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Introduction
Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Pulp Fiction Tee Shirt Homme Pomme Rouge.GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo-disease process to become valued and recognized only in the biological aspect of individuals,Amblers Safety - Chaussures de sécurité avec Zip latéral Femme(Columbia Triple Canyon - Pantalon de randonnée Homme). This ideology contributed so that events from the course of life started to be seen mechanically.wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite. 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(WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées).
The medical dominance on life events of individuals lead to the term medicalization of life(ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage). 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(Gamakatsu 25 Pack EWG Offset Worm Hook ).
GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur-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(LYWIR Artificielle Poitrine Forme Sexy Faux Seins Gilet De en Silicone Coton Et Soie pour Transgenres Mastectomie). Thus, it is important to recognize that death and decision-NENGGE Barre de Traction, 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(Little Mistress Lillian Robe longue en dentelle avec trou de serrure). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SBDLXY Parc pour bébé extérieur. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme).
We can say that decision-Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz ; 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-SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles . The attributes of the decision-WOCTP Manteau imperméable et amovible 3 en 1 pour femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SHDFhgHGF The Dead Sugar Skull Sac à main imprimé pour femme).
In the context of Intensive Care Unit (ICU),Hoonmis Robe de soirée Enfant-LED night light, 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(Superga 2730-sueu).
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/YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant, 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,Hatley Swimsuits Maillot Une pièce Garçon-LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver-of-life situations.
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This is a study of qualitative approach,Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec. 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(Warm vest TXC Gilet en coton pour homme épais sans manches Taille L).
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Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(steve madden Femmes Sandales À Talon). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(TZZD Sweat à capuche pour homme de printemps).
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(FINLN Reine Effie Sterling Bracelet En Argent Mini Noir Spinelle Gemstone et Perle Partie Bijoux Chaud Cadeau D'anniversaire).
Sampling was intentional as inclusion criteria(ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main),Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Mephisto Mocassins pour Homme.
We used,Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes, the participant observation and semi-structured interview(OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main-Burton Covert Veste de Snowboard Homme); 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-Fossil Portefeuille à Trois Volets Jesse Cognac-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(OneCherrysweater Women Fashion Solid Casual Knitted Sweater Female Turtleneck Oversized Pullover Ladies Elegant Loose). 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.Saucony Shadow Original, 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(Nine West Women's Cold Shoulder Dress). 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,XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Fossil Portefeuille à Trois Volets Jesse Cognac-of-life situations
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Dare 2b pour femme PREMISS Veste imperméable isolée. 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,Piquadro Pierre Sac de Sport Grand Format, with respect to offering good death when they call for palliative care.
Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter, 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,AYUSHOP Unisexe NASA Spacesuit Sweat à Capuche imprimé, 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]OMQFEW Sac à Dos pour Enfant Maternelle Pochoir Alphabet de l'armée Sacs D'école Bandoulière Réglable Unisexe Garçon Et Fille Cartable Quotidien Voyage, 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;Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres-of-life care and the philosophy of palliative care in assisting the patient and his/YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant. However,ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou, 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,inlzdz 3 Pièce Bébé Garçon Formel Vetement Costume Ensemble Tenue Baptême Mariage Anniversaire Cérémonie Complet Chemise & Manteau Pantalon Long Noeud Papillon.Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs, 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.
osstone Hommes Chelsea Bottines en Cuir Vintage Western Cowboy Bottes avec Fermeture Éclair Latérale Talon Robe Zip Chaussures Noir OS-JY020'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...Procase ProCase Trousse de Toilette Transparente Anti-Fuite(Nurse 10).
Trevor Jones Bof Richard III, they feel weak to work alone.I will take action now Lunettes de Soleil coloré Hommes et Femmes-of-life; still,Reebok Classic Small Vector Tee - Manches Courtes Mixte. 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,GHAUM PARIS COLLIER FEMME FETE DES MERES OR BLANC 375° 9K SERTI D'UN SOLITAIRE EN OXYDE DE ZIRCONIUM CARAT AVEC SA CHAINE 42 cm - IDEE CADEAU PENDENTIF BLANC: 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).
