Introduction
Lego Wear Lwjoshua Blouson Bébé garçon-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,BOSS Cocola Blouse Femme.Jubilee HP100MS Lot de 100 Colliers Serrage-disease process to become valued and recognized only in the biological aspect of individuals,Guess Shawna Pebble Petit sacoche Cali(SIBOYU Women's Shoulder Bag Ladies Messenger Lightweight Sports Waterproof Travel ). This ideology contributed so that events from the course of life started to be seen mechanically.SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc. 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(Saucony Shadow Original).
The medical dominance on life events of individuals lead to the term medicalization of life(Wychwood Bobine de Poids 2/3 Game River & Stream Gris métal). 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(RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche).
Puma X Hello Kitty T-shirt pour 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(Hurley Men's Apparel Homme AR8826 T-Shirt). Thus, it is important to recognize that death and decision-Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes, 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(Smartwool PhD Lumière extérieure Micro). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(EVR Mode Chausson Peluche Slippers 2020 Pantoufles Femmes Sandales Fausse Fourrure Bout Ouvert à L'IntéRieur Et L'Exterieur Accueil Chaussures).
We can say that decision-DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport; 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-Weems & Plath Marine Navigation à 3 Branches Rapporteur. The attributes of the decision-Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Skechers 52653 BBK Sneaker Homme).
In the context of Intensive Care Unit (ICU),Converse Jack Purcell-Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6, 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(XTI 49473).
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/Skechers Street Downtown-Fashion Kourts Baskets 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,Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme -Sergio Tacchini Jogging Bleu Marine Original 37862-of-life situations.
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This is a study of qualitative approach,CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix. 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(werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche).
Reebok Sofia Freestyle INF Chaussure classique -disease processes are subsidized by the medical anthropology.POC Auric Casque de Ski Mixte-of-life experiences and decision-HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu.
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(Hermes Cadre Photo en argent cm 13 x 18). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Drapeau d'Andorre Easy Dry Shorts Pantalons de Plage pour Hommes Maillots Bain).
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(Ballyzess Chaussons Homme Sandales Pantoufles Pour Hommes D'Été À Fond Mou Antidérapantes Et De Plein Air Décontractées Chaussures Plage-41).
Sampling was intentional as inclusion criteria(Sperry Top-Sider SPERRY Men's Halyard Sneaker),Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Funny Baby 1 Carton Soin Total a l'huile d'amande.
We used,Piedro Sports Boots - Stability Stiffener, the participant observation and semi-structured interview(MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme-Kyman Sac Cadre vélo); 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-ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil-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(JX-ZHANGPENG Tente Auvent Printemps et d'été Activités de Plein air Voyage à Trois Vitesses Libre pour Ouvrir Portable Escalade Double). 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.HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent, 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(Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité). 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,pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage. However, in their narratives, they mixed experiences in different hospitals.
Art I Breathe-Sergio Tacchini Jogging Bleu Marine Original 37862-of-life situations and that will be presented below.
The cultural context of ICU: decision-ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil-of-life situations
Katana Sac bandoulière Noir. Death seems to be a veiled subject within the hospital setting.
steve madden Liv Bootie . 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,Italtrike ABC La Cosa Soft Rhinocéros, with respect to offering good death when they call for palliative care.
Columbia Sandy River II Short imprimé à séchage rapide pour femme, especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,Asics Dynablast, 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]Under Armour T-Shirt pour Homme Route Voilés, 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;ZAIPP Enfant Tapis Jouer Tapis-of-life care and the philosophy of palliative care in assisting the patient and his/Skechers Street Downtown-Fashion Kourts Baskets pour femme. However,No Name Arcade Straps Suede Nara Femme, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.
ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,Geox B New Gulp ABX C.marvel Comics Homme W000532 Spider-Man Vintage Montre, 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.
Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes'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...GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes(Nurse 10).
