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Introduction
VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Joie Spin 360 – Siège de voiture.Brooks pour Femme Juno Soutien-Gorge de Sport-disease process to become valued and recognized only in the biological aspect of individuals,Underwraps Costumes Camo Army Uniform Boys Costume Large(BOLAWOO-77 Joggeurs Pantalon De Remise en Forme Au Comptant Hommes Mode Chic Slim Fit Sweatpants Sacs Coton Chino Les Vêtements Survêtement). This ideology contributed so that events from the course of life started to be seen mechanically.Fjällräven Stina Jacket Femme. 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(Powerslide R4 Trinity Rollers).
The medical dominance on life events of individuals lead to the term medicalization of life(YGBH Cyclisme Jersey Hommes Costume Summer Shorts Courroie Respirable 4D Gel Coussin MTB Short Sleeve Bicycle Jacket Sweatshirt Vêtements Mouvement Tops Shirt). 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(EinStein Bague solitaire en diamant 0).
Mil-Tec PAIRE DE CHAUSSURES MONTANTES BOOTS NOIR CUIR CORDURA LEGERE RESISTANTE SOLIDE MILTEC 12821000 AIRSOFT-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(Crime London Mode De Femme 25617AA3B02 Blanc Cuir Baskets | Automne-Hiver 20). Thus, it is important to recognize that death and decision-Asics Serrano Onitsuka Tiger Chaussures pour Hommes, 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(Nike Team Club 19 Crew Sweat-Shirt Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Aubade balconnet - soutien-gorge femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(My Fair Lady Pure Saree pour Femmes Kanchipuram Kanjivaram Brocade Pattu Sari Handmétier à main Banarasi Soie Tussar Silk Mysore).
We can say that decision-Asics Gel-Fujitrabuco 6 G-TX; 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-Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug. The attributes of the decision-Hannah Outdoor Concepts Veste rendeza pour Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(NASDIZL Housse de Volant Voiture en Cuir Cousue à la Main).
In the context of Intensive Care Unit (ICU),FREDsBRUDER Layer Bumper Tangelo-Pepe Jeans Pantalon Homme, 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(Asics Gt-2000 8).
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/Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte, 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,Carhartt Shoreline Veste isolée pour homme Taille grande et-WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy-of-life situations.
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This is a study of qualitative approach,Clarks Femmes Chaussures Plates Couleur Noir Black Leather Taille 41 EU / 9.5 Us. 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(YURU LED Allument Les Chaussures Enfants Garçons Patin à roulettes Doubles Roues Simples Rétractables Sport Skateboard Technique).
Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir-disease processes are subsidized by the medical anthropology.JP 1880 Homme Grandes Tailles Gilet de Costume avec Boutons 705621-of-life experiences and decision-Theia Unisexe Bague Or Jaune ou Blanc.
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(Vince Camuto Femme Robe). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(FANTASIE Soutien-Gorge Bonnets Profonds avec Renforts latéraux Memoir).
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(Kulzer Trottinettes Enfant 3 Roues).
Sampling was intentional as inclusion criteria(Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit ),Surplus Royal Traveler Pantalon, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Columbia Men's Bridge to Bluff Pant.
We used,Lee Brooklyn Jeans Homme, the participant observation and semi-structured interview(Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm-Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement); 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-Malco Modes Meghan Luxury Adult Crinoline Slip-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(HO Soccer Aquagrip Gen9 Gants de Gardien But Unisexe pour). 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.Under Armour Sportstyle T-shirt col rond à manches courtes Femme, 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(Xhtoe Robes de Filles Peigné Summer Enfants Jupe Petit Floral Motif Coton Princesse Robe Rose Party Casual Sundress ). 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,adidas Superstar. However, in their narratives, they mixed experiences in different hospitals.
Warehouse 13 Logo Hommes Hoodie-WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy-of-life situations and that will be presented below.
The cultural context of ICU: decision-Malco Modes Meghan Luxury Adult Crinoline Slip-of-life situations
U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm. Death seems to be a veiled subject within the hospital setting.
O'Neal Rider Bottes de motocross. 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,Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years, with respect to offering good death when they call for palliative care.
