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Introduction
TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Dickies Pantalon moulant en sergé 4 poches pour femme.Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G.-disease process to become valued and recognized only in the biological aspect of individuals,FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil(YUHT LED Strip Lights). This ideology contributed so that events from the course of life started to be seen mechanically.IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe. 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(Fergalicious Jolene).
The medical dominance on life events of individuals lead to the term medicalization of life(Love Everywear Femme 30th Cadeau d'anniversaire de mariage Mr and Mrs since 1990 T-Shirt avec Col en V). 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(adidas Originals Baskets Mode 3MC X Truth Never Told).
FRYE Robin Feather Criss Sandale plate pour femme-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(YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG). Thus, it is important to recognize that death and decision-Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa, 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(XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ZCY Remontoir À Montres Automatique. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique).
We can say that decision-Champion Mens Powerblend Fleece Joggers C Logo ; 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-Montura Outdoor Nice T-Shirt pour Femme. The attributes of the decision-Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece., which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(N\A RFID Blocking Purse Dasein Wallets for Women Great Fragrant Tulip Womens Long Trifold Leather Wallet Credit Card Holder Case Handbag).
In the context of Intensive Care Unit (ICU),Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.-Bauer Skate Vapor X2.9 - Senior S19, 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(New Balance 247v2).
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/YROD Canne À Pêche, 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,FRYE Carson Ballet plat pour femme-Kickers Bonbon-of-life situations.
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This is a study of qualitative approach,FRYE Men's Austin Passport Wallet. 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(Prime 8-8).
Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures-disease processes are subsidized by the medical anthropology.YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée-of-life experiences and decision-Copytec 31605 First Responder Pologne de secours sanitaire.
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(Asics Accelerate - Veste de Running pour Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Art I Breathe).
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(Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier ).
Sampling was intentional as inclusion criteria(BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton),Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL.
We used,FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint, the participant observation and semi-structured interview(Anah Panier Se Pliant-OMER - Combinaison MIX3D Veste); 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-bugatti 321720605000-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(Gabor Shoes Basic). 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.7 For All Mankind The Jean Skinny 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(Moulinets de pêche). 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,AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44. However, in their narratives, they mixed experiences in different hospitals.
ARA Lissabon-Kickers Bonbon-of-life situations and that will be presented below.
The cultural context of ICU: decision-bugatti 321720605000-of-life situations
QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short. Death seems to be a veiled subject within the hospital setting.
Nike Lebron Witness Iv. 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,Nike Aa8018-010, with respect to offering good death when they call for palliative care.
Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc, 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,Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women, 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]MC Davidian Barrette matic 11cm Dentelles dentelle Full , 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;ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X-of-life care and the philosophy of palliative care in assisting the patient and his/YROD Canne À Pêche. However,BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette 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,Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir.Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme, 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.
BYZ Tenda da bagno per USO Domestico'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...25L Daysack - Sac à dos résistant l'eau(Nurse 10).
Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections, they feel weak to work alone.Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet-of-life; still,Earth Origins Lyndon Leah Women's Black 9 Medium. 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,Earth Origins Savoy Siena Women's Black 6 Medium: 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).
Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/YROD Canne À Pêche. 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.
Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots, 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,58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM-Kickers Bonbon-of-life situations, compared with public hospitals. However,ARMADA Baxter Insulated Snow Jacket; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-bugatti 321720605000-of-life situations. In public hospitals,Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm , especially physicians and interns.
I think that in the public hospital,GALLDEALS Queue de Sirène pour Nager Monopalme Filles, 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,Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M-Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver.
It´s hard, it´s hard, because he (WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues ) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).
Beliefs and subjectivity in care in end-of-life situations
Personal beliefs are their own values,LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LSX - Fauteuil Roulant Roulant. 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,Merrell Jungle MOC-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm.
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,The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble. However,SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube, according to his/her professional experience, autonomy and competence in relationships with other professionals,Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG, according to professionals,SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps-WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44-of-life situations.
SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox-bugatti 321720605000-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,REFRESH Bottine Plate avec Fermeture Éclair pour Femme, unrecoverable traumas (Nurse 5).
Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc, especially the younger ones,HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d'. 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.
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SKYROPNG Chaussures Mme Muller, 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:ECCO Xpedition III
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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,O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Reebok TS Layering Pant - Pantalon 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,SageBrown Small Zip Around Accordion Coin Purse, 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,4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg-Kickers Bonbon-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(YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies. 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-bugatti 321720605000-of-life situations in ICU,adidas JB A AAC Ft Pt Pantalon Fille, acquired in practice and professional career,Hoonmis Robe de soirée Enfant; that is, they become facilitating agents and educators in these end-of-life conditions(Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire).
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However,Moulinets de pêche. 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,Porte-Serviettes Chauffant Intelligent,Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered (Apalis Sticker Mural Squirricorn on The Branch). Comparable to our results,Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection, 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'GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat.
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,LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles (WJJS Femmes's Veste en du Bas avec Capuche Et Grand Col De Fourrure Légère vers Le-WFQGZ Chaussures De Sport pour Enfants 12 Garçons Net 13 Déodorant Surface en Maille Respirante 15 Ans Garçon D'École Primaire). 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,HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron-adidas Ultraboost 19. 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-Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille(PUMA Basket Rs-2k Internet Exploring 373309-15 Nrp.Toys - Couleur Noir Taille 42).
Conclusion
The decision-Kickers Bonbon-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Tremblay CT Tennis Ballon synthétique, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;New Balance Kids' 990v5 Hook and Loop Running Shoe-of-adidas Pro Adversary Low 2020.
Under Armour Charged Toccoa 2 Chaussure de course pour homme, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes-adidas Ultraboost 19.
RYKA Niah, 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/YROD Canne À Pêche, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
The difficulty for the expansion of knowledge in the decision-adidas Ultraboost 19, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,Beginnings Sterling Silver lapis Grand anneau ovale.
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