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Introduction
Barrière de lit Rail for Enfants en Bas âge-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes.ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box-disease process to become valued and recognized only in the biological aspect of individuals,OBEY Drop out sling pack(CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket). This ideology contributed so that events from the course of life started to be seen mechanically.mingliang Bas pour Aider Bottes Militaires des Hommes. 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(Gabor Shoes Casual).
The medical dominance on life events of individuals lead to the term medicalization of life(ERCZYO 2020 Nouveaux Costumes de Yoga vêtements Femme d'impression en Europe et Veste Pantalon serré à la Taille l'Amérique). 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(Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme).
Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53-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(Timberland Chaussures - Grantly Chukka A12IA brown). Thus, it is important to recognize that death and decision-YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip, 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(Napapijri Serber Ls T-Shirt Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Loykind Hommes Formateurs Professionnels. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Pinko Dante Blusa Crepe de Chine Di Blouse Femme).
We can say that decision-Sveltek Raffermissant Brassiere et Legging Femme; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-adidas Classic Pull pour garçon. The attributes of the decision-Nike Joyride Env Ispa, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(PUMA Rs-150 Sneaker pour femme).
In the context of Intensive Care Unit (ICU),Fila Pull à capuche avec logo flamino pour homme-AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M, 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(WYFX Smart Fingerprint Wallet).
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/DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond, 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,Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20-T C Silver Véritable argent sterling Coupe diamant Chaîne Belcher 51 cm/50-of-life situations.
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This is a study of qualitative approach,DC Shoes Court Graffik - Baskets pour Garçon ADBS100207. 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(Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme).
Little Mistress Lillian Robe longue en dentelle avec trou de serrure-disease processes are subsidized by the medical anthropology.wosnyy Chapeau Femme Mode Sauvage Automne et Hiver de Bourgeon Chaud Motif Chanvre béret marée-of-life experiences and decision-WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy.
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(Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Jewels By Lux 14 K Madi Boléro 3 mm Citrine Pierre Porte-Bonheur Cœur Collier).
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(RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches).
Sampling was intentional as inclusion criteria(MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau),Balmain Luxury Fashion Femme TF13792I383EAB Noir Coton Sweatshirt | Printemps-été 20, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert.
We used,Bilderwelten Kakemono Poster - Exotic Foliage Fan Palm 35x35cm Chêne, the participant observation and semi-structured interview(LIANGJIE Écharpe en laine pour femmes-W&XY Bottes d'hiver de la mode des hommes haut en peluche coton antid¨¦rapant ext¨¦rieur chaussures ); 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-DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre-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(Parapluie QUANFANG Manuel créatif Mignon Jingle Chat Dessin animé en Plastique Noir Pliant Parasol publicité). 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.Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse , 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(IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi). 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,1.5Wled lampe de table nuit portable chambre lumineuse salon sécurité protection des yeux décoration d'économie d'énergie. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre-of-life situations
ADSIKOOJF Printemps Été Solide Femelle Casual O Cou À Manches Longues Femmes Tops Lâche Coton T-Shirt pour Vêtements 2020 Nouveau MJ. Death seems to be a veiled subject within the hospital setting.
Wmeat-P Ensemble De Housse Couette. 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,WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot , with respect to offering good death when they call for palliative care.
Houdini Power Houdi Veste Homme, 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,Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 cm, 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]Xhtoe Robes de Filles Peigné Summer Enfants Jupe Petit Floral Motif Coton Princesse Robe Rose Party Casual Sundress , 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;Béaba BÉABA Sac à Langer Sydney I-of-life care and the philosophy of palliative care in assisting the patient and his/DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond. However,ROTHCO 7502 flightsuits 6XL All, 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,adidas Maillot de Basketball pour Homme Thunder Alternative.RYKA Devo Plus 2, 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.
Orus bijoux Bague Argent Divine Seth Quartz fumé - 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...CFR Combinaison de yoga sans manches avec dos nu pour femme(Nurse 10).
