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Introduction
Papillio Daytona-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Etnies Fader 2.Etnies Fader 2-disease process to become valued and recognized only in the biological aspect of individuals,Mammut Ultimate Veste V So – (JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor). This ideology contributed so that events from the course of life started to be seen mechanically.MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge. 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(FRYE FRYE70663 - Billy Shootie Femme).
The medical dominance on life events of individuals lead to the term medicalization of life(Babylonia BB-SLEN Echarpe De Portage Facile à Enfiler). 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(Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal).
MUSH T-Shirt Castle Rock Night's Watch Game of Thrones - Film by Dress Your Style Femme-XL Anthracite-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(FYWTFY Netred Casual Ladies Work Wear Belle Veste). Thus, it is important to recognize that death and decision-New Balance Wj91524 Pull à Capuche Femme, 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(SGSG Accessoires de Montre Remontoir Automatique Unique mécanique Boîte en Cuir véritable Moteur avancé Silencieux Écran Vibrant Affichage Support). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Close Parent Caboo Porte-bébé Coton bleu clair. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HERITAGE54 Auto Gele - Tête de tête plissée Pour femme africaine).
We can say that decision-LXJ-CQ Oreiller de Cou Saint-Valentin Or Paillettes Amour Coeur Voyage en Forme U Ergonomique Conception profilée Housse Lavable; 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-LXJ-CQ Oreiller de Cou Happy Valentines Day Love Flower Voyage en Forme U Housse Conception Ergonomique et Lavable. The attributes of the decision-POSEIDON Bobbin KNOTTER Gold Black, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Nero Giardini E012491D Sandales Basses Femme).
In the context of Intensive Care Unit (ICU),Multifanshop Rétro sac à bandoulière modern love wiebke noir-Ajvani Femmes Plat Courroie de Cheville Strappy t-Bar Soir Diamante Sandale Taille, 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(Nike Court Royale Basket Femme Blanc 36 EU).
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/Geox B Todo Boy A, 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,ZXLLAFT Bottes à Talons Hauts Femmes Bottines Bout Pointu Imperméables Cuir Brillant Lacets-WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL-of-life situations.
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This is a study of qualitative approach,BOLAWOO-77 Joggeurs Pantalon De Remise en Forme Au Comptant Hommes Mode Chic Slim Fit Sweatpants Sacs Coton Chino Les Vêtements Survêtement. 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(3D Illusion Nuit Lumière Cheval animal Led Bureau Table Lampe 7 Couleur Tactile Maison Chambre Décor Pour Enfants D'Anniversaire De Noël Cadeau).
Haedr Coussin résistant à la Casse pour bébé-disease processes are subsidized by the medical anthropology.camel active Ethnic 12-of-life experiences and decision-PICTO Montre à Quartz Unisexe.
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(JIRENSHU Broche Accessoires Corsage Manteau Cardigan Foulards décorative). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(THE NORTH FACE Denali 2 Veste pour femme).
In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(CMP Giacca Full Zip Wooltech Jacket Femme).
Sampling was intentional as inclusion criteria(XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard),MARCO TOZZI 23712 Femme Chaussures Noir, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Riposella 2611 Feutre de Laine Bouillie Verte Pantoufle tyrolienne.
We used,Jané Isize Siège Auto Gris 75 à 150 cm, the participant observation and semi-structured interview(YuYzHanG Housse De Pluie pour Voiture Bébé Pare-Brise Générale Enfant Parapluie Poussette -Nero Giardini E033771M Sneakers Garçon); 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-Oilily YS19GPA207 Short de sport unisexe avec imprimé floral-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(Genérico Boucles d'oreilles en or blanc 750 18 carats). 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.Betsey Johnson Montre pour Femme avec Bracelet et Cadran nacré, 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(Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu). 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,Oilily YS19GPA260 Pantalon de survêtement avec imprimé Floral Rose. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Oilily YS19GPA207 Short de sport unisexe avec imprimé floral-of-life situations
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DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling. 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,EDELRID Cordes d'escalade Boa 9, with respect to offering good death when they call for palliative care.
