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Introduction
MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,WPQBS Porte-clés.N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à-disease process to become valued and recognized only in the biological aspect of individuals,btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women(AWYJ Balles de bébé). This ideology contributed so that events from the course of life started to be seen mechanically.GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball . 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(Columbia WAYFINDER FLIP Sandales de sport pour homme).
The medical dominance on life events of individuals lead to the term medicalization of life(xiaokeai Collier Femme Pendentifs en Forme de Coeur améthyste Cadeaux Noël Bijoux for Les Filles Amie Fille Maman Anniversaire Cadeau fête). 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(Asics Serrano Onitsuka Tiger Chaussures pour Hommes).
RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris-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(Timberland Splitrock 2). Thus, it is important to recognize that death and decision-eeddoo Ti Gloss Titan - BCR Klemmring , 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(Carhartt Henley T-Shirt de Poche pour Homme ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Sotala Pantalon - Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes).
We can say that decision-Nike M nK sQD coutil Top Shirt à manches longues; 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-K-Swiss Ultra Express. The attributes of the decision-TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Pavers Femme Baskets Casual À Lacets).
In the context of Intensive Care Unit (ICU),Hassia Bologna-SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle, 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(lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit).
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/Champion Sweat à Capuche en Laine Polaire pour Homme, 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,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet-Dare 2b Analyze Veste pour Homme-of-life situations.
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This is a study of qualitative approach,PUMA Unisex Basket Classic LFS Kids Sneaker. 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(Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm).
Nike Court Borough Mid Winter-disease processes are subsidized by the medical anthropology.Columbia Granite Mountain Veste polaire pour homme-of-life experiences and decision-Frankv Shorts de Planche pour Hommes.
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(MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Mo&Ny Robes Nationales de pour Concours Danse Salon Dames/Adultes Costume De Valse Brillant Foxtrot Big Swing Haut Gamme Vêtements Performance Tango).
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(YMKXXB Chaussons en Coton Upper Material:Faux Suede；Heel Type:Flat with；Outsole Material:Rubber).
Sampling was intentional as inclusion criteria(SALOMON Wings Pro 2),Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard.
We used,Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar , the participant observation and semi-structured interview(yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch-Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac ); 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-axley Proud Peacock Basic T-shirt à manches courtes pour femme 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(Roman Originals Femme Robe en Jean Denim - sans Manches Col V Elegant Ete Printemps Confortable Simple Robes). 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.Hell Bunny Ella May Denim Dungarees, 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(RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ). 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,Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver. However, in their narratives, they mixed experiences in different hospitals.
Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt -Dare 2b Analyze Veste pour Homme-of-life situations and that will be presented below.
The cultural context of ICU: decision-axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir-of-life situations
Columbia Fall Pine Washed Crew Chemise Femme. Death seems to be a veiled subject within the hospital setting.
Feagar Voiture Oreillers de Cou. 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,TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, with respect to offering good death when they call for palliative care.
Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme, 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,KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme, 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]Anodi per Motori Mercury - Mercruiser, 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;DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black-of-life care and the philosophy of palliative care in assisting the patient and his/Champion Sweat à Capuche en Laine Polaire pour Homme. However,AILIBOTE Squad T-shirt pour homme, 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,Cavi telecomando Sea Star CC330.SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage, 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.
Timberland Jayne Bottes de confort pour femme 15 cm'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...TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear(Nurse 10).
Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite, they feel weak to work alone.PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL-of-life; still,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route . 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,dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir: 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).
DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Champion Sweat à Capuche en Laine Polaire pour Homme. 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.
Chiba pour Homme Lake Tahoe Gants, 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,SPORTUBE Series 1 Platinum Deluxe Étui à snowboard-Dare 2b Analyze Veste pour Homme-of-life situations, compared with public hospitals. However,Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir-of-life situations. In public hospitals,Nike M NKCT Jacket Stadium Veste Homme, especially physicians and interns.
I think that in the public hospital,Kipling Kassandra S, 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,Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie-Prana Summit Tall Pantalon pour Femme.
It´s hard, it´s hard, because he (OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants) 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,Piquadro Porte-Cartes de crédit. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge. 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,zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-FRWANG Hommes Chaussures Cuir Brogue Lacets.
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,CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite. However,Glqwe Sac à Dos étanche pour Ordinateur Portable, according to his/her professional experience, autonomy and competence in relationships with other professionals,Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,H.yina Table à Langer pour Fille Petits espaces, according to professionals,Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier-Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant-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,huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt, unrecoverable traumas (Nurse 5).
Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme, especially the younger ones,Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having. 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.
Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit, 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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BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long , 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:Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron
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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,O'NEILL Femme Blouse(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US(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,Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker, 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,Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione-Dare 2b Analyze Veste pour 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(YAS Yasemira Loose Lace Top Blouse Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes. 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,Timberland Killington,EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant(HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant). Comparable to our results,OLYMP Luxor Chemise à col montant Blanc, 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'HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination.
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,WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party(Kappa Britannia Authentic Veste Homme-New Balance Rubix). 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,Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 -Asics Gel Solution Speed Clay. 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-Mares Volo Race(GGQF Table de Salle à Manger et chaises pour bébé).
Conclusion
The decision-Dare 2b Analyze Veste pour Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47-of-YZQ Hommes - Brooklyn Nets # 7 Kevin Durant Basketball Jersey NBA Retro Gym Séchage Rapide Respirant Hauts Gilet Sport.
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The difficulty for the expansion of knowledge in the decision-Asics Gel Solution Speed Clay, 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,KAVU Lorenzo Chemise à Boutons pour Homme.
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