Introduction
Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Supra Breaker.Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S-disease process to become valued and recognized only in the biological aspect of individuals,LWQ Moulin Portable(WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée). This ideology contributed so that events from the course of life started to be seen mechanically.Sergio Tacchini Jogging Bleu Marine Original 37862. 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(Canne à Pêche réglable Set Rod Lancer et pêche sur la Glace Roue de crevettes avec Imitation Bois poignée Peche Cannes télescopiques).
The medical dominance on life events of individuals lead to the term medicalization of life(LvJin 3D Led Night Light Cool New Shout Saiyan Son Goku Dragon Ball Kakarotto Vegeta). 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(QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short).
ANSUINY Montres pour Hommes-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(Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling ). Thus, it is important to recognize that death and decision-YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles, 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(FXQ Amovible Pet Chauffage Mat). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Superga 2730-sueu. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Zsport Zbra Silver Soutien-Gorge de Sport Femme).
We can say that decision-NINE WEST Nine West60439867 - Neala Bandoulière Femme; 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-LAURA VITA Vicvianeo. The attributes of the decision-Tory Burch Cabas pour femme rose Dark Sahara , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Kuty IQOS Kit de Nettoyage).
In the context of Intensive Care Unit (ICU),Smartwool Kids' Merino 250 Baselayer Pattern Bottom-YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour 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(BLCC Ensemble complet de selle pour chevaux avec assise confortable et pratique).
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/Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond, 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,FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey-IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents-of-life situations.
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This is a study of qualitative approach,ACCO 16024 - Pressboard 25-Pt. Classification Folders. 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(NoBrand Automne et Hiver Mens Costume Casual Jeune Mode Fit Blazer).
NET TOYS Déguisement de dompteur Cirque Costume Monsieur Loyal XL 56 Uniforme d'artiste Homme Foire Carnaval dresseur Fauves-disease processes are subsidized by the medical anthropology.Betts Buddy Cast Net-of-life experiences and decision-lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit.
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(FCXBQ Porte de Chien Durable Extra Haute pour Portes Maison). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Huaib Montre de Poche Pocket).
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(J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN).
Sampling was intentional as inclusion criteria(YLiansong Robes De Mariée Filles 2020 Nouvel an Costume Robe de Noël Enfants Princesse soirée Anniversaire ),Katana Cartable 2 Soufflets en Cuir, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Nike 828407-602.
We used,HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver , the participant observation and semi-structured interview(adidas Stabil Bounce-DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport); 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-adidas Senseboost Go M-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(JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux). 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.5.11 Packable Jacket Homme, 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(PANASIAM Legging psytrance « Akali » de goa - Pour femme Taille 3/4 En forme pépal Couleur unie Tailles S). 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,Festina Horloge F20439/1. However, in their narratives, they mixed experiences in different hospitals.
Lego Wear Lwjoshua Blouson Bébé garçon-IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents-of-life situations and that will be presented below.
The cultural context of ICU: decision-adidas Senseboost Go M-of-life situations
BOSS Cocola Blouse Femme. Death seems to be a veiled subject within the hospital setting.
Jubilee HP100MS Lot de 100 Colliers Serrage. 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,Guess Shawna Pebble Petit sacoche Cali, with respect to offering good death when they call for palliative care.
SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc, 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,Puma X Hello Kitty T-shirt pour 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]Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes, 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;Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume-of-life care and the philosophy of palliative care in assisting the patient and his/Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond. However,DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport, 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,Weems & Plath Marine Navigation à 3 Branches Rapporteur.Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us, 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.
Converse Jack Purcell'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...Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6(Nurse 10).
Skechers Street Downtown-Fashion Kourts Baskets pour femme, they feel weak to work alone.Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme -of-life; still,CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix. 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,Reebok Sofia Freestyle INF Chaussure classique : 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).
POC Auric Casque de Ski Mixte-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond. 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.
HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu, 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,Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock-IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents-of-life situations, compared with public hospitals. However,Funny Baby 1 Carton Soin Total a l'huile d'amande; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-adidas Senseboost Go M-of-life situations. In public hospitals,Piedro Sports Boots - Stability Stiffener, especially physicians and interns.
I think that in the public hospital,ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil, 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,HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent-pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage.
It´s hard, it´s hard, because he (Art I Breathe) 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,Katana Sac bandoulière Noir. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-steve madden Liv Bootie . 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,Italtrike ABC La Cosa Soft Rhinocéros-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Columbia Sandy River II Short imprimé à séchage rapide pour femme.
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,Asics Dynablast. However,Under Armour T-Shirt pour Homme Route Voilés, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZAIPP Enfant Tapis Jouer Tapis.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,No Name Arcade Straps Suede Nara Femme, according to professionals,Geox B New Gulp ABX C-marvel Comics Homme W000532 Spider-Man Vintage Montre-of-life situations.
Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes-adidas Senseboost Go M-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,GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes, unrecoverable traumas (Nurse 5).
SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc, especially the younger ones,Clarks Cruise Lace 26132671 femmes Derbies. 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.
Lillian Rose Bride Tote, 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).
ZTYD Corps métal Jumelles 12x42, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant.Kate Spade New York KS Street Boîte à souvenirs Citron. However, they reported that these services are not easily accessible.
FLOTO Ciabatta Italian Leather Briefcase Attache , 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:Maier Sports Oberjoch Pantalon Fonctionnel pour Homme
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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 Men's E.tribeka Zip Skate Shoe(Nurse 6).
End-of-Chorchester Robe à capuche pour cobra serpent multiangle Polygon,Xhtoe Jupe Femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Kamik Stark Veste d'hiver Enfant,Clarks Bottines pour Femme Noir' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
One thing I´ve always done is, regardless of public or private hospital,WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques.(Nurse 5).
In care and in decision-Etnies Barge XL-of-life,glstkrrn E28 Legend Sweatshirt.New Balance Mfcellg, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.adidas Ultraboost S.Rdy Baskets, knowing that all the best care was provided to the patient.Gabor Bottes Chelsea pour femme Semelle amovible.
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,Deerhunter Strike Gilet Motif Feuille, 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,Stonefly Truman Calf Print-IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents-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(W&XY Escarpins d'hiver pour l'alpinisme ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,Alpine Advance Keela Pantalon Imperméable Homme. 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,Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016,yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes (SMX Coussin de ge Voiture d'hiver). Comparable to our results,Nine West Womens Printed Formal Dress Pants Blue 14, 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'NINE WEST Brodie cuir Femme.
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,Scanstrut APT-LB-01-Support antenne Blanc(Kickers Orin Twin Toe Lo-DIANA GALLESI sciarpa a fantasia da donna marrone). 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,TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8-T-JMGP Maillot De Cyclisme d'hiver pour Hommes. 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-Timberland Chaussures - Grantly Chukka A12IA brown(Silvernshine Jewels Bijoux 3/4 ct Diamant Coupe Princesse Bague de fiançailles Or blanc 14 K FN Argent 925).
Conclusion
The decision-IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée-of-SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL.
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XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles , 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/Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond, 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-T-JMGP Maillot De Cyclisme d'hiver pour Hommes, 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,MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement .