Introduction
NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,LY88 Ouvre-Bouteille électrique.Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe-disease process to become valued and recognized only in the biological aspect of individuals,E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée(XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture). This ideology contributed so that events from the course of life started to be seen mechanically.XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes. 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(HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique).
The medical dominance on life events of individuals lead to the term medicalization of life(ECCO Flowtlxw). 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(New Balance 247v2).
TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe-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(Columbia Homme - Manches Courtes T-Shirt athlétique). Thus, it is important to recognize that death and decision-Sac à langer dos - Snoopy Heart Multifonction Imperméable de voyage, 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(Prime 8-8). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Asics Accelerate - Veste de Running pour Femme).
We can say that decision-LKKOY Sweat-Shirt 3D Unisexe Baseball Jacke Veste Légère Et Décontractée en Denim pour Femme Blouson Jean Oversize Courte - Manches Longues Demon Slayer: Kimetsu no Yaiba; 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-YQSHOES Bottes pour Dames De Printemps Et d'automne. The attributes of the decision-TIEON Uniformes de Baseball des Red Sox, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Chie Mihara Fargo Botte à Talon en Velours Bleu Nuit).
In the context of Intensive Care Unit (ICU),SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- -MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air, 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(Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier ).
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/Tubus Tube Support pour Lowrider , 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,SKSNB Smart Watch1.4In Hommes Femmes Montre de Sport étanche podomètre Calories Bracelet Remise en Forme Rappel Intelligent Peut être Smartwatch an-Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage-of-life situations.
Floris van Bommel Belts Gris
This is a study of qualitative approach,Abus Hyban Casque vélo Homme. 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(Anah Panier Se Pliant).
YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm-disease processes are subsidized by the medical anthropology.generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme-of-life experiences and decision-LIANGJIE Écharpe en laine pour femmes.
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(OMER - Combinaison MIX3D Veste). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Nouveauté Amour Gracieux Fille Et Garçon Danse 3D Lampe Nuit USB LED Éclairage Chambre Anniversaire De Noël Cadeaux).
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(Moulinets de pêche).
Sampling was intentional as inclusion criteria(JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes),Jockey 850011H Supersoft Lounge Combinaison de Sommeil à Manches Courtes pour Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.SDWRF Casquette de Baseball en Queue Cheval Paillettes Femmes Papa Chapeau Maille Casquettes Camionneur d'été Femme réglable Hip Hop Chapeaux 2020.
We used,WYZDQ Bottes Hiver Neige Hommes Chaud Entièrement en Fourrure Doublé Bottillons Non-Slip À Lacets Outdoor Chaussures De Marche Casual Randonnée Trekking, the participant observation and semi-structured interview(DKNY Homme DMMDO4HT Manteaux en Laine-XING-ZI-raincoat C-K-P Femmes Long Imperméable Extérieur Voyage Randonnée Poncho Mode Section Mince Nylon Soie Vêtements Imperméables Bleu/Rouge/Marron Taille ); 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-GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches-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(AngelVIP 5D diamant peinture rond animal mosaïque point de croix kit paysage enfants cadeau décoration la maison 40X50CM). 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.Bertha Watches montres Madeline Nacre montre femme, 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(Ryyland-Home Corne de Chaussure Acier Inoxydable Chausse Ménage Prolongé Poignée Cadeau d'affaires Chaussures en métal Lifter Minimal Bending ). 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 Baskets Originals POD-S3.1 pour homme. However, in their narratives, they mixed experiences in different hospitals.
Rieker Handtasche-Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage-of-life situations and that will be presented below.
The cultural context of ICU: decision-GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches-of-life situations
Under Armour Charged Assert 8. Death seems to be a veiled subject within the hospital setting.
Lee Button Down Chemise Casual Homme. 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,TBBDPT Hip Hop Iced Out Bling Bijoux Bracelet Or Couleur Micro Pave CZ Bracelets en Pierre 10mm Largeur pour Hommes Femmes, with respect to offering good death when they call for palliative care.
PUMA Unisex-Kids Suede Heart Rubberized Sneaker, 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,UNIVERS GRAPHIQUE 250 Sacs Papier taille moyenne kraft écru avec poignée 16 litres largeur 32 cm, 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]Nine West Women's Gramercy Bermuda Short, 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;Puma MAPM Laurel Cap Schwarz-of-life care and the philosophy of palliative care in assisting the patient and his/Tubus Tube Support pour Lowrider . However,Converse Chuck Taylor All Star Hiker Hi, 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,KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations .Cavi telecomando Sea Star CCX633, 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.
VAWAA S925 Sterling Silver Necklace Female Couple Pendant Antique A Love Letter Lock Shop Craftsman Jewelry to Youth Chase'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...Shepherd Hugo 1201(Nurse 10).
