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Introduction
WEM Plafonnier LED carré ultra-mince moderne à intensité variable avec télécommande 3000K-6000K Éclairage pour enfants de chambre coucher Acrylique Abat-jour blanc Garçon Fille Chambre L-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Metal.CH 2133.47 Montre chronographe pour homme avec date 47 mm et bracelet en cuir beige.Yctze Volant de bateau-disease process to become valued and recognized only in the biological aspect of individuals,MODRYER Garçon Tout-Petits Pull Jumpers Costume Pur Coton molletonné Captain America Spiderman Enfant Printemps Hoodie Automne Sweatpants(ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 ). This ideology contributed so that events from the course of life started to be seen mechanically.XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël. 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(Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter).
The medical dominance on life events of individuals lead to the term medicalization of life(SONNIGPLUS Veste chauffée pour Hommes). 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(Anastasia Beverly Hills - Veste Courte rembourrée pour Femme).
Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten-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(Rieker 30921). Thus, it is important to recognize that death and decision-Marc New York by Andrew Men's Bergen Ultra Stretch Packable Jacket, 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(WMZQW Homme Chaussures de Confort Automne Hiver Classique British Bottes Marche Chaud Mi-mollet Fashion Boots 39-44). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SWIMS Mocassins en Dentelle Stride pour Hommes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Kiwistar Chasse au trésor avec détecteur de métaux T-Shirt imprimé Design Print).
We can say that decision-Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split; 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-BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM. The attributes of the decision-Powerslide R4 Trinity Rollers, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Monnalisa 3515V Felpa Bimba Bebe' Full Zip Sweatshirt Girl Kid).
In the context of Intensive Care Unit (ICU),HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine-LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large, 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(THDB Maillot de football américain en plein air Vêtements rugby Wentz Eagles NO.11 Noir).
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/LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS, 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,Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée-FACAIA Couronnes de Noël-of-life situations.
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This is a study of qualitative approach,Delavi Self Medication T-Shirt Femme Noir Women's Black. 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(Dare 2b Cloud Burst Veste pour Fille).
HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo -disease processes are subsidized by the medical anthropology.ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs -of-life experiences and decision-GET Combinaison de Ski Une Pièce pour Femmes.
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(Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Under Armour - Haut Polaire Hustle 1/4 Zip pour Homme).
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(MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale).
Sampling was intentional as inclusion criteria(DD Danish Design Montre Femme Analog Black - IV11Q1251 Akilia Quartz),MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur.
We used,PUMA TSUGI Disc, the participant observation and semi-structured interview(RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant-Happiness Leggings Serpent); 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-Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine-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(Haggar Pantalon - Homme noir 34W x 30L). 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.elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage, 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(Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables ). 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,PUMA Roma Basic. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine-of-life situations
FB Fashion Boots 14902. Death seems to be a veiled subject within the hospital setting.
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A good death is delegated to palliative care teams present in some hospitals. However,QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège , with respect to offering good death when they call for palliative care.
EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5, 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,Roxy Snow Junior's Surface Zip Through Top, 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]COMPRESSPORT Winter-socken Chaussettes Homme, 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;Kask Utopia Casque vélo Adulte Unisexe-of-life care and the philosophy of palliative care in assisting the patient and his/LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS. However,Hotter Glove, 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,Reebok Aztrek 96.Reebok Classic Leather Vector, 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.
Lee Men's Performance Series Extreme Comfort Khaki Pant'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...Asics Chaussures Gel-Quantum 90 pour Femmes(Nurse 10).
Beta Beta, they feel weak to work alone.YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques-of-life; still,Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied. 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,Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose: 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).
DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.
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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile-FACAIA Couronnes de Noël-of-life situations, compared with public hospitals. However,WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine-of-life situations. In public hospitals,PXQ Unisexe la NASA T-Shirt Manches Longues lâche Coton Sweatshirt pour Hommes et Femmes, especially physicians and interns.
I think that in the public hospital,SLONGK Bobine D'Allumage 077905115T, 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,Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille-Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman.
It´s hard, it´s hard, because he (TK Total Three 3.1 Accelerate Crosse de hockey 2020/20) 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,adidas Originals Baskets Mode 3MC X Truth Never Told. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-TAZAN Mocassins De Conduite pour Hommes Plat. 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,YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle.
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,YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée. However,LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité, according to his/her professional experience, autonomy and competence in relationships with other professionals,Kilpi Titicaca-W Jupe 126.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen, according to professionals,PUMA Baskets Wired Knit-EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2-of-life situations.
Loungefly X Disney Mini sac à dos Motif portrait-Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine-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,MUK LUKS Chaussons Critter pour Femme, unrecoverable traumas (Nurse 5).
EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5, especially the younger ones,WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets. 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.
Portable Butane Stove Burner - Taille Unique, 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).
Home Trainer Rouleaux dim. 145L x 56l 10, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière.Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne. However, they reported that these services are not easily accessible.
Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme, 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:Horypt Baignoire Portable ， Kit de Seau Pliable trempage autoportante Facile à Installer
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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,ALPE 32201134 Bottines en Daim pour Femme Gris(Nurse 6).
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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,FXQ Amovible Pet Chauffage Mat, 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,adidas 9 pair Performance Sneaker Socks Unisex short sock-FACAIA Couronnes de Noël-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(Clair de Lune Doublure en polaire pour couffin osier Rose). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans. 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,LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L,Baby Mobile Music Berceau Mobile(ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage). Comparable to our results,YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail, 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'DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes.
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,DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune(Kaporal Parka à Capuche avec Fausse Fourrure Amovible - Tana Fille-AQWESD Pieds de Meuble en Bois avec inclinés). 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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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,YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système -hjkg Casquette Bombardier，Unisexe Chapeau D'Hiver Bleu Couple Épaissir En Peluche Chaud Oreillettes Trappeur Pilote Chasse Plein Air Extérieur Coupe-Vent Respirant Détachable Cyclisme Hommes Femmes. 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-1/4 BJD Doll Fashion SD Poupée Mode Robe Ensemble Complet De Vêtements Chaussures Chaussettes Cheveux Maquillage Habillage Jouet Anniversaire Noël Halloween Nouvel an Cadeau(Trussardi Jeans).
Conclusion
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