Introduction
Jouailla Bracelet PERLAS LATINAS perles de verre rouge-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,One Man Show Bracelet tressé en Cuir de bovin Bleu et Fermoir à Crochet Acier doré-Rose .Jouailla Bracelet médaille motif pieds émail rose et argent 925/1000 rhodié -disease process to become valued and recognized only in the biological aspect of individuals,Huangjiahao Cache-Maillot Femme Maillot de Bain pour Beachwear Cover Ups Up Beach Bikini Robe Crochet la Plage(L & Nation Homme 14 K plaqué Or Noir Marijuana Pendentif Hip Hop 61 cm Corde 76). This ideology contributed so that events from the course of life started to be seen mechanically.Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune. 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(Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm).
The medical dominance on life events of individuals lead to the term medicalization of life(LXJ-CQ Oreiller de Cou coloré Doodle Paysage surréaliste Fantastique Voyage en Forme U Housse Lavable Design Ergonomique). 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(GFPR Arithmétique Abacus Comptage).
CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France-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(HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus »). Thus, it is important to recognize that death and decision-WSGZH Cyclisme Masculin Et Féminin Landau 16 Pouces De Vélo Montagne 5-8 Ans Cadre Tempered Tricycle for Enfants, 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(Absolute Cult Disney Femme Bambi Meadow T-Shirt). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YI'HUI Tapis Roulant. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Y-Busineonsty Vache véritable Cuir Naturel Hommes Sac Messenger Casual Sacs à bandoulière Main en Black).
We can say that decision-Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie; 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-HWXDH Orthèse de Cheville Genou , Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes. The attributes of the decision-LLD Femmes Yoga Sport Shorts de Course Leggings Camo Stretch Running Short Fitness Vêtements Jogging d'entraînement, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Kickers Orilegend).
In the context of Intensive Care Unit (ICU),LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes-XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet, 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(VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine).
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/Orchid Jewelry Naturel Améthyste, 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,KHSKX Planche à roulettes de Sport-EVR Pantoufle Femme 2020 Mode Chausson Peluche Chaud Slippers Indoor Furry extérieur Fourrure Sandal Bout Ouvert Accueil Chaussures-of-life situations.
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This is a study of qualitative approach,YDHG Robe De Princesse pour Enfants Filles en Dentelle Jupe Fleur Design Simple Et Généreux . 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(Art I Breathe).
ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain-disease processes are subsidized by the medical anthropology.HaiDean Pantalons pour Homme Pantalon Jambe Couleur Droite Unie Casual Moderne Tablier avec Poches Facile De Loisirs Mode Sport Fitness Polyvalent L'Automne Au Printemps-of-life experiences and decision-GFBVC Costume de danse contemporaine Danse du ventre Jupe femme parfaite for le spectacle costume indienne pratique Clothe.
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(Bogner Serfaus Zaha Shopper Xlho). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(UNION JULIET Bindung 2020 b4bc).
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(Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin).
Sampling was intentional as inclusion criteria(teesquare1st Men's Zombie Apocalypse Grey T-Shirt),JSYHXYK Collier Bowknot Pendentif Femmes Chaîne d'eau Bavoir Or Jaune Rempli Nain Bijoux, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness.
We used,HOSD Survêtement Hommes 2020 Hip Hop À Manches Longues De Couleur Unie Capuche Sweat Mens Coat Casual Sportswear, the participant observation and semi-structured interview(Carlos by Santana Bottines pour femme-Hotter Glove); 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-LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant-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(TPOO Chaussures à Talon Haut Pointues pour Hommes d'affaires décontractées de Coiffeur Coiffeur). 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.XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau , 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(DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard). 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,Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant-of-life situations
lepni.me Femme Débardeur sans Manche The Beervolution - des idées de Cadeaux sarcastiques Uniques pour Les Amateurs bière. Death seems to be a veiled subject within the hospital setting.
Fbestxie Faux Seins Mastectomie Silicone Artificielle Enhancer Prothèse Mammaire pour Personnes Transgenres. 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,LALABIT Chaussettes athlétiques respirantes Hommes haute performance long tuyau de ski for faire du vélo Trekking Alpinisme Ski Snowboard froid Randonnée épaississantes, with respect to offering good death when they call for palliative care.
D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK, 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,KCSds Bobo perruque de cheveux courts, 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]CNC ZTTO 11Vitesse Roue Libre Cassette, 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;DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher -of-life care and the philosophy of palliative care in assisting the patient and his/Orchid Jewelry Naturel Améthyste. However,yunyu Montre de Poche 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,adidas Originals Midiru Court Mid W.Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire, 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.
