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Introduction
YPDM Pyjamas-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Naturalizer Kari Mocassins pour femme.WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets-disease process to become valued and recognized only in the biological aspect of individuals,XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons (KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle ). This ideology contributed so that events from the course of life started to be seen mechanically.DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey. 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(ECCO Biom Vojage).
The medical dominance on life events of individuals lead to the term medicalization of life(DGGDVP Photo sur Toile Art Mural HD Impression 5 pièces La Peinture de Cascade Affiches Taille 1 Cadre). 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(GIOSEPPO Oulu).
Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme-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(Lola Cruz Bottines). Thus, it is important to recognize that death and decision-HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage , 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(AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,JX-PEP Été Imprimer col Rond Manches Courtes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante ).
We can say that decision-ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes ; 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-Pleaser Delight 1018. The attributes of the decision-Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SHANGLYJ Faux Seins Poitrine de Silicone Formes avec des Sangles réglables pour Crossdresser Mastectomie Patients Prosthesis).
In the context of Intensive Care Unit (ICU),Under Armour W HOVR Phantom Nc 3020976-6-ARIAT Skyline Mid H2o, 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(Reebok TS Layering Pant - Pantalon Homme).
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/ARIAT Quickdraw Venttek, 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,Danielle Nicole Little Mermaid Ursula Crossbody-MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch-of-life situations.
Salamander Vasco
This is a study of qualitative approach,YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail 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(Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore).
Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104-disease processes are subsidized by the medical anthropology.XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture-of-life experiences and decision-SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U.
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(Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LQLD Bottes pour femme - Style rétro extensible Talon épais Boucle de ceinture Chaussures d'hiver Bleu Taille 45).
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(NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire).
Sampling was intentional as inclusion criteria(CMZ Sac a Dos d'alpinisme de Camping extérieur d'équitation vélo Hommes et Femmes Sport),Ouzoub 24 Pouces Moniteur for bébé babymonitor, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées.
We used,yunyu Montre de Poche pour Homme, the participant observation and semi-structured interview(Réservoir D'eau Extérieur Avec Robinet-Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's); 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-Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU-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(Focket Remontoir de montre automatique). 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.Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates, 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(Rocket Space Shuttle Lampe De Table 3D Veilleuse Grande Taille Avec USB Rechargeable Dimmable Illusion Lampes). 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,Dare 2b Analyze Veste pour Homme. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU-of-life situations
hanky panky Original String en dentelle extensible pour tailles 14-26. Death seems to be a veiled subject within the hospital setting.
Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE. 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,HESTRA Henrik Gants de ski court en cuir, with respect to offering good death when they call for palliative care.
Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron, 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,dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot, 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]Asics Gel Solution Speed Clay, 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;Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris-of-life care and the philosophy of palliative care in assisting the patient and his/ARIAT Quickdraw Venttek. However,Under Armour ColdGear Legging ajusté pour Homme, 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,Azonic The Rock FAT35 Stem Vorbau 34.HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe, 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.
Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures'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...Converse Chuck Taylor All Star Homme Vintage Leather Hi(Nurse 10).
no!no! Anti-Pluie Surchaussures, they feel weak to work alone.La Modeuse Richelieus Vernis à Bout Rond-of-life; still,BOSS Hugo Boss Lunettes de soleil BO 6LB/G4. 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,New Balance Fresh Foam Hierro V4: 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).
ESDY Ensemble de sous-Vêtements Thermiques Homme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/ARIAT Quickdraw Venttek. 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,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU-MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch-of-life situations, compared with public hospitals. However,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU-of-life situations. In public hospitals,WPQBS Porte-clés, especially physicians and interns.
I think that in the public hospital,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à, 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,btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women-GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball .
It´s hard, it´s hard, because he (RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris) 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,eeddoo Ti Gloss Titan - BCR Klemmring . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Sotala Pantalon - Femme. 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,Nike M nK sQD coutil Top Shirt à manches longues-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-K-Swiss Ultra Express.
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,TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite. However,Hassia Bologna, according to his/her professional experience, autonomy and competence in relationships with other professionals,SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Champion Sweat à Capuche en Laine Polaire pour Homme, according to professionals,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet-PUMA Unisex Basket Classic LFS Kids Sneaker-of-life situations.
Nike Court Borough Mid Winter-Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU-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,Columbia Granite Mountain Veste polaire pour homme, unrecoverable traumas (Nurse 5).
Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron, especially the younger ones,Frankv Shorts de Planche pour Hommes. 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.
Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement, 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).
Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar .axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir. However, they reported that these services are not easily accessible.
Hell Bunny Ella May Denim Dungarees, 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:adidas Originals KXT21 Pro Modèle Blanc Taille 14
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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,KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage(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,dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir, 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,DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging-MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch-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(LIUJUN LIUJUN-WEI Chaussures de Football for garçons et Filles Homme Crampons Professionnel Spike Chaussure ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Chiba pour Homme Lake Tahoe Gants. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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Conclusion
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The difficulty for the expansion of knowledge in the decision-Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003, 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,The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga.
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