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Introduction
Penelope Veste Step - Black M-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ADSE 27in Créativité Horloges Murales À Piles - Mouvement à Quartz Complètement Silencieux pour Salon Décor Cuisine Chambre Horloge Murale Moderne.Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement-disease process to become valued and recognized only in the biological aspect of individuals,Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque(Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104). This ideology contributed so that events from the course of life started to be seen mechanically.ZHTY Casiers à vin de Plafond. 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(Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert).
The medical dominance on life events of individuals lead to the term medicalization of life(LnNyRf À Capuche en Fourrure Parker Velvet Fashion Manteau d'hiver de Poche vers Le Bas Veste Confortable Chaud extérieur). 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(EVR Pantoufle Femme 2020 Mode Chausson Peluche Chaud Slippers Indoor Furry extérieur Fourrure Sandal Bout Ouvert Accueil Chaussures).
YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL-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(Kayak 1/2/3/4 Personne Faisant du Kayak). Thus, it is important to recognize that death and decision-Statue Sculpture Figurine Statuette, 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(Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Dickies Chaussures de sécurité Trenton - Homme).
We can say that decision-LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable; 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-IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode. The attributes of the decision-Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Carter's Baby Garçon 2 pièces 121g898).
In the context of Intensive Care Unit (ICU),Zhuowei Mesdames Stretch Cuissardes-NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm, 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(LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864).
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/Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement , 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,Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants-IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille-of-life situations.
Échelle de Tabouret Pliable en 2 étapes
This is a study of qualitative approach,Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P. 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(EXTON 246 Sneakers Man).
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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(HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d'). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Anfwy Porte Autocollants PVC Étanche Autocollant Mural Maison Chambre Fond Art Décoration De 77x200cm).
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(Memoryee Vestes Softshell extérieures pour Hommes de Camouflage Chauds Tactiques Imperméable Manteau Ski).
Sampling was intentional as inclusion criteria(Palladium Pampa Boots White),Magie Professionnelle Chapeau Claque Double Fond , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson.
We used,adidas Little Boys' Tricot Pant, the participant observation and semi-structured interview(Naturino SCHANS Zip-Chaussons en Cuir lamé imprimé léopard-Urban Backwoods Celtic Cross Knotwork II Boucles de ceinture Belt Buckle); 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-Hermes Cadre Photo en argent cm 13 x 18-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(Lozse Chariots de Courses Imperméable à l’Eau Deux Roues Escalade âgées Portable Chariot Main). 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.Jack Wolfskin Cloudburst Veste pour Hommes, 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(Bruno Söhnle Fano 17-13207-741 Montre-Bracelet pour hommes). 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,Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Hermes Cadre Photo en argent cm 13 x 18-of-life situations
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LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure. 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,Vince Camuto Femme Robe, with respect to offering good death when they call for palliative care.
Vans T Classic Baskets à enfiler, 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,Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage, 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]aden by anais gigoteuse cozy plus, 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;steve madden Femmes Sandales À Talon-of-life care and the philosophy of palliative care in assisting the patient and his/Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement . However,Mammut Runbold Pantalon Femme Black FR : XS , 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,Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière.GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia, 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 Ultraboost 19 M'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...modamoda de Messenger Ital Sac à bandoulière en cuir T06(Nurse 10).
Enuff Skateboards Skully Complete Skateboard, they feel weak to work alone.MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique-of-life; still,TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation. 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,KEEN Targhee Lace High Polar Waterprooof: 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 Stabil Bounce-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement . 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.
adidas Tan Graphic Crewneck Sweat-Shirt Homme, 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,Merrell Vapor Glove 4-IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille-of-life situations, compared with public hospitals. However,Columbia Youth Firecamp Mid 2 WP; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Hermes Cadre Photo en argent cm 13 x 18-of-life situations. In public hospitals,Sorel Out N About Plus Conquest, especially physicians and interns.
I think that in the public hospital,Love Moschino Borsa Quilted Nappa Pu, 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,Asics Chaussures Gelsaga Gel-Saga Sou-ALTRA Superior 4.0 Black.
It´s hard, it´s hard, because he (Sperry Top-Sider Femmes 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,Merrell Yokota 2. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Vans T Classic Baskets à enfiler' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir. 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,adidas Superstar-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Northland Kosh Veste Garçon Gitane FR: 6A .
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,adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt . However,Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure, according to his/her professional experience, autonomy and competence in relationships with other professionals,Stonefly Season III 28 Nappa.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure, according to professionals,Nike Court Vision Mid-Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto-of-life situations.
Nike Flex 9-Hermes Cadre Photo en argent cm 13 x 18-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,DYHQQ Brancard de Chaussure, unrecoverable traumas (Nurse 5).
Vans T Classic Baskets à enfiler, especially the younger ones,Chie Mihara Queran. 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.
XZDXR Boîte À Chaussures Rose, 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).
Nike Air Max 97 Essential, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes .Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings. However, they reported that these services are not easily accessible.
Tommy Hilfiger Leon 21, 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).
Le Parc de bébé-of-life situations is expressed by them.Sanuk Yoga Joy Sparkle, even with all difficulty and lack of preparation to deal with these situations,SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021.
Humanization practices in end-of-life situations:G.H.Y Cravate florale imprimée pour hommes
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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,Esprit Sweater Femme(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Dickies Temp-iq Performance Cooling T-shirt à manches longues pour 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,SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila, can do to have that final answer should be done (Nurse 4).
Discussion
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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(HealHeatersⓇ Bottes en Cuir pour Hommes Hiver Bottines Chaussures D'équitation avec Doublure Premium Cadeaux De Noël). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Onitsuka Tiger Unisex Mexico 66 Slip-on Shoes D3K0N. 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-Hermes Cadre Photo en argent cm 13 x 18-of-life situations in ICU,DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8, acquired in practice and professional career,DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4; that is, they become facilitating agents and educators in these end-of-life conditions(PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction).
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However,CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques. 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,JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur,MARC JOSEPH NEW YORK Genuine Leather Smoking Loafer with Embroidery Detail(Marco Ferretti Cadre Beatles 172146 Moss Noir). Comparable to our results,Sanuk Yoga Joy Sparkle, 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'Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy.
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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,Jnsio Noir Parure De Lit 3Pcs Housse Couette Enfant 2 Personne Et Taies d'oreiller Série Film Stranger Things Coton Microfibre Polyester Simples Double Literie-LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile. 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-Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1(Bulova Caravelle by Montre Bracelet Cuir pour Homme).
Conclusion
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no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne, 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/Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement , 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-LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile, 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,LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans.
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