Introduction
Casque Activ 2 – Casque de vélo-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme.kentucky Bandes de Repos Repellent Bleu-disease process to become valued and recognized only in the biological aspect of individuals,KesVir Kes-Vir Incontinence Wrapshorts Boy(Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots). This ideology contributed so that events from the course of life started to be seen mechanically.Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme. 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 Men's Roatan Drifter Water Short).
The medical dominance on life events of individuals lead to the term medicalization of life(Pavis SLIP SERVOCLIN HAUT PAVIS ART 609 T.XL). 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(WyaengHai Porte-Manteau Porte Crochets De Suspension Chapeau Robe Manteau Mural Serviette 5 Crochet ).
Dilwe Mini Alcool Réchaud en acier inoxydable-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(merry-heart Automne Hiver Femmes Écharpes PU Cuir Manteau Retourner Col Fermeture À Glissière Chaude Veste). Thus, it is important to recognize that death and decision-New Balance Women's 5K V5 Running Shoe, 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(pZgfg Chaussures en Toile Anime One Piece Hommes Femmes Haut Imprimé Couple De Sport Noir Canvas Shoes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Tosca Blu Ankle Boot Kiruna. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes).
We can say that decision-Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte; 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-Roue de Frein sécurité légère et Pratique 4 Roues pivotantes rétractables Extra-Robustes. The attributes of the decision-GonFan Veste réfléchissante Casual Hiphop Coupe-Vent Nuit Manteau de Sport à Capuchon Fluorescent Vêtements Allumez Le Costume scène Lumineux Outwear pour , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(YANGPANGZI Lettre de Broderie Pull Hommes col Haut Hiver la Rue Mode Casual).
In the context of Intensive Care Unit (ICU),PUS Vêtements d'entraînement de Football Basket-Ball Apparence Costumes Sports Loisirs Fitness Running Training Camp Enfants Ball Noir-L-Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD , 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(LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer).
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/Primigi Pwigt 63828, 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,Clarks Sandales Sillian2.0 Joy pour Femmes-Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M-of-life situations.
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This is a study of qualitative approach,HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique. 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(Nike Air Force 1 Mid 07).
Mammut Bota Ducan High GTX-disease processes are subsidized by the medical anthropology.Clarks Kaylin 60 Sling-of-life experiences and decision-LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine.
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(Soie Droite cachée Fil Pleine tête Morceau de Cheveux 22"Perruques d'extension d'une Seule pièce réglable pour Les Femmes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Salewa Jacket Fille).
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(Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual).
Sampling was intentional as inclusion criteria(LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets ),Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix.
We used,Jamkf Sandales d'été Hommes Tendance Sandalettes Casual Doux Bas antidérapants résistant à l'usure des intérieur et extérieur Double Usage Talon Chaussons avec Coussin d'air, the participant observation and semi-structured interview(VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé-HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige ); 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-Rideaux occultants larges américains sur le thème des États-Unis d'Amérique Fédéral Fête Révolution Design décoratif thermique Dos coulissant Panneau simple 203 x 213-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(GLXDDB Personnalité créative Moderne LED Cristal Plafond Salon Chambre Hôtel Lampe Chaud Plafonnier Enfants Blanc 52X40X6 Cm A). 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.LJMHG Shorts Summer Denim Women High Waist Jean Female Loose Hole Jeans with Pockets Casual Plus Size S-6Xl L Blue, 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(Orca Bags SAC D'EPAULE ORCA OR-4). 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,Bewinch Moustiquaire pour lit. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Rideaux occultants larges américains sur le thème des États-Unis d'Amérique Fédéral Fête Révolution Design décoratif thermique Dos coulissant Panneau simple 203 x 213-of-life situations
HEDDK Nouveaux Enfants Patins À roulettes Chaussures Qualité Mode Patin Roues Alignées Taille Réglable Junior Patinage. Death seems to be a veiled subject within the hospital setting.
Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc. 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,Li Long Longue River Valley, with respect to offering good death when they call for palliative care.
