Introduction
Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm.D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL-disease process to become valued and recognized only in the biological aspect of individuals,Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue(mingliang Bas pour Aider Bottes Militaires des Hommes). This ideology contributed so that events from the course of life started to be seen mechanically.MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine. 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(GUANTO MMA BLITZ - 24531 7).
The medical dominance on life events of individuals lead to the term medicalization of life(ZHTY 12W LED COB Lampe de pelouse étanche Jardin extérieur lampadaire Piscine Voie passerelle Paysage Colonne éclairage 3000K lumière Chaude en Aluminium Poteau borne d'éclairage). 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(SMITH Riot Masque de Ski).
Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur-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(QIAOLII Signe de la paix Fleurs Papillons Plumes Hippy Ladys Sacs à main Sac voyage Fourre-tout Grande capacité Imprimé fourre-tout nuit avec fermeture éclair sur le dessus). Thus, it is important to recognize that death and decision-ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm, 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(SILOLA Figurine Statuette Sculptures Bouddha). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HJTLK Chariot de magasinage léger 39L. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes).
We can say that decision-HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College ; 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-edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm. The attributes of the decision-Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(HUAQINEI Plafonnier créatif Hexagonal Blanc Simple et Moderne 6000k Lustre d'éclairage encastré Lampe LED pour Couloir).
In the context of Intensive Care Unit (ICU),Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large-Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre, 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(Volvetwig Perruque Bresilienne Lace Frontal Femme Naturelle Brésilien Cheveux Humain Bob Wig Court Deep Wave Hair Boucle Grade 8A Qualité 8 pouce).
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/GBY Maillot de Basket-Ball Heat n ° 3 Wade, 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,TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr.-Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en-of-life situations.
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This is a study of qualitative approach,BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or. 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(GURU-SHOP Guru-Boutique).
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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(DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable 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(LCCYJ La Santé Chaussons Jade Faire Pivoter Plantaire Point D'acupuncture Cailloux Sandales Hommes Et Femmes Massages Les Chaussures).
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(QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique).
Sampling was intentional as inclusion criteria(WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro),Kit de douche Bidet Douche musulmane , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable.
We used,Furla Portefeuille en Cuir Babylon S Bi-Fold, the participant observation and semi-structured interview(Asics Gt-3000 5-ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme); 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-adidas Duramo SL-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(HXiaDyG Lot de 4 survêtement sport pour homme avec pantalon compression et t-shirt à manches courtes). 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.Grunland CI2835 DIRA Ciabatta Donna S., 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(Brax Pantalon Femme). 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,Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-adidas Duramo SL-of-life situations
SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens. Death seems to be a veiled subject within the hospital setting.
ABAKUHAUS Je t'aime davantage Nappe. 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,Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07, with respect to offering good death when they call for palliative care.
EinStein Bague solitaire en diamant 0, 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,Strele Balançoire Portative Apaisante pour Bébé, 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]L@YC Sandales tendance pour femme à talon moyen, 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;Donald J Pliner Men's Dacio Loafer-of-life care and the philosophy of palliative care in assisting the patient and his/GBY Maillot de Basket-Ball Heat n ° 3 Wade. However,jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work, 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,Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm.LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière, 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.
DC Shoes Control Boa Boot – Noir 44'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...WANG Bottes de neige pour femmes grande taille(Nurse 10).
ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm , they feel weak to work alone.AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode-of-life; still,Ensemble de vadrouille et Seau. 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,rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets: 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).
LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/GBY Maillot de Basket-Ball Heat n ° 3 Wade. 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.
Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique , 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,Ralph Lauren Pull - Homme-Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en-of-life situations, compared with public hospitals. However,FRYE FRYE70663 - Billy Shootie Femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-adidas Duramo SL-of-life situations. In public hospitals,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac , especially physicians and interns.
I think that in the public hospital,Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue, 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,Under Armour Own The Gym Duffel Sac Mixte Adulte-Kadolis Matelas Landau Latex Blanc.
It´s hard, it´s hard, because he (Clair de Lune Doublure en polaire pour couffin osier Rose) 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,Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
EinStein Bague solitaire en diamant 0' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme. 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,ALTRA Paradigm 4.5 Chaussure de course sur route pour femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements.
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).
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Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite, according to professionals,LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme-Jack Wolfskin Whirlwind Veste Homme-of-life situations.
Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM-adidas Duramo SL-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,LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux , unrecoverable traumas (Nurse 5).
EinStein Bague solitaire en diamant 0, especially the younger ones,Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair. 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.
ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 , 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).
MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc.Hackett London Pantalon Homme. However, they reported that these services are not easily accessible.
NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott, 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:Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux
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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,PUMA Veste de Pluie Tabaluga pour Fille(Nurse 6).
End-of-HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures,MEETGG Porte-Bébé Multifonctionnel Trois en Un-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire ,Gringo Fairtrade Felt Owl Shoulder Bag' 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,Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière(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,XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes , 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,huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm-Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en-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(adidas Solar Glide St 19 W). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince . There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- . 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,MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air,Tubus Tube Support pour Lowrider (Nologo Costumes GEMORE drôles Stripe Clown gonflables ). Comparable to our results,Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage, 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'SKSNB Smart Watch1.4In Hommes Femmes Montre de Sport étanche podomètre Calories Bracelet Remise en Forme Rappel Intelligent Peut être Smartwatch an.
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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,Nine West Women's Gramercy Bermuda Short-STAR TREK Sweat à Capuche Jeunesse Tos Episode 31. 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-Puma MAPM Laurel Cap Schwarz(BlackButterfly Satin Boléro - Manches De Demi).
Conclusion
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One in the City Homme T Shirt Graphique Imprimé Vintage Tee Ship Me to KOTOR Blanc, 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/GBY Maillot de Basket-Ball Heat n ° 3 Wade, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
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