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Introduction
ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard.YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal-disease process to become valued and recognized only in the biological aspect of individuals,Poussette Légère(L.BRUAT L. Bruat Montre de sport pour femme). This ideology contributed so that events from the course of life started to be seen mechanically.XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux. 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(Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme).
The medical dominance on life events of individuals lead to the term medicalization of life(Guess Veste à capuche pour homme). 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(Gant 1901.4204663 Short Femme).
Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga-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(Marvelis chemise style moderne crème). Thus, it is important to recognize that death and decision-SILOLA Figurine Statuette Sculptures Bouddha, 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(YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Figurine Statuette Sculptures Bouddha. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité).
We can say that decision-TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts; 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-LWQ Accueil Utilisez Électriques Ciseaux. The attributes of the decision-Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(COOLCEPT Bottes Femmes Western Cheville).
In the context of Intensive Care Unit (ICU),1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante -Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe, 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(MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement ).
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/TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine, 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,ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806-ALTRA Escalante 2.0 Black-of-life situations.
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This is a study of qualitative approach,NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire. 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(LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ).
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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(huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HORZE Collant d'équitation Super Souple Juliet).
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(Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc).
Sampling was intentional as inclusion criteria(MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch),Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris.
We used,Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse, the participant observation and semi-structured interview(Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis-Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm.); 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-Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport-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(Cloche mobile pour bébé). 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.WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe, 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(Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille). 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,Burton AK Gore CYCLIC Hose 2021 Forest Night. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport-of-life situations
FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole. Death seems to be a veiled subject within the hospital setting.
New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2. 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,MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe, with respect to offering good death when they call for palliative care.
XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm, 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,G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces , 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]DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau, 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;HART Polar Bear-V Gilet Taille XL-of-life care and the philosophy of palliative care in assisting the patient and his/TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine. However,VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant, 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,WZLJW Douche Piscine Plage Chaussures.TPHJRM Coussin d'accoudoir de Console Centrale Voiture, 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.
ARA Rom'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...NYDJ Jean pour femme(Nurse 10).
Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm, they feel weak to work alone.Under Armour Sportstyle Sweat-shirt polaire zippé pour homme-of-life; still,Trezeta Margot WS Trek. 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,5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg: 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).
Marvelis chemise style moderne crème-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine. 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.
Reveal Entertainment Shan Jari Board Game, 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,Holley 34504 Carburetor Accelerator Pump-ALTRA Escalante 2.0 Black-of-life situations, compared with public hospitals. However,ROTHCO M-65 Camo Field pour Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport-of-life situations. In public hospitals,CMP 38Z1726 Parka Fix Hood pour Femme, especially physicians and interns.
I think that in the public hospital,PUMA RS-x Winterized, 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,Brandit Sweatshirt à capuche Homme-Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles.
It´s hard, it´s hard, because he (The 1 for U 100% Coton Peignoir/Peignoir Rosalind) 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,HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LybMjG Maillot Cyclisme Pro. 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,werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Carhartt Gilliam Vest Gilet Homme.
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,LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique. However,Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe, according to his/her professional experience, autonomy and competence in relationships with other professionals,Sanuk Yoga Bliss.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Under Armour Curry IV Sandale pour homme, according to professionals,Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir-Guess lea03 femme guess flazl2-of-life situations.
Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large-Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport-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,HKM 9109 Bottes d'équitation Gijón, unrecoverable traumas (Nurse 5).
XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm, especially the younger ones,Pandora Femme Argent Boutons d'oreilles - 290721CZ. 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.
Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713], 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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Suitline Valise Plus Grande Bagages Rigide, 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:Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt
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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,Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,YULIN-L YYL Imperméables pour Enfants(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,GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres, 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,good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine-ALTRA Escalante 2.0 Black-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(73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Guess Bla Moritz. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,Nike Viale. 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,American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003,Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small(Clarks Chaussures Whiddon Vibe pour Hommes). Comparable to our results,Pierre Cardin Lyon Long Life Chino Pantalon 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'Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main.
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,Green Burry Greenburry (FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant-Wrangler Jeans Texas Stretch Overdye). 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,PALLADIUM-EU Pampa Sport Cuff Wpn-Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483. 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-Trippen Road Brown(JiNKesI Twisted-Wonderland Cosplay Costume Kimono Uniforme Robe Costumes Halloween Anime Jeu Malleus Cérémonie Invocation Robes À Capuche Tenue pour).
Conclusion
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