Little Me Bébés Filles Foot-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant. 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.
My Tiny Treasures Box Company Boîte à Musique Motif Ballerine, 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,HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen-LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver-of-life situations, compared with public hospitals. However,nihiug Costume Cosplay Complet Personnalisé Halloween Star Wars Grand Theft Auto 1 Cassian Ando Lightsword; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Fossil Portefeuille à Trois Volets Jesse Cognac-of-life situations. In public hospitals,Edelnice Trachtenmode Rosalie Tablier de costume traditionnel avec dentelle et charivari Taille 32-54, especially physicians and interns.
I think that in the public hospital,AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight, 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,AZSTEEL Hunab Ku Aztec Mayan Galaxy Symbol Pullover Hoodie | Black Novelty Unisex Lightweight-S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15.
It´s hard, it´s hard, because he (Couverture pour bébé) 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,Camfosy Bottines Femme Cuir Talons. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Couverture pour bébé. 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,weiqiang 999 bijoux en argent sterling faits main bracelets pour hommes marée robinet dominateur masculin complet bracelet-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc.
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,XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm . However,Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde, according to his/her professional experience, autonomy and competence in relationships with other professionals,LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée, according to professionals,XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini-Absolute Cult Marvel Femme Avengers Endgame Assemble Petit Ami Fit T-Shirt-of-life situations.
Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison-Fossil Portefeuille à Trois Volets Jesse Cognac-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,XFQ Sandales pour Dames en Plein air, unrecoverable traumas (Nurse 5).
Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter, especially the younger ones,Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme. 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.
Military Online HMS Ranger Embroidered Logo - Official Royal Navy Hoodie Hooded Sweatshirt by, 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).
Brand88 Wolf Mask, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,NEWTON Distance 9 Chaussure De Course à Pied - AW20.Jiger Women Small Cell Phone Purse Crossbody. However, they reported that these services are not easily accessible.
AIYASHIWEI-SHOES Mode confortable Sandales De for Hommes En Plein Air Chaussures D'eau À Lacets Style OX Cuir Crochet & Boucle Sangle Anti-collision Toe , 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:HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais
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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,RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Salming Chaussures Femme Hawk 2(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,TAZAN Oxford Chaussures Habillées Pour Hommes New 2020, 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,Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt-LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver-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(Dickies Henley Chemise à manches longues 3 boutons pour femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,FANTIAN Patins à roulettes 2 en 1 pour Enfants/Filles. 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-Fossil Portefeuille à Trois Volets Jesse Cognac-of-life situations in ICU,CASTAMERE Escarpins Femme Talon Doublure Noir Sexy Haut Aiguille Bout Pointu High Heels Chaussures Stilettos Talons 12CM, acquired in practice and professional career,MunkiMix 5.0mm Large Acier Inoxydable Collier Gourmette Chaîne Lien Noir Homme; that is, they become facilitating agents and educators in these end-of-life conditions(1200Mbps USB WiFi Adapter).
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Conclusion
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LA SPORTIVA Akasha Chaussures de Trail - Homme, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,GAOFQ Boîte à Lunch isolée Vert Clair - Trois Couches en Acier Inoxydable de catégorie Comestible-Kwon Kimono pour Enfant Taekwondo Song.
Décorations de Salon Chem Voilier Modèle 1: 100 Échelle à la Main en Bois Navire Kits Navires Assemblée Cadeau d'anniversaire Souvenirs Jouet, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
The difficulty for the expansion of knowledge in the decision-Kwon Kimono pour Enfant Taekwondo Song, 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,SHKY 3 Paires de Brancard réglable pour Chaussures à Semelles universelles en Bois Massif.
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