Introduction
CEL Marcheur # 8 Vêtements De Basket-Ball Sport Jersey Hommes Survêtements Pour Les Fans Adulte Unisexe Pull À Capuche Manche Longue Manteau Avec Poche Kangourou-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,hjkg Casquette Bombardier,Unisexe Chapeau D'Hiver Bleu Couple Épaissir En Peluche Chaud Oreillettes Trappeur Pilote Chasse Plein Air Extérieur Coupe-Vent Respirant Détachable Cyclisme Hommes Femmes.SILOLA Kits Peinture par numéros Kit à l'huile Bricolage pour Adultes Enfants Débutant Cadeaux Noël 16 X 20 Pouces - Taj Mahal Night View-disease process to become valued and recognized only in the biological aspect of individuals,JALAL Couronne de blé Noël(Chantelle Hedona Soutien-gorge à bretelles). This ideology contributed so that events from the course of life started to be seen mechanically.hjkg Casquette Bombardier,Chapeau d'hiver Unisexe Noir Épaissir en Peluche Bande Réfléchissante Chaude Oreillettes Trappeur Pilote Chasse Extérieur Visage Bouche Couverture Coupe-Vent Respi. 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(Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt).
The medical dominance on life events of individuals lead to the term medicalization of life(Elephant Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga). 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(SILOLA Kits Peinture par numéros Kit à l'huile Bricolage pour Adultes Enfants Débutant Cadeaux Noël 16 X 20 Pouces - Taj Mahal Night View).
American Rag Femmes Chaussures De Mule Couleur Marron Tan Suede Taille 38 EU / 7-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(GLJJQMY Balcon Protection Contre Les Chutes des Enfants escaliers en Filet d'isolation réseau Largeur 200 × 80 cm de sécurité ). Thus, it is important to recognize that death and decision-Pneus de Scooter électrique, 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(Timberland Kendrick Bottes imperméables pour homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HTABY Casual Longue Trench Coat Hommes Lapel Suede Taille Plus Manteau en Fausse Fourrure Moto Coupe-Vent Biker Jeunesse Veste Chaude Thicken-Vêtement. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme).
We can say that decision-YHDNCG Balai d'essuie-Glace arrière de Voiture 14"Bras fenêtre arrière; 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-Cakunmik Raquettes à Neige Plus la Taille des Plates Dames Bottes de Laine Coton. The attributes of the decision-Global Vision Lunettes de Soleil Nouvelle Attitude, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(HUIGE Body Sculptant Shapewear Femme Amincissant Gainant Taille Haute Ventre Plat Minceur Corset Lingerie Sculptante Respirant Bodysuit).
In the context of Intensive Care Unit (ICU),NIHAOA Cravate de Mode Clip Costume Joker Red Deep Blue Hommes et Blanc Motif décoratif Chasse au Sol Noeud Papillon -Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual, 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(DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir).
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/Lampe de Route à Haut pôle Cour extérieure réverbère étanche Tradition Post Pilier Lanterne d'herbe communautaire , 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,Walker Valentin Chapeau IBHT Femmes Cap Plein Air Scarf points imprimés style décontracté Pare-soleil extensible respirant Yoga chaud cou sommeil Couvre-chef ST Nouveau-ZJIIXON Sweat-Shirt imprimé en 3D-of-life situations.
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This is a study of qualitative approach,WEM Plafonnier LED carré ultra-mince moderne à intensité variable avec télécommande 3000K-6000K Éclairage pour enfants de chambre coucher Acrylique Abat-jour blanc Garçon Fille Chambre L. 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(Qiterr Remontoir de Montre).
Metal.CH 2133.47 Montre chronographe pour homme avec date 47 mm et bracelet en cuir beige-disease processes are subsidized by the medical anthropology.Yctze Volant de bateau-of-life experiences and decision-MODRYER Garçon Tout-Petits Pull Jumpers Costume Pur Coton molletonné Captain America Spiderman Enfant Printemps Hoodie Automne Sweatpants.
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(Sperry Top-Sider Femmes Bottes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Clarks Women's Step Glow Slip Loafer Flat).
