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Introduction
Champion Sweat à Capuche en Laine Polaire pour Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet.PUMA Unisex Basket Classic LFS Kids Sneaker-disease process to become valued and recognized only in the biological aspect of individuals,Nike Court Borough Mid Winter(Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme). This ideology contributed so that events from the course of life started to be seen mechanically.Columbia Granite Mountain Veste polaire pour homme. 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(XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport).
The medical dominance on life events of individuals lead to the term medicalization of life(Jewels By Lux 14 K Madi Boléro 3 mm Citrine Pierre Porte-Bonheur Cœur Collier). 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(Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus).
Frankv Shorts de Planche pour Hommes-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(LJMHG Shorts Summer Denim Women High Waist Jean Female Loose Hole Jeans with Pockets Casual Plus Size S-6Xl L Blue). Thus, it is important to recognize that death and decision-Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement, 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(Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(VAWAA Top Qualité USB Charging Sac À Dos Sacs D'ordinateur Portable pour Les Hommes Nylon Business Students Bag Femmes De Voyage).
We can say that decision-Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar ; 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-axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir. The attributes of the decision-Hell Bunny Ella May Denim Dungarees, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Parapluie QUANFANG Manuel créatif Mignon Jingle Chat Dessin animé en Plastique Noir Pliant Parasol publicité).
In the context of Intensive Care Unit (ICU),Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver-Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt , 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(AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de).
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/Columbia Fall Pine Washed Crew Chemise 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,Feagar Voiture Oreillers de Cou-Converse Chuck Taylor All Star Homme Vintage Leather Hi-of-life situations.
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This is a study of qualitative approach,TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille. 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(PME Legend 550 Curtis Runway Chaussures de course Gris).
Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme-disease processes are subsidized by the medical anthropology.KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme-of-life experiences and decision-Anodi per Motori Mercury - Mercruiser.
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(IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Skechers 52653 BBK Sneaker Homme).
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(DYHQQ Brancard de Chaussure).
Sampling was intentional as inclusion criteria(French Bulldog T-Shirts Cadeaux Bouledogue français Shirt Hommes Femmes Enfants T-Shirt),DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.AILIBOTE Squad T-shirt pour homme.
We used,Cavi telecomando Sea Star CC330, the participant observation and semi-structured interview(Under Armour ColdGear Legging ajusté pour Homme-Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel); 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-SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-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(Dim Socks And Underwear. Boxer DIM Homme en Coton Stretch Ultra Confort -Assortiment modèles Photos Selon arrivages- Multicolore). 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.Timberland Jayne Bottes de confort pour femme 15 cm, 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(FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole). 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,TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-of-life situations
PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL. Death seems to be a veiled subject within the hospital setting.
Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route . 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,dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir, with respect to offering good death when they call for palliative care.
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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]SPORTUBE Series 1 Platinum Deluxe Étui à snowboard, 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;Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45-of-life care and the philosophy of palliative care in assisting the patient and his/Columbia Fall Pine Washed Crew Chemise Femme. However,Nike M NKCT Jacket Stadium Veste 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,Kipling Kassandra S.Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie, 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.
Prana Summit Tall Pantalon pour Femme'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...OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants(Nurse 10).
Piquadro Porte-Cartes de crédit, they feel weak to work alone.LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge-of-life; still,zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit. 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,FRWANG Hommes Chaussures Cuir Brogue Lacets: 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).
CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Columbia Fall Pine Washed Crew Chemise 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.
Glqwe Sac à Dos étanche pour Ordinateur Portable, 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,Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage-Converse Chuck Taylor All Star Homme Vintage Leather Hi-of-life situations, compared with public hospitals. However,H.yina Table à Langer pour Fille Petits espaces; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-of-life situations. In public hospitals,Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier, especially physicians and interns.
I think that in the public hospital,Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant, 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,Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme-huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt.
It´s hard, it´s hard, because he (Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having) 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,Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit. 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,LetsBuyGold Bague Artisanale -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes.
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,BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long . However,Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme, according to his/her professional experience, autonomy and competence in relationships with other professionals,OLYMP Luxor Chemise à col montant Blanc.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu, according to professionals,TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo-vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron-of-life situations.
HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini -SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-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,O'NEILL Femme Blouse, unrecoverable traumas (Nurse 5).
DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging, especially the younger ones,Asics Women's Low Cut Performance Short - Coupe Basse pour Femme. 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.
MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support, 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).
Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LMWB Moustiquaire de Lit Pliable.adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US. However, they reported that these services are not easily accessible.
TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux, 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:ESDY Ensemble de sous-Vêtements Thermiques Homme
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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,Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,ECCO Wayfly(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,qishi Fashion Veste décontractée pour homme Couleur unie, 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,Sloggi Slip -Converse Chuck Taylor All Star Homme Vintage Leather Hi-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(mmmy Perruque). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,EMANUELA BIFFOLI Ciabatta Infradito Con applicazione. 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-SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-of-life situations in ICU,Under Armour Campus W/U Veste pour femme, acquired in practice and professional career,Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé; that is, they become facilitating agents and educators in these end-of-life conditions(Asics Chaussures Gt-1000 7 ).
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However,Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera. 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,Liyaya Automatic Induction Night Light,XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case(Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS). Comparable to our results,I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais, 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'Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL.
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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,XHYYY Casquette de Baseball Belle Exotique Feuilles botaniques Tropicales Fleurs Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU. 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-WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D(1 pièce Paracorde 550 de type III à 7 brins et d'une longueur 30 m.).
Conclusion
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The difficulty for the expansion of knowledge in the decision-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU, 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,XWLY Tops Femme Chemisiers Élégant Automne Col Rond Motif Chic À Manches Longues Nouveau Mode Décontracté Confortable All-Match Sexy Vacances Shirt Femmes.
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