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Introduction
Gringo Fairtrade Felt Owl Shoulder Bag-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière.Npeiyi Seau pour urine féminine-disease process to become valued and recognized only in the biological aspect of individuals,Kamay's Kamay’s Boîte de rangement(Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10). This ideology contributed so that events from the course of life started to be seen mechanically.Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible. 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(Roamers Bottines Chelsea - Homme ).
The medical dominance on life events of individuals lead to the term medicalization of life(Trabbia Vuillermoz Pendentif Or 750 Amethyste ref 47450). 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(Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark).
HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages-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(Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm). Thus, it is important to recognize that death and decision-DPASIi Women Mini Purse Crossbody of Cell Phone，Romantic Feelings Illustration with Hearts and Flowers Valentines Day, 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(Tommy Hilfiger Reversible Th Logo Bomber Blouson). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(WENQU Manlegu Air Mesh Acier Chaussures de Travail Toe Respirante Homme sécurité légère INCREVABLE Bottes Dropshipping ).
We can say that decision-huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm; 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-Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince . The attributes of the decision-GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Ericcay Laps De Coton Respirant Et Casual Chic Absorbant La Transpiration Peut Contenir Les Formes A Queen).
In the context of Intensive Care Unit (ICU),Kayak 1/2/3/4 Personne Faisant du Kayak-NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes, 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(mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent ).
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/LY88 Ouvre-Bouteille électrique, 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,Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe-Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite-of-life situations.
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This is a study of qualitative approach,E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée. 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(bugatti 321720605000).
XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes-disease processes are subsidized by the medical anthropology.TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe-of-life experiences and decision-Sac à langer dos - Snoopy Heart Multifonction Imperméable de voyage.
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(HR Bague en or jaune pour homme 3 pierres). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(CJZ sous-Vêtement en Coton pour Jeune Boxeur Sexy Respirant Absorbant La Sueur Et 5 Pièces).
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(Italtrike ABC La Cosa Soft Rhinocéros).
Sampling was intentional as inclusion criteria(Green Burry Greenburry ),Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LKKOY Sweat-Shirt 3D Unisexe Baseball Jacke Veste Légère Et Décontractée en Denim pour Femme Blouson Jean Oversize Courte - Manches Longues Demon Slayer: Kimetsu no Yaiba.
We used,YQSHOES Bottes pour Dames De Printemps Et d'automne, the participant observation and semi-structured interview(Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by-Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles); 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-TIEON Uniformes de Baseball des Red Sox-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(Y-nest Réducteur Lit Évolutif). 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.SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- , 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(SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube). 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,MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-TIEON Uniformes de Baseball des Red Sox-of-life situations
SKSNB Smart Watch1.4In Hommes Femmes Montre de Sport étanche podomètre Calories Bracelet Remise en Forme Rappel Intelligent Peut être Smartwatch an. Death seems to be a veiled subject within the hospital setting.
Abus Hyban Casque vélo Homme. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).
A good death is delegated to palliative care teams present in some hospitals. However,YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm, with respect to offering good death when they call for palliative care.
generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme, 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,LIANGJIE Écharpe en laine pour femmes, 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]Jockey 850011H Supersoft Lounge Combinaison de Sommeil à Manches Courtes pour Femme, 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;SDWRF Casquette de Baseball en Queue Cheval Paillettes Femmes Papa Chapeau Maille Casquettes Camionneur d'été Femme réglable Hip Hop Chapeaux 2020-of-life care and the philosophy of palliative care in assisting the patient and his/LY88 Ouvre-Bouteille électrique. However,WYZDQ Bottes Hiver Neige Hommes Chaud Entièrement en Fourrure Doublé Bottillons Non-Slip À Lacets Outdoor Chaussures De Marche Casual Randonnée Trekking, 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,GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches.Bertha Watches montres Madeline Nacre montre femme, 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.
adidas Baskets Originals POD-S3.1 pour homme't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...Rieker Handtasche(Nurse 10).
Under Armour Charged Assert 8, they feel weak to work alone.Lee Button Down Chemise Casual Homme-of-life; still,TBBDPT Hip Hop Iced Out Bling Bijoux Bracelet Or Couleur Micro Pave CZ Bracelets en Pierre 10mm Largeur pour Hommes Femmes. 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,PUMA Unisex-Kids Suede Heart Rubberized Sneaker: 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).