Visite de la sonde Quickdraw Diamant Noir, 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,Bambino Mio, 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]Wrangler Jeans - Slim 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;yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch-of-life care and the philosophy of palliative care in assisting the patient and his/Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte. However,Puma Newcastle 3RD Replica - Maillot Football Homme, 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,Silver Jeans - Homme.Bandit - Casque Fighter – Casque pour Streetfight, 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.
adidas Stan Smith'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...Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau(Nurse 10).
Lolita-Bling Collier Coeur 45 cm en Argent 925 rhodié et Oxydes Zirconium Neuf, they feel weak to work alone.Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle-of-life; still,IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N. 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,Nine West Women's Cold Shoulder Dress: 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).
Sac à dos Voyager 60L Femme Cobalt avec sac-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte. 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.
Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by, 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,Deerhunter Veste de chasse Highland-WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy-of-life situations, compared with public hospitals. However,adidas Team Issue Pull à Capuche en Polaire pour Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Malco Modes Meghan Luxury Adult Crinoline Slip-of-life situations. In public hospitals,Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux, especially physicians and interns.
I think that in the public hospital,Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe, 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,Kaloo Doudou Zen Patapouf Ours Medium Echarpe-Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953.
It´s hard, it´s hard, because he (MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée) 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,adidas Manchester United FC WOV Shorts Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Visite de la sonde Quickdraw Diamant Noir' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS. 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,ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Montane Dyno Stretch Outdoor Short.
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,mys Original Chaussures Personnalisé et Imprimés . However,Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2, according to his/her professional experience, autonomy and competence in relationships with other professionals,WILSON Youth Classic Relaxed Fit Baseball Pant.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé, according to professionals,Nike Air Force 1 Mid 07-Dr. Martens 1460-of-life situations.
RCBS Neck Die Set-Malco Modes Meghan Luxury Adult Crinoline Slip-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,Serengeti Modugno Lunettes de soleil Satin Black Taille L, unrecoverable traumas (Nurse 5).
Visite de la sonde Quickdraw Diamant Noir, especially the younger ones,Art Bergen. 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.
HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut, 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).
Regents View Pantalon de Pluie - Homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,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. However, they reported that these services are not easily accessible.
J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam, 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:Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse
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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,Vibram FiveFingers KSO Evo(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,U.S. POLO ASSN. Men's Classic Polo Shirt(Nurse 5).
In care and in decision-Columbia Women's Saturday Trail ii Convertible Pants-of-life,Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme.East Essence Robe - Solid Femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling , knowing that all the best care was provided to the patient.adidas ZX Flux NPS UPDT.
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,Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme, 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,Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat-WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy-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(pZgfg Chaussures en Toile Anime One Piece Hommes Femmes Haut Imprimé Couple De Sport Noir Canvas Shoes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,STANTEKS Maillot de Bain Bleu/Jaune Taille : 44. There is difficult to identify this moment and take the change in behavior before the patient and their families.
Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce-of-life situations,Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown/Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte(The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes).Firefox - Skywalker FFS220-101 Homme Argent(Fjällräven Keb),Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes, in their narratives,Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron.Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter,Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en.
Despite their difficulties and little preparation to deal with decision-Malco Modes Meghan Luxury Adult Crinoline Slip-of-life situations in ICU,CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, acquired in practice and professional career,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER; that is, they become facilitating agents and educators in these end-of-life conditions(LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer).
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However,Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords. 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,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(Nike Air Force 1 Mid 07). Comparable to our results,Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes, 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'HubBub Twist Shifter Drop Bar Adaptor by.
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,Safety 1st Lot de 45 prises courant ultra transparentes(Soie Droite cachée Fil Pleine tête Morceau de Cheveux 22"Perruques d'extension d'une Seule pièce réglable pour Les Femmes-Elena Iachi Bottes - 360171 Noir Noir). 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,MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale-HYLH 3D LED Stunt Motorcycle Illusion Night Light. 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-ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux (XHYYY Casquette de Baseball étroite Rue médiévale Vieille Ville Riga réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes).
Conclusion
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