Introduction
dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee.TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween-disease process to become valued and recognized only in the biological aspect of individuals,FUNBN T-Shirt de Basket-Ball Version Fan Basket(Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003). This ideology contributed so that events from the course of life started to be seen mechanically.VIVIANE Boucle D'oreille Support De Rangement. 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(All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga).
The medical dominance on life events of individuals lead to the term medicalization of life(Combinaison de surf femme Maillots bain à la mode pour femmes Pantalons manches longues Plongée Sous-marine Costumes Conserver Haute élasticité Beach Spa Maillot Split 4 Pièce). 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(Pinko LOVE STARRY LANIERE Femme Nero UNI).
GPWDSN Montre de Poche et chaîne-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(ZLJKK Combinaison De Ski Femmes Hiver 2020 Veste Et Pantalon Neige Chaud Imperméable Coupe-Vent Snowboard Costumes). Thus, it is important to recognize that death and decision-Piquadro Blue Square Leather Backpack Rosa Chiaro, 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(Maillots de Basket-Ball pour Hommes et Femmes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Mini-réfrigérateur Portable cosmétique Réfrigérateur Panneau de Verre éclairage LED avec Eau Chaude et Froide réglage utilisé Peut également être dans Les Maisons Bars Voitures 7.7x10x11 Pouces. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Pleine Dentelle Faite à la Main Topper Curly Hair Piece Clip dans Une Frange de Base Mono PU).
We can say that decision-HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support ; 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-SKSNB Funny Mask Masque de déguisement Frais. The attributes of the decision-JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif).
In the context of Intensive Care Unit (ICU),Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres-F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile, 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(Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme).
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/Radiateur Électrique - Ventilateur De Chauffage Portable, 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,TEEZILY T-Shirt Homme Si Papou ne Peut Pas Le réparer-MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet-of-life situations.
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This is a study of qualitative approach,WH-IOE Femmes Jeans Ceinture en Cuir Hip Hop Punk Style Rock avec Rivets à la Taille Pantalon . 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(TIEON Uniformes de Baseball des Red Sox).
Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D -disease processes are subsidized by the medical anthropology.Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size-of-life experiences and decision-LIMQ Lingerie en Peluche Babydoll.
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(Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(DSHUJC Stepper Pedal Machine Installation Gratuite Multifonction Équipement de Fitness à Hauteur réglable Accueil - pédales).
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(21 shoes Chaussures personnalisé cloutée Customized Original ).
Sampling was intentional as inclusion criteria(APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes),Certified Freak Hail Santa Gym White, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty.
We used,YILANJUN Canapé pour Bébé, the participant observation and semi-structured interview(Montane Dyno Stretch Outdoor Short-Yhjkvl Hommes Gym Legging Fitness); 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-Softinos Iggy269sof-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(Rideaux d’ombrage en henné avec motifs de fleurs sauvages et feuilles décoratives œillets imprimés). 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.Timberland Splitrock 2, 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(Under Armour Sportstyle T-shirt col rond à manches courtes Femme). 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,Vince Femmes Sandales À Talon. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Softinos Iggy269sof-of-life situations
Visit the Carhartt Store Wip Car-Lux Jacket Homme. Death seems to be a veiled subject within the hospital setting.
Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large . 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,adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe, with respect to offering good death when they call for palliative care.
adidas Femmes Chaussures Athlétiques, 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,DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant, 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]FERRINO ZAINO Core 30 Nero Trekking, 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;2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de Femme-of-life care and the philosophy of palliative care in assisting the patient and his/Radiateur Électrique - Ventilateur De Chauffage Portable. However,MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal, 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,Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre .Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles, 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.
Clarks Women's Juliet Rose Loafer'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...W&XY Bottes d'hiver de la mode des hommes haut en peluche coton antid¨¦rapant ext¨¦rieur chaussures (Nurse 10).
ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage, they feel weak to work alone.Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme-of-life; still,adidas Forest Grove. 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,Blackskies Streetwear Hoodie | Pull-Over Chandail Sweatshirt Hommes Sweat-Shirt Long à Capuche: 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).
PUMA Alee Gore-Tex Mens Performance Bottes de Voile-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Radiateur Électrique - Ventilateur De Chauffage Portable. 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.
Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).
The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire-MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet-of-life situations, compared with public hospitals. However,XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Softinos Iggy269sof-of-life situations. In public hospitals,VearFit Cuir véritable, especially physicians and interns.
I think that in the public hospital,Dickies Henley Chemise à manches longues 3 boutons pour femme, 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,Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux -JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman.
It´s hard, it´s hard, because he (STAR TREK Sweat à Capuche Jeunesse Tos Episode 31) 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,ZWF Boots Bottes De Cow-Boy Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
adidas Femmes Chaussures Athlétiques' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair. 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,Tom Ford mixte adulte Lunettes de Soleil Huck FT0665-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-adidas Phosphere.
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,Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small. However,Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et, according to his/her professional experience, autonomy and competence in relationships with other professionals,wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,wxl&gz Leggings Énergie sans Couture Taille Haute Gym Nylon Spandex Pantalon De Yoga Contrôle du Ventre Course Athlétique Femm Livraison Gratuite, according to professionals,Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33-hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté-of-life situations.
CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver-Softinos Iggy269sof-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,WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude , unrecoverable traumas (Nurse 5).
adidas Femmes Chaussures Athlétiques, especially the younger ones,Lee Petit Pantalon cargo pour femme. 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.
Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible, 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).
Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL.Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue. However, they reported that these services are not easily accessible.
MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine, 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:Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy
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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,Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large(Nurse 6).
End-of-Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre,GBY Maillot de Basket-Ball Heat n ° 3 Wade-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr.,BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or' 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,Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite(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,adidas Duramo SL, 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,Grunland CI2835 DIRA Ciabatta Donna S.-MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet-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(Molly Bracken Manteau Droit à Chevron). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.. 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-Softinos Iggy269sof-of-life situations in ICU,L@YC Sandales tendance pour femme à talon moyen, acquired in practice and professional career,Donald J Pliner Men's Dacio Loafer; that is, they become facilitating agents and educators in these end-of-life conditions(Lind88 Chaussures de baseball texturées pour femme - Blanc et rouge Pour marche).
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However,ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm . 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,AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode,Ensemble de vadrouille et Seau(Mammut Runbold Pantalon Femme Black FR : XS ). Comparable to our results,ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm, 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'rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets.
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Conclusion
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MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri, 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/Radiateur Électrique - Ventilateur De Chauffage Portable, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
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