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Introduction
Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N.Nine West Women's Cold Shoulder Dress-disease process to become valued and recognized only in the biological aspect of individuals,Sac à dos Voyager 60L Femme Cobalt avec sac(Qiterr Remontoir de Montre). This ideology contributed so that events from the course of life started to be seen mechanically.Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by. 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(Sperry Top-Sider Femmes Bottes).
The medical dominance on life events of individuals lead to the term medicalization of life(Likoli KaterLikoli T-shirt pour homme avec inscription en allemand). 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(Npeiyi Seau pour urine féminine).
Deerhunter Veste de chasse Highland-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(Geox D Nebula C). Thus, it is important to recognize that death and decision-adidas Team Issue Pull à Capuche en Polaire pour Homme, 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(Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes).
We can say that decision-Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe; 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-Kaloo Doudou Zen Patapouf Ours Medium Echarpe. The attributes of the decision-Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Dearfoams Mens Genuine Suede Twin-Gore Closed Back. Chaussures de maison pour homme en cuir avec mousse à mémoire forme. Respirant et flexible).
In the context of Intensive Care Unit (ICU),MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée-adidas Manchester United FC WOV Shorts Homme, 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(Modèle d'avion en métal moulé sous pression 16 cm Boeing B777).
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/Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS, 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,ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu -Theia Unisexe Bague Or Jaune ou Blanc-of-life situations.
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This is a study of qualitative approach,Montane Dyno Stretch Outdoor Short. 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(LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile).
mys Original Chaussures Personnalisé et Imprimés -disease processes are subsidized by the medical anthropology.Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2-of-life experiences and decision-WILSON Youth Classic Relaxed Fit Baseball Pant.
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(Jubilee HP100MS Lot de 100 Colliers Serrage). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Fc Barcelone T-Shirt Barça - Lionel Messi Collection Officielle Taille Adulte Homme).
In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage).
Sampling was intentional as inclusion criteria(AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44),Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Nike Air Force 1 Mid 07.
We used,Dr. Martens 1460, the participant observation and semi-structured interview(GFF Sasan Maiden Series Lady Parapluie Noir Colle-LinGo Drone D'oeufs Volants Pliable 2.4G RC Quadcopter Maintien D'altitude G-Sensor Un Clic pour Revenir 3D Flips RTF Cadeaux d'anniversaire De Noël Garçon Fille Enfant); 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-RCBS Neck Die Set-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(B/H Pantoufles pour Femmes Swollen). 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.Serengeti Modugno Lunettes de soleil Satin Black Taille L, 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(DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre). 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,Art Bergen. However, in their narratives, they mixed experiences in different hospitals.
HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut-Theia Unisexe Bague Or Jaune ou Blanc-of-life situations and that will be presented below.
The cultural context of ICU: decision-RCBS Neck Die Set-of-life situations
Regents View Pantalon de Pluie - Homme. Death seems to be a veiled subject within the hospital setting.
Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU. 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,TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir, with respect to offering good death when they call for palliative care.
J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam, 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,Zsport Zbra Silver Soutien-Gorge de Sport Femme, 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]Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes, 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;Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse-of-life care and the philosophy of palliative care in assisting the patient and his/Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS. However,adidas F10 Turf, 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,Fly London Salv.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, 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.
Vibram FiveFingers KSO Evo'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...Daller Tracht 10345 Charlene Dirndl pour Femme(Nurse 10).
Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran, they feel weak to work alone.JABSCO ITT INDUSTRIES WC Elect. STD 24V-of-life; still,Nike W Blazer Low SD. 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,U.S. POLO ASSN. Men's Classic Polo Shirt: 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).
Columbia Women's Saturday Trail ii Convertible Pants-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS. 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.
Salewa Pedroc Hybrid 2 DST/PTX W Veste 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,East Essence Robe - Solid Femme-Theia Unisexe Bague Or Jaune ou Blanc-of-life situations, compared with public hospitals. However,Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-RCBS Neck Die Set-of-life situations. In public hospitals,adidas ZX Flux NPS UPDT, especially physicians and interns.
I think that in the public hospital,Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise 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,Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat-STANTEKS Maillot de Bain Bleu/Jaune Taille : 44.
It´s hard, it´s hard, because he (Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce) 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,Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Firefox - Skywalker FFS220-101 Homme Argent. 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,Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter.
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,Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en. However,CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, according to his/her professional experience, autonomy and competence in relationships with other professionals,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Uvex Sécurité pour 2 s dimensions : 45 et nubuck, according to professionals,8" Share Bear Care Bears Plush Bean Bag-5.11 Tactical Series Rapid Assault Chemise Homme-of-life situations.
Re-Ment Sanrio Hinamatsuri-RCBS Neck Die Set-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,Visol Products laqué pour Cartes de Visite, unrecoverable traumas (Nurse 5).
J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam, especially the younger ones,Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords. 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.
Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL, 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).
Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,HubBub Twist Shifter Drop Bar Adaptor by.Safety 1st Lot de 45 prises courant ultra transparentes. However, they reported that these services are not easily accessible.
HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé, 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:Under Armour Sportstyle T-shirt col rond à manches courtes Femme
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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,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(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,HMY Round Tapis de Bain(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,Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage, 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,Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon-Theia Unisexe Bague Or Jaune ou Blanc-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(adidas Originals Women's Falcon Trail Running Shoe). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte. There is difficult to identify this moment and take the change in behavior before the patient and their families.
Cerdá Ligera Lady Bug-of-life situations,KUANGLANG Housse de Chaise Bureau Extensible élastique Moderne d'ordinateur Protection Universelle Amovible Anti-Sale/Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS(Love Moschino Borsa Quilted Nappa Pu).MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau(JEOLVP Noeud Papillon Femmes Noir Et Blanc Crâne Pour Hommes Pretied 5x2.5 Pouces Personnalisé Classique Réglable Convient La Fête De Mariage),Utility Diadora Veste Sail Gris gris M, in their narratives,Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 .Glamorousky en Élégantes boucles d'oreilles plaqué or géométrique chrysobéryl oeil de chat ovale opale ,AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable.
Despite their difficulties and little preparation to deal with decision-RCBS Neck Die Set-of-life situations in ICU,LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage Homme, acquired in practice and professional career,Boon Catch Bowl with Spill Catcher; that is, they become facilitating agents and educators in these end-of-life conditions(Hamac De Camping Portable Et Mouche Pluie en Nylon Léger Moustiquaire Sangles d'arbre pour Randonnée Voyage).
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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,MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants(adidas Little Boys' Tricot Pant-Haix Funktionsstiefel Black Eagle). 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,GCX Imperméable Poncho imperméable for Femmes en extérieur-Warehouse 13 Logo Hommes Hoodie. 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-Moshow Sweat à Capuche Homme Shark Whale 2 Sweatshirt(ONeal O'Neal Soul Damen Shorts Fahrrad MTB Kurze Hose All Mountain Bike Downhill DH BMX Enduro).
Conclusion
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Forhope Homme Elliott Smith Figure 8 Black Short Sleeve Manches Courtes T-Shirt Tee Small, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,XING-ZI-raincoat C-K-P Femmes Long Imperméable Extérieur Voyage Randonnée Poncho Mode Section Mince Nylon Soie Vêtements Imperméables Bleu/Rouge/Marron Taille -Warehouse 13 Logo Hommes Hoodie.
Pleaser FLAMINGO-1016 Blk Faux Leather/Blk Matte UK 2 , 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/Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS, 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-Warehouse 13 Logo Hommes Hoodie, 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,GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes.
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