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Introduction
HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,JX-PEP Été Imprimer col Rond Manches Courtes.ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes -disease process to become valued and recognized only in the biological aspect of individuals,Pleaser Delight 1018(Emporio Armani Stretch Long Sleeve T-Shirt). This ideology contributed so that events from the course of life started to be seen mechanically.Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm . 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(Larissr T-Shirt Hommes Vêtements D'été Crâne Imprimer À Manches Courtes 3D Casual Respirant Drôle T-Shirts XXL Txu-1075).
The medical dominance on life events of individuals lead to the term medicalization of life(Odlo 350332 - Gilet à Capuche 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(RZHSS Sweats à Capuche).
Under Armour W HOVR Phantom Nc 3020976-6-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(XinXinFeiEr Femmes Orange Cavaliers drôle Couverture en Peluche Dentelle Poche Pull Veste À Manches Longues Hop moitié ). Thus, it is important to recognize that death and decision-ARIAT Skyline Mid H2o, 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(YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ARIAT Quickdraw Venttek. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Cactus Décoration de lit bébé Cadeau nouveau-né Mobile musical en).
We can say that decision-Danielle Nicole Little Mermaid Ursula Crossbody; 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-YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme . The attributes of the decision-Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Rideaux occultants colorés - Style psychédélique futuriste Effet fard à joues graphique Dos thermique Pour chambre d'enfant 132 x 213 cm).
In the context of Intensive Care Unit (ICU),XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture-SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U, 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(MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson).
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/Ouzoub 24 Pouces Moniteur for bébé babymonitor, 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,WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées-MATEIN Sac à dos roulettes pour ordinateur portable-of-life situations.
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This is a study of qualitative approach,yunyu Montre de Poche pour Homme. 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(BCAJFL Aux Femmes Bandoulière Petit Sac en Cuir).
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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(Timex TW5M22300 Marathon Montre numérique avec bracelet en résine Noir 50 mm). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(JOOLA Disc Raquette Coque avec Boule de Stockage).
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(Hannah Outdoor Concepts Veste rendeza pour Femme).
Sampling was intentional as inclusion criteria(No Name Arcade Straps Suede Nara Femme),Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.hanky panky Original String en dentelle extensible pour tailles 14-26.
We used,Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE, the participant observation and semi-structured interview(ZHANGNUO 5 Paires/Ensemble Chaussettes pour Enfants éTé Coton Bébé Filles Tout-Petit Dessin Animé sans Couture Garçons Maille-P&B Salopette 1409 Système Bleu Roi); 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-HESTRA Henrik Gants de ski court en cuir-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(COOLCEPT Sandale Femmes Mode Talons Epais Mules Sandales). 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.Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron, 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(denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm ). 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,dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot. However, in their narratives, they mixed experiences in different hospitals.
Asics Gel Solution Speed Clay-MATEIN Sac à dos roulettes pour ordinateur portable-of-life situations and that will be presented below.
The cultural context of ICU: decision-HESTRA Henrik Gants de ski court en cuir-of-life situations
Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris. Death seems to be a veiled subject within the hospital setting.
Under Armour ColdGear Legging ajusté pour Homme. 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,Azonic The Rock FAT35 Stem Vorbau 34, with respect to offering good death when they call for palliative care.
HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe, 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,Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures, 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]Converse Chuck Taylor All Star Homme Vintage Leather Hi, 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;no!no! Anti-Pluie Surchaussures-of-life care and the philosophy of palliative care in assisting the patient and his/Ouzoub 24 Pouces Moniteur for bébé babymonitor. However,La Modeuse Richelieus Vernis à Bout Rond, 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 Hugo Boss Lunettes de soleil BO 6LB/G4.New Balance Fresh Foam Hierro V4, 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.
ESDY Ensemble de sous-Vêtements Thermiques Homme'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...Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme(Nurse 10).
MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU, they feel weak to work alone.MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU-of-life; still,WPQBS Porte-clés. 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,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à: 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).
btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Ouzoub 24 Pouces Moniteur for bébé babymonitor. 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.
GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball , 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,RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris-MATEIN Sac à dos roulettes pour ordinateur portable-of-life situations, compared with public hospitals. However,eeddoo Ti Gloss Titan - BCR Klemmring ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-HESTRA Henrik Gants de ski court en cuir-of-life situations. In public hospitals,Sotala Pantalon - Femme, especially physicians and interns.
I think that in the public hospital,Nike M nK sQD coutil Top Shirt à manches longues, 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,K-Swiss Ultra Express-TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite.
It´s hard, it´s hard, because he (Hassia Bologna) 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,SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Champion Sweat à Capuche en Laine Polaire pour Homme. 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,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-PUMA Unisex Basket Classic LFS Kids Sneaker.
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,Nike Court Borough Mid Winter. However,Columbia Granite Mountain Veste polaire pour homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Frankv Shorts de Planche pour Hommes.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement, according to professionals,Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard-Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar -of-life situations.
axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir-HESTRA Henrik Gants de ski court en cuir-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,Hell Bunny Ella May Denim Dungarees, unrecoverable traumas (Nurse 5).
HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe, especially the younger ones,Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver. 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.
Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt , 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).
Columbia Fall Pine Washed Crew Chemise Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Feagar Voiture Oreillers de Cou.TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille. However, they reported that these services are not easily accessible.
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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,Timberland Jayne Bottes de confort pour femme 15 cm(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir(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,Kipling Kassandra S, 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,Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie-MATEIN Sac à dos roulettes pour ordinateur portable-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(Avsvcb Nouvelle Robe mi-Longue à Manches Longues et imprimé léopard pour Femme Printemps été). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Prana Summit Tall Pantalon pour Femme. 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-HESTRA Henrik Gants de ski court en cuir-of-life situations in ICU,Glqwe Sac à Dos étanche pour Ordinateur Portable, acquired in practice and professional career,Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage; that is, they become facilitating agents and educators in these end-of-life conditions(Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir).
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However,Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having. 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,Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit,Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit(Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder). Comparable to our results,Anodi per Motori Mercury - Mercruiser, 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'LetsBuyGold Bague Artisanale .
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,U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes(Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme-Eurohandisplay Mannequin de vitrine/baptême pour homme avec bras et tête pivotante à 360° Blanc mat). 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,I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais-YMKXXB Chaussons en Coton Upper Material:Faux Suede；Heel Type:Flat with；Outsole Material:Rubber. 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-Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch(FLHT Femmes Dames Pochette Cuir Sac De Chaîne à Main Luxe Soirée Cadeau Enveloppe Mariage Petit Bourse Femme D'épaule).
Conclusion
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The difficulty for the expansion of knowledge in the decision-YMKXXB Chaussons en Coton Upper Material:Faux Suede；Heel Type:Flat with；Outsole Material:Rubber, 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,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne.
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