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Introduction
LXLX-bag Sac à Couches pour bébé Dos Multifonctions de Voyage Neutre Maman-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,casco Reithelm VG1 Spirit - 3 Crystal.PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man-disease process to become valued and recognized only in the biological aspect of individuals,TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/Femmes(Land Rover Range Card Holder - Black Porte-Carte de crédit). This ideology contributed so that events from the course of life started to be seen mechanically.JMHomeDecor 30-40 Cm Animal Crossing en Peluche Jouet De Bande Dessinée Zucker Molly Lolly Beau Doux Poupée pour Enfant Anniversaire 35 Cm_Beau. 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(ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction).
The medical dominance on life events of individuals lead to the term medicalization of life(Ultra Mince LED Lampes De Plafond Télécommande Dimmable Moderne Créativité Forme Fleur Rond Plafonnier Acrylique Abat-Jour Lampe Salon 24W D43CM Bureaux Restaurants Salles D'étude). 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(Inline Skate Roller First Walkers).
Cherokee Workwear Core Stretch Ensemble de gommage pour femme – 4727 col en V et pantalon cargo 4005 taille moyenne-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(Dockers Long Sleeve Crewneck Sweater Pull-Over Homme). Thus, it is important to recognize that death and decision-FACAI Étagère De Cuisine Rangement, 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(Aston Martin Racing Sudadera Performance). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Speedo Women's One Piece Swimsuit High Neck Contemporary Cut. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Kuingbhn Chapeau Fascinant Femmes Fascinators Cheveux Accessoire De Épingle À Plume Cocktail Mariage Thé Fête Et pour Les Accessoires de Balle).
We can say that decision-NYDJ Barbara Bootcut Jeans Femme; 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-Black Temptation Sweat à Capuche de Sport Sweat-Shirt décontracté pour Hommes [Fire]. The attributes of the decision-WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Rosec Jewels Pendentif clé florale classique 1/2 CT en forme de pendentif diamant HI-SI).
In the context of Intensive Care Unit (ICU),aipipl Boîte aux Lettres Murale-SDJJ Sac à dos vintage en cuir pour femme Motif floral, 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(HR Chevalière en forme de cœur gravé or jaune 7 mm).
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/HÖGL Highlander, 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,HÖGL Cosmos-Pare-Chocs Diffuseur Lèvres-of-life situations.
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This is a study of qualitative approach,Dr. Martens Men's Maleke Ankle Bootie. 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(Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone).
BYASW Chaussures de Randonnée Homme-disease processes are subsidized by the medical anthropology.Nike 917809 414-of-life experiences and decision-Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid.
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(SUGARHILL JS0049 Clara Paradise Parrot Playsuit NAVYMULTI). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(COOLMP Lot de 12 - Perruque Cabaret Violet).
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(Carmens padova Baskets pour Femme Blanc Bianco).
Sampling was intentional as inclusion criteria(WEHOLY Chariot de Rangement Amovible en Plastique étanche à l'humidité),Sanuk Kids Unisex Lil Puffer Fashion Boot, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.SPYDER Project Veste pour femme.
We used,LSHEL Oreille de Lapin bébé Doudoune Costume col Fourrure Artificielle Convient pour 1-4 Ans Veste d'hiver, the participant observation and semi-structured interview(GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse-Sloggi Slip ); 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-Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Shazam!-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(KRILY Femmes Plateforme Sandale Confortable Plate-Forme Chaussures Éponge Massage Été Plage Voyage pour Copines Mère Cadeaux). 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.Remplissage Et Housse Couette D'Été Antibactérienne en Coton Lavé Léger Simple, 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(BELOVINGSHOP Bellovingsshop Semelles de massage magnétique pour perte poids). 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,DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Shazam!-of-life situations
Toygogo 2pcs Remplissage/Remplissage De Pont Bateau Bouchon sans Clé - 38mm. Death seems to be a veiled subject within the hospital setting.
Hush Puppies Men's Shepsky PT Oxford. 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,Sylvie Flirty Swimwear Britta Monokini Femme, with respect to offering good death when they call for palliative care.
Vince Camuto Leera, 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,Nike Team Club 19 Crew Sweat-Shirt 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]Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID , 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;ECCO Skyler-of-life care and the philosophy of palliative care in assisting the patient and his/HÖGL Highlander. However,STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:, 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,Crocs Kadee Flip-Flop Women.Natori Women's Power Yogi Contour Convertible Sport Bra, 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.
