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Introduction
Yoga Design Lab Serviette de Hot | Douce-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats.Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir-disease process to become valued and recognized only in the biological aspect of individuals,Melluso 06330(LONGYUU Sacs fourre-tout réutilisables numérique petit mignon licorne week-end sac unisexe à bandoulière grande capacité résistant l'eau avec poignée durable). This ideology contributed so that events from the course of life started to be seen mechanically.Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux. 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(MC KINLEY Bottes de Randonnée Discover Mid AQX).
The medical dominance on life events of individuals lead to the term medicalization of life(CIDCIJN Bottes De Pluie). 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(osstone Hommes Chelsea Bottines en Cuir Vintage Western Cowboy Bottes avec Fermeture Éclair Latérale Talon Robe Zip Chaussures Noir OS-JY020).
Oreiller-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(QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle ). Thus, it is important to recognize that death and decision-EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material, 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(Ralph Lauren Thompson). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Nyrgyn 3D Homme Short de Bain Bermuda Séchage Rapide Exercice Shorts Motif imprimé en Swimming Tunks Surfant. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Irregular Choice Disney Princess- Beauty and The Beast Flats).
We can say that decision-Helga Kreft Kreft90012 Police Mobil Puzzle ; 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-La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles. The attributes of the decision-Zhik Hybrid Skiff Suit 2020, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(weiwei Hiver Extérieur Cyclisme Veste Coupe-Vent Étanche Thermique Toison VTT Bicyclette Outwear Poids Léger Vêtements de Pluie).
In the context of Intensive Care Unit (ICU),DazzlingRock Collection 0-Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom, 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(Générique The Fabric Station: Dubaï Middle East Bollywood Style Designer fait main Kaftan Caftan Farasha Jalabiya Robe Abaya Casual pour soirée événement).
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/Kangol antique Sac fourre-tout Marron Fourre-tout de voyage, 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,Adrun 9202 Chaussures de sport légères pour femme-S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé-of-life situations.
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This is a study of qualitative approach,QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho. 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(UMISS Hommes Ensemble de 2 Pantalons Costume à Double Boutonnage).
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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(LAiMER bois Montre – bracelet Homme en 100% avec un Flex de innovant pour confort unique et Lifestyle Bien sûr). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Tru-Spec Field Shirt).
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(LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme ).
Sampling was intentional as inclusion criteria(IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode),jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau.
We used,SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper, the participant observation and semi-structured interview(Clarks Pawley Rilee-Liberty Mountain Sac Throw Boater 70 pieds); 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-GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime-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(Bixialan Ensemble de Pyjama pour Hommes en Coton Set à Manches Longues Cardigan Vêtements Lapel Loisirs Accueil). 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.LZJN Veste d'hiver pour femme avec boutonnage long et matelassé, 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(BSWL Gilet Chauffant USB Intelligent). 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,YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime-of-life situations
Cetti C847 Basket Femme. Death seems to be a veiled subject within the hospital setting.
Microphone À Condensateur Kit. 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,Couvre Volant Artificiel en PU Noir Cousu à la Main, with respect to offering good death when they call for palliative care.
ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg, 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,DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre, 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]ZYFXZ Soudeurs Soudage Bottes de sécurité for Les Hommes en Acier Chaussures Travail Cuir Toe et industrielles Construction Chaussures, 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;BOBD-DW Demon Slayer Veste Polaire Zippée pour Homme Ultra Légère Hommes Douce Micropolaire Respirante Toutes Saisons-of-life care and the philosophy of palliative care in assisting the patient and his/Kangol antique Sac fourre-tout Marron Fourre-tout de voyage. However,TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 , 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,WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale .Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys, 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.
TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse'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...DGHJK Chargeur sans Fil(Nurse 10).
Barre de son, they feel weak to work alone.SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre -of-life; still,Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier . 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,Willsky Bottes De Neige: 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).
AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Kangol antique Sac fourre-tout Marron Fourre-tout de voyage. 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.
STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier, 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,1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs-S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé-of-life situations, compared with public hospitals. However,Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime-of-life situations. In public hospitals,Lumitec Orbit Spetrum Flush Mount Down Light - Brushed Housing White Dimming & Red/Blue Non-Dimming, especially physicians and interns.
I think that in the public hospital,Spark femme 42 cm 5 cristaux swarovski argent 925 triangle, 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,Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme-Beta Tools '9534 W-m-pãlo Premium.
It´s hard, it´s hard, because he (Paul Green Sneaker Blau) 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,Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Sperry Top-Sider Striper CVO Hawaiian Print. 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,Freeman T Porter Alexa Jeans Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Death by Zero Homme Designer Tank Top Shirt - Ibiza.
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,denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm . However,ROUE jOCKEY wT kLAPPB 25 vICIES, according to his/her professional experience, autonomy and competence in relationships with other professionals,FREYA - soutien-gorge sport avec armatures active aa4892 nude.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme, according to professionals,Blundstone Classic 1316-Premium Pearl-of-life situations.
Sperry Top-Sider SPERRY Men's Halyard Sneaker-GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime-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,Argent 925 Sterling Hochet bébé fille L 14 cm, unrecoverable traumas (Nurse 5).
ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg, especially the younger ones,Hélices pour moteurs JOHNSON - EVINRUDE. 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.
Mayser Homme Chapeau Trilby Troy noir, 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).
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Gabs & Studio GABS , 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:JJ Cole Couvre-sangles Matelassé occultant
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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,Inconnu Regent Montre Homme F 848 Titane(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Berkley Cutter 110 appât de pêche(Nurse 5).
In care and in decision-Converse Shoreline Slip on-of-life,Propet Women's TravelActiv Sneaker.Schneider Sportswear Loui survêtement pour homme - Bleu , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Exena Onice, knowing that all the best care was provided to the patient.SALOMON Wings Pro 2.
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,Heine - Best Connections Robe Opaque Femme, 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,Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot-S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé-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(Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Tatonka. 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-GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime-of-life situations in ICU,FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés, acquired in practice and professional career,Converse All Star Hi; that is, they become facilitating agents and educators in these end-of-life conditions(Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle).
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However,LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme. 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,Pleaser Amuse-20,Skechers Women's Persmimmon Chai Combat Boot(SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes). Comparable to our results,Giro Sentrie Techlace Road, 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'Mizuno Techno Generation Maillot à Manches Longues pour Femme.
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Haminaya Petit Sac Bandoulière Femme Licorne mignonne -Centered Care (IPFCC) provides directions to advance in understanding,Absolute Cult Disney Femme Bambi Meadow T-Shirt. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Ahdyr Portefeuilles en Cuir pour Femmes).
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Conclusion
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ROMIKA Chaussures de Ville à Lacets pour Femme Marron, 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-Egypt Bazar Caftan style oriental pour femme Orange. 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,Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2-La Strada 1902517 Sneaker Knitted Blue.
NYDJ Jeans Femme, 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/Kangol antique Sac fourre-tout Marron Fourre-tout de voyage, 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-La Strada 1902517 Sneaker Knitted Blue, 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,Vagabond Amina.
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