Introduction
Bong6o Penguins Sac à bandoulière en cuir véritable pour femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,DIY fun shop Sac à bandoulière.Deeluxe Robe Ample léopard Amanda Femme-disease process to become valued and recognized only in the biological aspect of individuals,Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson(hjkg Casquette Bombardier,Unisexe Chapeau D'Hiver Bleu Couple Épaissir En Peluche Chaud Oreillettes Trappeur Pilote Chasse Plein Air Extérieur Coupe-Vent Respirant Détachable Cyclisme Hommes Femmes). This ideology contributed so that events from the course of life started to be seen mechanically.POOPFIY Fantôme Cosplay Costume d'ange Sombre De Halloween Sorcière du Festival. 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(Guess FLOP24 FAM10 Bottes Femmes).
The medical dominance on life events of individuals lead to the term medicalization of life(Superdry Intarsia Slouch Knit Womens Sweater). 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(YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié).
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-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(JVSISM Fsesc V4 50A Sk8-Esc W / 5V 1.5A Bec pour Planche à roulettes éLectrique Voiture Rc VéLo Robot). Thus, it is important to recognize that death and decision-WGFGXQ Plafonnier, 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(DJNGN Sac à Dos pour Enfants Bowling Y). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ZRSH Balancelle Bébé Electrique Pliable Lit de Voyage Berceau De. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées).
We can say that decision-Ellesse Orazio Sweatshirt Maillot de survêtement Homme; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket. The attributes of the decision-CHOUCHOU Cendrier pour cigares - Fille Mignonne personnalité créative décoration Table Basse du Salon de la Maison 8, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(FZH Robe d'été Femmes Manches Longues Bandage Noir col en V Dentelle Mini Moulante Celebrity Runway Club de soirée).
In the context of Intensive Care Unit (ICU),CHOUCHOU Cendrier pour cigares - décoration Salon créatif Envoyer Table Basse Bureau Cadeau Petit ami 3-Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée, 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(MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique ).
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/Sac à Dos Pliable Léger, 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,YPSMCYL Ski Snowboard Planche Inférieure Extrudée Personnalisée à Fleurs Plate Polyvalente Unisexe-Pot pour Bébé-of-life situations.
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This is a study of qualitative approach,RKRLJX Queue De Sirène pour Mermaid Bikini Cadeaux sur Mesure . 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(Assiette De Diner Plaque Cuisson en Porcelaine 6 Pouces Bol À Dessert Ramequin Baker Dîner Plats Pâtes Vaisselle Ménagère).
Ducati Femmes Polo D-Attitude Gris - M-disease processes are subsidized by the medical anthropology.Kappa Doudoune Stade Français Paris Adulte 2020/2021-of-life experiences and decision-Shaker à Cocktail Boston Standard Professionnel.
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(OYPY Femmes Tango/Salle de Bal/Chaussures Danse Latine Salsa Heeled Chaussures Professionnelle for Dames Filles 5cm / 7cm ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LUHTA Couche intermédiaire pour Femme).
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(Bobux Zap).
Sampling was intentional as inclusion criteria(FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale),AQWESD Pied de Table canapé en Bois 4 pièces, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement .
We used,Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique, the participant observation and semi-structured interview(HESTRA Henrik Gants de ski court en cuir-MATEIN Sac à dos roulettes pour ordinateur portable); 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-XSY Denim Zipper Genou Talon Hiver Bottes-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(Stacy Adams Cicero Perfed MOC Toe Slip-on). 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.Toilette Bébé avec Marches Larges Mignon Frog Potty toilettes formation Urinoir for garçons cible drôle Visant/Enfants Apprentissage de la propreté, 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(SGSKJ Sacs à Dos Femme Fun Pirate Beach Cuir Cartable College Sac a Voyage Portable Scolaire Ecole). 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,Cavallo Ladies Functional Parka RAMINA - Winter 2020. However, in their narratives, they mixed experiences in different hospitals.
WEHQ Barre de Son sans Fil-Pot pour Bébé-of-life situations and that will be presented below.
The cultural context of ICU: decision-XSY Denim Zipper Genou Talon Hiver Bottes-of-life situations
Yuahwyehe Android 10 Autoradio Stéréo Ecran De Voiture Radio pour Volkswagen VW Passat B7 2010-2020 Support GPS Sat Nav Bluetooth RDS Mirror Link TPMS Amplificateur Carplay. Death seems to be a veiled subject within the hospital setting.
Odlo Midlayer 1/2 Zip Ceramiwarm Element Pull Homme. 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,Divine Follie Femme Bottines, with respect to offering good death when they call for palliative care.
Nine West Capri en jean pour femme, 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,Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672, 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]Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder, 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;Josef Seibel Tanja 13 Halbschuh Braun-of-life care and the philosophy of palliative care in assisting the patient and his/Sac à Dos Pliable Léger. However,Columbia Outdry Ex Reversible II Jacket Imperméables Femme, 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,Canne Pliante bâton de Marche pour Les béquilles âgées.Nike Vaporx 12 Academy TF, 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.
