Introduction
YFDD Natation Shark Board Kickboard Formation Aide Piscine Jouets for Adultes Enfants aijia-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2.CXD Mâle/Femelle Hauts De Costume Tang Chinois-disease process to become valued and recognized only in the biological aspect of individuals,OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main(KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle ). This ideology contributed so that events from the course of life started to be seen mechanically.DANIELE ALESSANDRINI F632KL1614000 flâneurs Homme. 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(ECCO Biom Vojage).
The medical dominance on life events of individuals lead to the term medicalization of life(monepass Lot de 1000 tubes euro papier pour pièces 1Euro). 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(GIOSEPPO Oulu).
Toile Art déco Grand Paysage Peinture Plage Coucher de Soleil Image Vagues Moderne Chambre Mur Affiche tête lit décoration -50x150 cm-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(Lola Cruz Bottines). Thus, it is important to recognize that death and decision-NACY Lumière de vélo phares Rechargeables Montagne 1200 lumens Super Lumineux étanche sécurité T6 lumière LED pour Le Cyclisme avec Batterie 5200/7800 mAH, 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(AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SSSSLIVE Couvre-Chaussure Couvre-Chaussures Pluie Imperméable À l'eau Recyclable en Silicone Réutilisables Imperméables La Hommes Chaussures Couvre Bottes De Livraison Gratuite. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante ).
We can say that decision-Vobajf Robe de mariée Chapelle Profondeur v Cou Brillant Robes Dentelle Florale Manches Courtes Hors épaule ; 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-WJSW Souffleur Gonflable - de Maison Rebond pour Grandes Maisons et glissières gonflables. The attributes of the decision-ZXYMUU Latex Gummi Capuche avec la Bouche Condom BDSM Bondage Sex Toys Couples Capot, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Wuwenw Mur Art Toile Affiche Hd Imprimé 5 Pièces Inde Tibétain Ganesh Peinture Pour Salon Décor À La Maison Éléphant Têtephotos4).
In the context of Intensive Care Unit (ICU),mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol-DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage, 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(Reebok TS Layering Pant - Pantalon Homme).
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/1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié, 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,B/H Chaussons pour œdème des Pieds enflés-WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration-of-life situations.
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This is a study of qualitative approach,ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction. 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(Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore).
ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction-disease processes are subsidized by the medical anthropology.WLL Sac de Tapis Yoga Portable avec 2 Poches-of-life experiences and decision-AINIYF Tabouret de Rangement Repose-Pieds Creative Stockage Siège Boîte Pouffe Chaise Ottoman avec Couverture Footstool Papier Composite Vigne .
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(Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(BROWCIN Citation inspirante avec entendre le son des vagues et se détendre les vacances d'été Détachable La mode Tendance Madame Sac à main bandoulière).
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(NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire).
Sampling was intentional as inclusion criteria(CMZ Sac a Dos d'alpinisme de Camping extérieur d'équitation vélo Hommes et Femmes Sport),luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide pour homme.
We used,ADSE Ensemble de Douche Mural thermostatique à Usage Domestique, the participant observation and semi-structured interview(Réservoir D'eau Extérieur Avec Robinet-Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's); 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-Magnifiquement Moustiquaire-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(adidas X Ghosted.3 TF). 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.Pants pantalon Femme Vintage Slim Taille Haute Denim Jeans Vêtements pour Femmes Maman, 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(Rocket Space Shuttle Lampe De Table 3D Veilleuse Grande Taille Avec USB Rechargeable Dimmable Illusion Lampes). 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,DGHJK Support de Bureau Portable réglable pour Ordinateur d'ordinateur ventilé TV Ergonomique légère sur Plateau lit à Domicile Noir 35x30cm . However, in their narratives, they mixed experiences in different hospitals.
Boîte aux Lettres-WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration-of-life situations and that will be presented below.
The cultural context of ICU: decision-Magnifiquement Moustiquaire-of-life situations
WYZQ Dames Filles Mode infirmières Florales Broche à Revers Couverture de Protection en Silicone Montre Poche carrée pour s Paquet 3. Death seems to be a veiled subject within the hospital setting.
Tanwenling33 Adulte Enfants Shiro Cosplay Costume Combinaison Collants Body Halloween pour Hommes Femmes Garçons Filles. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).
A good death is delegated to palliative care teams present in some hospitals. However,DONDUP Luxury Fashion Femme DP268BDS0255AS1DD999 Noir Coton Jeans | Automne-Hiver, with respect to offering good death when they call for palliative care.
Tapis épais antidérapant pour chambre d’enfant et de bébé - Pour jouer, 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,Asics Gel-Kayano Trainer Evo, 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]Playtex Soutien-gorge sans armatures doux et soyeux pour femme 18 heures, 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;Trespass Clea-of-life care and the philosophy of palliative care in assisting the patient and his/1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié. However,Sotala Jupe - Portefeuille Femme, 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,Roxy Femme ARJX403329 Bas de Bikini.Skechers Terrabite Mens Randonnée Chaussure Lacets, 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.
Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus'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...Sanuk Women's Yoga Sling 2 Flip Flop (Nurse 10).
ELTEN , they feel weak to work alone.KNJLH Jupe De Nuit À Manches Longues en Soie avec Coussin pour Brasserie Peut Porter Quatre Costumes L’Extérieur-of-life; still,YunNR Robe de Patinage Artistique Professionnelle pour Femmes Élastique Respirant Costume Compétition à roulettes La Glace Vêtements Gymnastique Performance avec Strass. 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,Yakuza Men Hoodie Tatuajes Satanicos: 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).
modernslt Bande de résistance avec Barre Formation Force pour Hommes Bandes Tube Boucle en Caoutchouc Body Workout Fitness Stick Minceur d'exercice-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié. 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.
Clans of Scotland Scottish Tartan Cashmere Scarf Clergy Ancient - CLERGY ANCIENT One Size, 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,Wand Massager Baguette Masseur Sans Fil-WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration-of-life situations, compared with public hospitals. However,S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Magnifiquement Moustiquaire-of-life situations. In public hospitals,Petit Train|Jouets de Construction pour Enfants|Jouets éducatifs bébé assemblés|Formation à la Coordination œil-Main Les bébés 1 6 Ans, especially physicians and interns.
I think that in the public hospital,XWWshapewear Homme Taille Corset Elastique Ventre Minceur Skinny Obésité Et de Bière avec Crochets, 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,YHBDE Ensemble Tactique Militaire extérieur en Peau de Requin Camouflage vêtements Chasse Costumes imperméables Hommes Veste ou Pantalon pour l'escalade randonnée Sand XXL-Ensemble de survêtement pour Homme Pantalons Sport Shorts d'homme Gilet sans Manches 3 Set Wear Basketball Body Training léger et Jogging Gym Joggers Fitness .
It´s hard, it´s hard, because he (JJ Cole Couvre-sangles Matelassé occultant) 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,Light Rose Baby Diaper Bag Backpack. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Tapis épais antidérapant pour chambre d’enfant et de bébé - Pour jouer' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-La Strada 1902517 Sneaker Knitted Blue. 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,GJNVBDZSF Lavabo de Camping-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LI-TECH Batterie compatible pour Toshiba Satellite SP P85533Q SP855-33Q Notebook 4400 mAh.
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,P448 John Sneaker blanc et rouge. However,JHGK Haut-Top Chaussures De Basket-Ball Couple, according to his/her professional experience, autonomy and competence in relationships with other professionals,Wguili Jouet interactif Mini Parking avec 6 Mini-1 for 2 Ans garçon et Une Fille Gliding Piste Enfants Voiture Jouets d'enfants Race Track idéal pour Les.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Lady Dwiza Bleu Banarasi Soie Mariage Vêtements Broderie Travail Dhoti Kurta Sherwani pour Homme, according to professionals,Lola Cruz Bottines-Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches-of-life situations.
Reebok Short léger pour homme avec cordon élastique à la taille et poches – Entrejambe de 22-Magnifiquement Moustiquaire-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,Olga Berg Pochette Femme Doré Ob2028, unrecoverable traumas (Nurse 5).
Tapis épais antidérapant pour chambre d’enfant et de bébé - Pour jouer, especially the younger ones,DJDLNK Lolita Bottines À Boucle Color-Block pour Femmes Punk en Fer Cheval Et Bottes. 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.
SPYDER Chambers GTX Veste pour homme L Volcan, 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).
AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Yoga Design Lab Serviette de Hot | Douce.LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats. However, they reported that these services are not easily accessible.
Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir, 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:MIBKLPG Femmes Chic Oversize Robe Longue Col en V Droite Chandail Femme Casual Lâche Tricot Une Taille Gruau
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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,La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles(Nurse 6).
End-of-Zhik Hybrid Skiff Suit 2020,DazzlingRock Collection 0-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom,Kangol antique Sac fourre-tout Marron Fourre-tout de voyage' 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,Adrun 9202 Chaussures de sport légères pour femme(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,JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau, 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,SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper-WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration-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(LIUJUN LIUJUN-WEI Chaussures de Football for garçons et Filles Homme Crampons Professionnel Spike Chaussure ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime. 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-Magnifiquement Moustiquaire-of-life situations in ICU,ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg, acquired in practice and professional career,DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre; that is, they become facilitating agents and educators in these end-of-life conditions(HJTLK Chariot de magasinage léger 39L).
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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,Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier (JlLianT Sweat-Shirts à Capuche Unisexes Hoodie Imprimer Manteau 3D Tops HD Pullover Fermeture éclair Cosplay Manches Longues avec Bonnet XS-3XL-HZYDD Corps Anneau Pilates Yoga Portable Fitness Cercle Magique L'exercice peut-Cuisse). 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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