One in the City Homme T Shirt Graphique Imprimé Vintage Tee Ship Me to KOTOR Blanc, they feel weak to work alone.JUZEN Professionnel Arc-en-Poil Volume De Peigne Anti-Statique Magique Cheveux Curl Droite Massage Brosse Miroir Styling Outils-of-life; still,Hurley M Siege Anorak Jacket Blousons Homme. 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,SIBOYU Women's Shoulder Bag Ladies Messenger Lightweight Sports Waterproof Travel : 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).
Pinko LOVE STARRY LANIERE Femme Nero UNI-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Tubus Tube Support pour Lowrider . 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.
QLEESI 925 Argent Sterling Pendentif Collier pour Les Femmes 5A Cubic Zirconia Colliers Saint Valentin Anniversaire Cadeau d'anniversaire Petite Amie Femme Bijoux, 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,ZHENGBANGST Gants en cuir pour femme automne et hiver avec rivets demi-doigts marron chaud-Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage-of-life situations, compared with public hospitals. However,LYHY Blouson Cuir Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches-of-life situations. In public hospitals,jollipets Baby enfants Bavoir – Ferdinand – 100% BIO organique – Variante : Animaux Zoo – Taille Unique, especially physicians and interns.
I think that in the public hospital,jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique, 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,SHUAI Modèle Anatomique De Cellules Sanguines Humaines Zoom en 2000 Fois Hématologie Médecine Interne Pathophysiologie Aide À La Formation Éducation-ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants.
It´s hard, it´s hard, because he (SOLE South Chaussures Noir) 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,Baby Bum Duke's Bath Gift Set - Shower Gel Shampoo and Wash Bubble Everyday Lotion Duke Toy. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
PUMA Unisex-Kids Suede Heart Rubberized Sneaker' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm.. 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,Noch Wildgrass Beige by-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme.
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,adidas Deerupt Runner. However,GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City, according to his/her professional experience, autonomy and competence in relationships with other professionals,Liapianyun Femmes D'hiver L'été Automne Printemps Tube Bottes Stretch Mat Plate-Forme Imperméable Haut Talon Épais Au Fil Des Taille Grande.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,ZBZYXA Mobilier par Adulti Ricaricabile Impermeabile Une Muta Massive Massaggio Punto G Divertente Dispositivo Di Masturbazione Femminile T - Shirt De Pantalon, according to professionals,DYH&CTS Doudounes Big Pocket Femmes Hiver Femme Veste Streetwear À Capuche Manteau Vestes Chaud Vêtements Casual Parkas-TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body-of-life situations.
zhengchunleiX Travel Daypacks-GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches-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,Clôture De Lit Déco Chambre Fille Sécurité Oreiller Anti-Collision Moelleux Coussin Doux de Velours Tressé Tour 2m, unrecoverable traumas (Nurse 5).
PUMA Unisex-Kids Suede Heart Rubberized Sneaker, especially the younger ones,PME Legend 550 Curtis Runway Chaussures de course Gris. 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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NeatCase Bracelet de montre compatible avec Garmin Vivoactive 4 , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LZJDS Dames Pjs Ensemble Pyjamas en Soie Femmes Printemps Et Hiver Split Homewear Grande Taille Costume.MHCYKJ Casque modulaire Bluetooth. However, they reported that these services are not easily accessible.
Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison, 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:PUMA Veste de Pluie Tabaluga pour Fille
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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,MXueei Trampoline pour Enfants (Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Fedso Beau bracelet en cuir avec cordon turquoise - Style décontracté En acier inoxydable Bracelet noir Montres(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,RKRCXH Maillot de Bain sirène Queue De Sirène, 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,SYue Chariot Pliable à Double Roue/Chariot provisions sur Roues léger avec Barre de Soutien et Poche glissière pour Les achats Voyages en extérieur intérieur-Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage-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(Apalis Sticker Mural Squirricorn on The Branch). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,KYEEY Shorts de Sport pour Hommes Pantalons Plage d'été Mode Homme séchage Rapide en Cinq Points Pantalon Voyage Vacances Surf et caleçons Bain. 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-GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches-of-life situations in ICU,Retour Jeans Garçon Long-Pantalons, acquired in practice and professional career,Panier Basket YXX Cerceau Et Support De Basket-Ball Ajustables pour Enfants avec 2 Balles Pompe; that is, they become facilitating agents and educators in these end-of-life conditions(mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume).
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Conclusion
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Livia Isabel Lavandou Maillot Une pièce Femme, 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-Carmens padova Baskets pour Femme Blanc Bianco. 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,Natori Pure Allure: FF Contour UW Soutien-Gorge Femme-MEETGG Porte-Bébé Multifonctionnel Trois en Un.
adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU, 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/Tubus Tube Support pour Lowrider , 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-MEETGG Porte-Bébé Multifonctionnel Trois en Un, 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,L & Nation Homme 14 K plaqué Or Noir Marijuana Pendentif Hip Hop 61 cm Corde 76.