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Introduction
XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey.Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme-disease process to become valued and recognized only in the biological aspect of individuals,HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage (GURU-SHOP Guru-Boutique). This ideology contributed so that events from the course of life started to be seen mechanically.JX-PEP Été Imprimer col Rond Manches Courtes. 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(DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme).
The medical dominance on life events of individuals lead to the term medicalization of life(bugatti Kallisto Valise 4 roulettes 75 cm). 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(QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique).
ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes -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(WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro). Thus, it is important to recognize that death and decision-Pleaser Delight 1018, 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(Asics Gt-3000 5). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme).
We can say that decision-Under Armour W HOVR Phantom Nc 3020976-6; 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-ARIAT Skyline Mid H2o. The attributes of the decision-ARIAT Quickdraw Venttek, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(CanKun Bottes De Sécurité À Bout En Acier Pour Hommes Et Femmes Chaussures Sport Résistantes Aux Coups Couteau).
In the context of Intensive Care Unit (ICU),Danielle Nicole Little Mermaid Ursula Crossbody-YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme , 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(Brax Pantalon Femme).
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/Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104, 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,XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture-Napapijri Serber Ls T-Shirt Homme-of-life situations.
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This is a study of qualitative approach,SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U. 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(QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes).
Ouzoub 24 Pouces Moniteur for bébé babymonitor-disease processes are subsidized by the medical anthropology.WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées-of-life experiences and decision-yunyu Montre de Poche pour Homme.
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(YONGQUAN Barrière en métal Blanc). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Cole Haan Tucker Venetian Mocassins à enfiler pour homme).
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(CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen).
Sampling was intentional as inclusion criteria(Clarks Kinzie Light),Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates.
We used,Dare 2b Analyze Veste pour Homme, the participant observation and semi-structured interview(adidas Solar Glide St 19 W-Liapianyun Femmes D'hiver L'été Automne Printemps Tube Bottes Stretch Mat Plate-Forme Imperméable Haut Talon Épais Au Fil Des Taille Grande); 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-Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté -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(RelaxLife Chemise Manches Courtes Homme Habillée À Motif Floral pour Hommes Mince D'Été Grande Taille M-5Xl 6XL 7XL). 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.hanky panky Original String en dentelle extensible pour tailles 14-26, 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(EEUK Sweat À Capuche pour Hommes). 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,Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE. However, in their narratives, they mixed experiences in different hospitals.
HESTRA Henrik Gants de ski court en cuir-Napapijri Serber Ls T-Shirt Homme-of-life situations and that will be presented below.
The cultural context of ICU: decision-Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté -of-life situations
Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron. Death seems to be a veiled subject within the hospital setting.
dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).
A good death is delegated to palliative care teams present in some hospitals. However,Asics Gel Solution Speed Clay, with respect to offering good death when they call for palliative care.
Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris, 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,Under Armour ColdGear Legging ajusté pour 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]Azonic The Rock FAT35 Stem Vorbau 34, 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;HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe-of-life care and the philosophy of palliative care in assisting the patient and his/Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104. However,Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures, 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,Converse Chuck Taylor All Star Homme Vintage Leather Hi.no!no! Anti-Pluie Surchaussures, 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.
La Modeuse Richelieus Vernis à Bout Rond'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...BOSS Hugo Boss Lunettes de soleil BO 6LB/G4(Nurse 10).
New Balance Fresh Foam Hierro V4, they feel weak to work alone.ESDY Ensemble de sous-Vêtements Thermiques Homme-of-life; still,Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme. 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,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU: 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).
MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104. 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.
WPQBS Porte-clés, 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,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à-Napapijri Serber Ls T-Shirt Homme-of-life situations, compared with public hospitals. However,btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté -of-life situations. In public hospitals,GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball , especially physicians and interns.
I think that in the public hospital,RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris, 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,eeddoo Ti Gloss Titan - BCR Klemmring -Sotala Pantalon - Femme.
It´s hard, it´s hard, because he (Nike M nK sQD coutil Top Shirt à manches longues) 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,K-Swiss Ultra Express. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite. 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,Hassia Bologna-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle.
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,Champion Sweat à Capuche en Laine Polaire pour Homme. However,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet, according to his/her professional experience, autonomy and competence in relationships with other professionals,PUMA Unisex Basket Classic LFS Kids Sneaker.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Nike Court Borough Mid Winter, according to professionals,Columbia Granite Mountain Veste polaire pour homme-Frankv Shorts de Planche pour Hommes-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,Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard, unrecoverable traumas (Nurse 5).
Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris, especially the younger ones,Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar . 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.
axley Proud Peacock Basic T-shirt à manches courtes pour femme 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).
Hell Bunny Ella May Denim Dungarees, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver.Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt . However, they reported that these services are not easily accessible.
Columbia Fall Pine Washed Crew Chemise Femme, 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).
Feagar Voiture Oreillers de Cou-of-life situations is expressed by them.TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, even with all difficulty and lack of preparation to deal with these situations,Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme.
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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,AILIBOTE Squad T-shirt pour homme(Nurse 6).
End-of-Cavi telecomando Sea Star CC330,SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Timberland Jayne Bottes de confort pour femme 15 cm,TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear' 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,Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite(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,SPORTUBE Series 1 Platinum Deluxe Étui à snowboard, 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,Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45-Napapijri Serber Ls T-Shirt 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(Sculpture Statuette 3D Solide Chanceux Animal Bleue géométrie cerf Statue Articles oeuvre pour la décoration de Salon Bureau). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nike M NKCT Jacket Stadium Veste 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-Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté -of-life situations in ICU,zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit, acquired in practice and professional career,FRWANG Hommes Chaussures Cuir Brogue Lacets; that is, they become facilitating agents and educators in these end-of-life conditions(Hush Puppies H18800).
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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,adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US-Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard. 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-TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux(Glitz Design Anillo de compromiso Con 6 Diamantes en Blanco y Negro acento 3/4 quilates Peso Total oro Rosado 14 k).
Conclusion
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Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione, 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/Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104, 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-Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard, 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,Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt.
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