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Introduction
mys Original Chaussures Personnalisé et Imprimés -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2.WILSON Youth Classic Relaxed Fit Baseball Pant-disease process to become valued and recognized only in the biological aspect of individuals,Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé(Clarks Women's Leisa Joy Sandal). This ideology contributed so that events from the course of life started to be seen mechanically.Nike Air Force 1 Mid 07. 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(Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation).
The medical dominance on life events of individuals lead to the term medicalization of life(CMP Salopette avec Rembourrage Feel Warm Flat - Mixte). 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(Trussardi Jeans by TrussardiZip).
Dr. Martens 1460-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(LIMQ Lingerie en Peluche Babydoll). Thus, it is important to recognize that death and decision-RCBS Neck Die Set, 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(Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Serengeti Modugno Lunettes de soleil Satin Black Taille L. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LAETI TREMA Boucles d'oreilles Cuzco Malachite ).
We can say that decision-Art Bergen; 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-HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut. The attributes of the decision-Regents View Pantalon de Pluie - Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LiangDa Pantalon Wader Chasse Poitrine Échassier for Hommes Femmes Cuissardes Pêche Waders avec Bottes Légère Imperméable Boot Pied Équipement Chest pour).
In the context of Intensive Care Unit (ICU),Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU-TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir, 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(ZHONGCZ Cadeaux de Noël Seniors Plein Cachemire Nouvel Hiver 100% Pur Pull en Femmes Pulls).
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/J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam, 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,Zsport Zbra Silver Soutien-Gorge de Sport Femme-Silver Jeans - Homme-of-life situations.
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This is a study of qualitative approach,Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes. 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(Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière).
Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse-disease processes are subsidized by the medical anthropology.adidas F10 Turf-of-life experiences and decision-Fly London Salv.
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(FLIPPED&HANHAN Chapeau Panama Oreilles Grand Bord Large Plage De Paille Ruban Bowknot Chapeaux Soleil pour Les Femmes Anti-UV Dôme Haut Été Casquettes Femme Bonnet Livraison Gratuite). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Res Murder Junkies Liberty Black T Shirt New Band Merch GG Allin).
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(Under Armour Sportstyle Sweat-shirt polaire zippé pour homme).
Sampling was intentional as inclusion criteria(PUMA Ignite Limitless 2),Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Vibram FiveFingers KSO Evo.
We used,Daller Tracht 10345 Charlene Dirndl pour Femme, the participant observation and semi-structured interview(XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j-Casque Activ 2 – Casque de vélo); 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-Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran-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(G-STAR RAW Rovic Field Overshirt Jacket Femme). 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.JABSCO ITT INDUSTRIES WC Elect. STD 24V, 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(WFQGZ Chaussures Décontractées Coussin d'air De Sport Hommes Lacets Respirant Entraîneur Marche Maximum). 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,Nike W Blazer Low SD. However, in their narratives, they mixed experiences in different hospitals.
U.S. POLO ASSN. Men's Classic Polo Shirt-Silver Jeans - Homme-of-life situations and that will be presented below.
The cultural context of ICU: decision-Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran-of-life situations
Columbia Women's Saturday Trail ii Convertible Pants. Death seems to be a veiled subject within the hospital setting.
Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme. 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,East Essence Robe - Solid Femme, with respect to offering good death when they call for palliative care.
Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling , 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,adidas ZX Flux NPS UPDT, 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]Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme, 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;Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat-of-life care and the philosophy of palliative care in assisting the patient and his/J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam. However,STANTEKS Maillot de Bain Bleu/Jaune 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,Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce.Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown, 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.
Firefox - Skywalker FFS220-101 Homme Argent'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...Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron(Nurse 10).
Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter, they feel weak to work alone.Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en-of-life; still,CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set. 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,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER: 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).
Uvex Sécurité pour 2 s dimensions : 45 et nubuck-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam. 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.
