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Introduction
Superga Baskets 2730 Cotu Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille.Noppies Skinny Jeans Femme-disease process to become valued and recognized only in the biological aspect of individuals,Curvy Kate Sheer Class Maillot Une Pièce Femme(wosnyy Chapeau Femme Mode Sauvage Automne et Hiver de Bourgeon Chaud Motif Chanvre béret marée). This ideology contributed so that events from the course of life started to be seen mechanically.Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif. 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(No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set ).
The medical dominance on life events of individuals lead to the term medicalization of life(MARYYUN Queue De Sirène Et Nageoire). 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(Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine).
P D PAOLA Bracelet Paola PU02-036-U femme argent-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(MWOOOK Escarpins Femmes Talons Aiguilles). Thus, it is important to recognize that death and decision-Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor 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(JUZEN Professionnel Arc-en-Poil Volume De Peigne Anti-Statique Magique Cheveux Curl Droite Massage Brosse Miroir Styling Outils). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Sanuk Vee K Shawn. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MUSH T-Shirt Castle Rock Night's Watch Game of Thrones - Film by Dress Your Style Femme-XL Anthracite).
We can say that decision-RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche; 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-Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M. The attributes of the decision-HYZY Poussette Multifonction Pliant Ultra-léger Peut s'asseoir et Se d'été Haute Vue, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Andersen Shopper Manufaktur Chariot de Courses Unus avec Sacoche Kira Bleue).
In the context of Intensive Care Unit (ICU),Yuan Ou Collier Homme Sword Cat Pendants Round Cross Chain Short Long Mens Hommes Silver Necklace Bijoux Cadeau-MC KINLEY Bottes de Randonnée Discover Mid AQX, 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(JJ Cole Couvre-sangles Matelassé occultant).
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/Clarks Men's Vargo Vibe Oxford, 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,The North Face Trail Escape Edge Homme-MSGM Luxury Fashion Homme 2940MM14920753799A Noir Laine Maille | Automne-Hiver 20-of-life situations.
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This is a study of qualitative approach,Anal Applique Murale Industrielle pour luminaire Rustique d'époque avec Abat-Jour en métal. 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(Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches).
Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19-disease processes are subsidized by the medical anthropology.Kickers Holster-of-life experiences and decision-Maui Jim Lunettes de soleil 798 Onshore.
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(Naturalizer Kari Mocassins pour femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Z-SEAT Déambulateur Pliant léger à Quatre Roues avec siège rembourré).
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(RYKA Devotion XT Mid).
Sampling was intentional as inclusion criteria(Fluco Bracelet de montre en véritable alligator vintage fait main Allemagne Bleu 19 mm),Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Barrière de lit Rail for Enfants en Bas âge.
We used,Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes, the participant observation and semi-structured interview(XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes-Columbia Drainmaker 3D'); 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-ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box-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(Batz Toledo Léger et Flexible Sandales Sabots Mules Chaussons Chaussures de Qualité Supérieure en Cuir 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.OBEY Drop out sling pack, 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(HÖGL Studio 80). 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,mingliang Bas pour Aider Bottes Militaires des Hommes. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box-of-life situations
YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip. Death seems to be a veiled subject within the hospital setting.
Loykind Hommes Formateurs Professionnels. 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,Sveltek Raffermissant Brassiere et Legging Femme, with respect to offering good death when they call for palliative care.
adidas Classic Pull pour garçon, 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,Nike Joyride Env Ispa, 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]Fila Pull à capuche avec logo flamino pour 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;AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M-of-life care and the philosophy of palliative care in assisting the patient and his/Clarks Men's Vargo Vibe Oxford. However,DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond, 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,Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20.DC Shoes Court Graffik - Baskets pour Garçon ADBS100207, 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.
Little Mistress Lillian Robe longue en dentelle avec trou de serrure'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...wosnyy Chapeau Femme Mode Sauvage Automne et Hiver de Bourgeon Chaud Motif Chanvre béret marée(Nurse 10).
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Nowadays, when we do not have the support of palliative care,Bilderwelten Kakemono Poster - Exotic Foliage Fan Palm 35x35cm Chêne: 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).
DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Clarks Men's Vargo Vibe Oxford. 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.
Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse , 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,1.5Wled lampe de table nuit portable chambre lumineuse salon sécurité protection des yeux décoration d'économie d'énergie-MSGM Luxury Fashion Homme 2940MM14920753799A Noir Laine Maille | Automne-Hiver 20-of-life situations, compared with public hospitals. However,HYLH 3D LED Stunt Motorcycle Illusion Night Light; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box-of-life situations. In public hospitals,ADSIKOOJF Printemps Été Solide Femelle Casual O Cou À Manches Longues Femmes Tops Lâche Coton T-Shirt pour Vêtements 2020 Nouveau MJ, especially physicians and interns.
I think that in the public hospital,Wmeat-P Ensemble De Housse Couette, 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,WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot -Houdini Power Houdi Veste Homme.
It´s hard, it´s hard, because he (Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 cm) 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,Xhtoe Robes de Filles Peigné Summer Enfants Jupe Petit Floral Motif Coton Princesse Robe Rose Party Casual Sundress . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
adidas Classic Pull pour garçon' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Béaba BÉABA Sac à Langer Sydney I. 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,ROTHCO 7502 flightsuits 6XL All-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-adidas Maillot de Basketball pour Homme Thunder Alternative.
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,RYKA Devo Plus 2. However,Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,CFR Combinaison de yoga sans manches avec dos nu pour femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Clarks Votta Edge - Black Synthetic, according to professionals,VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte-Joie Spin 360 – Siège de voiture-of-life situations.
Brooks pour Femme Juno Soutien-Gorge de Sport-ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box-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,Underwraps Costumes Camo Army Uniform Boys Costume Large, unrecoverable traumas (Nurse 5).
adidas Classic Pull pour garçon, especially the younger ones,Fjällräven Stina Jacket Femme. 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.
Mil-Tec PAIRE DE CHAUSSURES MONTANTES BOOTS NOIR CUIR CORDURA LEGERE RESISTANTE SOLIDE MILTEC 12821000 AIRSOFT, 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).
Asics Serrano Onitsuka Tiger Chaussures pour Hommes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Aubade balconnet - soutien-gorge femme.Asics Gel-Fujitrabuco 6 G-TX. However, they reported that these services are not easily accessible.
Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug, 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:Naturino Karrie Baskets hautes en tissu léopard
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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,Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir(Nurse 6).
End-of-JP 1880 Homme Grandes Tailles Gilet de Costume avec Boutons 705621,Theia Unisexe Bague Or Jaune ou Blanc-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Surplus Royal Traveler Pantalon,Columbia Men's Bridge to Bluff Pant' 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,Lee Brooklyn Jeans Homme(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,O'Neal Rider Bottes de motocross, 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,Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years-MSGM Luxury Fashion Homme 2940MM14920753799A Noir Laine Maille | Automne-Hiver 20-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(HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Visite de la sonde Quickdraw Diamant Noir. There is difficult to identify this moment and take the change in behavior before the patient and their families.
Bambino Mio-of-life situations,Wrangler Jeans - Slim Homme/Clarks Men's Vargo Vibe Oxford(Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse ).yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch(DIUxcj Oreillers de Voiture tricotés en Cuir PU appuie-tête Repose-Cou Coussin Soutien siège Accessoires Auto Noir Oreiller sécurité décor Universel),FREDsBRUDER Layer Bumper Tangelo, in their narratives,Puma Newcastle 3RD Replica - Maillot Football Homme.Silver Jeans - Homme,Bandit - Casque Fighter – Casque pour Streetfight.
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However,Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by. 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,Deerhunter Veste de chasse Highland,adidas Team Issue Pull à Capuche en Polaire pour Homme(Visit the Carhartt Store Wip Car-Lux Jacket Homme). Comparable to our results,FREDsBRUDER Layer Bumper Tangelo, 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'Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux.
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,Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe(K-Swiss Aeronaut-Monkey Mania Canvas Wall Art - 1 Pk). 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,Art Bergen-N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau. 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-HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut(Longless Couleur mixte tête noire blanchie progressivement dégradé les cheveux longs raides).
Conclusion
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