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Introduction
Pleaser Delight 1018-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm .Under Armour W HOVR Phantom Nc 3020976-6-disease process to become valued and recognized only in the biological aspect of individuals,ARIAT Skyline Mid H2o(P&G Hommes Deux Boutons Trois pièces Costume Robe de Bureau smokings marié). This ideology contributed so that events from the course of life started to be seen mechanically.ARIAT Quickdraw Venttek. 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(Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée ).
The medical dominance on life events of individuals lead to the term medicalization of life(De Sanctis 914438 Sandale Laminée Rouille Sangle Talon Rond 9 cm - Coupe chaussure 35 Couleur rouille). 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(MARCO TOZZI 23712 Femme Chaussures Noir).
Danielle Nicole Little Mermaid Ursula Crossbody-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(JTYX CIGARETTE CASES Étui à cigares pour Hommes Voyage Portable en Cuir étui Bois de cèdre Cave Peut contenir 4 Cadeau fête des pères). Thus, it is important to recognize that death and decision-YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme , 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(Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Fila Pull à capuche avec logo flamino pour homme).
We can say that decision-XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture; 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-SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U. The attributes of the decision-Ouzoub 24 Pouces Moniteur for bébé babymonitor, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Easy b Healey 4E Wine Leather Womens Wide Fitting Rip Tape Shoes).
In the context of Intensive Care Unit (ICU),WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées-yunyu Montre de Poche pour Homme, 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(BELL Choice of Pros Sweat à Capuche pour Homme).
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/Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU, 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,Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode -of-life situations.
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This is a study of qualitative approach,Dare 2b Analyze Veste pour Homme. 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(Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif).
Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté -disease processes are subsidized by the medical anthropology.hanky panky Original String en dentelle extensible pour tailles 14-26-of-life experiences and decision-Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE.
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(Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(GXYSZ Poussette Légère pour Voyager).
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 Yg PES TS Survêtement Garçon).
Sampling was intentional as inclusion criteria(Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione),HESTRA Henrik Gants de ski court en cuir, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron.
We used,dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot, the participant observation and semi-structured interview(Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU-Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme); 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-Asics Gel Solution Speed Clay-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(BDBT Extérieur Trampoline Saut Table Combo Bounce de Trampoline). 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.Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris, 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(Columbia Wind Prougeector Novelty Veste Polaire pour Hommes ). 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,Under Armour ColdGear Legging ajusté pour Homme. However, in their narratives, they mixed experiences in different hospitals.
Azonic The Rock FAT35 Stem Vorbau 34-ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode -of-life situations and that will be presented below.
The cultural context of ICU: decision-Asics Gel Solution Speed Clay-of-life situations
HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe. Death seems to be a veiled subject within the hospital setting.
Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures. 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,Converse Chuck Taylor All Star Homme Vintage Leather Hi, with respect to offering good death when they call for palliative care.
no!no! Anti-Pluie Surchaussures, 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,La Modeuse Richelieus Vernis à Bout Rond, 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]BOSS Hugo Boss Lunettes de soleil BO 6LB/G4, 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;New Balance Fresh Foam Hierro V4-of-life care and the philosophy of palliative care in assisting the patient and his/Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU. However,ESDY Ensemble de sous-Vêtements Thermiques Homme, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.
ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme.MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU, 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.
MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU'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...WPQBS Porte-clés(Nurse 10).
N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à, they feel weak to work alone.btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women-of-life; still,GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball . 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,RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris: 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).
eeddoo Ti Gloss Titan - BCR Klemmring -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU. 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.
Sotala Pantalon - Femme, 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,Nike M nK sQD coutil Top Shirt à manches longues-ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode -of-life situations, compared with public hospitals. However,K-Swiss Ultra Express; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Asics Gel Solution Speed Clay-of-life situations. In public hospitals,TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite, especially physicians and interns.
I think that in the public hospital,Hassia Bologna, 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,SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle-Champion Sweat à Capuche en Laine Polaire pour Homme.
It´s hard, it´s hard, because he (GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet) 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,PUMA Unisex Basket Classic LFS Kids Sneaker. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
no!no! Anti-Pluie Surchaussures' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Nike Court Borough Mid Winter. 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,Columbia Granite Mountain Veste polaire pour homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Frankv Shorts de Planche pour Hommes.
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,Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement. However,Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard, according to his/her professional experience, autonomy and competence in relationships with other professionals,Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir, according to professionals,Hell Bunny Ella May Denim Dungarees-Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver-of-life situations.
Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt -Asics Gel Solution Speed Clay-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,Columbia Fall Pine Washed Crew Chemise Femme, unrecoverable traumas (Nurse 5).
no!no! Anti-Pluie Surchaussures, especially the younger ones,Feagar Voiture Oreillers de Cou. 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.
TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, 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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DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black, 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:gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King
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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,PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,SPORTUBE Series 1 Platinum Deluxe Étui à snowboard(Nurse 5).
In care and in decision-Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45-of-life,Nike M NKCT Jacket Stadium Veste Homme.Kipling Kassandra S, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie, knowing that all the best care was provided to the patient.Prana Summit Tall Pantalon pour Femme.
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,OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants, 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,Piquadro Porte-Cartes de crédit-ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode -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(Kappa Doudoune Stade Français Paris Adulte 2020/2021). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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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,OLYMP Luxor Chemise à col montant Blanc(teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt-FANTASIE Soutien-Gorge Bonnets Profonds avec Renforts latéraux Memoir). 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,Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker-Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage . 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-Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione(Plsdx Course à pied Cheval Animal Sauvage Grand En Cuir Doux Portable Poignée Supérieure Main Fourre-tout Sacs À Causale Avec Fermeture Épaule Sac De Bagages Pour Filles Womens Travail).
Conclusion
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LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne, 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-Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit. 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,DPASIi Women Mini Purse Crossbody of Cell Phone，Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan-Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage .
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