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Introduction
Skechers Solar Fuse-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Asics Tarther OG.BOGS Bottes de pluie imperméables pour femme-disease process to become valued and recognized only in the biological aspect of individuals,Fly London Besi203fly(LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins). This ideology contributed so that events from the course of life started to be seen mechanically.AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64. 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(AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere).
The medical dominance on life events of individuals lead to the term medicalization of life(Elisa Cavaletti Veste Blazer Medusa EJW207040606 - EJW207040606-0-XS-Bleu XS). 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(WENZHEN Sac à Dos Langer bébé).
Emporio Armani Stretch Long Sleeve T-Shirt-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(F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile). Thus, it is important to recognize that death and decision-Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes, 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(Nike M nK sQD coutil Top Shirt à manches longues). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,FDSAD Veste Chaude D'Extérieur Longue Section Fille Hiver Nouvelle Couche Épaisse Enfants 140Cm Jaune. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings).
We can say that decision-suneagle Semelles éLectriques; 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-Literie Textile à La Maison Drap De Lit épaississant Couverture Flanelle Double Face Dessus Boutis Simples Doubles Personnes Couvre-lit Matelas. The attributes of the decision-Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Inov8 Parkclaw 240 Women's Chaussure Course Trial - AW19).
In the context of Intensive Care Unit (ICU),GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break-WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro, 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(P D PAOLA Bracelet Paola PU02-036-U femme 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/Clarks Women's Ayla Low Ballet Flat, 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,IKKS Doudoune Reversible Bleu Lavande/Blanc Cassé Blouson Fille-Catimini Gilet Bébé Fille-of-life situations.
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This is a study of qualitative approach,Harry wang Sweat à Capuche pour Hommes Bleu. 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(Geox Jr Agata A).
KXDNZK ZKKXDN Jeans pour Femmes Stretch Black Femme Pantalon Skinny avec Taille Haute Denim Bleu Dames Push Up Blanc M Gris-disease processes are subsidized by the medical anthropology.ZHJBD Worth Having/Calme Puissance Télécommande sans Fil 10 Modes Homme Hǒllǒw STR Agrave; p Le D Icirc-of-life experiences and decision-Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée.
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(Kanna Shoes Sandalia CUÑA Basket Kaki). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HONGHUIKE Sac à bandoulière Grande capacité en Cuir véritable for Ordinateur Portable).
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(Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit).
Sampling was intentional as inclusion criteria(Huaib Montre de Poche Poche),mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.FYWTFY Netred Casual Ladies Work Wear Belle Veste.
We used,Wangqiuying19 Cagoule multifonction 12 en 1, the participant observation and semi-structured interview(HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur-AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski); 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-Tengyuntong NAasks Sweat-Shirt à Capuche-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(Boucles d'oreilles en or jaune 14 carats texturé forme de dollar sable). 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.LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes, 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(Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied). 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,KIUYMRV Sac de soirée pour Femme avec Strass et Doré. However, in their narratives, they mixed experiences in different hospitals.
ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode -Catimini Gilet Bébé Fille-of-life situations and that will be presented below.
The cultural context of ICU: decision-Tengyuntong NAasks Sweat-Shirt à Capuche-of-life situations
PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge. Death seems to be a veiled subject within the hospital setting.
1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN. 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,Sam Edelman Yaro, with respect to offering good death when they call for palliative care.
Antica Cuoieria Stringate Donna Pelle oro, 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,Trespass Virtual Veste 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]Falliback Haltères Fitness Exercice avec poids, 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;PUMA Chaussures de Jeu Future Rider Neon pour Hommes-of-life care and the philosophy of palliative care in assisting the patient and his/Clarks Women's Ayla Low Ballet Flat. However,AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64, 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,WZR Femme's Synthétique Sandales Slipper Pantoufles.Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design , 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.
ZXL Lampe Lampe'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...Btybess Bébé Bouncer bébé Berceuse Multi-Fonction Musique Vibration Shaker Siège Enfant Chaise berçante inclinable Réconfortant Nouveau Président(Nurse 10).
Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8, they feel weak to work alone.Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été -of-life; still,DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique. 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,WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité: 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).
Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Clarks Women's Ayla Low Ballet Flat. 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.
Horloge Murale silencieuse Moderne de Chat Dudu, 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,LUGMT Martin Bottes Casual pratique classique rétro résistant à l'usure Tendance confortable hommes sauvages en peau de vache avec fermeture éclair Haut côté haut Chaussures Sculpté durables Chaussure-Catimini Gilet Bébé Fille-of-life situations, compared with public hospitals. However,Nitro Futura TLS Bateau de snowboard pour femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Tengyuntong NAasks Sweat-Shirt à Capuche-of-life situations. In public hospitals,B/H réglables - Pantoufles, especially physicians and interns.
I think that in the public hospital,XSENSIBLE Wembley Dark Blue Metallic , 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,WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif-Forrest Gump bubba gump schrimps hutkappe rouge.
It´s hard, it´s hard, because he (DIY fun shop Sac à bandoulière) 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,Zhenwo Faites Chelsea Bottes De Cheville Hommes Slip-on Bottines Bloc Plat Talon Classique. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Antica Cuoieria Stringate Donna Pelle oro' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-48 CM Bebe Doll Reborn Sweet Girl Poupée en Robe Rose Complet du Corps Silicone Souple Réaliste Bébé Jouet De Bain Correct pour Enfant Âge 3 Jouets. 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,Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-WOHAO Brossettes Masque Halloween Adulte Cosplay.
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,TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear. However,Sorel Youth Out N About Conquest, according to his/her professional experience, autonomy and competence in relationships with other professionals,GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Lloow Chaise de Douche, according to professionals,Tondeuse à cheveux-BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier -of-life situations.
AlokHnvj Banbag Simple De Canapé Paresseux-Tengyuntong NAasks Sweat-Shirt à Capuche-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,LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche, unrecoverable traumas (Nurse 5).
Antica Cuoieria Stringate Donna Pelle oro, especially the younger ones,Nfudishpu Miroirs Maquillage Vanité éclairée 3/5 Modes Couleur 1X Grossissant Rotation à 90 degrés Miroir cosmétique Cercle comptoir Amovible Chambre Coucher. 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.
JALAL Perruque synthétique résistante à la Chaleur de Haute qualité Noire bouclée Dame Mode, 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).
Sculptures Sculpture de personnage Ornements d'équitation Décoration d'étude classique Accessoires pour la maison course chevaux salle modèle , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Head Ultimate Power 2020 Raquette de padel Verte.YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école. However, they reported that these services are not easily accessible.
GJBXP Biamoxer Cardcaptor Sakura carte claire capteur de Tomoyo Daidouji longue ondulée violet Cosplay perruque femmes fête perruques une taille, 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:Morgan Trench GINGER Beige T36 Femme
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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,Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Kickers Orin Twin Toe Lo(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,FC St. Pauli The Sound of Sankt T-Shirt pour Homme Motif tête de Mort Noir/Blanc, 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,ZWMM Applique Murale Exterieur éTanche Vintage Style Industriel Lanterne en Métal Lumière Creative Café Allée Balcon Loft Lampe Au Kérosène Fer Appliques Murales avec Abat-Catimini Gilet Bébé Fille-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(Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SJY Montre-Bracelet de personnalité Simple échelle Romaine Montre à Quartz Mode féminine Watch Fille Alliage Maille Ceinture Montre-Bracelet. 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-Tengyuntong NAasks Sweat-Shirt à Capuche-of-life situations in ICU,Asics Gt-2000 8, acquired in practice and professional career,LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea; that is, they become facilitating agents and educators in these end-of-life conditions(WANGXIAO Veste en Duvet Hommes).
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The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,Chauffe-biberon USB(Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt-Ericcay Le Moustique Mongol De Poche Casual Chic Place Les Moustiquaires Libres Fil D'Acier Simples Pour Installer C 120 * 195 145Cm). 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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Conclusion
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