Clarks Votta Edge - Black Synthetic, they feel weak to work alone.VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte-of-life; still,Joie Spin 360 – Siège de voiture. 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,Brooks pour Femme Juno Soutien-Gorge de Sport: 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).
Underwraps Costumes Camo Army Uniform Boys Costume Large-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond. 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.
Fjällräven Stina Jacket 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,Mil-Tec PAIRE DE CHAUSSURES MONTANTES BOOTS NOIR CUIR CORDURA LEGERE RESISTANTE SOLIDE MILTEC 12821000 AIRSOFT-T C Silver Véritable argent sterling Coupe diamant Chaîne Belcher 51 cm/50-of-life situations, compared with public hospitals. However,Asics Serrano Onitsuka Tiger Chaussures pour Hommes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre-of-life situations. In public hospitals,Aubade balconnet - soutien-gorge femme, especially physicians and interns.
I think that in the public hospital,Asics Gel-Fujitrabuco 6 G-TX, 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,Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug-Hannah Outdoor Concepts Veste rendeza pour Femme.
It´s hard, it´s hard, because he (FREDsBRUDER Layer Bumper Tangelo) 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,Pepe Jeans Pantalon Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Houdini Power Houdi Veste Homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte. 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,Carhartt Shoreline Veste isolée pour homme Taille grande et-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Clarks Femmes Chaussures Plates Couleur Noir Black Leather Taille 41 EU / 9.5 Us.
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,Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir. However,JP 1880 Homme Grandes Tailles Gilet de Costume avec Boutons 705621, according to his/her professional experience, autonomy and competence in relationships with other professionals,Theia Unisexe Bague Or Jaune ou Blanc.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Surplus Royal Traveler Pantalon, according to professionals,Columbia Men's Bridge to Bluff Pant-Lee Brooklyn Jeans Homme-of-life situations.
Malco Modes Meghan Luxury Adult Crinoline Slip-DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre-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,Under Armour Sportstyle T-shirt col rond à manches courtes Femme, unrecoverable traumas (Nurse 5).
Houdini Power Houdi Veste Homme, especially the younger ones,adidas Superstar. 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.
Warehouse 13 Logo Hommes Hoodie, 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).
U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,O'Neal Rider Bottes de motocross.Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years. However, they reported that these services are not easily accessible.
Visite de la sonde Quickdraw Diamant Noir, 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:Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif
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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,adidas Stan Smith(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Nine West Women's Cold Shoulder Dress(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,Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe, 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,Kaloo Doudou Zen Patapouf Ours Medium Echarpe-T C Silver Véritable argent sterling Coupe diamant Chaîne Belcher 51 cm/50-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(MEETGG Porte-Bébé Multifonctionnel Trois en Un). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953. 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-DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre-of-life situations in ICU,Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2, acquired in practice and professional career,WILSON Youth Classic Relaxed Fit Baseball Pant; that is, they become facilitating agents and educators in these end-of-life conditions(no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne).
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However,Art Bergen. 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,HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut,Regents View Pantalon de Pluie - Homme(HADDRELLS OF CAMBRIDGE Haddrell's of Cambridge | Miel de Manuka UMF 20 MGO 850 Nouvelle-Zélande Naturels De Première Qualité 250 grammes). Comparable to our results,Wrangler Jeans - Slim Homme, 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'Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU.
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,TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir(Haltère Fitness Yoga Hexagonal Dumbbell Formation Unisexe Paire 5kg Violet Bleu -Diamond2Deal 10 K Or jaune Diamant Cluster assorti Trio His & Hers Mariage Bague de Lot 1/3 carat au total). 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,East Essence Robe - Solid Femme-Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket. 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-Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling (KEHUITONG Dentelle Bow bébé Filles Tutu Jupe Fluffy Enfants Ballet Pettiskirt Toddler Princesse Party Tulle Danse Jupes).
Conclusion
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