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Introduction
ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire.GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V-disease process to become valued and recognized only in the biological aspect of individuals,Bath Sac à Dos Grande capacité 56-75L extérieur(Skechers Performance Go Walk Evolution Ultra - 54736). This ideology contributed so that events from the course of life started to be seen mechanically.John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot. 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(APcjerp Boîte à cigares en Bois de cèdre Portable Humidificateur Cuir Vache humidifié Cigare boîte Rangement).
The medical dominance on life events of individuals lead to the term medicalization of life(LYVN Ajustable Tabouret Hauteur Canne Bâton De Marche Pliable pour Les Personnes Âgées Cannes en Aluminium). 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(Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile).
Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons-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(TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear). Thus, it is important to recognize that death and decision-qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris, 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(Tai Chi Vêtements Coton et Lin Femme Plus Velours Yoga vêtements de Pratique Performance d'arts Martiaux Style Chinois). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag).
We can say that decision-Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport; 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-WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe. The attributes of the decision-Burton AK Gore CYCLIC Hose 2021 Forest Night, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(MINGDIAN Chaussures De Travail en Acier for Hommes).
In the context of Intensive Care Unit (ICU),Jourdan Bracelet Homme Nuku Bois-FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole, 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(Huangwanru Boîte de Montre pour Homme Bracelet Plateau Couvercle en Verre Noir 12 Affichage Rangement Bijoux Case Hommes ou Femmes ).
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/New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2, 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,MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe-Clergerie Berlin 3-of-life situations.
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This is a study of qualitative approach,XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm. 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(JEWEL BEADS Gemstone Beads Opal - Boulder Beads).
G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces -disease processes are subsidized by the medical anthropology.DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau-of-life experiences and decision-HART Polar Bear-V Gilet Taille XL.
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(XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Brigitte von Boch BRIGITTE de – azurema Bracelet Long).
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(H&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique).
Sampling was intentional as inclusion criteria(ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau),VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WZLJW Douche Piscine Plage Chaussures.
We used,TPHJRM Coussin d'accoudoir de Console Centrale Voiture, the participant observation and semi-structured interview(Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates); 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-ARA Rom-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(Columbia Men's Dorado Slip II). 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.NYDJ Jean pour femme, 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(1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte). 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,Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm. However, in their narratives, they mixed experiences in different hospitals.
Under Armour Sportstyle Sweat-shirt polaire zippé pour homme-Clergerie Berlin 3-of-life situations and that will be presented below.
The cultural context of ICU: decision-ARA Rom-of-life situations
Trezeta Margot WS Trek. Death seems to be a veiled subject within the hospital setting.
5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg. 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,Marvelis chemise style moderne crème, with respect to offering good death when they call for palliative care.
Reveal Entertainment Shan Jari Board Game, 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,Holley 34504 Carburetor Accelerator Pump, 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]ROTHCO M-65 Camo Field pour Homme, 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;CMP 38Z1726 Parka Fix Hood pour Femme-of-life care and the philosophy of palliative care in assisting the patient and his/New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2. However,PUMA RS-x Winterized, 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,Brandit Sweatshirt à capuche Homme.Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles, 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.
The 1 for U 100% Coton Peignoir/Peignoir Rosalind'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...HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête(Nurse 10).
LybMjG Maillot Cyclisme Pro, they feel weak to work alone.werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche-of-life; still,Carhartt Gilliam Vest Gilet Homme. 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,LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique: 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).
Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2. 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.
Sanuk Yoga Bliss, 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,Under Armour Curry IV Sandale pour homme-Clergerie Berlin 3-of-life situations, compared with public hospitals. However,Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ARA Rom-of-life situations. In public hospitals,Guess lea03 femme guess flazl2, especially physicians and interns.
I think that in the public hospital,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large, 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,HKM 9109 Bottes d'équitation Gijón-Pandora Femme Argent Boutons d'oreilles - 290721CZ.
It´s hard, it´s hard, because he (Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713]) 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,J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Reveal Entertainment Shan Jari Board Game' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Onitsuka Tiger Mexico 66. 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,Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Suitline Valise Plus Grande Bagages Rigide.
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,WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT. However,Pierre Cardin Lyon Long Life Chino Pantalon Homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,adidas Supernova de Course pour Femme à Manches Longues Tee.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Montane Ineo Pro Women's Pantalon, according to professionals,Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle-Manfrotto Travel Backpack Sac à dos Gris-of-life situations.
Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir-ARA Rom-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,Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro, unrecoverable traumas (Nurse 5).
Reveal Entertainment Shan Jari Board Game, especially the younger ones,Hexagona Sacoche en cuir de vachette RÉPUBLIQUE. 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.
X-Bionic O100093 - Cuissards de vélo Femme, 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).
YUHT Album Photo Hybride interstitiel, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YULIN-L YYL Imperméables pour Enfants.DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles . However, they reported that these services are not easily accessible.
Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck, 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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GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres-of-life situations when the patient has an incurable disease.good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine. To achieve these goals,Guess Bla Moritz, 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,Haggar Cool 18 Pro Stretch Madras Short pour Homme(Nurse 6).
End-of-YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe,Tosca Blu Bottes Mary-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute,WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud ' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
One thing I´ve always done is, regardless of public or private hospital,Radio Portable multifonctionnelle(Nurse 5).
In care and in decision-Spyder Raider Pull à fermeture éclair intégrale pour homme-of-life,Palladium Pampa Boots White.Apalis Sticker Mural Squirricorn on The Branch, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk, knowing that all the best care was provided to the patient.Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband.
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,ALPHA INDUSTRIES Blouson - Homme, 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,Kamik Snowvalley-Clergerie Berlin 3-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(camel active Ethnic 12). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nike Viale. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,American Tourister Soundbox Spinner Extensible. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,Strellson Premium Express-w Blouson Homme,El Naturalista Borago(Kala-isbijoux Pendentif ). Comparable to our results,Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'Bisgaard Dora.
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise, and the only one who has the power of decision(Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05). Thus, care practices in end-of-HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl, 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(HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College ).
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,Superga 2750-cotu Classic-ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween. 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-Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir(Tissu visière XXT Ombre épaissi Pluie imperméable Bâche à Vapeur Camion Canopy Oxford Toile en Plastique).
Conclusion
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