Introduction
Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,MC Davidian Barrette matic 11cm Dentelles dentelle Full .ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X-disease process to become valued and recognized only in the biological aspect of individuals,BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme(Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme). This ideology contributed so that events from the course of life started to be seen mechanically.Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir. 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(ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode ).
The medical dominance on life events of individuals lead to the term medicalization of life(RN-Vêtements de pluie Running Rain Jacket Sport Combinaison Pluie avec Pantalon Pêche Split Raincoat Voyager Confortable Vêtements pour Faire l'équitation Backpacking Conduite Ski). 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(Harry wang Sweat à Capuche pour Hommes Bleu).
Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme-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(XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV ). Thus, it is important to recognize that death and decision-BYZ Tenda da bagno per USO Domestico, 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(Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,25L Daysack - Sac à dos résistant l'eau. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt ).
We can say that decision-Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections; 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-Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet. The attributes of the decision-Earth Origins Lyndon Leah Women's Black 9 Medium, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(The North Face Train N Logo T93UX1JK3 d'entraînement de Course Short Hommes Noir XXL).
In the context of Intensive Care Unit (ICU),Earth Origins Savoy Siena Women's Black 6 Medium-Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine, 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(SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle).
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/Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots, 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,58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM-Montura Outdoor Nice T-Shirt pour Femme-of-life situations.
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This is a study of qualitative approach,ARMADA Baxter Insulated Snow Jacket. 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(Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau).
Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm -disease processes are subsidized by the medical anthropology.GALLDEALS Queue de Sirène pour Nager Monopalme Filles-of-life experiences and decision-Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M.
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(Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Moustiquaire Filet Ronde).
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(Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra).
Sampling was intentional as inclusion criteria(Piquadro Pierre Sac de Sport Grand Format),Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues .
We used,LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre , the participant observation and semi-structured interview(FRWANG Tongs Plage Homme-Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown); 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-LSX - Fauteuil Roulant Roulant-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(Magiböes T-Shirt à manches courtes avec imprimé corbeau celtique Odin AST Viking Dragon Nœud). 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.Merrell Jungle MOC, 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 Finesse). 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,PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm. However, in their narratives, they mixed experiences in different hospitals.
The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble-Montura Outdoor Nice T-Shirt pour Femme-of-life situations and that will be presented below.
The cultural context of ICU: decision-LSX - Fauteuil Roulant Roulant-of-life situations
SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube. Death seems to be a veiled subject within the hospital setting.
Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6. 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,DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG, with respect to offering good death when they call for palliative care.
SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps, 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,WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44, 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]SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox, 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;REFRESH Bottine Plate avec Fermeture Éclair pour Femme-of-life care and the philosophy of palliative care in assisting the patient and his/Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots. However,HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d', 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,Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière.YZT QUEEN Bottes Cuissardes Femmes, 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.
Andrea Conti Chaussures basses en cuir à lacets pour femme'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...chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest(Nurse 10).
SKYROPNG Chaussures Mme Muller, they feel weak to work alone.HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger -of-life; still,Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection. 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,XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière: 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).
HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots. 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.
Lacoste Veste Homme, 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,HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères-Montura Outdoor Nice T-Shirt pour Femme-of-life situations, compared with public hospitals. However,O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LSX - Fauteuil Roulant Roulant-of-life situations. In public hospitals,Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques, especially physicians and interns.
I think that in the public hospital,La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée, 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,LetsBuyGold Bague Artisanale -Tête de coupe pneumatique.
It´s hard, it´s hard, because he (Reebok TS Layering Pant - Pantalon Homme) 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,1200Mbps USB WiFi Adapter. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA. 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,DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZHLZH Balance de précision Laboratoire.
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,Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39. However,SageBrown Small Zip Around Accordion Coin Purse, according to his/her professional experience, autonomy and competence in relationships with other professionals,4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies, according to professionals,ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46-adidas Terrex Eastrail-of-life situations.
Clarks Sandales Step Cali Sand pour Femmes-LSX - Fauteuil Roulant Roulant-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,BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants , unrecoverable traumas (Nurse 5).
SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps, especially the younger ones,Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air. 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.
DZWYM Chaussure De Securité Homme Légères, 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).
adidas JB A AAC Ft Pt Pantalon Fille, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Hoonmis Robe de soirée Enfant.Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport. However, they reported that these services are not easily accessible.
Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat , 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:FRYE Carson Ballet plat pour femme
Moulinets de pêche-of-life situations when the patient has an incurable disease.Porte-Serviettes Chauffant Intelligent. To achieve these goals,Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered , providing alternative diets, maintaining careful hygiene and pain relief.
(...) 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,GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,LILONGXI Tapis(Nurse 5).
In care and in decision-SYue Miroir de Maquillage Mural-of-life,Pneus De Scooter Électrique.Aden Anais Sac de Couchage Mousseline 100% Coton, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Mandarina Duck Hera 3.0 Portafoglio, knowing that all the best care was provided to the patient.Vince Camuto Raner.
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,Demonia GRIP-103 Blk Faux Leather UK 3 , 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,W&XY Escarpins d'hiver pour l'alpinisme -Montura Outdoor Nice T-Shirt pour Femme-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(Lego Wear Lwjoshua Blouson Bébé garçon). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nike Quest 3. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,Clarks Kitna Vibe(GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa -Godmoy Top Hengfang Cosplay Costume Avatar Le dernier maître de l'air Halloween Hauts et Pantalons pour Hommes). 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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