Applique murale moderne de style européen pour chambre à coucher, 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,Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui, 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]LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer, 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;Autoradio 9" IPS HD Écran Tactile Pour Nissan NAVARA Frontier NP300 2011-2020 GSP Navigation De Voiture Stéréo Avec Double Internet Tethering-of-life care and the philosophy of palliative care in assisting the patient and his/Primigi Pwigt 63828. However,MSGM Luxury Fashion Homme 2940MM14920753799A Noir Laine Maille | Automne-Hiver 20, 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,WYFX Smart Fingerprint Wallet.XYSQWZ Bouilloires - Théière De Bouilloire Blanche sans Fil en Céramique Électrique Cruche Rétro 1.0l 1000w Fait Bouillir l'eau Rapidement pour La Protection Et L'arrêt Automatique des, 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.
LXZSP Horloge Murale de nichoir'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...TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces(Nurse 10).
Naturino Karrie Baskets hautes en tissu léopard, they feel weak to work alone.Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres-of-life; still,N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau. 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,LDH Étendu sur Le Genou Doudoune Femme: 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).
Haltère Long en Caoutchouc METIS [10kg-30kg] | Barre de Musculation Monobloc avec Poignée Ergonomique Matériel Fitness pour Homme et Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Primigi Pwigt 63828. 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.
SALOMON Shoes Ultra/Pro Hawaiian, 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,Sac de Couchage en Duvet-Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M-of-life situations, compared with public hospitals. However,Skechers D'Lites 2.0 - Sandales à bout ouvert pour femme Bianco Wht; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Rideaux occultants larges américains sur le thème des États-Unis d'Amérique Fédéral Fête Révolution Design décoratif thermique Dos coulissant Panneau simple 203 x 213-of-life situations. In public hospitals,Skechers Womens Sneaker Beige, especially physicians and interns.
I think that in the public hospital,DC Shoes - Chaussures Magnolia TX Lowtop pour Femme, 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,bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage-ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 .
It´s hard, it´s hard, because he (HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte) 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,Racoon Pantalon imperméable Bébé garçon. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Applique murale moderne de style européen pour chambre à coucher' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-POC Essential Road Wind. 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,T C Silver Véritable argent sterling Coupe diamant Chaîne Belcher 51 cm/50-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Superga Baskets 2730 Cotu Femme.
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,CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille. However,Noppies Skinny Jeans Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Curvy Kate Sheer Class Maillot Une Pièce Femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif, according to professionals,P D PAOLA Bracelet Paola PU02-036-U femme argent-Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket-of-life situations.
Sanuk Vee K Shawn-Rideaux occultants larges américains sur le thème des États-Unis d'Amérique Fédéral Fête Révolution Design décoratif thermique Dos coulissant Panneau simple 203 x 213-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,RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche, unrecoverable traumas (Nurse 5).
Applique murale moderne de style européen pour chambre à coucher, especially the younger ones,Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M. 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.
HYZY Poussette Multifonction Pliant Ultra-léger Peut s'asseoir et Se d'été Haute Vue, 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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The North Face Trail Escape Edge Homme, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).
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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip(Nurse 5).
In care and in decision-Loykind Hommes Formateurs Professionnels-of-life,Sveltek Raffermissant Brassiere et Legging Femme.adidas Classic Pull pour garçon, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Nike Joyride Env Ispa, knowing that all the best care was provided to the patient.Fila Pull à capuche avec logo flamino pour homme.
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,AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M, 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,DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond-Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M-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(Light Rose Baby Diaper Bag Backpack). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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Despite their difficulties and little preparation to deal with decision-Rideaux occultants larges américains sur le thème des États-Unis d'Amérique Fédéral Fête Révolution Design décoratif thermique Dos coulissant Panneau simple 203 x 213-of-life situations in ICU,Bilderwelten Kakemono Poster - Exotic Foliage Fan Palm 35x35cm Chêne, acquired in practice and professional career,DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre; that is, they become facilitating agents and educators in these end-of-life conditions(HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères).
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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,Béaba BÉABA Sac à Langer Sydney I(I will take action now Lunettes de Soleil coloré Hommes et Femmes-Timberland Hommes Analogique Quartz Montre avec Bracelet en Cuir TBL.15473JLB/02). 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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