Introduction
K-Swiss Legging taille moyenne 7/8 pour femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,LEYOUDIAN Chariot à Deux Roues en Aluminium Pliant Bagages Panier.BCAJFL Aux Femmes Bandoulière Petit Sac en Cuir-disease process to become valued and recognized only in the biological aspect of individuals,PYLOVER Pull à capuche unisexe pour femme Motif bonhomme de neige élan Père Noël(XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm ). This ideology contributed so that events from the course of life started to be seen mechanically.Cactus Décoration de lit bébé Cadeau nouveau-né Mobile musical en. 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(Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000).
The medical dominance on life events of individuals lead to the term medicalization of life(Terrain de jouets pour enfants/Sécurité portable parc jeu for bébé avec porte). 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(Sotala Pantalon - Femme).
Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture-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(Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes). Thus, it is important to recognize that death and decision-CAMELBAK Eddy Bouteilles, 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(Sanuk Kids Unisex Lil Puffer Fashion Boot). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YPDM Peignoir. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower).
We can say that decision-Lumières de Partie; 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-FXPCQC Mesdames Dentelle Compensée Sexy À Talons Hauts Plateforme Cheville Bootie Fermeture Glissière Boucle De Pompes SM Ballet Queen Bottes Unisexe. The attributes of the decision-SOCCX Pull pour femme avec structure en maille et logo, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(X-Toy 1/72 Chariot Modèle en Alliage).
In the context of Intensive Care Unit (ICU),Jixi Sac de Couchage for bébé Automne Hiver Tenir Dormir Enfants à Double Usage Deux Voies Zipper Wearable Blanket Sommeil -PENGSHAO Plateau à Fromage en Bambou, 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(Mandarina Duck MD20 Sac bandoulière bleu).
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/AXDNH Chaussures de Danse Femme, 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,ADSE Horloge Murale à Pendule-XLTCK Lunettes de soleil en titane pur polarisées B-of-life situations.
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This is a study of qualitative approach,Dead Threads - Four Pockets Men's Slim-Fit Punk Pants. 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(DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage).
HAFLINGER Everest Cascade-disease processes are subsidized by the medical anthropology.mofeng Mesh Plateforme compensée à bascule Baskets Chaussures de marche Femmes Dames Filles Extérieur Confortable Conduite-of-life experiences and decision-RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles .
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(Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Helly Hansen Pinecliff Boot).
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(adidas Stan Smith).
Sampling was intentional as inclusion criteria(Cult – Bottes de sécurité # Gun CLASS-1),Brandless Women fluffy Maternity Robe de soirée mariage chinois mariée longue robes Cheongsams, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.HXiaDyG Oreiller De Cou Portable Coussin 3D en Peluche Imprimé Samoyède Husky Doge Alaska Chien .
We used,KnSam Bracelet Chaîne Gourmette La Sainte Vierge Rétro Homme Argent 925 Punk Personnalité, the participant observation and semi-structured interview(BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant-ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte); 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-Ssrsgyp 2pair Chaussons Femme d'été Doux Non-dérapant Salle de Bain Accueil Couple Sandales d'intérieur et Pantoufles Homme EVA légère -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(Byjia Doudoune d'hiver). 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.Aris Diamond Bague de Fiançailles Solitaire Femme - Or Blanc 14ct , 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(HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine). 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,Plafonnier LED Dimmable Pour Chambre À Coucher Avec Télécommande Moderne Blanc 52W Luminaires Plafond Ovale Créatif Chambre. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Ssrsgyp 2pair Chaussons Femme d'été Doux Non-dérapant Salle de Bain Accueil Couple Sandales d'intérieur et Pantoufles Homme EVA légère -of-life situations
THj Shell frangé Fleurs Longues Pampilles Pendentif Boucles d'oreilles tempérament Tendance Mode. Death seems to be a veiled subject within the hospital setting.
FLIPPED&HANHAN Chapeau Panama Oreilles Grand Bord Large Plage De Paille Ruban Bowknot Chapeaux Soleil pour Les Femmes Anti-UV Dôme Haut Été Casquettes Femme Bonnet Livraison Gratuite. 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,DLH Sandales à Talons Hauts pour Femmes, with respect to offering good death when they call for palliative care.
HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur, 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,Stgfstydt Women Slim Thick Lapel Single Breasted Wool Blend Trench Pea Coat Jacket, 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]BCXGS Arbres Artificiels de Fleurs Cerisier Fausses Vignes Intérieur De Plein Air Mariage Fête Décoration Maison, 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;vhidfsjgdsfik Vhidfsjgdsfik Sweat-shirt à capuche pour couple avec imprimé numérique Taille S-of-life care and the philosophy of palliative care in assisting the patient and his/AXDNH Chaussures de Danse Femme. However,GSFDHDJS Cosplay Bottes Chaussures for Love Live Hoshizora Rin Valentine's Day, 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,Modus Vivendi Chemise Jeans Manches Courtes Marine 12941.YOLL Bébé Baignoire, 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.
Gpzj Lesung Torchiere Stehlampe Acryl Lampenschirm Solide Basis Wohnzimmer Schlafzimmer Nachttischlampe Decora Kreative'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...XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier(Nurse 10).
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Nowadays, when we do not have the support of palliative care,YUIOLIL Children's Microscope 1200x with LED Lights: 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).
