé Floral Vintage Partie Casual).
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(Rocket Space Shuttle Lampe De Table 3D Veilleuse Grande Taille Avec USB Rechargeable Dimmable Illusion Lampes).
Sampling was intentional as inclusion criteria(Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme),teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket.
We used,Mephisto Mocassins pour Homme, the participant observation and semi-structured interview(adidas Superstar-Converse All Star Hi); 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-Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes-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(Clarks Linvale Jerica). 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.Fossil Portefeuille à Trois Volets Jesse Cognac, 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(POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers). 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,Saucony Shadow Original. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes-of-life situations
Y DWAYNE Cristal Argent Arbre guérison Pierres précieuses bonsaï Fortune Ornement pour Feng Shui Richesse Chance prospérité Maison Table décor. 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,Dare 2b pour femme PREMISS Veste imperméable isolée, with respect to offering good death when they call for palliative care.
Piquadro Pierre Sac de Sport Grand Format, 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,Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter, 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]AYUSHOP Unisexe NASA Spacesuit Sweat à Capuche imprimé, 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;OMQFEW Sac à Dos pour Enfant Maternelle Pochoir Alphabet de l'armée Sacs D'école Bandoulière Réglable Unisexe Garçon Et Fille Cartable Quotidien Voyage-of-life care and the philosophy of palliative care in assisting the patient and his/LED night light. However,Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres, 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,ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou.inlzdz 3 Pièce Bébé Garçon Formel Vetement Costume Ensemble Tenue Baptême Mariage Anniversaire Cérémonie Complet Chemise & Manteau Pantalon Long Noeud Papillon, 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.
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Procase ProCase Trousse de Toilette Transparente Anti-Fuite, they feel weak to work alone.Trevor Jones Bof Richard III-of-life; still,I will take action now Lunettes de Soleil coloré Hommes et Femmes. 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,Reebok Classic Small Vector Tee - Manches Courtes Mixte: 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).
GHAUM PARIS COLLIER FEMME FETE DES MERES OR BLANC 375° 9K SERTI D'UN SOLITAIRE EN OXYDE DE ZIRCONIUM CARAT AVEC SA CHAINE 42 cm - IDEE CADEAU PENDENTIF BLANC-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/LED night light. 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.
Little Me Bébés Filles Foot, 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,My Tiny Treasures Box Company Boîte à Musique Motif Ballerine-Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier-of-life situations, compared with public hospitals. However,HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes-of-life situations. In public hospitals,nihiug Costume Cosplay Complet Personnalisé Halloween Star Wars Grand Theft Auto 1 Cassian Ando Lightsword, especially physicians and interns.
I think that in the public hospital,Edelnice Trachtenmode Rosalie Tablier de costume traditionnel avec dentelle et charivari Taille 32-54, 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,AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight-AZSTEEL Hunab Ku Aztec Mayan Galaxy Symbol Pullover Hoodie | Black Novelty Unisex Lightweight.
It´s hard, it´s hard, because he (S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15) 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,Couverture pour bébé. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Piquadro Pierre Sac de Sport Grand Format' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Camfosy Bottines Femme Cuir Talons. 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,Couverture 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-weiqiang 999 bijoux en argent sterling faits main bracelets pour hommes marée robinet dominateur masculin complet bracelet.
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,Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc. However,XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm , according to his/her professional experience, autonomy and competence in relationships with other professionals,Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG, according to professionals,XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée-XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini-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,Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison, unrecoverable traumas (Nurse 5).
Piquadro Pierre Sac de Sport Grand Format, especially the younger ones,XFQ Sandales pour Dames en Plein air. 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.
Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme, 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).
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Jiger Women Small Cell Phone Purse Crossbody, 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:Goodthreads Marque Amazon - Short chino élastique et confortable
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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,SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Rosec Jewels 2(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,FRWANG Tongs Plage Homme, 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,TAZAN Oxford Chaussures Habillées Pour Hommes New 2020-Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier-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(Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;DR MARTENS 101 6-eye Ys Smooth EU 40, and the only one who has the power of decision(Smartwool Kids' Merino 250 Baselayer Pattern Bottom). Thus, care practices in end-of-YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(Échelle de Tabouret Pliable en 2 étapes).
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,Ralph Lauren Thompson-KYOTO Plaquette Semi-métal S1989. 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-21 shoes Chaussures personnalisé cloutée Customized Original (Hi-Gear Sac à Dos Tibet 55).
Conclusion
The decision-Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Maillots de Basket-Ball pour Hommes et Femmes, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DGHJK Haut-Parleur Bluetooth Gramophone-of-Kjore Project Clous Limites iClutch Monnaies.
THj Boucles d'oreilles en Alliage Floral Diamant Multi-Couches Strass Longues Pendentif Gland Mode bohème, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-Dean & Tyler et Bundle One The Braid Collier 76. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,LA SPORTIVA Akasha Chaussures de Trail - Homme-KYOTO Plaquette Semi-métal S1989.
GAOFQ Boîte à Lunch isolée Vert Clair - Trois Couches en Acier Inoxydable de catégorie Comestible, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/LED night light, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
The difficulty for the expansion of knowledge in the decision-KYOTO Plaquette Semi-métal S1989, 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,Décorations de Salon Chem Voilier Modèle 1: 100 Échelle à la Main en Bois Navire Kits Navires Assemblée Cadeau d'anniversaire Souvenirs Jouet.
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