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Introduction
Converse Chuck Taylor All Star Homme Vintage Leather Hi-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,no!no! Anti-Pluie Surchaussures.La Modeuse Richelieus Vernis à Bout Rond-disease process to become valued and recognized only in the biological aspect of individuals,BOSS Hugo Boss Lunettes de soleil BO 6LB/G4(Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs ). This ideology contributed so that events from the course of life started to be seen mechanically.New Balance Fresh Foam Hierro V4. 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(COMPRESSPORT Winter-socken Chaussettes Homme).
The medical dominance on life events of individuals lead to the term medicalization of life(LFLFZH Tapis Mousse Enfant PE Épissure Ménage De Sol Antidérapant Mat Rampant for Enfants Yoga Salle Jeux). 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(Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon).
ESDY Ensemble de sous-Vêtements Thermiques 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(YULIN-L YYL Imperméables pour Enfants). Thus, it is important to recognize that death and decision-Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme, 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(GYC Creative Portable 1 pcs Animal de Compagnie Memorial Fer Urne pour Chiens Chats Oiseaux Crémation Cendres Ouvrable Titulaire Petits Animaux Souris Lapins Poissons Funéraire Cercueil). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées).
We can say that decision-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU; 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-WPQBS Porte-clés. The attributes of the decision-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, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Générique Portefeuille pour Femme en Cuir véritable avec Porte-Cartes et dragonne).
In the context of Intensive Care Unit (ICU),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-GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball , 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(FREYA - soutien-gorge sport avec armatures active aa4892 nude).
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/RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris, 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,eeddoo Ti Gloss Titan - BCR Klemmring -Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104-of-life situations.
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This is a study of qualitative approach,Sotala Pantalon - 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(HS-Zak Miller LAL Bryant # 24 Vêtements De Basket-Ball Sport Jersey Hommes Entraînement Sportif pour Les Fans Adulte Unisexe Pur Coton Loose Col Rond Gilet Manche Courte T-Shirt Manteau).
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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(RYKA Dévotion pour femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(XLFD Porte-Feuille en Cuire Colorful Pink Flamingo and Pineapple Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized).
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(LVYE1 LAMP Dessin Animé Créatif Animaux LED Lustre Garçons Et Filles Chambre Enfants Lumières Moderne Simple Personnalité Tissu Lustre-CE).
Sampling was intentional as inclusion criteria(Multiple colors New ballet LED table lamp 7 color touch 3d night light),Hassia Bologna, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle.
We used,Champion Sweat à Capuche en Laine Polaire pour Homme, the participant observation and semi-structured interview(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-DC Shoes - Chaussures Trase V Se Low pour Garçon); 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-GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet-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(0.5L Mini Plongée sous-marine Équipement Réservoir). 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.PUMA Unisex Basket Classic LFS Kids Sneaker, 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(YXZQ Cartouche de Toner). 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,Nike Court Borough Mid Winter. However, in their narratives, they mixed experiences in different hospitals.
Columbia Granite Mountain Veste polaire pour homme-Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104-of-life situations and that will be presented below.
The cultural context of ICU: decision-GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet-of-life situations
Frankv Shorts de Planche pour Hommes. Death seems to be a veiled subject within the hospital setting.
Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement. 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,Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard, with respect to offering good death when they call for palliative care.
Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar , 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,axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir, 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]Hell Bunny Ella May Denim Dungarees, 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;Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver-of-life care and the philosophy of palliative care in assisting the patient and his/RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris. However,Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt , 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,Columbia Fall Pine Washed Crew Chemise Femme.Feagar Voiture Oreillers de Cou, 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.
TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille'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...Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme(Nurse 10).
KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme, they feel weak to work alone.Anodi per Motori Mercury - Mercruiser-of-life; still,DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black. 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,AILIBOTE Squad T-shirt pour homme: 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).
Cavi telecomando Sea Star CC330-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris. 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.
SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage, 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,Timberland Jayne Bottes de confort pour femme 15 cm-Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104-of-life situations, compared with public hospitals. However,TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet-of-life situations. In public hospitals,Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite, especially physicians and interns.
I think that in the public hospital,PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL, 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,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route -dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir.
It´s hard, it´s hard, because he (DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging) 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,Chiba pour Homme Lake Tahoe Gants. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-SPORTUBE Series 1 Platinum Deluxe Étui à snowboard. 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,Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Nike M NKCT Jacket Stadium Veste Homme.
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,Kipling Kassandra S. However,Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie, according to his/her professional experience, autonomy and competence in relationships with other professionals,Prana Summit Tall Pantalon pour Femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants, according to professionals,Piquadro Porte-Cartes de crédit-LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge-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,FRWANG Hommes Chaussures Cuir Brogue Lacets, unrecoverable traumas (Nurse 5).
Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar , especially the younger ones,CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite. 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.
Glqwe Sac à Dos étanche pour Ordinateur Portable, 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).
Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,H.yina Table à Langer pour Fille Petits espaces.Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier. However, they reported that these services are not easily accessible.
Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant, 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:yunyu Montre de Poche pour Homme
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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,U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes(Nurse 6).
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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,Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales, 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,LMWB Moustiquaire de Lit Pliable-Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104-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(Sac de rangement moulinet pêche portable). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US. 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-GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet-of-life situations in ICU,Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione, acquired in practice and professional career,Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt; that is, they become facilitating agents and educators in these end-of-life conditions(Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec).
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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,Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon(Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage-SJB Ventilador de escape montado en la pared Extractor 10 ventilateur mural pouces). 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,Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates. 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-Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera(adidas Gazelle).
Conclusion
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YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-ECCO Wayfly. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,Speedo Vengeance Mirror Lunette Mixte-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates.
Tom' s Company Tom Drag's Spirale d'énergie Limite 300, 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/RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris, 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-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates, 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,Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 .
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