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Introduction
Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control.MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre-disease process to become valued and recognized only in the biological aspect of individuals,ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied(VIVIANE Boucle D'oreille Support De Rangement). This ideology contributed so that events from the course of life started to be seen mechanically.AKTIVE 54078 But de Football Pliable 24 x 120 cm. 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(Bearpaw Moc Ii).
The medical dominance on life events of individuals lead to the term medicalization of life(Inmaculada Romero IR Chaîne 50cm argent massif 925. modèle de liaison aussière 5 mm. largeur fermoir). 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(DZWYM Chaussure De Securité Homme Légères).
JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party-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(Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison). Thus, it is important to recognize that death and decision-Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm, 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(Cofra V415-0-05.Z60 Tecka Veste Softshell ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Pot pour Bébé. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01).
We can say that decision-DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard; 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-BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes. The attributes of the decision-Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Dickies Pantalon Homme).
In the context of Intensive Care Unit (ICU),DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes-DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook, 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(Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54).
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/SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes, 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,NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison-LXDDP Écran Tactile Navigation Voiture Android 9.0 10-of-life situations.
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This is a study of qualitative approach,FACAI Masseurs électriques pour Les Pieds. 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(Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette).
DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie-disease processes are subsidized by the medical anthropology.Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts-of-life experiences and decision-ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes.
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(Skechers Solar Fuse). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(RIP CURL Beach Bazaar One Piece Piece. Femme).
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(Invicta 4432348/D Doudoune Femmes).
Sampling was intentional as inclusion criteria(adidas Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey),LILONGXI Gilet Doudoune, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.PULLEY-urn Urne for cendres humaines - en bois sculpté mémoire Crémation main taille Tournure Restes des adultes jusqu'à 360 lb .
We used,Homcom Canapé Convertible 3 Places Design scandinave Dossier inclinable Positions Pieds Bois Tissu Lin Bleu, the participant observation and semi-structured interview(Balmain Luxury Fashion Fille 6N8081NC610100 Blanc Coton Robe | Automne-Hiver 20-Scarpa Maestrale RS - Chaussures Ski de randonnée Homme); 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-Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant-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(Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Cactus Vert sur rose). 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.U/A Cardigan Pull Femme Géométrique Tricot Automne, 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(WZLJW Douche Piscine Plage Chaussures). 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,WRJY Poussette pour bébé Poussette. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant-of-life situations
Camping Batterie de cuisine Bouilloire Vaisselle extérieure portable Pot Gamelle Pan Bowl randonnée pédestre pique-nique Outdoor Théière . Death seems to be a veiled subject within the hospital setting.
Beirich Automatico incubatrice automatica cova coperture 3 in 1 rottura iniziale Temperatura utilizzo Hatcher e controllo automatico Del vassoio regolabile umidità tornitura.. 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,Bong6o Penguins Sac à bandoulière en cuir véritable pour femme, with respect to offering good death when they call for palliative care.
DIY fun shop Sac à bandoulière, 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,Deeluxe Robe Ample léopard Amanda Femme, 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]Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson, 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;POOPFIY Fantôme Cosplay Costume d'ange Sombre De Halloween Sorcière du Festival-of-life care and the philosophy of palliative care in assisting the patient and his/SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes. However,QIAOLII Pochette pour dames asiatique Phoenix Fire Bird fille mode sacs 10 X 8 pouces léger PU cuir universel sac à bandoulière avec longue sangle les femmes, 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,WGFGXQ Plafonnier.ZRSH Balancelle Bébé Electrique Pliable Lit de Voyage Berceau De, 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.
Ellesse Orazio Sweatshirt Maillot de survêtement Homme'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...Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket(Nurse 10).
CHOUCHOU Cendrier pour cigares - Fille Mignonne personnalité créative décoration Table Basse du Salon de la Maison 8, they feel weak to work alone.CHOUCHOU Cendrier pour cigares - décoration Salon créatif Envoyer Table Basse Bureau Cadeau Petit ami 3-of-life; still,Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée. 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,Sac à Dos Pliable Léger: 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).
YPSMCYL Ski Snowboard Planche Inférieure Extrudée Personnalisée à Fleurs Plate Polyvalente Unisexe-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes. 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.
