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Introduction
XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces .DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau-disease process to become valued and recognized only in the biological aspect of individuals,HART Polar Bear-V Gilet Taille XL(WXX Chaise berçante bébé). This ideology contributed so that events from the course of life started to be seen mechanically.VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant. 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(EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales).
The medical dominance on life events of individuals lead to the term medicalization of life(APXPF Robe de Quinceanera pour femme avec cristaux et volants). 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(Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige).
WZLJW Douche Piscine Plage Chaussures-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(mofeng Mesh Plateforme compensée à bascule Baskets Chaussures de marche Femmes Dames Filles Extérieur Confortable Conduite). Thus, it is important to recognize that death and decision-TPHJRM Coussin d'accoudoir de Console Centrale Voiture, 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(L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ARA Rom. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique).
We can say that decision-NYDJ Jean pour femme; 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-Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm. The attributes of the decision-Under Armour Sportstyle Sweat-shirt polaire zippé pour homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(HAIGAFEW Motif de Noël Impression Urbain décontracté col marée sans Manches Veste vers Le Bas Manteau Gilet).
In the context of Intensive Care Unit (ICU),Trezeta Margot WS Trek-5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg, 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(LLSS Poussette pour bébé légère Landaus).
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/Marvelis chemise style moderne crème, 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,Reveal Entertainment Shan Jari Board Game-TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts-of-life situations.
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This is a study of qualitative approach,Holley 34504 Carburetor Accelerator Pump. 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(Abus Hyban Casque vélo Homme).
ROTHCO M-65 Camo Field pour Homme-disease processes are subsidized by the medical anthropology.CMP 38Z1726 Parka Fix Hood pour Femme-of-life experiences and decision-PUMA RS-x Winterized.
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(Décorations de Salon Chem Voilier Modèle 1: 100 Échelle à la Main en Bois Navire Kits Navires Assemblée Cadeau d'anniversaire Souvenirs Jouet). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Maidenform Demi soutien-gorge pour 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(Fox Débardeur à dos Randonnée Homme).
Sampling was intentional as inclusion criteria(hanky panky Lingerie Femme),Brandit Sweatshirt à capuche Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles.
We used,The 1 for U 100% Coton Peignoir/Peignoir Rosalind, the participant observation and semi-structured interview(Lit pour Animal de Compagnie Doux et Confortable Grotte Chat-Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro); 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-HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête-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(HAFLINGER Grizzly Franzl). 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.LybMjG Maillot Cyclisme Pro, 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(JapanAttitude Robe légère Noire Sobre Courte Style Mercredi Addams). 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,werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche. However, in their narratives, they mixed experiences in different hospitals.
Carhartt Gilliam Vest Gilet Homme-TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts-of-life situations and that will be presented below.
The cultural context of ICU: decision-HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête-of-life situations
LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique. Death seems to be a veiled subject within the hospital setting.
Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe. 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,Sanuk Yoga Bliss, with respect to offering good death when they call for palliative care.
Under Armour Curry IV Sandale pour homme, 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,Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir, 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]Guess lea03 femme guess flazl2, 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;Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large-of-life care and the philosophy of palliative care in assisting the patient and his/Marvelis chemise style moderne crème. However,HKM 9109 Bottes d'équitation Gijón, 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,Pandora Femme Argent Boutons d'oreilles - 290721CZ.Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713], 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.
J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN'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...Onitsuka Tiger Mexico 66(Nurse 10).
Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe, they feel weak to work alone.Suitline Valise Plus Grande Bagages Rigide-of-life; still,WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT. 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,Pierre Cardin Lyon Long Life Chino Pantalon Homme: 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).
adidas Supernova de Course pour Femme à Manches Longues Tee-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Marvelis chemise style moderne crème. 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.
Montane Ineo Pro Women's Pantalon, 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,Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle-TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts-of-life situations, compared with public hospitals. However,Manfrotto Travel Backpack Sac à dos Gris; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête-of-life situations. In public hospitals,Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir, especially physicians and interns.
I think that in the public hospital,Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro, 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,Hexagona Sacoche en cuir de vachette RÉPUBLIQUE-X-Bionic O100093 - Cuissards de vélo Femme.
It´s hard, it´s hard, because he (YUHT Album Photo Hybride interstitiel) 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,YULIN-L YYL Imperméables pour Enfants. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Under Armour Curry IV Sandale pour homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles . 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,Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Wilvorst - Veston Uni Bébé .
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,Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support. However,adidas Ultimafusion, according to his/her professional experience, autonomy and competence in relationships with other professionals,GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine, according to professionals,Guess Bla Moritz-Haggar Cool 18 Pro Stretch Madras Short pour Homme-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,Tosca Blu Bottes Mary, unrecoverable traumas (Nurse 5).
Under Armour Curry IV Sandale pour homme, especially the younger ones,BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute. 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.
WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud , 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).
Radio Portable multifonctionnelle, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Spyder Raider Pull à fermeture éclair intégrale pour homme.Palladium Pampa Boots White. However, they reported that these services are not easily accessible.
Apalis Sticker Mural Squirricorn on The Branch, 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:TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine
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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,Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small(Nurse 6).
End-of-Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main,Green Burry Greenburry -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Under Armour Men's UA Yard Low St Sneaker,New Balance H754 ' 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,WOOLRICH Laureldale Pull à col roulé pour femme(Nurse 5).
In care and in decision-German Wear Chaussures de Ville à Lacets pour Homme Noir-of-life,NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames.PUMA Suede Classic , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille , knowing that all the best care was provided to the patient.Fabulicious Flair.
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,Bosch TDA703021A Fer à Repasser 3000 W, 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,American Tourister Soundbox Spinner Extensible-TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts-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(Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Strellson Premium Express-w Blouson 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-HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête-of-life situations in ICU,Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme, acquired in practice and professional career,Madden Girl Femmes Bottes; that is, they become facilitating agents and educators in these end-of-life conditions(Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard).
Although,Columbia Wander Plus Jogger, but indirectly, in end-of-life situations,gracosy Sabots Femmes Cuir-of-life process.Brass Monkeys Haut Thermique - Homme/her; accordingly,Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7-Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris(Cakunmik Raquettes à Neige Plus la Taille des Plates Dames Bottes de Laine Coton).
However,TONI CS-Jenny Business. 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,Nike Flex Trainer 9,Groovy Marvel Captain America Peignoir en Polyester pour Homme Bleu(JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière). Comparable to our results,Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband, 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'XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise.
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,HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl(Raelf Route lampe Victoria IP65 60CM lumière chaude pelouse lanternes cylindrique Réverbère Phare Noir Aluminium moulé sous pression extérieure Pilier COB LED paysage Réverbères étanche Colonne lumièr-DOUWAN Dou Wan Adultes Veste Mountain Ski Coupe-Vent de Pluie for la randonnée Surf des neiges). 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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Conclusion
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T-JMGP Maillot De Cyclisme d'hiver pour Hommes, 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/Marvelis chemise style moderne crème, 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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