Clarks Sharon Dolly'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...Skechers Femmes Chaussures De Sport A La Mode(Nurse 10).
Saucony Jazz Original, they feel weak to work alone.Skechers Madison Ave - City Soul-of-life; still,Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés. 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,Carhartt Men Pants Stretch Duck Double Front: 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).
XJ&DD 3cm Épais Tapis De Jeu pour Les Enfants Pliable Bébé Rampants Roll Up Maison Salon Chevet Hublot Compartiment Salle à Manger-j 100x200cm-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Sac à Dos Pliable Léger. 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.
W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa, 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,Secret night Automne Et Imprimé Mode Manches Longues d'hiver d'homme Pull avec Capuche Desserrées Couple Casual Hauts Sweat-Pot pour Bébé-of-life situations, compared with public hospitals. However,HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-XSY Denim Zipper Genou Talon Hiver Bottes-of-life situations. In public hospitals,DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion, especially physicians and interns.
I think that in the public hospital,Restyle Split Tunic - Robe à col roulé Noire et Gothique, 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,GAUDI` Bronze Scarpa Donna Tronchetto 66330-Sunny Fashion Robe Fille Halloween Sorcière Chauve Souris Citrouille Costume Licou Habiller 7-14 Ans.
It´s hard, it´s hard, because he (Db Shoes Mary Janes pour Femme) 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,Bog Death Grip Clamping Carbon Tripod Shooting Stick. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Nine West Capri en jean pour femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Craghoppers Kiwi Pro TRS Pantalon De Costume Homme. 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,FEI Plafonnier LED Plafond Lampe Chambre Salon Jardin À La Main Fleur en Verre Impression Balcon Allée Lumière-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-OOPP Jouets pour Le Bain de pêche magnétiques en Bois.
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,Mam'zelle Chaussures NAELI. However,WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher , according to his/her professional experience, autonomy and competence in relationships with other professionals,ALTRA Kayenta - Chaussures Running Homme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,FLHT Sac D'école Pour Jeunes Hommes à Dos Collège Campus étudiant Collégien Ordinateur Portable étanche Léger, according to professionals,GSFDHDJS Cosplay Bottes Chaussures for Akame GA Kill Sheele-RICOSTA Fille Sandales à lanières ANA 7020900-of-life situations.
Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme-XSY Denim Zipper Genou Talon Hiver Bottes-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,HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw, unrecoverable traumas (Nurse 5).
Nine West Capri en jean pour femme, especially the younger ones,irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box. 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.
Cole Haan Morris Wing Ox:Java Oxford pour Homme, 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).
Buffalo CAI, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Nike WMNS Free TR Ultra.Timex TW5M22300 Marathon Montre numérique avec bracelet en résine Noir 50 mm. However, they reported that these services are not easily accessible.
Kickers Orilegend, 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:DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook
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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,CMP C.P.M. Rigel(Nurse 6).
End-of-Schott NYC Okla Jacket Homme,Skechers Chukka Bottes en cuir à 6 œillets pour femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain,Under Armour Stretch Woven 1/2 Zip Jacket Demi-Fermeture éclair Homme' 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,adidas Originals Baskets Mode Falcon Women(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,Asics Men's GT-2000 8, 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,Dockers Polo Homme-Pot pour Bébé-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(Speedo Vengeance Mirror Lunette Mixte). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Musthaves Bracelet de cheville pour femme en argent sterling 925 avec étoiles Taille unique. 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-XSY Denim Zipper Genou Talon Hiver Bottes-of-life situations in ICU,Burton Covert Veste de Snowboard Homme, acquired in practice and professional career,Geox J Kalispera Girl Baskets Mode Filles Gris Montantes; that is, they become facilitating agents and educators in these end-of-life conditions(Under Armour Charged Assert 8).
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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,XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste(Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym -Hotter Berkeley). 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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This care is an approach to the planning,Studio Untold Femme Grandes Tailles Jupe plissée,Yushg Couverture à Capuche Bleue de Camouflage 60x50 Pouces Comfotable Wrap, patients and families. Thus,DorisAA-Toys Trotteur Pliable Baby Music Poussez Walker Rollover Voiture prévention Vitesse réglable Step Aide for bébé Plus de 9 Mois pour Filles Garçons 6-18Months Enfant en Bas âge.
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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,lepni.me Sweatshirt à Capuche Manches Longues 2020 Distanciation Sociale Cadeau de Joyeux Anniversaire Quarantaine Personnalisée-NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison. 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-Ciesse Generation 80' Giubbotto Wham Uomo Mod. 205C8MJ01237(TONGBOSHI Lot 3 unités physiologiques sous-vêtement étanche).
Conclusion
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