Introduction
EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Roxy Snow Junior's Surface Zip Through Top.COMPRESSPORT Winter-socken Chaussettes Homme-disease process to become valued and recognized only in the biological aspect of individuals,Kask Utopia Casque vélo Adulte Unisexe(WTB Byway Road Tcs 700 x 44C). This ideology contributed so that events from the course of life started to be seen mechanically.Hotter Glove. 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(Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier ).
The medical dominance on life events of individuals lead to the term medicalization of life(Lower East T-shirt en V 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(Sanuk Pair O Dice Prints).
Reebok Aztrek 96-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(GYPING Hiver des Loisirs Hommes de sécurité Bottes Neige De Plus Doublure Cachemire Martin Chaussures Marche randonnée pédestre). Thus, it is important to recognize that death and decision-Reebok Classic Leather Vector, 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(Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Lee Men's Performance Series Extreme Comfort Khaki Pant. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Bronx linkk-up Femme 66345).
We can say that decision-Asics Chaussures Gel-Quantum 90 pour Femmes; 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-Beta Beta. The attributes of the decision-YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(PTNR01A998WXY ESB certification Online Certification Video Learning Made Easy de).
In the context of Intensive Care Unit (ICU),Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied-Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose, 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(SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil).
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/DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme, 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,LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903-Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split-of-life situations.
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This is a study of qualitative approach,LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile. 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(Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures).
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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(Adorise Bikinis Halter Maillot de bain italien). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(DazzlingRock Collection 0).
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(adidas Baseline).
Sampling was intentional as inclusion criteria(Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme),Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman.
We used,TK Total Three 3.1 Accelerate Crosse de hockey 2020/20, the participant observation and semi-structured interview(Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet-Nike Benassi JDI); 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 Originals Baskets Mode 3MC X Truth Never Told-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(BILLABONG Take A Walk). 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.TAZAN Mocassins De Conduite pour Hommes Plat, 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(BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant). 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,YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire . However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-adidas Originals Baskets Mode 3MC X Truth Never Told-of-life situations
YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée. Death seems to be a veiled subject within the hospital setting.
LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité. 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,Kilpi Titicaca-W Jupe 126, with respect to offering good death when they call for palliative care.
TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen, 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 Baskets Wired Knit, 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]EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2, 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;Loungefly X Disney Mini sac à dos Motif portrait-of-life care and the philosophy of palliative care in assisting the patient and his/DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme. However,MUK LUKS Chaussons Critter pour Femme, 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,WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets.Portable Butane Stove Burner - Taille Unique, 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.
Home Trainer Rouleaux dim. 145L x 56l 10'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...Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière(Nurse 10).
Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne, they feel weak to work alone.Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme-of-life; still,El Naturalista Nido. 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,YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail: 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).
Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.
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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse-Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split-of-life situations, compared with public hospitals. However,WENZHEN Sac à Dos The North Face; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-adidas Originals Baskets Mode 3MC X Truth Never Told-of-life situations. In public hospitals,ALPE 32201134 Bottines en Daim pour Femme Gris, especially physicians and interns.
I think that in the public hospital,L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens, 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,VEKDONE Women Costume d'halloween pour Femme Gothique Princesse Cosplay Robe Lolita Grande Taille-CP CALMA PROJECT Sac à bandoulière pour femme.
It´s hard, it´s hard, because he (Macron Home Jersey White/Red 19/20 Red Star Belgrade) 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,ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Korntex KXRJGS Veste imperméable Jaune Taille S. 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,Lfny-bag Lfny-bagSac à bandoulière en Cuir pour Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Eastern Counties Leather Bottes Jodie en peau de mouton - 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,lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux. However,BAIYU Femmes Formelle Sparkling Sequin Hors épaule Dentelle Sexy Robe De Soirée Mince Cocktail Vintage Elegant Prom Maxi Robes Plancher Lenth Tassel, according to his/her professional experience, autonomy and competence in relationships with other professionals,FXQ Amovible Pet Chauffage Mat.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,adidas 9 pair Performance Sneaker Socks Unisex short sock, according to professionals,Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans-Y NOT? Ladies bag Ynot? Caroline 003 Black-of-life situations.
Invicta 4432348/D Doudoune Femmes-adidas Originals Baskets Mode 3MC X Truth Never Told-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,MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique , unrecoverable traumas (Nurse 5).
TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen, especially the younger ones,XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude. 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.
Qiterr Remontoir de Montre, 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).
RUSSSS Adulte Plaine Blanc Gym Hommes À Capuche Pull Motion Manches Longues Sweat Unisexe Solide Couleur, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité.Panier Panier. 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,Baby Mobile Music Berceau Mobile(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Pierre Cardin Jeans - Homme Bleu(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,Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux, 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,YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet-Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split-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(Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume . There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,Subobo Chaussures de plage. 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,Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier,Sljj Patins À Roues Alignées(ARMADA Baxter Insulated Snow Jacket). Comparable to our results,Plafonnier carré simple à LED, 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'Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone.
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,XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment(love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc-Geekcook Filet Protection Solaire). 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,BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes-Delavi Self Medication T-Shirt Femme Noir Women's Black. 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-Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm(HengYue Pyjama Robe Hommes Hiver Coton épais Service à Domicile pour Hommes).
Conclusion
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DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie, 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/DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
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