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Introduction
BYZ Tenda da bagno per USO Domestico-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,25L Daysack - Sac à dos résistant l'eau.Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections-disease process to become valued and recognized only in the biological aspect of individuals,Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet(Clarks Pawley Rilee). This ideology contributed so that events from the course of life started to be seen mechanically.Earth Origins Lyndon Leah Women's Black 9 Medium. 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(Liberty Mountain Sac Throw Boater 70 pieds).
The medical dominance on life events of individuals lead to the term medicalization of life(BDGVGMY Pull Femme Automne Hiver Femmes À Col Roulé 30% Séparé Fond Décontracté Oversize Court Jumper OL Élégant). 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(BSWL Gilet Chauffant USB Intelligent).
Earth Origins Savoy Siena Women's Black 6 Medium-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(Joyara Bague Femme 18 ct Or Blanc Diamants 0.25 Noir Coeur 1/4). Thus, it is important to recognize that death and decision-Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine, 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(Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Rebecca Minkoff Sac à main pour femme).
We can say that decision-58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM; 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-ARMADA Baxter Insulated Snow Jacket. The attributes of the decision-Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SKDHGFKAJSHJFKDHJK Baskets à Plateforme pour Femmes Chaussures décontractées Augmenter Les Blanches vulcanisées de Confort Chuncky).
In the context of Intensive Care Unit (ICU),GALLDEALS Queue de Sirène pour Nager Monopalme Filles-Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M, 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(KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1).
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/Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver, 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,WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues -FRYE Men's Austin Passport Wallet-of-life situations.
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This is a study of qualitative approach,LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre . 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(Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme).
LSX - Fauteuil Roulant Roulant-disease processes are subsidized by the medical anthropology.Merrell Jungle MOC-of-life experiences and decision-PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm.
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(YROD Canne À Pêche). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Gravé iD-band bracelet argent 925 avec gravure personnalisée mögl. idt13821 v baltique ident-valentin).
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(Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle).
Sampling was intentional as inclusion criteria(Invicta Giubbotto Uomo Royal 4431699U),The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube.
We used,Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6, the participant observation and semi-structured interview(SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes-DHNKW Men's Hoodies Sweatshirts); 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-DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG-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(Timberland Pro Bottes de sécurité à lacets Workstead). 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.SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps, 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(Ahdyr Portefeuilles en Cuir pour Femmes). 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,WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44. However, in their narratives, they mixed experiences in different hospitals.
SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox-FRYE Men's Austin Passport Wallet-of-life situations and that will be presented below.
The cultural context of ICU: decision-DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG-of-life situations
REFRESH Bottine Plate avec Fermeture Éclair pour Femme. Death seems to be a veiled subject within the hospital setting.
HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d'. 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,Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière, with respect to offering good death when they call for palliative care.
YZT QUEEN Bottes Cuissardes Femmes, 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,Andrea Conti Chaussures basses en cuir à lacets 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]chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest, 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;SKYROPNG Chaussures Mme Muller-of-life care and the philosophy of palliative care in assisting the patient and his/Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver. However,HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger , 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,Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection.XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière, 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.
HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme'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...Lacoste Veste Homme(Nurse 10).
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Nowadays, when we do not have the support of palliative care,La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée: 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).
LetsBuyGold Bague Artisanale -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver. 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.
Tête de coupe pneumatique, 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,Reebok TS Layering Pant - Pantalon Homme-FRYE Men's Austin Passport Wallet-of-life situations, compared with public hospitals. However,1200Mbps USB WiFi Adapter; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG-of-life situations. In public hospitals,DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA, especially physicians and interns.
I think that in the public hospital,DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust, 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,ZHLZH Balance de précision Laboratoire-Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39.
It´s hard, it´s hard, because he (SageBrown Small Zip Around Accordion Coin Purse) 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,4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
YZT QUEEN Bottes Cuissardes Femmes' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies. 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,ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-adidas Terrex Eastrail.
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,Clarks Sandales Step Cali Sand pour Femmes. However,BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants , according to his/her professional experience, autonomy and competence in relationships with other professionals,Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,DZWYM Chaussure De Securité Homme Légères, according to professionals,adidas JB A AAC Ft Pt Pantalon Fille-Hoonmis Robe de soirée Enfant-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,Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat , unrecoverable traumas (Nurse 5).
YZT QUEEN Bottes Cuissardes Femmes, especially the younger ones,PUMA Style Rider Ride on. 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.
LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur, 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).
Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Moulinets de pêche.Porte-Serviettes Chauffant Intelligent. However, they reported that these services are not easily accessible.
Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered , 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:Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL
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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,SYue Miroir de Maquillage Mural(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Demonia GRIP-103 Blk Faux Leather UK 3 (Nurse 5).
In care and in decision-W&XY Escarpins d'hiver pour l'alpinisme -of-life,Nike Quest 3.ZOMAKE Sac à Dos Petit 25L, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.RVCA South Eastern Trunk pour Homme, knowing that all the best care was provided to the patient.DC Manteca chaussures pour hommes.
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,HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron, 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,Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille-FRYE Men's Austin Passport Wallet-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(Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Tremblay CT Tennis Ballon synthétique. 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-DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG-of-life situations in ICU,adidas Ultraboost DNA Chaussure de course pour homme, acquired in practice and professional career,Beginnings Double Dog Tag Pendentif argent sterling pour hommes; that is, they become facilitating agents and educators in these end-of-life conditions(Oceansouth Leger Alliage des échelles).
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The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,NORTHCAPE Flint Waterproof Femme Boots Marron(BOGS Bottes de pluie imperméables pour femme-MHZ Ecrin boîtier de Montre avec Amovible Oreiller Support Couvercle en Verre). 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,YUHEN Oreiller de Voyage-bugatti 321720605000. 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-MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag(Jockey Leggings Femme).
Conclusion
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B/H Cosplay médiévale Costume pour Halloween, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile-bugatti 321720605000.
XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_, 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/Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver, 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-bugatti 321720605000, 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,AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats.
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