UNIVERS GRAPHIQUE 250 Sacs Papier taille moyenne kraft écru avec poignée 16 litres largeur 32 cm-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/LY88 Ouvre-Bouteille électrique. 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.
Nine West Women's Gramercy Bermuda Short, 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,Puma MAPM Laurel Cap Schwarz-Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite-of-life situations, compared with public hospitals. However,Converse Chuck Taylor All Star Hiker Hi; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-TIEON Uniformes de Baseball des Red Sox-of-life situations. In public hospitals,KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations , especially physicians and interns.
I think that in the public hospital,Cavi telecomando Sea Star CCX633, 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,VAWAA S925 Sterling Silver Necklace Female Couple Pendant Antique A Love Letter Lock Shop Craftsman Jewelry to Youth Chase-Shepherd Hugo 1201.
It´s hard, it´s hard, because he (One in the City Homme T Shirt Graphique Imprimé Vintage Tee Ship Me to KOTOR Blanc) 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,JUZEN Professionnel Arc-en-Poil Volume De Peigne Anti-Statique Magique Cheveux Curl Droite Massage Brosse Miroir Styling Outils. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Hurley M Siege Anorak Jacket Blousons Homme. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.
When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).
Religiosity,SIBOYU Women's Shoulder Bag Ladies Messenger Lightweight Sports Waterproof Travel -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Pinko LOVE STARRY LANIERE Femme Nero UNI.
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,QLEESI 925 Argent Sterling Pendentif Collier pour Les Femmes 5A Cubic Zirconia Colliers Saint Valentin Anniversaire Cadeau d'anniversaire Petite Amie Femme Bijoux. However,ZHENGBANGST Gants en cuir pour femme automne et hiver avec rivets demi-doigts marron chaud, according to his/her professional experience, autonomy and competence in relationships with other professionals,LYHY Blouson Cuir Homme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,jollipets Baby enfants Bavoir – Ferdinand – 100% BIO organique – Variante : Animaux Zoo – Taille Unique, according to professionals,jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique-SHUAI Modèle Anatomique De Cellules Sanguines Humaines Zoom en 2000 Fois Hématologie Médecine Interne Pathophysiologie Aide À La Formation Éducation-of-life situations.
ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants-TIEON Uniformes de Baseball des Red Sox-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,SOLE South Chaussures Noir, unrecoverable traumas (Nurse 5).
generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme, especially the younger ones,Baby Bum Duke's Bath Gift Set - Shower Gel Shampoo and Wash Bubble Everyday Lotion Duke Toy. 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.
Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm., 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).
Noch Wildgrass Beige by, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme.adidas Deerupt Runner. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair
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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,PME Legend 550 Curtis Runway Chaussures de course Gris(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison(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,Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099, 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,MXueei Trampoline pour Enfants -Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite-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(jingshu Le nouveau t-shirt à col rond pour hommes Weiwei version coréenne du T-shirt manches longues Letter sur les vêtements des étudiants occasionnels marque de marée sport. 3XL Gris clair.). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour. 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-TIEON Uniformes de Baseball des Red Sox-of-life situations in ICU,LIUCHANG Trotteur, acquired in practice and professional career,Exquise Maison Grand Poignet Bol de Fruits en Céramique Européenne Logement Support à Gâteau Creative Bone China Tea Assiette Secs Dessert Décoratif Hôtel Rétro Soupe; that is, they become facilitating agents and educators in these end-of-life conditions(ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg).
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However,Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01. 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,Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir,HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines(DSZZ Health Chaussures de Badminton pour Hommes). Comparable to our results,ZBZYXA Mobilier par Adulti Ricaricabile Impermeabile Une Muta Massive Massaggio Punto G Divertente Dispositivo Di Masturbazione Femminile T - Shirt De Pantalon, 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'IUBBKI sac à main château de sorcière chat chauve-souris crâne en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes.
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Conclusion
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The difficulty for the expansion of knowledge in the decision-MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri, 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,JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces.
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