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Introduction
Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard.Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar -disease process to become valued and recognized only in the biological aspect of individuals,axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir(Brandit Sweatshirt à capuche Homme). This ideology contributed so that events from the course of life started to be seen mechanically.Hell Bunny Ella May Denim Dungarees. 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(Topashe Femme Halloween Renaissance Medievale Costume).
The medical dominance on life events of individuals lead to the term medicalization of life(Selle FIZIK ANTARES R3 VERSUS EVO Rails Kium Couleur Noir). 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(Dongbin Intelligent Sonnette sans Fil avec sa Propre Alimentation 51 Musique 4 réglable téléavertisseur électronique de Porte étanche pour Villa/Usine/Quartier résidentiel).
Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver-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(SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet). Thus, it is important to recognize that death and decision-Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt , 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(Zhuowei Mesdames Stretch Cuissardes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Columbia Fall Pine Washed Crew Chemise Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Feagar Voiture Oreillers de Cou).
We can say that decision-Feagar Voiture Oreillers de Cou; 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-TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille. The attributes of the decision-Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Dmwfaker pour Mercedes Benz W205 C Classe C43 C63 C63s AMG C200 C220 C300 C320 C350 C400 4MATIC).
In the context of Intensive Care Unit (ICU),KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme-Anodi per Motori Mercury - Mercruiser, 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(Qipao Grande taille 5XL Vintage Chinois Traditionnel Femmes Imprimé Fleur Mandarine Col Cheongsam Nouveauté Chinoise Robe formelle).
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/DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black, 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,AILIBOTE Squad T-shirt pour homme-Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme-of-life situations.
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This is a study of qualitative approach,Cavi telecomando Sea Star CC330. 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(Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh).
SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-disease processes are subsidized by the medical anthropology.Timberland Jayne Bottes de confort pour femme 15 cm-of-life experiences and decision-TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear.
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(HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Cat Footwear Intruder/Unisex).
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(Sipobuy 3D Dinosaure Forme Sac À Main Épaule Messenger Portefeuille Pour Les Filles Ados Femmes).
Sampling was intentional as inclusion criteria(Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière ),Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL.
We used,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route , the participant observation and semi-structured interview(Zeraty Gilet De Natation pour Le Kayak-ZXLLAFT Bottes à Talons Hauts Femmes Bottines Bout Pointu Imperméables Cuir Brillant Lacets); 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-dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir-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(LOVEKUSH 50% Off Gemstone Jewellery Natural Ethiopian Welo Opal 9.80Cts. Pear Shape Cabochon 20x12MM Super Rainbow Electric Fire Play Code:- RADE-5035). 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.DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging, 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(Merrell Juno Mid Zip Sandal - Women's Brindle). 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,Chiba pour Homme Lake Tahoe Gants. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir-of-life situations
Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45. Death seems to be a veiled subject within the hospital setting.
Nike M NKCT Jacket Stadium Veste Homme. 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,Kipling Kassandra S, with respect to offering good death when they call for palliative care.
Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie, 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,Prana Summit Tall Pantalon pour Femme, 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]OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants, 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;Piquadro Porte-Cartes de crédit-of-life care and the philosophy of palliative care in assisting the patient and his/DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black. However,LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge, 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,zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit.FRWANG Hommes Chaussures Cuir Brogue Lacets, 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.
CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite'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...Glqwe Sac à Dos étanche pour Ordinateur Portable(Nurse 10).
Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage, they feel weak to work alone.H.yina Table à Langer pour Fille Petits espaces-of-life; still,Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier. 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,Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant: 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).
Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black. 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.
huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt, 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,Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having-Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme-of-life situations, compared with public hospitals. However,Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir-of-life situations. In public hospitals,Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit, especially physicians and interns.
I think that in the public hospital,LetsBuyGold Bague Artisanale , 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,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 .
It´s hard, it´s hard, because he (Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme) 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,OLYMP Luxor Chemise à col montant Blanc. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-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. 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,TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron.
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,HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini . However,O'NEILL Femme Blouse, according to his/her professional experience, autonomy and competence in relationships with other professionals,Asics Women's Low Cut Performance Short - Coupe Basse pour Femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support, according to professionals,Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales-LMWB Moustiquaire de Lit Pliable-of-life situations.
adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US-dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir-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,TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux, unrecoverable traumas (Nurse 5).
Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie, especially the younger ones,PUMA S XT nuageux Chaussure gris 359 135 02. 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.
I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais, 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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(...) 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,Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,qishi Fashion Veste décontractée pour homme Couleur unie(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,HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination, 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,WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party-Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme-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(Geox B New Gulp ABX C). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,WYZDQ Mens Bottes De Neige. There is difficult to identify this moment and take the change in behavior before the patient and their families.
Under Armour Campus W/U Veste pour femme-of-life situations,Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé/DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black(fischer 13948 Hausschuh).Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent(A1 FASHION GOODS Sac à Dos En Cuir De Pour Femme A59 Marron Rucksack Sport Randonnée Organisateur),MPOQZI Couvre-Volant de Voiture en Cuir Bricolage, in their narratives,Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent.ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille,Osiris Protocol pour Homme Noir/Miel.
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Conclusion
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Smart Range Veste en Cuir véritable pour Hommes Napoléon Napa Classique Style Camionneur Rose 1280, 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/DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black, 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-RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris, 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,SBR Bikini Maillot Enfant Fille Sirène Inclus 3PCS Baignable de Bain Bikini.
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