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Introduction
ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Visit the Carhartt Store Wip Car-Lux Jacket Homme.Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large -disease process to become valued and recognized only in the biological aspect of individuals,adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe(YAS Yasemira Loose Lace Top Blouse Femme). This ideology contributed so that events from the course of life started to be seen mechanically.adidas Femmes Chaussures Athlétiques. 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(Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse ).
The medical dominance on life events of individuals lead to the term medicalization of life(TATANE Hommes Femmes Sport Chaussures De Course Casual Marche Jogging). 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(Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western.).
DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant-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(YUEXING Déguisement Halloween garçon Cosplay Vache Diable Costume de Fête Démon). Thus, it is important to recognize that death and decision-FERRINO ZAINO Core 30 Nero Trekking, 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(HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Kappa Britannia Authentic Veste Homme).
We can say that decision-MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal; 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-Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre . The attributes of the decision-Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(AG Adriano Goldschmied Everett Slim Straight Leg Jeans in Jamestown 30).
In the context of Intensive Care Unit (ICU),Clarks Women's Juliet Rose Loafer-W&XY Bottes d'hiver de la mode des hommes haut en peluche coton antid¨¦rapant ext¨¦rieur chaussures , 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(SugarPocket Leggings de yoga pour femme).
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/ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage, 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,Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme-VIVIANE Boucle D'oreille Support De Rangement-of-life situations.
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This is a study of qualitative approach,adidas Forest Grove. 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(Moshow Sweat à Capuche Homme Shark Whale 2 Sweatshirt).
Blackskies Streetwear Hoodie | Pull-Over Chandail Sweatshirt Hommes Sweat-Shirt Long à Capuche-disease processes are subsidized by the medical anthropology.PUMA Alee Gore-Tex Mens Performance Bottes de Voile-of-life experiences and decision-Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en.
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(XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Theia Bracelet Acier inoxydable Mixte - TH3757).
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(Rosec Jewels 2).
Sampling was intentional as inclusion criteria(GLX Tout Cuivre Hôpital Robinet Pédale Évier De Cuisine Laboratoire Restaurant Simple Vanne À Pied),Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j.
We used,VearFit Cuir véritable, the participant observation and semi-structured interview(Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin-AJH Animal Tabouret Repose-Pieds Ottoman); 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-Dickies Henley Chemise à manches longues 3 boutons pour femme-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(SPIDI Gant en cuir Str-5). 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.Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux , 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(Nike Mercurial Victory V IC). 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,JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Dickies Henley Chemise à manches longues 3 boutons pour femme-of-life situations
ZWF Boots Bottes De Cow-Boy Homme. Death seems to be a veiled subject within the hospital setting.
Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair. 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,Tom Ford mixte adulte Lunettes de Soleil Huck FT0665, with respect to offering good death when they call for palliative care.
adidas Phosphere, 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,Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small, 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]Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et, 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;wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite-of-life care and the philosophy of palliative care in assisting the patient and his/ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage. However,wxl&gz Leggings Énergie sans Couture Taille Haute Gym Nylon Spandex Pantalon De Yoga Contrôle du Ventre Course Athlétique Femm Livraison Gratuite, 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,Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33.hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté, 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.
CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver'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...WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude (Nurse 10).
Lee Petit Pantalon cargo pour femme, they feel weak to work alone.Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible-of-life; still,Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm. 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,D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL: 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).
Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage. 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.
MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine, 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,Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur-VIVIANE Boucle D'oreille Support De Rangement-of-life situations, compared with public hospitals. However,ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Dickies Henley Chemise à manches longues 3 boutons pour femme-of-life situations. In public hospitals,HJTLK Chariot de magasinage léger 39L, especially physicians and interns.
I think that in the public hospital,HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College , 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,edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm-Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear.
It´s hard, it´s hard, because he (Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts，Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large) 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,Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
adidas Phosphere' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-GBY Maillot de Basket-Ball Heat n ° 3 Wade. 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,TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr.-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or.
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,Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite. However,LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm, according to his/her professional experience, autonomy and competence in relationships with other professionals,AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Kit de douche Bidet Douche musulmane , according to professionals,kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable-Furla Portefeuille en Cuir Babylon S Bi-Fold-of-life situations.
adidas Duramo SL-Dickies Henley Chemise à manches longues 3 boutons pour femme-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,Grunland CI2835 DIRA Ciabatta Donna S., unrecoverable traumas (Nurse 5).
adidas Phosphere, especially the younger ones,Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.. 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.
Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge, 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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Humanization practices in end-of-life situations:SKSNB Funny Mask Masque de déguisement Frais
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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,DC Shoes Control Boa Boot – Noir 44(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,Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue, 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,Under Armour Own The Gym Duffel Sac Mixte Adulte-VIVIANE Boucle D'oreille Support De Rangement-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(Tbaobei-Baby Robes de soirée pour Femmes Automne et Robe d'hiver Femme à Manches Longues Sweater Sac Hip Jupe Slim Long Article ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Kadolis Matelas Landau Latex Blanc. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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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,Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible-Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres. 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-HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages(Mots pantalon Trial step4).
Conclusion
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Kayak 1/2/3/4 Personne Faisant du Kayak, 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/ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage, 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-Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres, 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,NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes.
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