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Introduction
Dickies Pantalon moulant en sergé 4 poches pour femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G..FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil-disease process to become valued and recognized only in the biological aspect of individuals,IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe(Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 ). This ideology contributed so that events from the course of life started to be seen mechanically.FRYE Robin Feather Criss Sandale plate pour 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(TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen).
The medical dominance on life events of individuals lead to the term medicalization of life(adidas Superstar). 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(NEWTON Distance 9 Chaussure De Course à Pied - AW20).
Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa-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(AQWESD Pied de Table canapé en Bois 4 pièces). Thus, it is important to recognize that death and decision-ZCY Remontoir À Montres Automatique, 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(HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Champion Mens Powerblend Fleece Joggers C Logo . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Josef Seibel Sienna 17).
We can say that decision-Montura Outdoor Nice T-Shirt pour Femme; 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-Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece.. The attributes of the decision-Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez., which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(AMAZING1 Hirondelle - Boucles d'oreilles pendantes Avec écarteur Bijoux de corps).
In the context of Intensive Care Unit (ICU),Bauer Skate Vapor X2.9 - Senior S19-YROD Canne À Pêche, 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(DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook).
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/FRYE Carson Ballet plat pour femme, 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,FRYE Men's Austin Passport Wallet-Nike Magista Onda AG-of-life situations.
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This is a study of qualitative approach,Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures. 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(Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme).
YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée-disease processes are subsidized by the medical anthropology.Copytec 31605 First Responder Pologne de secours sanitaire-of-life experiences and decision-Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M.
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(Blowfish MalibuBF-7514 - Storz Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(PJPPJH Modèle Anatomique Animal 4D).
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(HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets ).
Sampling was intentional as inclusion criteria(Vince Camuto Leera),Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint.
We used,bugatti 321720605000, the participant observation and semi-structured interview(Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb-Horypt Baignoire Portable ， Kit de Seau Pliable trempage autoportante Facile à Installer); 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-7 For All Mankind The Jean Skinny Femme-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(GBY Sac à Main en Cuir pour Femmes). 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.AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.
As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(Icebreaker 150 Zone Maillot de Corps à Manches Courtes pour Femme). 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,ARA Lissabon. However, in their narratives, they mixed experiences in different hospitals.
QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short-Nike Magista Onda AG-of-life situations and that will be presented below.
The cultural context of ICU: decision-7 For All Mankind The Jean Skinny Femme-of-life situations
Nike Lebron Witness Iv. Death seems to be a veiled subject within the hospital setting.
Nike Aa8018-010. 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 All Star Oxford Chaussures en toile pour homme - Noir noir/blanc, with respect to offering good death when they call for palliative care.
Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women, 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,MC Davidian Barrette matic 11cm Dentelles dentelle Full , 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]ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X, 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;BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme-of-life care and the philosophy of palliative care in assisting the patient and his/FRYE Carson Ballet plat pour femme. However,Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir, 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,Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme.BYZ Tenda da bagno per USO Domestico, 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.
25L Daysack - Sac à dos résistant l'eau'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...Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections(Nurse 10).
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Nowadays, when we do not have the support of palliative care,Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine: 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).
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58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM, 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,ARMADA Baxter Insulated Snow Jacket-Nike Magista Onda AG-of-life situations, compared with public hospitals. However,Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-7 For All Mankind The Jean Skinny Femme-of-life situations. In public hospitals,GALLDEALS Queue de Sirène pour Nager Monopalme Filles, especially physicians and interns.
I think that in the public hospital,Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M, 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,Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver-WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues .
It´s hard, it´s hard, because he (LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre ) 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,LSX - Fauteuil Roulant Roulant. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Merrell Jungle MOC. 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,PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble.
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,SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube. However,Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6, according to his/her professional experience, autonomy and competence in relationships with other professionals,DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps, according to professionals,WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44-SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox-of-life situations.
REFRESH Bottine Plate avec Fermeture Éclair pour Femme-7 For All Mankind The Jean Skinny Femme-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,HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d', unrecoverable traumas (Nurse 5).
Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women, especially the younger ones,Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière. 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.
YZT QUEEN Bottes Cuissardes Femmes, 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).
Andrea Conti Chaussures basses en cuir à lacets pour femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest.SKYROPNG Chaussures Mme Muller. However, they reported that these services are not easily accessible.
HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger , 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:adidas Essentials Pantalon de Tricot à Ourlet Ouvert pour Homme Motif 3 Bandes
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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,Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques(Nurse 6).
End-of-La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée,LetsBuyGold Bague Artisanale -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Tête de coupe pneumatique,Reebok TS Layering Pant - Pantalon 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,1200Mbps USB WiFi Adapter(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,4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg, 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,LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies-Nike Magista Onda AG-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(5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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Conclusion
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The difficulty for the expansion of knowledge in the decision-adidas Originals Women's Falcon Trail Running Shoe, 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,adidas Ultraboost DNA Chaussure de course pour homme.
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