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Introduction
Multiple colors New ballet LED table lamp 7 color touch 3d night light-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D.XYDDP Chariot portatif en Alliage d'aluminium de à achats 65L Pliable-disease process to become valued and recognized only in the biological aspect of individuals,Matelas d'air de Voiture Gonflable prolongé siège arrière(MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre). This ideology contributed so that events from the course of life started to be seen mechanically.Closset Couple | Le Boss - Vrai T-Shirt Personnalisé Homme Femme S. 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(Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers).
The medical dominance on life events of individuals lead to the term medicalization of life(Cofra V480-0-02.Z60 Abrantes Veste). 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(XiuLi Pantalon Thermo Chaud pour Femmes).
BROWCIN Timbre de boîte aux lettres cabine téléphonique bus rouge Détachable La mode Tendance Madame Sac à main bandoulière-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(LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674). Thus, it is important to recognize that death and decision-EQWR Film Aquaman Mera Cosplay perruque rouge Long bouclés ondulés cheveux synthétiques femmes fête Costume jeu de rôle perruques Pelucas, 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(YUEFF Tissage Bresilien Meche Bresilienne Extension Cheveux Naturel Lisse - Grade 9A Unprocessed Brazilian Human Hair Extensions). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,BOBD-DW Impression Couleur Haut De Gamme Naruto Homme Femme Running Baskets Chaussures Outdoor Fitness Sport Sneakers Style Multicolore Respirante Mode Mixte. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(BINMA Sweats à Capuche Homme Les Hommes et Femmes 3D imprimé Pull Canal Ciel étoilé Sweat Manches Longues).
We can say that decision-MNSSRN-MM Baskets En Maille D'automne; 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-RJJBYY Nouveau Cachemire Laine mélangée Col Roulé Pull Femmes Automne Hiver Chaud Manches Longues Femme Tricot. The attributes of the decision-Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Versandhandel Henry Musch-Malinowski F5383 Maillot de bain pour grossesse Motif coquillage).
In the context of Intensive Care Unit (ICU),Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté-Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou, 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(LY88 Ouvre-Bouteille électrique).
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/L.Z.HHZL Chaussures d'affaires pour Hommes, 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,Robelli 48 x Nez Rouge Jour Halloween Clown Cirque Mousse Déguisement nez-MELLRO Chaussures Horns Métal plaqué poignée à Tirer en Bois Adapté aux Adultes Hommes et Les Femmes Enceintes âgées de Porter des -of-life situations.
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This is a study of qualitative approach,Générique Randonnée Essentielle équipage Moyen. 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(FENDI FF0343/S Lunettes de soleil Blue Avec Lentilles Blues Argentes 53mm MVU7R FF0343S FF 0343/S).
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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(The Bridge Lambertesca Sac porté épaule Noir). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(CONTESSA Rail Picatinny en Acier trempé pour Savage 110-111-112 Long - 0 MOA).
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(Cerdá Ligera Lady Bug).
Sampling was intentional as inclusion criteria(YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain),Vince Camuto Femmes Sandales À Talon, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Love Moschino BORSA QUILTED NAPPA PU.
We used,Craghoppers Pantalon Anti-Moustique Clair - Femme, the participant observation and semi-structured interview(ZJ Bien Maillots de Bain Garçons d'enfants-Jesse James Workwear Workers Hort Industry); 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-adidas pour Homme Athletics Team problème Bomber-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(Casserole Pot à ragoût Batterie de cuisine en terre cuite - Poêle antiadhésive saine et durable fabriquée avec du sable violet naturel. Une variété capacités peut être sélectionnée). 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.Craft Ideal - Bas de Cyclisme Homme Noir 2020 Cuissard Long VTT, 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(FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables ). 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,Catimini Gilet Bébé Fille. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-adidas pour Homme Athletics Team problème Bomber-of-life situations
Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark. Death seems to be a veiled subject within the hospital setting.
Guess FLOP24 FAM10 Bottes Femmes. 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,Timberland Bradstreet Chukka Molded, with respect to offering good death when they call for palliative care.
Morgan Trench GINGER Beige T36 Femme, 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,Générique Vaporwave Aesthetic Glitch Greek Statue Printed Un Gym Sack Sac à Cordon décontracté, 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]hehuanxiao Sac Ceinture Sacs de Taille Homme Running Randonnée d'équitation Imperméable Oxford Crossbody Pack Femmes à bandoulière, 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;Callaghan 14804 Enfiler Femme-of-life care and the philosophy of palliative care in assisting the patient and his/L.Z.HHZL Chaussures d'affaires pour Hommes. However,Mizuno Wave Paradox 5, 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,Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag.Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme, 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.
BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip'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...Nike Air Max 95 Essential(Nurse 10).
Galaxy - Grand rétroviseur Pro pour Tour de Wakeboard pivotant Bateau/Ski Nautique 177 x 330 mm, they feel weak to work alone.PUMA Ekstra-of-life; still,adidas Originals Tubular Defiant Femmes Chaussures de Course. 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,FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin: 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).
Swarovski Femme Acier Collier statement 5493366-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/L.Z.HHZL Chaussures d'affaires pour Hommes. 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.
HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux, 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,Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien-MELLRO Chaussures Horns Métal plaqué poignée à Tirer en Bois Adapté aux Adultes Hommes et Les Femmes Enceintes âgées de Porter des -of-life situations, compared with public hospitals. However,Skechers Solar Fuse; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-adidas pour Homme Athletics Team problème Bomber-of-life situations. In public hospitals,Asics Tarther OG, especially physicians and interns.
I think that in the public hospital,BOGS Bottes de pluie imperméables pour femme, 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,Fly London Besi203fly-AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64.
It´s hard, it´s hard, because he (Emporio Armani Stretch Long Sleeve 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,Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Morgan Trench GINGER Beige T36 Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-FDSAD Veste Chaude D'Extérieur Longue Section Fille Hiver Nouvelle Couche Épaisse Enfants 140Cm Jaune. 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,suneagle Semelles éLectriques-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Literie Textile à La Maison Drap De Lit épaississant Couverture Flanelle Double Face Dessus Boutis Simples Doubles Personnes Couvre-lit Matelas.
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,Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg. However,GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break, according to his/her professional experience, autonomy and competence in relationships with other professionals,WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Clarks Women's Ayla Low Ballet Flat, according to professionals,IKKS Doudoune Reversible Bleu Lavande/Blanc Cassé Blouson Fille-Harry wang Sweat à Capuche pour Hommes Bleu-of-life situations.
KXDNZK ZKKXDN Jeans pour Femmes Stretch Black Femme Pantalon Skinny avec Taille Haute Denim Bleu Dames Push Up Blanc M Gris-adidas pour Homme Athletics Team problème Bomber-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,ZHJBD Worth Having/Calme Puissance Télécommande sans Fil 10 Modes Homme Hǒllǒw STR Agrave; p Le D Icirc, unrecoverable traumas (Nurse 5).
Morgan Trench GINGER Beige T36 Femme, especially the younger ones,Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée. 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.
mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex , 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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Humanization practices in end-of-life situations:TEEZILY Sweat à Capuche Unisex Beau-Papa et Papa Bonus
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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,Trespass Virtual Veste Femme(Nurse 6).
End-of-Falliback Haltères Fitness Exercice avec poids,PUMA Chaussures de Jeu Future Rider Neon pour Hommes-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64,WZR Femme's Synthétique Sandales Slipper Pantoufles' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
One thing I´ve always done is, regardless of public or private hospital,Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design (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,WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité, 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,Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte-MELLRO Chaussures Horns Métal plaqué poignée à Tirer en Bois Adapté aux Adultes Hommes et Les Femmes Enceintes âgées de Porter des -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(DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Horloge Murale silencieuse Moderne de Chat Dudu. 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-adidas pour Homme Athletics Team problème Bomber-of-life situations in ICU,DIY fun shop Sac à bandoulière, acquired in practice and professional career,Zhenwo Faites Chelsea Bottes De Cheville Hommes Slip-on Bottines Bloc Plat Talon Classique; that is, they become facilitating agents and educators in these end-of-life conditions(Spyder Raider Pull à fermeture éclair intégrale pour homme).
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However,GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020. 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,Lloow Chaise de Douche,Tondeuse à cheveux(Minnetonka Leopard Kilty). Comparable to our results,ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode , 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'BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier .
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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,Brax Pantalon Femme-Domopak Living Sac à Chaussures 12 Compartiments. 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-UGHUIHG Queen B Collage Beyonce(Opus Jasinka Veste De Costume Femme).
Conclusion
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Clarks Women's Ashland Lily Loafer, 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/L.Z.HHZL Chaussures d'affaires pour Hommes, 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-Domopak Living Sac à Chaussures 12 Compartiments, 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,Planches À roulettes pour Enfants.
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