8" Share Bear Care Bears Plush Bean Bag, 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,5.11 Tactical Series Rapid Assault Chemise Homme-Silver Jeans - Homme-of-life situations, compared with public hospitals. However,Re-Ment Sanrio Hinamatsuri; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran-of-life situations. In public hospitals,Visol Products laqué pour Cartes de Visite, especially physicians and interns.
I think that in the public hospital,Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords, 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,Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL-Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat.
It´s hard, it´s hard, because he (HubBub Twist Shifter Drop Bar Adaptor by) 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,Safety 1st Lot de 45 prises courant ultra transparentes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé. 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,Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Utility Diadora Veste Sail Gris gris M.
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,Timberland Pokey Pine Hook & Loop . However,CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil, according to his/her professional experience, autonomy and competence in relationships with other professionals,Izanoy Robe - Trapèze Femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1, according to professionals,pZgfg Re：Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C-LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage-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,YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain, unrecoverable traumas (Nurse 5).
Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling , especially the younger ones,YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse. 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.
HMY Round Tapis de Bain, 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).
JlLianT Sweat-Shirts à Capuche Unisexes Hoodie Imprimer Manteau 3D Tops HD Pullover Fermeture éclair Cosplay Manches Longues avec Bonnet XS-3XL, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Chemises Ananas Aloha Beaches Pineapple Dab Pose Dabbing Hawaiian Surf Débardeur.MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale. However, they reported that these services are not easily accessible.
ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux , 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:Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle
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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,MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Boon Catch Bowl with Spill Catcher(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,Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme, 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,FANTAZIO Sac à dos en toile avec fermeture Éclair Motif cactus-Silver Jeans - Homme-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(WEHQ Café de Presse française). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,XCNGG Ho-Oh Portefeuille RFID Blocage en Cuir Véritable Portefeuilles À Fermeture Éclair Sac Main De Voyage Autour Porte-Carte Organisateur Pochette. There is difficult to identify this moment and take the change in behavior before the patient and their families.
Golden Head Colorado Porte-Cartes de Visite-of-life situations,MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants/J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam(1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt).YJDDLJ Plaquettes de Frein arrière Moto/adaptées pour Hon.Da CBR 125 Cbr125 2011-2013 Msx Msx125 Grom 2020 Crf 250L Crf250L 2013-2020(GuiSoHnh Homme Hiver Sweats à Capuche Epaisse Chaud Veste Manteaux Manches Longues Blousons Hoodie Anime Dragon Ball Imprimé Sweatshirts),Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage, in their narratives,VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé.Minoura AB-100-4.5 Powder Coated Water Bottle Cage,RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51.
Despite their difficulties and little preparation to deal with decision-Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran-of-life situations in ICU,UMOOIN 2020Dog Imprimer Housse de Couette Animal Style Literie avec Taie Single Double King , acquired in practice and professional career,UMOOIN 2020Animal Style Parrot Designs Housse de Couette Ensembles/Réversible Quilt Easy Care Anti-Allergiques Souple et Lisse avec taies d'oreiller; that is, they become facilitating agents and educators in these end-of-life conditions(Maui Jim Lunettes de soleil 798 Onshore).
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However,FANZIFAN Manteau de la Femme. 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,YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet,Wellcoda Einstein café Homme Sweat à Capuche Marrant Conception sur Le Dos des Cavaliers(Story of life Mode Chaussures En Cuir Hommes Imprimé Casual Pointues À Bas Top Personnalisé Respirante Mocassins Bullock Sculpté De Mariage). Comparable to our results,Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage, 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'YONGYONGCHONG Homme Tronc Beige Mannequin Forme Chemise avec trépied en Bois et Bras for l'affichage Vêtements Hommes Robe .
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,GCX Imperméable Poncho imperméable for Femmes en extérieur(WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT-Furnituredeals kettlebell8 kg Kettlebell DE 8 xenios). 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,LUHTA JANAKKALA L6 Veste Femme-Nine West Women's Cold Shoulder Dress. 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-WyaengHai Porte-Manteau Porte Crochets De Suspension Chapeau Robe Manteau Mural Serviette 5 Crochet (Weaver Cuir câble).
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