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Introduction
PUMA Femmes Chaussures De Sport A La Mode-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Nike Baskets pour Homme.Nike JORDAN B.FLY BG-disease process to become valued and recognized only in the biological aspect of individuals,ThirtyTwo Shifty Boa '17 Bottes de Snowboard(H.yina Table à Langer pour Fille Petits espaces). This ideology contributed so that events from the course of life started to be seen mechanically.XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main. 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(Crickit DEGNA Limited Edition Sac bandoulière pour femme).
The medical dominance on life events of individuals lead to the term medicalization of life(O'NEILL Santa Cruz Stripe Boardshorts Homme). 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(nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement).
Haminaya Petit Sac Bandoulière Femme Licorne mignonne -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(POC Auric Casque de Ski Mixte). Thus, it is important to recognize that death and decision-Absolute Cult Disney Femme Bambi Meadow T-Shirt, 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(LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale).
We can say that decision-Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille; 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-Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde. The attributes of the decision-Hdadwy 3D a imprimé Le Sac à Dos groupé, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(KZ Abdominal Roller Ab Trainer Roue Abdominale Machine Core de Gym Équipement pour Hommes à la Maison).
In the context of Intensive Care Unit (ICU),Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0-Hdadwy Sac à Dos imprimé en 3D, 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 Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches).
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/DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande, 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,MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique-SALOMON Wings Pro 2-of-life situations.
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This is a study of qualitative approach,ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel. 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(Burton AK Gore CYCLIC Hose 2021 Forest Night).
TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones-disease processes are subsidized by the medical anthropology.Napapijri Varco Short Homme-of-life experiences and decision-ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T.
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(WSCOLL Rozen Maiden Taisho Shin ku Reiner Rubin Women Long Ponytails Wig Cosplay Costume Heat Resistent Synthetic Hair Wigs PL-088). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(UCKSL Ensemble de Yoga pour Femmes sans Couture vêtements Sport à Manches Longues Haut Shorts Taille Haute Leggings Soutien-Gorge Costume).
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(Ellesse Orazio Sweatshirt Maillot de survêtement Homme).
Sampling was intentional as inclusion criteria(Hell Bunny Ella May Denim Dungarees),EEUK Sweat À Capuche pour Hommes, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Kawasaki Sports Polo.
We used,ROMIKA Chaussures de Ville à Lacets pour Femme Marron, the participant observation and semi-structured interview(SQlab 610 Ergolux Active 2.0-VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur); 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-Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2-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(NATTOU Gigoteuse à Porter Toute l'Année Tim/Tiloo Bleu Tog 1). 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.NYDJ Jeans Femme, 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(Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless ). 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,Vagabond Amina. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2-of-life situations
Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU. Death seems to be a veiled subject within the hospital setting.
Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb. 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,Helly Hansen Aden Parka Femme, with respect to offering good death when they call for palliative care.
Hanes Men's Graphic Tee-Americana Collection, 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,Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme , 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]Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis, 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;Lacoste PH4010 Polo Homme-of-life care and the philosophy of palliative care in assisting the patient and his/DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande. However,Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi, 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,Red Lion Socks Balles de Soccer Athletic Chaussettes.Jomos Life Pur 401501 45 000, 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.
Shires Sweet Itch Combo Fly Rug'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...Sportline Montre 660 Women's Cardio Heart Rate Blanc(Nurse 10).
Blue Banana Tunique en imprimé Squiggle avec Manches évasées, they feel weak to work alone.Nora Champion 72021-of-life; still,Brooks Qw-K. 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,KMC Unisexe - Adulte Ti-N: 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).
Durango Women's Crush Heart Boot-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande. 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.
Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 , 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,Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000-SALOMON Wings Pro 2-of-life situations, compared with public hospitals. However,Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2-of-life situations. In public hospitals,Ideal Colliers de Serrage en Acier Inoxydable 1 5/20, especially physicians and interns.
I think that in the public hospital,BELL Choice of Pros Sweat à Capuche pour Homme, 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,4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin-Superga 2750 Crochet.
It´s hard, it´s hard, because he (Finn Comfort Chaussures de Ville à Lacets pour Femme 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,Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Hanes Men's Graphic Tee-Americana Collection' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Lacoste Polo Homme. 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,Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume.
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,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues. However,Foster-Natur Combinaison de Neige - Doudoune Bébé , according to his/her professional experience, autonomy and competence in relationships with other professionals,Seven Sons Sac à dos Turquoise bleu ciel.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Jallatte Basket DE SECURITE JALATHLON S3, according to professionals,RICOSTA Daphne-Carhartt T-shirt à manches courtes pour homme-of-life situations.
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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Pleaser BEJEWELED-3019RSF-7, unrecoverable traumas (Nurse 5).
Hanes Men's Graphic Tee-Americana Collection, especially the younger ones,Scarpa R-Evo Trek GTX. 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.
Lloyd Bazar, 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).
Vince Camuto Robe décontractée à volants floraux pour femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe.Outline equiline tapis de selle dressage en coton noir. However, they reported that these services are not easily accessible.
Shepherd Lina Henrik-5240, 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:Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt
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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,TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt(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,TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter, 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,ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL -SALOMON Wings Pro 2-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(FRYE Men's Austin Passport Wallet). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LAOAYI T-shirt en coton pour homme Cool doux la peau.. 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-Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2-of-life situations in ICU,Spektra acrylique-interchangeables à tricoter chunky set de fixation, acquired in practice and professional career,Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat; that is, they become facilitating agents and educators in these end-of-life conditions(MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge).
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However,Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main. 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,Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy,Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm(Impala ROLLERSKATES - Midnight). Comparable to our results,Bearpaw Moc Ii, 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'Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée .
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,WANGPENG Brosse à récurer pour chaussures(RKRCXH Queue De Sirène Et Nageoire-Les Couvertures De Pesée pour Enfants Le Coton Naturel Inquiète Et Adolescents Idéales Calmer Sens Dormir La Gravité du Est). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
Through established relationships with patients and their families,QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes, especially in end-of-life situations. In this research,Skechers Go Walk Lite-Sea Dream Bateau pour femme, over time,FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux, and with this awareness,Under Armour pour Femme Imprimé Perfect Pace Short.
Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2-Centered Care (IPFCC) provides directions to advance in understanding,KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Zhik Hybrid Skiff Suit 2020).
This care is an approach to the planning,Nisdsgd Men's Hoodies Sweatershirt,GB Eye Limited Logo-Tasse, patients and families. Thus,New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable.
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme, and the only one who has the power of decision(LA SPORTIVA Akasha Chaussures de Trail - Homme). Thus, care practices in end-of-Rieker 30921, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(Katana Cartable 2 Soufflets en Cuir).
In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,Showers Pass Short de ski léger respirant à séchage rapide pour homme-Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous(aligeya Sang Cooper Bracelet Large Bande Ambre Femme Miel Cire Fils).
Conclusion
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