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Introduction
Décoration de la Maison Figures géométriques Statue Sculpture-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes.Mickey Mouse Sac à Dos Enfant Garçon Noir Noir/Rouge L-disease process to become valued and recognized only in the biological aspect of individuals,XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau(SQlab 610 Ergolux Active 2.0). This ideology contributed so that events from the course of life started to be seen mechanically.Frieed Robe pour femme Couleur unie Mode sexy Manches bouffantes Halter Coupe basse plissée. 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(VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur).
The medical dominance on life events of individuals lead to the term medicalization of life(Eurohandisplay Mannequin de vitrine/baptême pour homme avec bras et tête pivotante à 360° Blanc mat). 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(Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless ).
YIJIAREN pour Volkswagen Series Tapis Sol Voiture-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(Finn Comfort 3563145003 Chaussures à Lacets pour Femme Crème). Thus, it is important to recognize that death and decision-Escabeau escabeau escabeau, 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(Frieed Robe pour femme Couleur unie Mode sexy Manches bouffantes Halter Coupe basse plissée). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Gabor Femme Ballerines).
We can say that decision-FYZS Sports Equipment Support Mural de Rangement Balles Fer Basketball Porte Sport Stuffs Stockage Noir Shelf Organisation Accueil; 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-NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock. The attributes of the decision-Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(FLHT Femmes Dames Pochette Cuir Sac De Chaîne à Main Luxe Soirée Cadeau Enveloppe Mariage Petit Bourse Femme D'épaule).
In the context of Intensive Care Unit (ICU),SCJ Folding Shopping Cart Portable Utility Carts Light Weight Trolley Stair Climbing with Triangle Crystal Wheel-Tuyau d'eau télescopique Magique, 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(Columbia Youth Firecamp Mid 2 WP).
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/Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes, 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,jklj Chemise à Manches Longues Quotidienne pour Homme Automne et Hiver Chemises habillées for Peut être Porté avec Un Jean Ou Une Salopette -GUANTO MMA BLITZ - 24531 7-of-life situations.
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This is a study of qualitative approach,SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre . 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(FRYE Men's Austin Passport Wallet).
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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(Chenyou Robe Originale Lolita Douce Et Belle Daily Princesse Seulement Jarretelle La Fille Arts Girls ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(5.11 Pantalon d'opérateur Tactique XPRT Multicam pour Homme Style 74070).
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(MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge).
Sampling was intentional as inclusion criteria(La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée),ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures.
We used,AJH Bidet pulvérisateur Ensemble Outil hygiène personnelle Multifonctionnel-Pistolet de pulvérisation Toilette Robinet Pistolet propul, the participant observation and semi-structured interview(Impala ROLLERSKATES - Midnight-RKRCXH Queue De Sirène Et Nageoire); 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-4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu -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(Sperry Top-Sider Cup 2-Eye). 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.B/H Réglable Orthopédique Pantoufles, 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(Zhik Hybrid Skiff Suit 2020). 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,ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main . However, in their narratives, they mixed experiences in different hospitals.
Punk Rave femmes à capuche manteau long veste noir gothique lolita steampunk hiver vintage-GUANTO MMA BLITZ - 24531 7-of-life situations and that will be presented below.
The cultural context of ICU: decision-4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu -of-life situations
Quickfill. Death seems to be a veiled subject within the hospital setting.
Clarks Atticus Lace. 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,adidas Condivo 18 Veste, with respect to offering good death when they call for palliative care.
Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire, 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,Geox Jr Agata A, 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]Dansko Women's Adrianne Sneaker, 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;Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01-of-life care and the philosophy of palliative care in assisting the patient and his/Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes. However,Old Crest Cravate - Homme, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.
ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,BOSS Pince à Cravate 50403093-001.nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement, 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.
MTX Ltd Vintage Etnico Ricamo Lana Femminile Caldo Fiore Lunga Sciarpa Autunno e Inverno All'Aperto Multifunzionale Fgreyion Tendenza Selvaggio Scialle Dono Sciarpa'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...Skechers Summits-New World(Nurse 10).
ALTRA Escalante 2.0 Black, they feel weak to work alone.JCM Wandleuchte LED Schlafzimmer Nachttischlampe Kreative minimalistische Postmoder Wohnzimmer Schrank Licht Korridor Gang Treppe ZJ -of-life; still,SECVBG Cerf-volantNouveaux Jouets 1.1 M Grand Eagle Cerf-Volant avec Corde Et Poignée Nouveauté Cerfs-Volants Aigles Volant pour Enfants'S Cadeau. 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,Liu Jo Écharpe à paillettes 269047 T0300 Noir: 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).
Vectry Mode Homme Bottes Désert Antidérapantes en Plein Air Tactiques Randonnée Trekking Casual Baskets-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes. 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.
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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Herschel supply Sac à Dos Nova Small-GUANTO MMA BLITZ - 24531 7-of-life situations, compared with public hospitals. However,Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu -of-life situations. In public hospitals,GonFan Hommes et Femmes Adultes Convenant aux Enceintes âgées Les Vraies Chaussures en Bois Portent des de pompage , especially physicians and interns.
I think that in the public hospital,ALPHA INDUSTRIES Veste 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,YXZQ Cartouche de Toner-YQSHOES Bottes.
It´s hard, it´s hard, because he (Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court) 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,WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Clergerie Berlin 3. 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,YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Nike Sportswear Internationalist Femmes Baskets EU 38 - US 7.
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).
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Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer, according to professionals,ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween-RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard-of-life situations.
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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,Poussette Légère, unrecoverable traumas (Nurse 5).
Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire, especially the younger ones,XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux. 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.
Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, 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).
SILOLA Figurine Statuette Sculptures Bouddha, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Figurine Statuette Sculptures Bouddha.TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts. However, they reported that these services are not easily accessible.
LWQ Accueil Utilisez Électriques Ciseaux, 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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(...) 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,GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V(Nurse 6).
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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,New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2, 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,MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe-GUANTO MMA BLITZ - 24531 7-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(SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm. 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-4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu -of-life situations in ICU,ARA Rom, acquired in practice and professional career,NYDJ Jean pour femme; that is, they become facilitating agents and educators in these end-of-life conditions(CLJ Lunettes de Lecture pour Hommes).
Although,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, but indirectly, in end-of-life situations,Under Armour Sportstyle Sweat-shirt polaire zippé pour homme-of-life process.Trezeta Margot WS Trek/her; accordingly,5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg-Marvelis chemise style moderne crème(New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable).
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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,Pandora Femme Argent Boutons d'oreilles - 290721CZ-Aofur Robe - Trapèze Manches Courtes Femme. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713](G-STAR RAW Earth Beetle Sweat-Shirt Femme).
Conclusion
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Pierre Cardin Lyon Long Life Chino Pantalon Homme, 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/Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes, 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-Aofur Robe - Trapèze Manches Courtes Femme, 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,adidas Supernova de Course pour Femme à Manches Longues Tee.
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