YUMI Blush 3D Floral Embellishment Party Dress, 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,GURU-SHOP Guru-Boutique, 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]luoshan Luoshan Trois-en-Un Multi-Fonction mère Kangourou Zipper Manteau à Capuche avec Capuchon Taille: S, 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;glstkrrn RX8 RX-8 Ugly Christmas Sweater-of-life care and the philosophy of palliative care in assisting the patient and his/Geox B Todo Boy A. However,Waldhausen Reithose Funktion Sport Silikon, 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,ALEIGEI Femmes Jupe Casual Vintage Imprimer Vêtements 2020 Nouvel Automne A-Ligne Poches Jupes Mi-Mollet Longueur Jeans.Boîte à bijoux de Rangement Bijoux, 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.
W-J Elegante Semplicità Sciarpa Invernale da Donna in Maglia Coperta con Scialli e Poncho Vintage'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...MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet(Nurse 10).
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Nowadays, when we do not have the support of palliative care,Clio Blue Bague Medicis en argent 925: 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).
Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Geox B Todo Boy A. 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.
L.O.L. Surprise ! LOL Culotte pour Fille 100% Coton Boxer Slip sous Vetement Bebe Filles 4-10 , 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,Ulla Popken Weiche Stretchhose Soft Peach Mony Pantalon Femme-WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL-of-life situations, compared with public hospitals. However,Irregular Choice Disney Princess- Beauty and The Beast Flats; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Oilily YS19GPA207 Short de sport unisexe avec imprimé floral-of-life situations. In public hospitals,STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver, especially physicians and interns.
I think that in the public hospital,Tommy Hilfiger Femmes Francie Bottes Couleur Bleu Blue Taille 41.5 EU / 10 Us, 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,Le Coq Sportif Sweat Essentiels-JHGK Trail Running Chaussures.
It´s hard, it´s hard, because he (RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ) 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,ABYSSTAR 68170WTR - Bottines Mixte Adulte. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
YUMI Blush 3D Floral Embellishment Party Dress' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-SEIDENFELT MANUFAKTUR Nora Beige. 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,Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo.
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,DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée. However,DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual, according to his/her professional experience, autonomy and competence in relationships with other professionals,Helikon CPU Hommes Short PL Woodland.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme , according to professionals,TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee-TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween-of-life situations.
FUNBN T-Shirt de Basket-Ball Version Fan Basket-Oilily YS19GPA207 Short de sport unisexe avec imprimé floral-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,VIVIANE Boucle D'oreille Support De Rangement, unrecoverable traumas (Nurse 5).
YUMI Blush 3D Floral Embellishment Party Dress, especially the younger ones,GPWDSN Montre de Poche et chaîne. 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.
Piquadro Blue Square Leather Backpack Rosa Chiaro, 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).
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JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds, 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:Sac de Selle vélo étanche Portable siège d'eau Bouteille Queue équipement arrière
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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,Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Softinos Iggy269sof(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,adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer 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,adidas Femmes Chaussures Athlétiques-WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL-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(HubBub Twist Shifter Drop Bar Adaptor by). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant. 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-Oilily YS19GPA207 Short de sport unisexe avec imprimé floral-of-life situations in ICU,W&XY Bottes d'hiver de la mode des hommes haut en peluche coton antid¨¦rapant ext¨¦rieur chaussures , acquired in practice and professional career,ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage; that is, they become facilitating agents and educators in these end-of-life conditions(Odlo Energy Pantalon pour Femme x).
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However,Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire. 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,XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j,VearFit Cuir véritable(Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental). Comparable to our results,F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile, 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'Dickies Henley Chemise à manches longues 3 boutons pour femme.
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,Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux (Gabor Shoes Jollys-CrystalTears 8mm Bracelet en Énergie Pierre Perle Oeil de Tigre Jaune/Bleu Reiki Gravure Personnalisé DIY Fil Ajustable Unisexe Homme Femme). 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,Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible-AZSTEEL We'all Need Jesus Christian Bible Gospel Shirt John 3:16. 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-Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm(ELBLEDER Portefeuille pour Femme en Cuir avec Fermeture éclair et Style Vintage Noir).
Conclusion
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HJTLK Chariot de magasinage léger 39L, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/Geox B Todo Boy A, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
The difficulty for the expansion of knowledge in the decision-AZSTEEL We'all Need Jesus Christian Bible Gospel Shirt John 3:16, 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,HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College .
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