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Introduction
TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806.NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire-disease process to become valued and recognized only in the biological aspect of individuals,GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V(FENDI FF0343/S Lunettes de soleil Blue Avec Lentilles Blues Argentes 53mm MVU7R FF0343S FF 0343/S). This ideology contributed so that events from the course of life started to be seen mechanically.Bath Sac à Dos Grande capacité 56-75L extérieur. 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(The Bridge Lambertesca Sac porté épaule Noir).
The medical dominance on life events of individuals lead to the term medicalization of life(Skechers 52653 BBK Sneaker Homme). 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(Cerdá Ligera Lady Bug).
John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot-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(YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain). Thus, it is important to recognize that death and decision-Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons, 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(ZJ Bien Maillots de Bain Garçons d'enfants). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Jesse James Workwear Workers Hort Industry).
We can say that decision-Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse; 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-Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport. The attributes of the decision-WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Dim Socks And Underwear. Boxer DIM Homme en Coton Stretch Ultra Confort -Assortiment modèles Photos Selon arrivages- Multicolore).
In the context of Intensive Care Unit (ICU),Burton AK Gore CYCLIC Hose 2021 Forest Night-Jourdan Bracelet Homme Nuku Bois, 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(FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables ).
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/FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole, 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,New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2-WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral-of-life situations.
Clergerie Berlin 3
This is a study of qualitative approach,MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe. 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(YQSHOES Bottes).
XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm-disease processes are subsidized by the medical anthropology.G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces -of-life experiences and decision-DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau.
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(KCSds Bobo perruque de cheveux courts). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Diamond2Deal 10 K Or jaune Diamant Cluster assorti Trio His & Hers Mariage Bague de Lot 1/3 carat au total).
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(Tory Burch Cabas pour femme rose Dark Sahara ).
Sampling was intentional as inclusion criteria(Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée),HART Polar Bear-V Gilet Taille XL, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant.
We used,WZLJW Douche Piscine Plage Chaussures, the participant observation and semi-structured interview(DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual-YATTYUG Women's Hoodies Tops); 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-TPHJRM Coussin d'accoudoir de Console Centrale Voiture-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(KEHUITONG Dentelle Bow bébé Filles Tutu Jupe Fluffy Enfants Ballet Pettiskirt Toddler Princesse Party Tulle Danse Jupes). 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.ARA Rom, 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(Spyder Raider Pull à fermeture éclair intégrale pour homme). 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,NYDJ Jean pour femme. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-TPHJRM Coussin d'accoudoir de Console Centrale Voiture-of-life situations
Under Armour Sportstyle Sweat-shirt polaire zippé pour homme. Death seems to be a veiled subject within the hospital setting.
Trezeta Margot WS Trek. 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,5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg, with respect to offering good death when they call for palliative care.
Marvelis chemise style moderne crème, 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,Reveal Entertainment Shan Jari Board Game, 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]Holley 34504 Carburetor Accelerator Pump, 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;ROTHCO M-65 Camo Field pour Homme-of-life care and the philosophy of palliative care in assisting the patient and his/FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole. However,CMP 38Z1726 Parka Fix Hood pour 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,PUMA RS-x Winterized.Brandit Sweatshirt à capuche Homme, 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.
Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles'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...The 1 for U 100% Coton Peignoir/Peignoir Rosalind(Nurse 10).
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Nowadays, when we do not have the support of palliative care,Carhartt Gilliam Vest Gilet Homme: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).
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Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe, 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,Sanuk Yoga Bliss-WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral-of-life situations, compared with public hospitals. However,Under Armour Curry IV Sandale pour homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-TPHJRM Coussin d'accoudoir de Console Centrale Voiture-of-life situations. In public hospitals,Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir, especially physicians and interns.
I think that in the public hospital,Guess lea03 femme guess flazl2, 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,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large-HKM 9109 Bottes d'équitation Gijón.
It´s hard, it´s hard, because he (Pandora Femme Argent Boutons d'oreilles - 290721CZ) 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,Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713]. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Marvelis chemise style moderne crème' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN. 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,Onitsuka Tiger Mexico 66-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe.
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,Suitline Valise Plus Grande Bagages Rigide. However,WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT, according to his/her professional experience, autonomy and competence in relationships with other professionals,Pierre Cardin Lyon Long Life Chino Pantalon Homme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,adidas Supernova de Course pour Femme à Manches Longues Tee, according to professionals,Montane Ineo Pro Women's Pantalon-Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle-of-life situations.
Manfrotto Travel Backpack Sac à dos Gris-TPHJRM Coussin d'accoudoir de Console Centrale Voiture-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,Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir, unrecoverable traumas (Nurse 5).
Marvelis chemise style moderne crème, especially the younger ones,Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro. 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.
Hexagona Sacoche en cuir de vachette RÉPUBLIQUE, 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).
X-Bionic O100093 - Cuissards de vélo Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YUHT Album Photo Hybride interstitiel.YULIN-L YYL Imperméables pour Enfants. However, they reported that these services are not easily accessible.
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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,Guess Bla Moritz(Nurse 6).
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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband, 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,ALPHA INDUSTRIES Blouson - Homme-WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral-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(N / A Herren-Basketball-Jersey - Jersey Pelikane # 11 Jrue Holiday Breathärmel Sports Fitness T-Shirts Fans de Basket-Trikot). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Kamik Snowvalley. 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-TPHJRM Coussin d'accoudoir de Console Centrale Voiture-of-life situations in ICU,New Balance H754 , acquired in practice and professional career,WOOLRICH Laureldale Pull à col roulé pour femme; that is, they become facilitating agents and educators in these end-of-life conditions(miwaimao Miwaimao Ensemble écharpe en tricot pour bébé avec cercle et cache-cou Jaune).
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However,Bosch TDA703021A Fer à Repasser 3000 W. 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,American Tourister Soundbox Spinner Extensible,Strellson Premium Express-w Blouson Homme(glstkrrn E90 Sweatshirt). Comparable to our results,Wilvorst - Veston Uni Bébé , 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'El Naturalista Borago.
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,Bisgaard Dora(Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys-YBWEN Femmes Danse Vêtements Costume de du Ventre for Femme Tassel Soutien-Gorge et Ceinture Professionnelle Carnaval Jupe Sexy Dancewear). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
Through established relationships with patients and their families,Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche , especially in end-of-life situations. In this research,Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants, over time,PALLADIUM-EU Pampa Sport Cuff Wpn, and with this awareness,Trippen Road Brown.
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Groovy Marvel Captain America Peignoir en Polyester pour Homme Bleu, and the only one who has the power of decision(CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille). Thus, care practices in end-of-XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise, 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(Rossignol Pantalon de Ski Homme).
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,HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl-DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer. 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-Superga 2750-cotu Classic(TruClothing.com Costume Homme 3 pièces Tweed Laine mélangée Carreaux Chevrons Marron Bleu Peaky Binders Gatsby Le Magnifique).
Conclusion
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