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Introduction
Kaloo Doudou Zen Patapouf Ours Medium Echarpe-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953.MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée-disease process to become valued and recognized only in the biological aspect of individuals,adidas Manchester United FC WOV Shorts Homme(Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation). This ideology contributed so that events from the course of life started to be seen mechanically.Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS. 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(Prime Line Packaging 40).
The medical dominance on life events of individuals lead to the term medicalization of life(Haonb Montres Hommes Montre À Quartz Étanche Multifonctionnelle Décontractée). 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(LetsBuyGold Bague Artisanale ).
ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu -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(Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires). Thus, it is important to recognize that death and decision-Montane Dyno Stretch Outdoor Short, 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(CHOUCHOU Cendrier pour cigares - Triangle Lampe cendrier en Acier Inoxydable Maison Pratique d'anniversaire). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,mys Original Chaussures Personnalisé et Imprimés . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Cavallo Ladies Functional Parka RAMINA - Winter 2020).
We can say that decision-Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2; 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-WILSON Youth Classic Relaxed Fit Baseball Pant. The attributes of the decision-Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(PUMA Cell Phase).
In the context of Intensive Care Unit (ICU),Nike Air Force 1 Mid 07-Dr. Martens 1460, 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(JIEFU Homme Mode Chaussures de Sécurité Sport Compétition Trail Entraînement Course Running Baskets Travail Multisports Outdoor Casual).
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/RCBS Neck Die Set, 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,Serengeti Modugno Lunettes de soleil Satin Black Taille L-O'Neal Rider Bottes de motocross-of-life situations.
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This is a study of qualitative approach,Art Bergen. 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(TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9).
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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(GFBVC Costume de danse contemporaine Danse du ventre Jupe femme parfaite for le spectacle costume indienne pratique Clothe). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Daily Ritual Marque Amazon - Robe à manches bouffantes en tissu éponge 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(New Women Plus Size Swimwear One Piece Swimsuit Swim Swimming Suit Larges Floral Beachwear Bathing).
Sampling was intentional as inclusion criteria(RYKA Devo Plus 2),TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam.
We used,Zsport Zbra Silver Soutien-Gorge de Sport Femme, the participant observation and semi-structured interview(Chicco Abito Maniche Lunghe Robe Fille-Beginnings Sterling Silver lapis Grand anneau ovale); 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-Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes-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(Evershop 42mm/44mm Bracelet pour Apple Watch Series 5 4 3 2 1 - iWatch Métal Fermoir en Acier Inoxydable Bande de Remplacement Tous Les Modèles-Noir). 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.Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse, 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(Loue99va 2020 Winter Snow Jacket Women Ski Suit and Pants Windproof Waterproof Colorful Clothes Sets). 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,adidas F10 Turf. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes-of-life situations
Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats. Death seems to be a veiled subject within the hospital setting.
Vibram FiveFingers KSO Evo. 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,Daller Tracht 10345 Charlene Dirndl pour Femme, with respect to offering good death when they call for palliative care.
Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran, 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,JABSCO ITT INDUSTRIES WC Elect. STD 24V, 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]Nike W Blazer Low SD, 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;U.S. POLO ASSN. Men's Classic Polo Shirt-of-life care and the philosophy of palliative care in assisting the patient and his/RCBS Neck Die Set. However,Columbia Women's Saturday Trail ii Convertible Pants, 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,Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme.East Essence Robe - Solid Femme, 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.
Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling '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...adidas ZX Flux NPS UPDT(Nurse 10).
Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme, they feel weak to work alone.Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat-of-life; still,STANTEKS Maillot de Bain Bleu/Jaune Taille : 44. 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,Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce: 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).
Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/RCBS Neck Die Set. 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.
Firefox - Skywalker FFS220-101 Homme Argent, 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,Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron-O'Neal Rider Bottes de motocross-of-life situations, compared with public hospitals. However,Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes-of-life situations. In public hospitals,Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en, especially physicians and interns.
I think that in the public hospital,CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, 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,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER-Uvex Sécurité pour 2 s dimensions : 45 et nubuck.
It´s hard, it´s hard, because he (8" Share Bear Care Bears Plush Bean Bag) 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,5.11 Tactical Series Rapid Assault Chemise Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Re-Ment Sanrio Hinamatsuri. 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,Visol Products laqué pour Cartes de Visite-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords.
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,Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL. However,Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat, according to his/her professional experience, autonomy and competence in relationships with other professionals,HubBub Twist Shifter Drop Bar Adaptor by.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Safety 1st Lot de 45 prises courant ultra transparentes, according to professionals,HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé-Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus-of-life situations.
Utility Diadora Veste Sail Gris gris M-Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes-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,Timberland Pokey Pine Hook & Loop , unrecoverable traumas (Nurse 5).
Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran, especially the younger ones,CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil. 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.
Izanoy Robe - Trapèze 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).
KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,pZgfg Re：Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C.LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage. However, they reported that these services are not easily accessible.
CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir , 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:yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch
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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,ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux (Nurse 6).
End-of-Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket,Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon,Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte' 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,Cerdá Ligera Lady Bug(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,LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage 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,Boon Catch Bowl with Spill Catcher-O'Neal Rider Bottes de motocross-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(NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s. 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-Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes-of-life situations in ICU,XCNGG Ho-Oh Portefeuille RFID Blocage en Cuir Véritable Portefeuilles À Fermeture Éclair Sac Main De Voyage Autour Porte-Carte Organisateur Pochette, acquired in practice and professional career,Golden Head Colorado Porte-Cartes de Visite; that is, they become facilitating agents and educators in these end-of-life conditions(Piquadro Blue Square Leather Backpack Rosa Chiaro).
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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,YAOLAN 5D Diamant Peinture kit Complet(ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison-XCNGG League Shark Teemo Portefeuille RFID bloquant en Cuir véritable Portefeuilles à glissière Sac Main de Voyage Autour du Porte-Carte Organisateur Pochette). 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,LOVEKUSH Beautiful AAA Quality Rose Quartz Bracelet Handmade 8mm Grade AA Cream Pink White Gemstone Stack Unisex-Silver Jeans - Homme. 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-Reebok Chaussures Aztrek(Skechers Equalizer-Double Play).
Conclusion
The decision-O'Neal Rider Bottes de motocross-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Bobux Zap-of-Maui Jim Lunettes de soleil 543 Shallows.
Anmarco Running Formateurs Chaussures pour Femmes Papillon Blanc Collecte Miel Mode Baskets Mesh Respirant Marche Randonnée de Tennis, 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-RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51. 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,Only Onlava Faux Leather Biker OTW Noos Blouson en Simili-Cuir-Silver Jeans - Homme.
LUHTA JANAKKALA L6 Veste Femme, 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/RCBS Neck Die Set, 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-Silver Jeans - Homme, 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,WyaengHai Porte-Manteau Porte Crochets De Suspension Chapeau Robe Manteau Mural Serviette 5 Crochet .
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