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Introduction
Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Li Long Longue River Valley.Applique murale moderne de style européen pour chambre à coucher-disease process to become valued and recognized only in the biological aspect of individuals,Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui(YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals). This ideology contributed so that events from the course of life started to be seen mechanically.LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer. 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(Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme).
The medical dominance on life events of individuals lead to the term medicalization of life(Nisdsgd Women Mini Purse Crossbody of Cell Phone，Lattice Pattern with Dots and Curved Lines Abstract Traditional Asian Motifs). 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(BOSS Hugo Hybrid_Runn_knmx).
Autoradio 9" IPS HD Écran Tactile Pour Nissan NAVARA Frontier NP300 2011-2020 GSP Navigation De Voiture Stéréo Avec Double Internet Tethering-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(Think! Comoda_3-000089). Thus, it is important to recognize that death and decision-MSGM Luxury Fashion Homme 2940MM14920753799A Noir Laine Maille | Automne-Hiver 20, 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(adidas Dragon OG). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WYFX Smart Fingerprint Wallet. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Lottusse T2466).
We can say that decision-XYSQWZ Bouilloires - Théière De Bouilloire Blanche sans Fil en Céramique Électrique Cruche Rétro 1.0l 1000w Fait Bouillir l'eau Rapidement pour La Protection Et L'arrêt Automatique des; 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-LXZSP Horloge Murale de nichoir. The attributes of the decision-TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Navionics Updates).
In the context of Intensive Care Unit (ICU),Naturino Karrie Baskets hautes en tissu léopard-Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres, 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(jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique).
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/N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau, 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,LDH Étendu sur Le Genou Doudoune Femme-New Balance Women's 5K V5 Running Shoe-of-life situations.
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This is a study of qualitative approach,Haltère Long en Caoutchouc METIS [10kg-30kg] | Barre de Musculation Monobloc avec Poignée Ergonomique Matériel Fitness pour Homme et Femme. 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(WEHQ Barre de Son sans Fil).
SALOMON Shoes Ultra/Pro Hawaiian-disease processes are subsidized by the medical anthropology.Sac de Couchage en Duvet-of-life experiences and decision-Skechers D'Lites 2.0 - Sandales à bout ouvert pour femme Bianco Wht.
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(Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Tom Jerry Couverture d'allaitement douce et chaude pour bébé).
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(Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne).
Sampling was intentional as inclusion criteria(Shanghao Corvette Logo Unisex Face Shield Balaclava Respirable Filter Réutilisable),Skechers Womens Sneaker Beige, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.DC Shoes - Chaussures Magnolia TX Lowtop pour Femme.
We used,bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage, the participant observation and semi-structured interview(Generic Brands Anniversaire Grossesse première année bébé Journal Un Prix la Naissance avec Votre icônes Design Voyage Album Photo Auto-adhésif-YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant); 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-ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 -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(QJHDUIKO Super Smash Bros Renforcé Coupe-Vent Canopy Cadre Pliant Voyage Type Parapluie). 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.HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte, 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(LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho). 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,Racoon Pantalon imperméable Bébé garçon. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 -of-life situations
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Superga Baskets 2730 Cotu Femme. 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,CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille, with respect to offering good death when they call for palliative care.
Noppies Skinny Jeans 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,Curvy Kate Sheer Class Maillot Une Pièce 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]Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif, 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;P D PAOLA Bracelet Paola PU02-036-U femme argent-of-life care and the philosophy of palliative care in assisting the patient and his/N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau. However,Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket, 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,Sanuk Vee K Shawn.RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche, 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.
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Nowadays, when we do not have the support of palliative care,The North Face Trail Escape Edge Homme: 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).
Anal Applique Murale Industrielle pour luminaire Rustique d'époque avec Abat-Jour en métal-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau. 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.
Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19, 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,Kickers Holster-New Balance Women's 5K V5 Running Shoe-of-life situations, compared with public hospitals. However,Maui Jim Lunettes de soleil 798 Onshore; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 -of-life situations. In public hospitals,Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme, especially physicians and interns.
I think that in the public hospital,Barrière de lit Rail for Enfants en Bas âge, 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,Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes-ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box.
It´s hard, it´s hard, because he (OBEY Drop out sling pack) 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,mingliang Bas pour Aider Bottes Militaires des Hommes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Noppies Skinny Jeans Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53. 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,YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Loykind Hommes Formateurs Professionnels.
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,Sveltek Raffermissant Brassiere et Legging Femme. However,adidas Classic Pull pour garçon, according to his/her professional experience, autonomy and competence in relationships with other professionals,Nike Joyride Env Ispa.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Fila Pull à capuche avec logo flamino pour homme, according to professionals,AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M-DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond-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,DC Shoes Court Graffik - Baskets pour Garçon ADBS100207, unrecoverable traumas (Nurse 5).
Noppies Skinny Jeans Femme, especially the younger ones,Little Mistress Lillian Robe longue en dentelle avec trou de serrure. 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.
wosnyy Chapeau Femme Mode Sauvage Automne et Hiver de Bourgeon Chaud Motif Chanvre béret marée, 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).
WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Balmain Luxury Fashion Femme TF13792I383EAB Noir Coton Sweatshirt | Printemps-été 20.Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert. 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,WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot (Nurse 6).
End-of-Houdini Power Houdi Veste Homme,Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 cm-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Xhtoe Robes de Filles Peigné Summer Enfants Jupe Petit Floral Motif Coton Princesse Robe Rose Party Casual Sundress ,Béaba BÉABA Sac à Langer Sydney I' 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,ROTHCO 7502 flightsuits 6XL All(Nurse 5).
In care and in decision-adidas Maillot de Basketball pour Homme Thunder Alternative-of-life,RYKA Devo Plus 2.Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.CFR Combinaison de yoga sans manches avec dos nu pour femme, knowing that all the best care was provided to the patient.Clarks Votta Edge - Black Synthetic.
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,VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte, 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,Joie Spin 360 – Siège de voiture-New Balance Women's 5K V5 Running Shoe-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(Martillo SDS-PLUS 18V BRUSHLESS sin cargador/batería). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Brooks pour Femme Juno Soutien-Gorge de Sport. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir. 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,JP 1880 Homme Grandes Tailles Gilet de Costume avec Boutons 705621,Theia Unisexe Bague Or Jaune ou Blanc(Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales). Comparable to our results,Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse , 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'Surplus Royal Traveler Pantalon.
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,Columbia Men's Bridge to Bluff Pant(Tosca Blu Bottes Mary-XHH Lampadaire trépied pour Salon). 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,adidas Stan Smith-Primigi Pwigt 63828. 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-Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau(Doctor Cutillas 33915 274 Blanco).
Conclusion
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