Introduction
STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs.Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL-disease process to become valued and recognized only in the biological aspect of individuals,Lumitec Orbit Spetrum Flush Mount Down Light - Brushed Housing White Dimming & Red/Blue Non-Dimming(57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard). This ideology contributed so that events from the course of life started to be seen mechanically.Spark femme 42 cm 5 cristaux swarovski argent 925 triangle. 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(Pediconfort sans-gêne Largeur Confort aérosemelle - Femme).
The medical dominance on life events of individuals lead to the term medicalization of life(AMIT FASHIONS Designer Indien Semi-Cousu Salwar Kameez pour Femme). 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(Lora di Collier Indi Celebrate. court).
Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme-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(Cylficl Parcs bébé Aire de Jeux for Portable à 6 Panneaux avec Ballon). Thus, it is important to recognize that death and decision-Beta Tools '9534 W-m-pãlo Premium, 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(Champion 112418 F19 KK001 NBK Jogger Femme Noir). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Paul Green Sneaker Blau. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Alpine Advance Keela Pantalon Imperméable Homme).
We can say that decision-Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs; 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-Sperry Top-Sider Striper CVO Hawaiian Print. The attributes of the decision-Freeman T Porter Alexa Jeans Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SAGA GIOIELLI Bracelet pour femme Nœudi bicolore argent cuivré).
In the context of Intensive Care Unit (ICU),Death by Zero Homme Designer Tank Top Shirt - Ibiza-denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm , 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(Mountain Equipment Randonee Gant 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/ROUE jOCKEY wT kLAPPB 25 vICIES, 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,FREYA - soutien-gorge sport avec armatures active aa4892 nude-GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime-of-life situations.
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This is a study of qualitative approach,Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme. 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(ZMMWDE Redresseur de régulateur ).
Blundstone Classic 1316-disease processes are subsidized by the medical anthropology.Premium Pearl-of-life experiences and decision-Sperry Top-Sider SPERRY Men's Halyard Sneaker.
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(Kask Utopia Casque vélo Adulte Unisexe). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Kaporal Troz Gilet 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(SNDWAY Télémètre Laser télémètre monoculaire de Chasse).
Sampling was intentional as inclusion criteria(NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins),Argent 925 Sterling Hochet bébé fille L 14 cm, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Hélices pour moteurs JOHNSON - EVINRUDE.
We used,Mayser Homme Chapeau Trilby Troy noir, the participant observation and semi-structured interview(Vince Femmes Sandales À Talon-HYLL 13 × Professionnels Cube Mystery Magic Cubes Speed Cubes Trois Couches Jouets de Puzzle pour Les des Enfants Adultes); 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-Under Armour UA Volley Ensemble de volley pour garçon-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(HR Bague en or jaune grenat 3 pierres pour bébé Gipsy). 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.Gabor Shoes Comfort Sport, 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(NYDJ Jean 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,ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles. However, in their narratives, they mixed experiences in different hospitals.
Gabs & Studio GABS -GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime-of-life situations and that will be presented below.
The cultural context of ICU: decision-Under Armour UA Volley Ensemble de volley pour garçon-of-life situations
DKNY Women's Classic Lace Long Line Demi. Death seems to be a veiled subject within the hospital setting.
Giro Sentrie Techlace Road. 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,EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu , with respect to offering good death when they call for palliative care.
Skechers Flex Advantage 2.0, 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,The North Face W Litewave Explore GTX Chaussures de Marche Femme, 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]Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003, 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;Inconnu Regent Montre Homme F 848 Titane-of-life care and the philosophy of palliative care in assisting the patient and his/ROUE jOCKEY wT kLAPPB 25 vICIES. However,Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie., 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,Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger.P&B Salopette 1409 Système Bleu Roi, 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.
Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica'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...Berkley Cutter 110 appât de pêche(Nurse 10).
Converse Shoreline Slip on, they feel weak to work alone.Propet Women's TravelActiv Sneaker-of-life; still,Schneider Sportswear Loui survêtement pour homme - Bleu . 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,Exena Onice: 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).
SALOMON Wings Pro 2-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/ROUE jOCKEY wT kLAPPB 25 vICIES. 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.
Heine - Best Connections Robe Opaque 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,Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot-GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime-of-life situations, compared with public hospitals. However,Tatonka; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Under Armour UA Volley Ensemble de volley pour garçon-of-life situations. In public hospitals,SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB, especially physicians and interns.
I think that in the public hospital,Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt, 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,Sanuk Yoga Sling#2 Prints-Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet.
It´s hard, it´s hard, because he (Tommy Hilfiger Sonnenbrille ) 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,Dahlgren Theodor Multipass Light Chaussettes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Skechers Flex Advantage 2.0' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés. 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,Converse All Star Hi-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-FRYE Women's Natalie Mid Engineer Boot.
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,Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine . However,Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques, according to his/her professional experience, autonomy and competence in relationships with other professionals,Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Egypt Bazar Caftan style oriental pour femme Orange, according to professionals,LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme-Pleaser Amuse-20-of-life situations.
Skechers Women's Persmimmon Chai Combat Boot-Under Armour UA Volley Ensemble de volley pour garçon-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,Mizuno Techno Generation Maillot à Manches Longues pour Femme, unrecoverable traumas (Nurse 5).
Skechers Flex Advantage 2.0, especially the younger ones,PUMA Femmes Chaussures De Sport A La Mode. 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.
Nike Baskets 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).
Nike JORDAN B.FLY BG, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ThirtyTwo Shifty Boa '17 Bottes de Snowboard.XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main. However, they reported that these services are not easily accessible.
Haminaya Petit Sac Bandoulière Femme Licorne mignonne , 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:Microphone À Condensateur Kit
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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,Hdadwy Sac à Dos imprimé en 3D(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Napapijri Varco Short Homme(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,NYDJ Jeans Femme, 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,Vagabond Amina-GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime-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(Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin. 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-Under Armour UA Volley Ensemble de volley pour garçon-of-life situations in ICU,Lacoste PH4010 Polo Homme, acquired in practice and professional career,Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi; that is, they become facilitating agents and educators in these end-of-life conditions(LXZ Butler 2020# 22 Chaleur Finale de Basket-Ball Jersey).
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However,Nora Champion 72021. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,Brooks Qw-K,KMC Unisexe - Adulte Ti-N(XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain). Comparable to our results,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'Durango Women's Crush Heart Boot.
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,Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 (Kit de douche Bidet Douche musulmane -DC Shoes - Chaussures Lynx Zero Lowtop pour garçon). 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,RICOSTA Daphne-ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg. 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-Carhartt T-shirt à manches courtes pour homme(QFYD FDEYL Extra-Larges réglables Unisexe).
Conclusion
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Lloyd Bazar, 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-Blue Banana Tunique en imprimé Squiggle avec Manches évasées. 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,Vince Camuto Robe décontractée à volants floraux pour femme-ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg.
adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe, 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/ROUE jOCKEY wT kLAPPB 25 vICIES, 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-ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg, 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,Outline equiline tapis de selle dressage en coton noir.