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(Npeiyi Seau pour urine féminine).
Sampling was intentional as inclusion criteria(Geox D Nebula C),XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten.
We used,Marc New York by Andrew Men's Bergen Ultra Stretch Packable Jacket, the participant observation and semi-structured interview(Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air-Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes); 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-SWIMS Mocassins en Dentelle Stride pour Hommes-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(Kjlkljhgfjh Beyblade Chaussons de Plage et Piscine Chaussures Bain Slipper Doux Flip Flops d'été antidérapants Maison Pantoufles Sandales Retour). 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.Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split, 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(Modèle d'avion en métal moulé sous pression 16 cm Boeing B777). 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,BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM. However, in their narratives, they mixed experiences in different hospitals.
Powerslide R4 Trinity Rollers-ZJIIXON Sweat-Shirt imprimé en 3D-of-life situations and that will be presented below.
The cultural context of ICU: decision-SWIMS Mocassins en Dentelle Stride pour Hommes-of-life situations
HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine. Death seems to be a veiled subject within the hospital setting.
LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large. 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,LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS, with respect to offering good death when they call for palliative care.
Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée, 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,Delavi Self Medication T-Shirt Femme Noir Women's Black, 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]HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo , 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;ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs -of-life care and the philosophy of palliative care in assisting the patient and his/Lampe de Route à Haut pôle Cour extérieure réverbère étanche Tradition Post Pilier Lanterne d'herbe communautaire . However,GET Combinaison de Ski Une Pièce pour Femmes, 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,MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe.VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur, 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.
PUMA TSUGI Disc'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...Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine(Nurse 10).
elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage, they feel weak to work alone.PUMA Roma Basic-of-life; still,Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne. 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,FB Fashion Boots 14902: 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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QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège , 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,EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5-ZJIIXON Sweat-Shirt imprimé en 3D-of-life situations, compared with public hospitals. However,Roxy Snow Junior's Surface Zip Through Top; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-SWIMS Mocassins en Dentelle Stride pour Hommes-of-life situations. In public hospitals,COMPRESSPORT Winter-socken Chaussettes Homme, especially physicians and interns.
I think that in the public hospital,Kask Utopia Casque vélo Adulte Unisexe, 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,Hotter Glove-Reebok Aztrek 96.
It´s hard, it´s hard, because he (Reebok Classic Leather Vector) 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,Lee Men's Performance Series Extreme Comfort Khaki Pant. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Asics Chaussures Gel-Quantum 90 pour Femmes. 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,Beta Beta-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques.
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,Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied. However,Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose, according to his/her professional experience, autonomy and competence in relationships with other professionals,DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903, according to professionals,LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile-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-of-life situations.
PXQ Unisexe la NASA T-Shirt Manches Longues lâche Coton Sweatshirt pour Hommes et Femmes-SWIMS Mocassins en Dentelle Stride pour Hommes-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,SLONGK Bobine D'Allumage 077905115T, unrecoverable traumas (Nurse 5).
Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée, especially the younger ones,Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille. 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.
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TK Total Three 3.1 Accelerate Crosse de hockey 2020/20, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,adidas Originals Baskets Mode 3MC X Truth Never Told.TAZAN Mocassins De Conduite pour Hommes Plat. However, they reported that these services are not easily accessible.
YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire , 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,EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2(Nurse 6).
End-of-Loungefly X Disney Mini sac à dos Motif portrait,MUK LUKS Chaussons Critter pour Femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets,Portable Butane Stove Burner - Taille Unique' 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,Home Trainer Rouleaux dim. 145L x 56l 10(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,Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant, 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,Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume-ZJIIXON Sweat-Shirt imprimé en 3D-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(GFF Sasan Maiden Series Lady Parapluie Noir Colle). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse. 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-SWIMS Mocassins en Dentelle Stride pour Hommes-of-life situations in ICU,ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant, acquired in practice and professional career,Korntex KXRJGS Veste imperméable Jaune Taille S; that is, they become facilitating agents and educators in these end-of-life conditions(DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre).
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