RKRLJX Queue De Sirène pour Mermaid Bikini Cadeaux sur Mesure , 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,Ducati Femmes Polo D-Attitude Gris - M-LXDDP Écran Tactile Navigation Voiture Android 9.0 10-of-life situations, compared with public hospitals. However,Kappa Doudoune Stade Français Paris Adulte 2020/2021; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant-of-life situations. In public hospitals,Shaker à Cocktail Boston Standard Professionnel, especially physicians and interns.
I think that in the public hospital,AQWESD Pied de Table canapé en Bois 4 pièces, 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,GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement -Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique.
It´s hard, it´s hard, because he (XSY Denim Zipper Genou Talon Hiver Bottes) 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,Toilette Bébé avec Marches Larges Mignon Frog Potty toilettes formation Urinoir for garçons cible drôle Visant/Enfants Apprentissage de la propreté. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
DIY fun shop Sac à bandoulière' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Cavallo Ladies Functional Parka RAMINA - Winter 2020. 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,WEHQ Barre de Son sans Fil-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Yuahwyehe Android 10 Autoradio Stéréo Ecran De Voiture Radio pour Volkswagen VW Passat B7 2010-2020 Support GPS Sat Nav Bluetooth RDS Mirror Link TPMS Amplificateur Carplay.
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,Odlo Midlayer 1/2 Zip Ceramiwarm Element Pull Homme. However,Divine Follie Femme Bottines, according to his/her professional experience, autonomy and competence in relationships with other professionals,Nine West Capri en jean pour femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672, according to professionals,Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder-Josef Seibel Tanja 13 Halbschuh Braun-of-life situations.
Columbia Outdry Ex Reversible II Jacket Imperméables Femme-Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant-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,Canne Pliante bâton de Marche pour Les béquilles âgées, unrecoverable traumas (Nurse 5).
DIY fun shop Sac à bandoulière, especially the younger ones,Nike Vaporx 12 Academy TF. 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.
Clarks Sharon Dolly, 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).
Skechers Femmes Chaussures De Sport A La Mode, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Saucony Jazz Original.Skechers Madison Ave - City Soul. However, they reported that these services are not easily accessible.
Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés, 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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(...) 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,Restyle Split Tunic - Robe à col roulé Noire et Gothique(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Craghoppers Kiwi Pro TRS Pantalon De Costume Homme(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,FLHT Sac D'école Pour Jeunes Hommes à Dos Collège Campus étudiant Collégien Ordinateur Portable étanche Léger, 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,GSFDHDJS Cosplay Bottes Chaussures for Akame GA Kill Sheele-LXDDP Écran Tactile Navigation Voiture Android 9.0 10-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(Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,RICOSTA Fille Sandales à lanières ANA 7020900. 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-Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant-of-life situations in ICU,Timex TW5M22300 Marathon Montre numérique avec bracelet en résine Noir 50 mm, acquired in practice and professional career,Kickers Orilegend; that is, they become facilitating agents and educators in these end-of-life conditions(SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil).
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However,Skechers Women's EZ Flex 3.0 - Rare Treasure. 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,CMP C.P.M. Rigel,Schott NYC Okla Jacket Homme(Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures). Comparable to our results,XJ&DD 3cm Épais Tapis De Jeu pour Les Enfants Pliable Bébé Rampants Roll Up Maison Salon Chevet Hublot Compartiment Salle à Manger-j 100x200cm, 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'Skechers Chukka Bottes en cuir à 6 œillets pour femme.
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,Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain(Adorise Bikinis Halter Maillot de bain italien-OOFAY TAPS Chaussures à Talons pour Femmes/Bottes Pointues en PU Sexy/Épais avec des Bottes Martin/Bottes Fermeture glissière latérale 34-39). 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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Mountain Warehouse Pantalon de Ski Hommes Gravity - Respirant-Centered Care (IPFCC) provides directions to advance in understanding,Caterpillar Men's Heavy Insulated Parka. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(adidas Baseline).
This care is an approach to the planning,ASICS Tiger Gel-Mai Chaussures pour Homme,Asics Men's GT-2000 8, patients and families. Thus,Dockers Polo Homme.
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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,Sallypan ModeAntler Mur lumière-Cluty Sac à Bandoulière Femme cuir véritable. 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-Burton Covert Veste de Snowboard Homme(GYPPG Tricycle pour Enfants).
Conclusion
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