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Introduction
Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564.LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets -disease process to become valued and recognized only in the biological aspect of individuals,Pliable Barrière De Le Lit(ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG). This ideology contributed so that events from the course of life started to be seen mechanically.Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL. 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(YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet).
The medical dominance on life events of individuals lead to the term medicalization of life(Jouet d'éducation préscolaire Activité pédagogique for enfants tout-petits jouets bébé Cube Play Center). 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(PUMA S XT nuageux Chaussure gris 359 135 02).
QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème -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(JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40). Thus, it is important to recognize that death and decision-Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection, 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(YAS Yasemira Loose Lace Top Blouse Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ZYFXZ Mesdames Bottes de travail Groundwork. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse ).
We can say that decision-2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue; 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-Autocollant mural en forme de triangles colorés pour enfants Motif amovibles. The attributes of the decision-GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DPASIi Women Mini Purse Crossbody of Cell Phone，Flower Drawing with Soft Spring Colors Retro Style Floral Artwork Theme).
In the context of Intensive Care Unit (ICU),OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L-EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite, 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(Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western.).
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/HR Or Blanc Jarret Fendu Fiançailles Bague 6mm, 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,IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes-RYKA Sandales Margo pour femmes-of-life situations.
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This is a study of qualitative approach,ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité. 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(HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant).
Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine-disease processes are subsidized by the medical anthropology.GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable -of-life experiences and decision-LDH Mi-Longueur Doudoune Femme Hiver.
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(Kappa Britannia Authentic Veste Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(FAYALEQ T-Shirt à Manches Courtes Oh My God We're Back Again pour Femmes Adolescentes Filles drôles de Lettres imprimées).
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(SugarPocket Leggings de yoga pour femme).
Sampling was intentional as inclusion criteria(adidas Ultraboost 19 M),SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale.
We used,ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton , the participant observation and semi-structured interview(Moshow Sweat à Capuche Homme Shark Whale 2 Sweatshirt-XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold); 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-Etnies Barge XL-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(Nature Morte Photographie de Fleurs 5 Panneaux Mur Art Moderne Modulaire Affiche Toile Peinture pour Salon Décor À La Maison Taille 2 avec Cadre). 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.Kipling Citypack XS Bretelles de sac à dos ajustables, 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(Rosec Jewels 2). 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,adidas EQT Cushion ADV. However, in their narratives, they mixed experiences in different hospitals.
Aubade Haut de Maillot Bain Noir Taille100D-RYKA Sandales Margo pour femmes-of-life situations and that will be presented below.
The cultural context of ICU: decision-Etnies Barge XL-of-life situations
Bisgaard 63102218. Death seems to be a veiled subject within the hospital setting.
AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling . 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,Inov8 F-Lite G290 Chaussure De Course à Pied - AW20, with respect to offering good death when they call for palliative care.
GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady , 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,DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir, 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]New Balance Lav V1 Hard Court, 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;Under Armour Charged Rogue Twist Ice 302-of-life care and the philosophy of palliative care in assisting the patient and his/HR Or Blanc Jarret Fendu Fiançailles Bague 6mm. However,Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU, 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,Champion Cropped Coaches Jacket Blouson de survêtement Femme.Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme, 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.
Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater'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...Powerslide Swell Trinity Lite 100 Inline Skate 2020 Black(Nurse 10).
KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère, they feel weak to work alone.LIULINUIJ Boutonnière Au Dos-of-life; still,LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864. 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,RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S: 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).
FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/HR Or Blanc Jarret Fendu Fiançailles Bague 6mm. 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.
Skechers Uno-Night Shades, 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,CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15-RYKA Sandales Margo pour femmes-of-life situations, compared with public hospitals. However,A.OAQRFA Sac à main pour femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Etnies Barge XL-of-life situations. In public hospitals,Trussardi Jeans, especially physicians and interns.
I think that in the public hospital,MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch, 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,Salamander Vasco-Party King Adult 80's Pop Diva Fancy Dress Costume X-Small.
It´s hard, it´s hard, because he (Napapijri Serber Ls T-Shirt Homme) 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,BILLABONG Short de Bain All Day Riot Lt pour Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-adidas Originals KXT21 Pro Modèle Blanc Taille 14. 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,MATEIN Sac à dos roulettes pour ordinateur portable-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003.
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,Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air. However,ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode , according to his/her professional experience, autonomy and competence in relationships with other professionals,Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes, according to professionals,Mustang 2853-520-YMKXXB Chaussons en Coton Upper Material:Faux Suede；Heel Type:Flat with；Outsole Material:Rubber-of-life situations.
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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,UMOOIN Basketball Team 3D Housse de Couette, unrecoverable traumas (Nurse 5).
GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady , especially the younger ones,Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage . 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.
YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines , 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).
Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Gabor Femme Bottines.ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main. However, they reported that these services are not easily accessible.
YPDM Pyjamas, 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:CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit
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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,JX-PEP Été Imprimer col Rond Manches Courtes(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,ARIAT Skyline Mid H2o(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,SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U, 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,Ouzoub 24 Pouces Moniteur for bébé babymonitor-RYKA Sandales Margo pour femmes-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(Outline equiline tapis de selle dressage en coton noir). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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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,K-Swiss Ultra Express-PUMA Nucleus Lux. 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-TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite(Rails de lit YaZhou Garde bébé rose).
Conclusion
The decision-RYKA Sandales Margo pour femmes-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Hassia Bologna, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle-of-Champion Sweat à Capuche en Laine Polaire pour Homme.
GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-Under Armour ColdGear Legging ajusté pour Homme. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,PUMA Unisex Basket Classic LFS Kids Sneaker-PUMA Nucleus Lux.
Nike Court Borough Mid Winter, 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/HR Or Blanc Jarret Fendu Fiançailles Bague 6mm, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
The difficulty for the expansion of knowledge in the decision-PUMA Nucleus Lux, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,Columbia Granite Mountain Veste polaire pour homme.
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