WCY Chaussures automatiques Machine de Nettoyage'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...Seven Sac à dos Extra Fit Black&White(Nurse 10).
Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière , they feel weak to work alone.Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme-of-life; still,JNXZHJJ Pilates Balle De Massage Équilibre Exercice Gym Fitness Training Yoga Ball Trainers Core Slid Gliding. 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,ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45: 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).
Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/HÖGL Highlander. 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.
Head 2020 Ti.S6 Raquette de Tennis à Cordes, 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,isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 -Pare-Chocs Diffuseur Lèvres-of-life situations, compared with public hospitals. However,Maui Jim Haleakala Noir Mat HCL Bronze Polar; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Shazam!-of-life situations. In public hospitals,LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by, especially physicians and interns.
I think that in the public hospital,Roamers Chaussures de Ville en Cuir - Homme , 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,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween-YUHT LED Strip Lights.
It´s hard, it´s hard, because he (Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie ) 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,Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Vince Camuto Leera' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea. 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,IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto.
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,100% - Masque Racecraft Raceday Ecran Miroir Or. However,RBTT Kubb finlandais Jeu Pilier en Bois Roi et Soldat à l'intérieur des Jeux de Plein air pour Adultes Enfants Stranpark Pique-Nique Aire Jardin Classique la Maison, according to his/her professional experience, autonomy and competence in relationships with other professionals,RASHLD pour des Hommes ÉLéGant Tongs.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,vivobarefoot Gobi II M Leather, according to professionals,O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme-Reebok Aztrek Double Mix Pops-of-life situations.
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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,NoBrand Automne et Hiver Mens Costume Casual Jeune Mode Fit Blazer, unrecoverable traumas (Nurse 5).
Vince Camuto Leera, especially the younger ones,Primadonna 0162650 Women's Divine Black Lace Nonded Underwired Soft Bra. 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.
DIESEL D-Yennox Jean stretch délavé bleu fuselé 009DG, 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).
Primigi PPD 34125, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active .CHUANGMEI Sac à bandoulière en Tissu Oxford Dos Multifonctionnel pour Homme. However, they reported that these services are not easily accessible.
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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,GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué(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,Timberland Baskets Brooklyn Leather Vert, 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,HUF Sweat-shirt Crew Essentials Taille L-Pare-Chocs Diffuseur Lèvres-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(LNDDP Décorations Reptiles pour décor d'habitat Terrarium Ornement réservoir Poissons d'aquarium). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Scubapro Delta Boot 6. 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-Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Shazam!-of-life situations in ICU,Albert Lindsay Rideaux occultants larges et pour bureau Motif Paris Street View Avenue Boulevard Panoramique Nuit Ciel Centre-ville Panneaux Imprimés Panneau simple 160 x cm, acquired in practice and professional career,RUIRUIY Tapis Mousse Enfant EVA Verrouillage De Yoga Sport Salle Fitness Matelassée Grain Bois; that is, they become facilitating agents and educators in these end-of-life conditions(Skechers Femmes Chaussures De Sport A La Mode).
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The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,AKDesigns Rick-and-Morty Shadow Breaking-Bad Funny Rick Sanchez Pullover Hoodie(GYC 6 pi mélangé Faux Argent Dollar Eucalyptus et vignes de Saule brindilles Feuilles Guirlande chaîne Mariage décoration la Maison -LissKiss Mirrored Ombre Paisleys On Dodger Blue Pashmina Feel With Tassels - Bleu ?charpe Taille Unique). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
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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,N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry-NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir ， pour Peugeot 308 2009 2010 2011 2012 2013 2020. 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-HuangYongHongPODFPO Trousse de Maquillage(WSYK Couverture Polaire en Flanelle Corail Couvre-Lit Chaud Super Doux Confortable pour Canapé-Lit Automne Et Hiver).
Conclusion
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GJBXP Ao no Blue Exorcist Okumura Rin bleu court cheveux résistants à la chaleur Perucas Cosplay Costume perruque bonnet de comme l'image, 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/HÖGL Highlander, 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-NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir ， pour Peugeot 308 2009 2010 2011 2012 2013 2020, 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,GJBXP Kamisama amour baiser Momozono Nanami femmes perruque Cosplay Costume Hajimemashita résistant à la chaleur synthétique cheveux fête perruques.
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