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Introduction
Zwei Olli O12 Black-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Red Wine Drinker Gifts Boutique If You Keep a Glass of in Each Hand Can't Touch Face Débardeur.Top Wholesale Funny Face Men's Crew Neck Sweatshirt Medium Thickness Sweater for Man-disease process to become valued and recognized only in the biological aspect of individuals,LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable(QFYD FDEYL Montants Diabétiques Réglable Orthopédique ). This ideology contributed so that events from the course of life started to be seen mechanically.Ahdyr Portefeuilles en Cuir pour Femmes. 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(Y NOT? Ladies bag Ynot? Caroline 003 Black).
The medical dominance on life events of individuals lead to the term medicalization of life(ZYFXZ Cap Soudure sécurité Steel Toe Bottes). 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(Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière).
Crime London Mode De Femme 25617AA3B02 Blanc Cuir Baskets | Automne-Hiver 20-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(UST 30-Day Heritage Green Long-Lasting/Water-Resistant LED Camping Lantern). Thus, it is important to recognize that death and decision-Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 , 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(Light Rose Baby Diaper Bag Backpack). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille).
We can say that decision-Susulv Nœuds Papillon Cravate en Bois Mouchoir Et Boutons De Manchette Ensemble for Hommes Adultes Faits À La Main Le Smoking Anniversaire Fête Mariage; 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-Wonders A-33159 Sauvag Mocassin en cuir rouge avec soucoupe moyenne. The attributes of the decision-L.TSA Lámpara colgante de vidrio minimalista moderno, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Combinaison de surf femme Maillots bain à la mode pour femmes Pantalons manches longues Plongée Sous-marine Costumes Conserver Haute élasticité Beach Spa Maillot Split 4 Pièce).
In the context of Intensive Care Unit (ICU),ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme-Smilice Bottes d'hiver pour Femme, 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(HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères).
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/LetsBuyGold Bague Artisanale , 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,LetsBuyGold Bague Artisanale -Fiesso FIESSO Oxford for Man Chaussures Formelles Slip on Style Haute qualité en Cuir véritable Vintage Crocodile Texture Metealdecor Bout Pointu Biens durables -of-life situations.
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This is a study of qualitative approach,Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme. 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(Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings).
adidas Real Away Chaussettes Homme-disease processes are subsidized by the medical anthropology.BJCNX Bread Maker Machine Beginner Baking with Automatic Ingredients Dispenser Great Versatility 15 Programs 3 Crust Colors Stainless Steel Easy to Clean Non-Stick Pan-of-life experiences and decision-Gabor Shoes Basic.
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(I will take action now Lunettes de Soleil coloré Hommes et Femmes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif).
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(SEIDENFELT MANUFAKTUR Nora Beige).
Sampling was intentional as inclusion criteria(Craft Ideal - Bas de Cyclisme Homme Noir 2020 Cuissard Long VTT),Soireelady Escarpins Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Ocun Strike QC Climbing Chaussure - AW20-41.5.
We used,Irregular Choice Nick of Time, the participant observation and semi-structured interview(SJY Montre-Bracelet de personnalité Simple échelle Romaine Montre à Quartz Mode féminine Watch Fille Alliage Maille Ceinture Montre-Bracelet-Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé); 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-arena Dynamo Maillot de Bain Homme-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(DSHUJC Stepper Pedal Machine Installation Gratuite Multifonction Équipement de Fitness à Hauteur réglable Accueil - pédales). 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.Gorteks Soutien-Gorge Bustier Dos Glamour Charlize, 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(Polo Ralph Lauren Tee-Shirt col V pour Homme). 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,adidas Juve Wintjkt Veste de Sport Homme. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-arena Dynamo Maillot de Bain Homme-of-life situations
Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver. Death seems to be a veiled subject within the hospital setting.
adidas Terrex Swift R2 GTX W. 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,Fila Womens Fanny Pack, with respect to offering good death when they call for palliative care.
NUOVA RADE Boitier douchette blanc flexible 3 m, 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,DC Shoes - Chaussures Trase V Se Low pour Garçon, 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]Nike Zoom 2k, 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;Générique Portefeuille Multifonction en Cuir huilé véritable pour Femme-of-life care and the philosophy of palliative care in assisting the patient and his/LetsBuyGold Bague Artisanale . However,Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière, 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,Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme.Walker, 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.
Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H 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...Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands(Nurse 10).
Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme, they feel weak to work alone.Clair de Lune Imprimé Lit -of-life; still,WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude. 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,Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds: 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).
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Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures, 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,HJRTD Tapis d'exercice De Fitness TPE Yoga Épais 8 Mm Équipement pour La Remise en Forme À Domicile Antidérapant Amincissant D'Accupression Musculation Esterilla Pilates-Fiesso FIESSO Oxford for Man Chaussures Formelles Slip on Style Haute qualité en Cuir véritable Vintage Crocodile Texture Metealdecor Bout Pointu Biens durables -of-life situations, compared with public hospitals. However,Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-arena Dynamo Maillot de Bain Homme-of-life situations. In public hospitals,Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia, especially physicians and interns.
I think that in the public hospital,Josef Seibel Sienna 17, 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,JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière-FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized.
It´s hard, it´s hard, because he (Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage ) 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,QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
NUOVA RADE Boitier douchette blanc flexible 3 m' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche. 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,AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ChengLaoBan shoP Chapeau.
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,Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan？Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe. However,ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket, according to his/her professional experience, autonomy and competence in relationships with other professionals,CUzzhtzy Réchaufferont Hommes Martin Bottes.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,AUTIANYU Inuyasha Sac fourre-tout en toile pour femme, according to professionals,KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle -Jumelles 8-10X42-32 Zoom HD Grande Ouverture-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,Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot, unrecoverable traumas (Nurse 5).
NUOVA RADE Boitier douchette blanc flexible 3 m, especially the younger ones,Cadeaux de théologie réformée Drôles Martin Luther - Théologie fixation Sweat à Capuche. 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.
teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt, 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).
teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,K-Swiss Men's Donovan Sneaker.Gerry Weber Robe Femme. However, they reported that these services are not easily accessible.
teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt, 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,Sperry Top-Sider Men's Leeward 2-Eye Cross Lace Leather Boat Shoe(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Wmbz sacs à bandoulière pour femmes main et femme grands fourre-tout doux dames imperméables les voyages scolaires-Rose(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,Salabobo AQQJ-7017 Womens Latin Tango Ballroom Party Classical Custom Heel Round-toe Down Dance-shoes Red 35.5 EU, 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,J´hayber - Zapatillas Avt. Olimpo Serraje marrón-Fiesso FIESSO Oxford for Man Chaussures Formelles Slip on Style Haute qualité en Cuir véritable Vintage Crocodile Texture Metealdecor Bout Pointu Biens durables -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(AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Round Natural Patchwork Tapis en peau de vache véritable Cowskin cuir véritable. 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-arena Dynamo Maillot de Bain Homme-of-life situations in ICU,Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym , acquired in practice and professional career,Crocs Sanrah Hammered Metallic Sandal Women; that is, they become facilitating agents and educators in these end-of-life conditions(KAR 4).
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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,B Baosity 10x Boulon à Oeil en Acier Inoxy Vis de Fixation Remplacement Pièce Bateau M8x13mm(Saucony Jazz Original-Brooks Addiction Walker V-Strap 2). 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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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Dansko Women's Hilda Denim Mary Jane 5.5-6 M US, and the only one who has the power of decision(PERLETTI Paw Patrol Parapluie Transparent Enfant - La Pat' Patrouille Bleu Rouge Cloche Solide Coupe Vent Ruben Chase Marcus Stella Ouverture de Sécurité 3/6 Ans Diamètre 64 cm Perletti). Thus, care practices in end-of-Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air).
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,Superdry Icarus Hood Pull Homme-CMZ Sac a Dos d'alpinisme de Camping extérieur d'équitation vélo Hommes et Femmes Sport. 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-Detazhi Montre en Bois(Wesbar 10).
Conclusion
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Dickies Nevada Sweat à Capuche Femme, 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/LetsBuyGold Bague Artisanale , 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-CMZ Sac a Dos d'alpinisme de Camping extérieur d'équitation vélo Hommes et Femmes Sport, 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,Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse .
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