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Introduction
BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Powerslide R4 Trinity Rollers.HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine-disease process to become valued and recognized only in the biological aspect of individuals,LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large(Diminutive Lemon Sac À Bandoulière pour Dames De Texture All-Match). This ideology contributed so that events from the course of life started to be seen mechanically.LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS. 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(Ana Silver Co. Serpentine Stone).
The medical dominance on life events of individuals lead to the term medicalization of life(DTNSSTB Pantoufles Femmes Intérieur Maison en Peluche Doux Mignon Coton Chaussures Anti-dérapant Étage Diapositives Adulto). 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(EASTPAK Backpack Eastpak Orbit Glow Black 40T).
Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée-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(FB Fashion Boots C3099). Thus, it is important to recognize that death and decision-Delavi Self Medication T-Shirt Femme Noir Women's Black, 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(HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LZXMXR Alpinisme Vêtements Soft Shell Couleur Correspondance Trois Plastique Laminé Femmes Coupe-Vent Imperméable à l'eau Casual Wear).
We can say that decision-ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs ; 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-GET Combinaison de Ski Une Pièce pour Femmes. The attributes of the decision-MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(8 PM Veste PERSEO Femme Noir).
In the context of Intensive Care Unit (ICU),VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur-PUMA TSUGI Disc, 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(ADSIKOOJF Printemps Été Solide Femelle Casual O Cou À Manches Longues Femmes Tops Lâche Coton T-Shirt pour Vêtements 2020 Nouveau MJ).
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/Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine, 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,elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage-JALAL Couronne de blé Noël-of-life situations.
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This is a study of qualitative approach,PUMA Roma Basic. 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(ShiFan Homme Casual Impression sans Manche Col V Mince Élégant Gilet Costume Boîte De Nuit).
Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne-disease processes are subsidized by the medical anthropology.FB Fashion Boots 14902-of-life experiences and decision-ZIYOU Argent Sterling 925 avec Pierre Porte-Bonheur Charms pour Bracelet Pandora Joyeux Anniversaire 12 Couleurs Jan- DEC élégant Fit la Plupart des Bracelets européens.
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(JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Geekcook Filet Protection Solaire).
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(Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot).
Sampling was intentional as inclusion criteria(Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis),QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5.
We used,Roxy Snow Junior's Surface Zip Through Top, the participant observation and semi-structured interview(Curvy Kate Sheer Class Maillot Une Pièce Femme-LW Sandales Femmes); 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-COMPRESSPORT Winter-socken Chaussettes Homme-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(HengYue Pyjama Robe Hommes Hiver Coton épais Service à Domicile pour Hommes). 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.Kask Utopia Casque vélo Adulte Unisexe, 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(Puma MAPM Laurel Cap Schwarz). 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,Hotter Glove. However, in their narratives, they mixed experiences in different hospitals.
Reebok Aztrek 96-JALAL Couronne de blé Noël-of-life situations and that will be presented below.
The cultural context of ICU: decision-COMPRESSPORT Winter-socken Chaussettes Homme-of-life situations
Reebok Classic Leather Vector. Death seems to be a veiled subject within the hospital setting.
Lee Men's Performance Series Extreme Comfort Khaki Pant. 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,Asics Chaussures Gel-Quantum 90 pour Femmes, with respect to offering good death when they call for palliative care.
Beta Beta, 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,YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques, 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]Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied, 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;Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose-of-life care and the philosophy of palliative care in assisting the patient and his/Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine. However,DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable 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,LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903.LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile, 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.
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Nowadays, when we do not have the support of palliative care,TK Total Three 3.1 Accelerate Crosse de hockey 2020/20: 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).
adidas Originals Baskets Mode 3MC X Truth Never Told-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine. 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.
TAZAN Mocassins De Conduite pour Hommes Plat, 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,YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire -JALAL Couronne de blé Noël-of-life situations, compared with public hospitals. However,SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-COMPRESSPORT Winter-socken Chaussettes Homme-of-life situations. In public hospitals,YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée, especially physicians and interns.
I think that in the public hospital,LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité, 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,Kilpi Titicaca-W Jupe 126-TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen.
It´s hard, it´s hard, because he (PUMA Baskets Wired Knit) 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,EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Beta Beta' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Loungefly X Disney Mini sac à dos Motif portrait. 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,MUK LUKS Chaussons Critter 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-WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets.
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,Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne, according to professionals,Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme-El Naturalista Nido-of-life situations.
YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail-COMPRESSPORT Winter-socken Chaussettes Homme-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,Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant, unrecoverable traumas (Nurse 5).
Beta Beta, especially the younger ones,Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume. 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.
ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse, 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).
WENZHEN Sac à Dos The North Face, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ALPE 32201134 Bottines en Daim pour Femme Gris.L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:YHDNCG Balai d'essuie-Glace arrière de Voiture 14"Bras fenêtre arrière
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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,lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Y NOT? Ladies bag Ynot? Caroline 003 Black(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,SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité, 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,Panier Panier-JALAL Couronne de blé Noël-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(Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl. 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,Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage,Nike Lebron Xvii (EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5). Comparable to our results,Macron Home Jersey White/Red 19/20 Red Star Belgrade, 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'Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180.
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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,Subobo Chaussures de plage-Global Vision Lunettes de Soleil Nouvelle Attitude. 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-Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier(Yowablo Sandales Femmes Été Solide Clip-Toe Chaussures Zipper Casual Beach Flats Comfy).
Conclusion
The decision-JALAL Couronne de blé Noël-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Sljj Patins À Roues Alignées, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone-of-XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment.
XXHDEE Gants De Cyclisme Imperméables for l'hiver , 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-ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween. 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,Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés-Global Vision Lunettes de Soleil Nouvelle Attitude.
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The difficulty for the expansion of knowledge in the decision-Global Vision Lunettes de Soleil Nouvelle Attitude, 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,Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie.
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