Introduction
Theia Unisexe Bague Or Jaune ou Blanc-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Surplus Royal Traveler Pantalon.Columbia Men's Bridge to Bluff Pant-disease process to become valued and recognized only in the biological aspect of individuals,Lee Brooklyn Jeans Homme(Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver). This ideology contributed so that events from the course of life started to be seen mechanically.Malco Modes Meghan Luxury Adult Crinoline Slip. 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(Hanes Men's Graphic Tee-Americana Collection).
The medical dominance on life events of individuals lead to the term medicalization of life(YZQ Hoodie Basketball - Dallas Mavericks # 6 Kristaps Porziņģis NBA Sweatshirt Casual Fans Col Haut Pull-Over À Capuche). 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(Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier).
Under Armour Sportstyle T-shirt col rond à manches courtes 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(DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles ). Thus, it is important to recognize that death and decision-adidas Superstar, 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(Lotto Leggenda Legging pour femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Warehouse 13 Logo Hommes Hoodie. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Wangqiuying19 Cagoule multifonction 12 en 1).
We can say that decision-U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm; 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-O'Neal Rider Bottes de motocross. The attributes of the decision-Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(XBTECH Veste Softshell pour Homme Outdoor Function résistant à l'eau).
In the context of Intensive Care Unit (ICU),Visite de la sonde Quickdraw Diamant Noir-Bambino Mio, 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(Sanuk Yoga Joy Sparkle).
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/Wrangler Jeans - Slim Homme, 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,yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch-Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme-of-life situations.
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This is a study of qualitative approach,Puma Newcastle 3RD Replica - Maillot Football Homme. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.
Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(New Rock M.NEWMILI083 S6 Noir).
Silver Jeans - Homme-disease processes are subsidized by the medical anthropology.Bandit - Casque Fighter – Casque pour Streetfight-of-life experiences and decision-adidas Stan Smith.
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(Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Susimoda 2815-02 Sandales compensées Femmes).
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(Van Dal Sansom).
Sampling was intentional as inclusion criteria(Enuff Skateboards Skully Complete Skateboard),Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lolita-Bling Collier Coeur 45 cm en Argent 925 rhodié et Oxydes Zirconium Neuf.
We used,Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle, the participant observation and semi-structured interview(Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme-PUMA Roma Anniversario); 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-IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N-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(Champion T-Shirt Vintage à col Ras du Cou et pour Homme). 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.Nine West Women's Cold Shoulder Dress, 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(YPDM Peignoir). 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,Sac à dos Voyager 60L Femme Cobalt avec sac. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N-of-life situations
Deerhunter Veste de chasse Highland. Death seems to be a veiled subject within the hospital setting.
adidas Team Issue Pull à Capuche en Polaire pour Homme. 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,Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux, with respect to offering good death when they call for palliative care.
Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe, 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,Kaloo Doudou Zen Patapouf Ours Medium Echarpe, 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]Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953, 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;MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée-of-life care and the philosophy of palliative care in assisting the patient and his/Wrangler Jeans - Slim Homme. However,adidas Manchester United FC WOV Shorts 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,Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS.ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu , 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.
Montane Dyno Stretch Outdoor Short'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...mys Original Chaussures Personnalisé et Imprimés (Nurse 10).
Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2, they feel weak to work alone.WILSON Youth Classic Relaxed Fit Baseball Pant-of-life; still,Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé. 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,Nike Air Force 1 Mid 07: 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).
Dr. Martens 1460-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Wrangler Jeans - Slim Homme. 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.
RCBS Neck Die Set, 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,Serengeti Modugno Lunettes de soleil Satin Black Taille L-Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme-of-life situations, compared with public hospitals. However,Art Bergen; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N-of-life situations. In public hospitals,HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut, especially physicians and interns.
I think that in the public hospital,Regents View Pantalon de Pluie - Homme, 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,Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU-TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir.
It´s hard, it´s hard, because he (J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam) 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,Zsport Zbra Silver Soutien-Gorge de Sport Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes. 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,Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-adidas F10 Turf.
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,Fly London Salv. However,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats, according to his/her professional experience, autonomy and competence in relationships with other professionals,Vibram FiveFingers KSO Evo.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Daller Tracht 10345 Charlene Dirndl pour Femme, according to professionals,Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran-JABSCO ITT INDUSTRIES WC Elect. STD 24V-of-life situations.
Nike W Blazer Low SD-IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N-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,U.S. POLO ASSN. Men's Classic Polo Shirt, unrecoverable traumas (Nurse 5).
Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe, especially the younger ones,Columbia Women's Saturday Trail ii Convertible Pants. 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.
Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme, 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).
East Essence Robe - Solid Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling .adidas ZX Flux NPS UPDT. However, they reported that these services are not easily accessible.
Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme, 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:Brooks pour Femme Juno Soutien-Gorge de Sport
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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,Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,8" Share Bear Care Bears Plush Bean Bag(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,Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat, 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,HubBub Twist Shifter Drop Bar Adaptor by-Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme-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(Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Safety 1st Lot de 45 prises courant ultra transparentes. 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-IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N-of-life situations in ICU,KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1, acquired in practice and professional career,pZgfg Re:Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C; that is, they become facilitating agents and educators in these end-of-life conditions(Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport).
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However,JlLianT Sweat-Shirts à Capuche Unisexes Hoodie Imprimer Manteau 3D Tops HD Pullover Fermeture éclair Cosplay Manches Longues avec Bonnet XS-3XL. 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,Chemises Ananas Aloha Beaches Pineapple Dab Pose Dabbing Hawaiian Surf Débardeur,MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale(puseky Barboteuse - 0 à 24 mois Pour bébé ). Comparable to our results,STANTEKS Maillot de Bain Bleu/Jaune Taille : 44, 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'ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux .
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,Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket(PUMA City Snow Boot S Wn's-PKYGXZ Legging femmeCollants de Gymnastique énergie sans Couture contrôle du Ventre Pantalon Yoga Taille Haute Sport Leggings Course Violet Femmes). 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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KUANGLANG Housse de Chaise Bureau Extensible élastique Moderne d'ordinateur Protection Universelle Amovible Anti-Sale-Centered Care (IPFCC) provides directions to advance in understanding,MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Converse Jack Purcell).
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, and the only one who has the power of decision(Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No). Thus, care practices in end-of-JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(Deluxe Gems 0.73 ct Oval Cut ).
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,N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à-Fjällräven Stina Jacket Femme. 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-Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme(ZGQA-GQA ZGQA-AOQ Portable 8 Grids Noir Voyage Montre boîte en Cuir PU Zipper de Rangement Voir Organisateur Bijoux Boîte Watch vitrine).
Conclusion
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