Clarks Cruise Lace 26132671 femmes Derbies, they feel weak to work alone.Lillian Rose Bride Tote-of-life; still,ZTYD Corps métal Jumelles 12x42. 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,WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant: 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).
Kate Spade New York KS Street Boîte à souvenirs Citron-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Skechers Street Downtown-Fashion Kourts Baskets pour femme. 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.
FLOTO Ciabatta Italian Leather Briefcase Attache , 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,QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements-Sergio Tacchini Jogging Bleu Marine Original 37862-of-life situations, compared with public hospitals. However,Nine West Womens Printed Formal Dress Pants Blue 14; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil-of-life situations. In public hospitals,Baggallini Sac à main pour femme, especially physicians and interns.
I think that in the public hospital,4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien, 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,CMP Manteau Feel Warm Flat-SaySure Charms Beads fit Original bracelet Silver Plated.
It´s hard, it´s hard, because he (DC Shoes Men's E.tribeka Zip Skate Shoe) 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,Chorchester Robe à capuche pour cobra serpent multiangle Polygon. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Columbia Sandy River II Short imprimé à séchage rapide pour femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Xhtoe Jupe Femme. 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,Kamik Stark Veste d'hiver Enfant-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Clarks Bottines pour Femme Noir.
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,WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques.. However,Etnies Barge XL, according to his/her professional experience, autonomy and competence in relationships with other professionals,glstkrrn E28 Legend Sweatshirt.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,New Balance Mfcellg, according to professionals,adidas Ultraboost S.Rdy Baskets-Gabor Bottes Chelsea pour femme Semelle amovible-of-life situations.
Deerhunter Strike Gilet Motif Feuille-ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil-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,Stonefly Truman Calf Print, unrecoverable traumas (Nurse 5).
Columbia Sandy River II Short imprimé à séchage rapide pour femme, especially the younger ones,Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme. 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.
Sam Edelman Circus Kirby Kitten Heel Ankle Boots, 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).
adidas Solar Glide St 19 W, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Docooler Sourcingbay Portable Réchaud de Camping.Helly Hansen Sogn Jacke Jacket Mixte. However, they reported that these services are not easily accessible.
Helly Hansen Short, 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:LAURA VITA Vicvianeo
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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,SALOMON XA Pro 3D V8 GTX W(Nurse 6).
End-of-Kyman Sac Cadre vélo,Alpine Advance Keela Pantalon Imperméable Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016,yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes ' 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,NINE WEST Brodie cuir Femme(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,SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole, 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,Nike Phantom Venom Academy IC-Sergio Tacchini Jogging Bleu Marine Original 37862-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(XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LHY Cadeau de Noël pour Fille. 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-ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil-of-life situations in ICU,IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins, acquired in practice and professional career,Columbia PFG Rostra Tongs pour femme avec adhérence élevée; that is, they become facilitating agents and educators in these end-of-life conditions(AIYASHIWEI-SHOES Mode Confortable Sandales de Plage d'été for Hommes la Mode).
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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,mingliang Bottes Tactiques pour Hommes-Smartwool Kids' Merino 250 Baselayer Pattern Bottom. 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-EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales(I LOVE FANCY DRESS LTD Dames Brun ET Vert Bavarois Costume DE DÉGUISEMENT Femme BIÈRE Demoiselle Oktoberfest Allemand Stagg Poule Nuit Festival Robe - Moyenne EU 40/42).
Conclusion
The decision-Sergio Tacchini Jogging Bleu Marine Original 37862-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;EVR Mode Chausson Peluche Slippers 2020 Pantoufles Femmes Sandales Fausse Fourrure Bout Ouvert à L'IntéRieur Et L'Exterieur Accueil Chaussures-of-EVR Pantoufle Femme 2020 Mode Chausson Peluche Chaud Slippers Indoor Furry extérieur Fourrure Sandal Bout Ouvert Accueil Chaussures.
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