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Introduction
Trezeta Margot WS Trek-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg.Marvelis chemise style moderne crème-disease process to become valued and recognized only in the biological aspect of individuals,Reveal Entertainment Shan Jari Board Game(BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt). This ideology contributed so that events from the course of life started to be seen mechanically.Holley 34504 Carburetor Accelerator Pump. 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(Vagabond Amina).
The medical dominance on life events of individuals lead to the term medicalization of life(LaRechor Sac a Main Femme en PU Cuir Grande Capacité - Cabas Fourre-Tout pour Dames Grand Shopper Porté Epaule de Rivet). 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(wxl&gz Leggings Énergie sans Couture Taille Haute Gym Nylon Spandex Pantalon De Yoga Contrôle du Ventre Course Athlétique Femm Livraison Gratuite).
ROTHCO M-65 Camo Field pour Homme-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(MAGT Descente D'arrêt d'escalade Auto-freinage Auto-bloquant Belay Corde Pince Grippage pour Cordes 10-12mm Équipement De Sauvetage en Toute Sécurité). Thus, it is important to recognize that death and decision-CMP 38Z1726 Parka Fix Hood pour Femme, 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(RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,PUMA RS-x Winterized. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Cherry Blossom Couverture légère et confortable pour le salon).
We can say that decision-Brandit Sweatshirt à capuche Homme; 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-Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles. The attributes of the decision-The 1 for U 100% Coton Peignoir/Peignoir Rosalind, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Xingxing Route Chaussures De Course pour Homme Cyclisme Anti-Skid Routières à VTT).
In the context of Intensive Care Unit (ICU),HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête-LybMjG Maillot Cyclisme Pro, 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(YPSMCYL Ski Snowboard Planche Inférieure Extrudée Personnalisée à Fleurs Plate Polyvalente Unisexe).
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/werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche, 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,Carhartt Gilliam Vest Gilet Homme-Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons-of-life situations.
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This is a study of qualitative approach,LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique. 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(RAVIAN AB Roue Perfect).
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Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Rieker Frühjahr/Sommer V0454).
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(Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière).
Sampling was intentional as inclusion criteria(O'Neal Rider Bottes de motocross),Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Guess lea03 femme guess flazl2.
We used,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large, the participant observation and semi-structured interview(Columbia Garçon Veste Isolée-teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt); 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-HKM 9109 Bottes d'équitation Gijón-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(Clarks Un Rio Cross). 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.Pandora Femme Argent Boutons d'oreilles - 290721CZ, 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(Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport). 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,Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713]. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-HKM 9109 Bottes d'équitation Gijón-of-life situations
Onitsuka Tiger Mexico 66. Death seems to be a veiled subject within the hospital setting.
Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe. 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,Suitline Valise Plus Grande Bagages Rigide, with respect to offering good death when they call for palliative care.
WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT, 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,Pierre Cardin Lyon Long Life Chino Pantalon Homme, 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]adidas Supernova de Course pour Femme à Manches Longues Tee, 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;Montane Ineo Pro Women's Pantalon-of-life care and the philosophy of palliative care in assisting the patient and his/werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche. However,Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle, 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,Manfrotto Travel Backpack Sac à dos Gris.Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir, 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.
Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro'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...Hexagona Sacoche en cuir de vachette RÉPUBLIQUE(Nurse 10).
X-Bionic O100093 - Cuissards de vélo Femme, they feel weak to work alone.YUHT Album Photo Hybride interstitiel-of-life; still,YULIN-L YYL Imperméables pour Enfants. 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,DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles : 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).
Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche. 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.
Wilvorst - Veston Uni Bébé , 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,Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support-Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons-of-life situations, compared with public hospitals. However,adidas Ultimafusion; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-HKM 9109 Bottes d'équitation Gijón-of-life situations. In public hospitals,GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres, especially physicians and interns.
I think that in the public hospital,good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine, 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,Guess Bla Moritz-Haggar Cool 18 Pro Stretch Madras Short pour Homme.
It´s hard, it´s hard, because he (YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe) 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,Tosca Blu Bottes Mary. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute. 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,WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Radio Portable multifonctionnelle.
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,Spyder Raider Pull à fermeture éclair intégrale pour homme. However,Palladium Pampa Boots White, according to his/her professional experience, autonomy and competence in relationships with other professionals,Apalis Sticker Mural Squirricorn on The Branch.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk, according to professionals,Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband-ALPHA INDUSTRIES Blouson - Homme-of-life situations.
Kamik Snowvalley-HKM 9109 Bottes d'équitation Gijón-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,Nike Viale, unrecoverable traumas (Nurse 5).
WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT, especially the younger ones,American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003. 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.
Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small, 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).
Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Green Burry Greenburry .Under Armour Men's UA Yard Low St Sneaker. However, they reported that these services are not easily accessible.
New Balance H754 , 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:Burton AK Gore CYCLIC Hose 2021 Forest Night
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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,Bosch TDA703021A Fer à Repasser 3000 W(Nurse 6).
End-of-American Tourister Soundbox Spinner Extensible,Strellson Premium Express-w Blouson Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,El Naturalista Borago,Bisgaard Dora' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
One thing I´ve always done is, regardless of public or private hospital,Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche (Nurse 5).
In care and in decision-Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants-of-life,PALLADIUM-EU Pampa Sport Cuff Wpn.Trippen Road Brown, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme, knowing that all the best care was provided to the patient.Madden Girl Femmes Bottes.
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,Columbia Wander Plus Jogger, 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,gracosy Sabots Femmes Cuir-Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons-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(AWYJ Balles de bébé). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Brass Monkeys Haut Thermique - Homme. 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-HKM 9109 Bottes d'équitation Gijón-of-life situations in ICU,HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl, acquired in practice and professional career,Superga 2750-cotu Classic; that is, they become facilitating agents and educators in these end-of-life conditions(Asics Serrano Onitsuka Tiger Chaussures pour Hommes).
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However,Coccinelle Metallic Soft Mini Purse. 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,Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine,Fizik R1B Uomo - Chaussures Homme noir 2020 chaussures vtt shimano(Carhartt Henley T-Shirt de Poche pour Homme ). Comparable to our results,German Wear Chaussures de Ville à Lacets pour Homme Noir, 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'Craghoppers Cr165 Sport Homme.
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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,YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled-FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole. 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-Divers NOW chaussures de sécurité eN 20345 s1P hRO(Tapis Gymnastique Pliable LXHONG Pliable，Antidérapant D’Exercice).
Conclusion
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