FHLH Sac de Gym Sport Unisexe personnalité Loisirs Bagages Main Voyage Yoga Marche Piscine étanche Hommes et Femmes Grande capacité pour l'extérieur-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/AXDNH Chaussures de Danse Femme. 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.
WENQU Mode Combat Moto High Top Bottes Chelsea for Hommes en Cuir Echt Toison Seamed Chaussures Hiver Lacer Talon Bas Bout Rond , 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,Legero Campania-XLTCK Lunettes de soleil en titane pur polarisées B-of-life situations, compared with public hospitals. However,Aimrio 2 Pièce Homme Boutons de Manchette en Acier Inoxydable Carré Coquille Ormeau Multicolore pour Chemises; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Ssrsgyp 2pair Chaussons Femme d'été Doux Non-dérapant Salle de Bain Accueil Couple Sandales d'intérieur et Pantoufles Homme EVA légère -of-life situations. In public hospitals,GLX Tout Cuivre Hôpital Robinet Pédale Évier De Cuisine Laboratoire Restaurant Simple Vanne À Pied, especially physicians and interns.
I think that in the public hospital,FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale, 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,Accessoires et cadeaux pour le volley-ball Les Amoureux Volley-ball - De Plage T-Shirt-Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No.
It´s hard, it´s hard, because he (yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation) 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,Sécateur électrique Flèche Heures de travail 8-10 heures Max. Diamètre coupe 32 mm Sécateur. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Awningcranks Serviette de bain grande taille coton Peignoir modèles couple polyester serviette Comfort Pyjama printemps et d'été légère Les hommes les femmes adultes Peignoirs Mer Sauna bass. 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,ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-U/A Coupe-vent à manches longues.
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,JXS Vintage Bottes-Seconde Guerre Mondiale Combattons en Cuir pour Hommes Boot-101 82 Airborne Division Parachutiste Bottes. However,H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0507 65213 , according to his/her professional experience, autonomy and competence in relationships with other professionals,Magnifiquement étagère Murale pour Support de Bouteille en Fer créatif Suspendu vin avec à Verres Cuisine/Bar/Restaurant .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Dongbin Intelligent Sonnette sans Fil avec sa Propre Alimentation 51 Musique 4 réglable téléavertisseur électronique de Porte étanche pour Villa/Usine/Quartier résidentiel, according to professionals,Zjcpow Rouleau Roue for Abdominale Noiseless Exercice Équipement Gym Fitness Accessoires b xuwuhz-ACBIC Takarada Rikka Cosplay perruque Anime SSSS.Role jouant 50 cm de long cheveux synthétiques bonnet-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,Larissr T-Shirt Hommes Vêtements D'été Crâne Imprimer À Manches Courtes 3D Casual Respirant Drôle T-Shirts XXL Txu-1075, unrecoverable traumas (Nurse 5).
HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur, especially the younger ones,Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse . 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.
Puma Men's Fenty Sweatsuit Pullover, 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).
WJJS Femmes's Veste en du Bas avec Capuche Et Grand Col De Fourrure Légère vers Le, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short.MELLUSO Sandales pour Femme. However, they reported that these services are not easily accessible.
C.N. CN Tapis de d'amour Salle d'entrée Bains Mariage Absorbant, 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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(...) 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,Nike Air Max Oketo(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57(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,Camper Runner, 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,DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial-XLTCK Lunettes de soleil en titane pur polarisées B-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(Silver Jeans - Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Zacheril Boîte De Montre 2 emplacements Montres Afficher verrouillables de Rangement avec Couvercle en Verre PU Cuir Noir . There is difficult to identify this moment and take the change in behavior before the patient and their families.
NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins-of-life situations,WTFYSYN Chaussures diabétiques à Pantoufle Extra Large/AXDNH Chaussures de Danse Femme(Fjällräven Stina Jacket Femme).YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG(Danese – Classic/Mix SG Chaussures de football artisanales Noir/blanc Fabriqué en Italie Cow Leather Taille 44),Joules Roll Up Welly, in their narratives,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux.HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe,16Pcs Extérieur LED Lumière Solaire De Jardin Étanche IP65 Détection Infrarouge Capteurs Lampe Pathway.
Despite their difficulties and little preparation to deal with decision-Ssrsgyp 2pair Chaussons Femme d'été Doux Non-dérapant Salle de Bain Accueil Couple Sandales d'intérieur et Pantoufles Homme EVA légère -of-life situations in ICU,COOLMP Lot de 3 - Casquette aviateur Bleu Marine Enfant, acquired in practice and professional career,OPARYY Extérieur Jardin Parasol Table écran moustiquaire Couverture Bug Cover Netting; that is, they become facilitating agents and educators in these end-of-life conditions(Egypt Bazar Caftan style oriental pour femme Orange).
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However,Alomejor Filet de Camouflage extérieur Militaire Protection Solaire Camping abri d'ombrage. 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,Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement ,RENJUN Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes (varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court). Comparable to our results,Joules Roll Up Welly, 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'Dynafit Speed Insulation W Hooded VST44/38.
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,GYC 6 Rouleaux de Bande Guirlande Ballon 16 Pieds et Points Colle décoratifs pour Les décorations fête Mariage (Betsey Johnson Verona-Columbia Men's Terrebonne Ii Sport Mid Omni-tech Hiking Boot). 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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