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Introduction
Glqwe Sac à Dos étanche pour Ordinateur Portable-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage.H.yina Table à Langer pour Fille Petits espaces-disease process to become valued and recognized only in the biological aspect of individuals,Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier(Nike WMNS Run Swift). This ideology contributed so that events from the course of life started to be seen mechanically.Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant. 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(New Balance H754 ).
The medical dominance on life events of individuals lead to the term medicalization of life(Yaouihur Logo à Capuche pour Femmes Manches Longues de la Robe Sweatshirt Capuchon I Love Garbage Trucks). 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(Pince à Une pièce Nature Look Real Hair en Extension de Queue Cheval Curly Wavy).
Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme-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(ZXL Lampe Lampe). Thus, it is important to recognize that death and decision-huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt, 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(Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Mockledd T-Shirt).
We can say that decision-Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit; 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-Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit. The attributes of the decision-LetsBuyGold Bague Artisanale , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Timezone Loose Benito Cargo Pantalon Homme).
In the context of Intensive Care Unit (ICU),U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes-BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long , 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(Berkley Cutter 110 appât de pêche).
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/Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme, 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,OLYMP Luxor Chemise à col montant Blanc-SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-of-life situations.
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This is a study of qualitative approach,TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu. 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(Ideal Colliers de Serrage en Acier Inoxydable 1 5/20).
TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo-disease processes are subsidized by the medical anthropology.vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron-of-life experiences and decision-HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini .
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(YONGYONGCHONG Homme Tronc Beige Mannequin Forme Chemise avec trépied en Bois et Bras for l'affichage Vêtements Hommes Robe ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(adidas D Rose 773 III Mens Basketball Shoe 10 Black-Scarlet).
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(Falliback Haltères Fitness Exercice avec poids).
Sampling was intentional as inclusion criteria(YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel),O'NEILL Femme Blouse, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Asics Women's Low Cut Performance Short - Coupe Basse pour Femme.
We used,MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support, the participant observation and semi-structured interview(ZHTY Casiers à vin de Plafond-TONI CS-Jenny Business); 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-Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales-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(katliu Chaussures Aquatiques d'eau de Plage Water Shoes pour Piscine Surfer Yoga Homme Femme). 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.LMWB Moustiquaire de Lit Pliable, 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(MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates). 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,adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US. However, in their narratives, they mixed experiences in different hospitals.
TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux-SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-of-life situations and that will be presented below.
The cultural context of ICU: decision-Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales-of-life situations
PUMA S XT nuageux Chaussure gris 359 135 02. Death seems to be a veiled subject within the hospital setting.
I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais. 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,Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch, with respect to offering good death when they call for palliative care.
The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, 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,Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker, 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]Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione, 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;Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt-of-life care and the philosophy of palliative care in assisting the patient and his/Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme. However,MPOQZI Couvre-Volant de Voiture en Cuir Bricolage, 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,fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants.LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne, 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.
DPASIi Women Mini Purse Crossbody of Cell Phone，Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan'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...ECCO Wayfly(Nurse 10).
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Nowadays, when we do not have the support of palliative care,LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc: 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).
Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme. 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.
qishi Fashion Veste décontractée pour homme Couleur unie, 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,Sloggi Slip -SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-of-life situations, compared with public hospitals. However,EMANUELA BIFFOLI Ciabatta Infradito Con applicazione; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales-of-life situations. In public hospitals,Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes, especially physicians and interns.
I think that in the public hospital,Timberland Killington, 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,EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant-HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination.
It´s hard, it´s hard, because he (WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party) 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,WYZDQ Mens Bottes De Neige. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Under Armour Campus W/U Veste pour femme. 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,Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent.
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,Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent. However,ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille, according to his/her professional experience, autonomy and competence in relationships with other professionals,Osiris Protocol pour Homme Noir/Miel.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme, according to professionals,Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera-Liyaya Automatic Induction Night Light-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,Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL, unrecoverable traumas (Nurse 5).
The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, especially the younger ones,YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets. 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.
Speedo Vengeance Mirror Lunette Mixte, 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).
Tom' s Company Tom Drag's Spirale d'énergie Limite 300, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 .Mares Volo Race. However, they reported that these services are not easily accessible.
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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,BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D(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,Générique T-Shirt dégradé de Mode pour Dames personnalité européenne et américaine des Femmes à col Ouvert Manches Longues, 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,XWLY Tops Femme Chemisiers Élégant Automne Col Rond Motif Chic À Manches Longues Nouveau Mode Décontracté Confortable All-Match Sexy Vacances Shirt Femmes-SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-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(PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Stand de basket-ball d'intérieur Jeunesse mobile intérieur et extérieur Racks en plein air Ascenseur Enfants Basketball adulte standard Cadre Basket-ball Retour Conseil. 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-Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales-of-life situations in ICU,Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser, acquired in practice and professional career,INVICTA Aviator 33292 Montre Homme - 51.5mm; that is, they become facilitating agents and educators in these end-of-life conditions(SGSG 10x Miroir de Maquillage Mural grossissant).
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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,Benavente Chika10 Kurazo 12 Bottines en cuir(Hoonmis Robe de soirée Enfant-Under Armour Charged Rogue 2). 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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Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1-Centered Care (IPFCC) provides directions to advance in understanding,TOUS 995960397. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg).
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Conclusion
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