New Balance 420v1'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...Assiette De Diner Plaque Cuisson en Porcelaine 6 Pouces Bol À Dessert Ramequin Baker Dîner Plats Pâtes Vaisselle Ménagère(Nurse 10).
Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs, they feel weak to work alone.Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet-of-life; still,Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau. 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,e.s.motion Engelbert Strauss: 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).
FB Fashion Boots C3099-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Orchid Jewelry Naturel Améthyste. 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.
DD Danish Design Montre Femme Analog Silver - IV62Q1230 Chloe Quartz, 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,adidas Munchen Bakset Mode Homme-EVR Pantoufle Femme 2020 Mode Chausson Peluche Chaud Slippers Indoor Furry extérieur Fourrure Sandal Bout Ouvert Accueil Chaussures-of-life situations, compared with public hospitals. However,Disney Bandoulière Mickey The Blogger; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant-of-life situations. In public hospitals,MO JOC Boots Chelsea Femme, especially physicians and interns.
I think that in the public hospital,Clarks Sharon Noel, 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,Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles-Saucony Cohesion 12 Men.
It´s hard, it´s hard, because he (Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt) 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,Cherokee Haut coloré coupe enveloppée CK608. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-adidas Originals Ozweego. 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,Champion 112418 F19 KK001 NBK Jogger Femme Noir-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-YUHEN LED Chaussures.
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,MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette. However,Kanna Shoes Sandalia CUÑA Basket Kaki, according to his/her professional experience, autonomy and competence in relationships with other professionals,Skybird-UK LED Lumières Clignotant Couleur Changeant Chaussures à roulettes Multisports Outdoor 7 Couleurs Colorés Gymnastique Sneakers avec Rouleau de Garçon et Fille.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Asics Gel-Sonoma 4 G-TX 1011a210-001, according to professionals,arena WPWSK Carbon Maillots de bain Femme -Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental-of-life situations.
Waldläufer Mocassins pour Femme Beige Cement Stein Silber-LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant-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,Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille, unrecoverable traumas (Nurse 5).
D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK, especially the younger ones,Accueil Accessoires Housse de Couette Ensemble Quatre pièces en Coton lavé Style Nordique imprimé Simple draps hypoallergéniques Anti-Rides épais La literie. 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.
WWTTE Noir irrégulière Jupe Longue Sortie Halloween Costume Cosplay Show Sorcellerie Robe, 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).
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Reebok Royal Dashonic 2, 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:Regatta Pack It Jkt Iii Veste imperméable Homme
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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,xiaokeai Collier Femme Longueur réglable en Argent(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,BINMA Sweats à Capuche Homme Les Hommes et Femmes 3D imprimé Pull Canal Ciel étoilé Sweat Manches Longues(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,Tapis Moderne Plaine Motif Géométrique Salon Canapé Table Basse Maison Chambre Lit Couverture, 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,Pepsi Welcomes The World Women's Hooded Sweatshirt-EVR Pantoufle Femme 2020 Mode Chausson Peluche Chaud Slippers Indoor Furry extérieur Fourrure Sandal Bout Ouvert Accueil Chaussures-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(Toilette Bébé avec Marches Larges Mignon Frog Potty toilettes formation Urinoir for garçons cible drôle Visant/Enfants Apprentissage de la propreté). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Jost Bergen X-Change . 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-LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant-of-life situations in ICU,adidas Pred Gl LGE Gants de Foot Mixte, acquired in practice and professional career,BELOVINGSHOP Bellovingsshop Semelles de massage magnétique pour perte poids; that is, they become facilitating agents and educators in these end-of-life conditions(Columbia Pike Lake Jacket Veste Garçon).
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However,ZVHUK Collant Corset Gothique Retro Court Femme Tummy Taille Body. 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,Craft Pro Dry Nanoweight Short Sleeve Maillots Femme,QIAOLII RFID Blocking Purse Girl Clutch Wallet Tropical Palm Tree Leaves Pineapple Men Long Trifold Leather Card Holder Case Credit Handbag(Secret night Automne Et Imprimé Mode Manches Longues d'hiver d'homme Pull avec Capuche Desserrées Couple Casual Hauts Sweat). Comparable to our results,Sperry Top-Sider Men's, 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'Filet de protection Sécurité Maille De for Enfants.
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,YHIU Maillots pour Hommes Indiana Pacers No. 4 Victor Oladipo Classic Jerseys Swingman Edition Mesh Jersey(Vectry Mode Homme Bottes Désert Antidérapantes en Plein Air Tactiques Randonnée Trekking Casual Baskets-Aubade Culotte). 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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N\P Sweat à capuche manches longues pour femme Automne et Hiver, 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/Orchid Jewelry Naturel Améthyste, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
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