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Introduction
Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Vibram FiveFingers KSO Evo.Daller Tracht 10345 Charlene Dirndl pour Femme-disease process to become valued and recognized only in the biological aspect of individuals,Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran(LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats). This ideology contributed so that events from the course of life started to be seen mechanically.JABSCO ITT INDUSTRIES WC Elect. STD 24V. 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(MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière ).
The medical dominance on life events of individuals lead to the term medicalization of life(PUMA Palace Guard Mid). 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(QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho).
Nike W Blazer Low SD-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(Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm). Thus, it is important to recognize that death and decision-U.S. POLO ASSN. Men's Classic Polo Shirt, 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(ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Columbia Women's Saturday Trail ii Convertible Pants. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Falke TK 1 Chaussettes randonnée homme).
We can say that decision-Salewa Pedroc Hybrid 2 DST/PTX W Veste 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-East Essence Robe - Solid Femme. The attributes of the decision-Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(FONLONLON Iron Maiden Flip-Flops College Wind Sandales à Bout Ouvert Casual for Les garçons et Filles Classique d'été Style Simple).
In the context of Intensive Care Unit (ICU),adidas ZX Flux NPS UPDT-Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise 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(New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2).
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/Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat, 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,STANTEKS Maillot de Bain Bleu/Jaune Taille : 44-ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu -of-life situations.
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This is a study of qualitative approach,Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce. 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(XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau).
Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-disease processes are subsidized by the medical anthropology.Firefox - Skywalker FFS220-101 Homme Argent-of-life experiences and decision-Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron.
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(GSFDHDJS Cosplay Bottes Chaussures for Shugo Chara Hinamori AMU). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(BOOSSONGKANG Jupe).
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(Onitsuka Tiger Baskets Corsair Unisexe-Adulte).
Sampling was intentional as inclusion criteria(Ocun Quattro),Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en.
We used,CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, the participant observation and semi-structured interview(Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage-Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 cm); 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-Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER-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(Creative coeur garçon et fille chambre plafonnier dimmable avec télécommande LED rose d'enfant salon jardin d'enfants hall cuisine salle à manger de jeux pour enfants lampe déco). 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.Uvex Sécurité pour 2 s dimensions : 45 et nubuck, 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(Walking Cradles Étui pour femme - Beige taupe). 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,8" Share Bear Care Bears Plush Bean Bag. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER-of-life situations
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Visol Products laqué pour Cartes de Visite. 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,Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords, with respect to offering good death when they call for palliative care.
Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL, 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,Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat, 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]HubBub Twist Shifter Drop Bar Adaptor by, 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;Safety 1st Lot de 45 prises courant ultra transparentes-of-life care and the philosophy of palliative care in assisting the patient and his/Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat. However,HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé, 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,Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus.Utility Diadora Veste Sail Gris gris M, 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.
Timberland Pokey Pine Hook & Loop '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...CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil(Nurse 10).
Izanoy Robe - Trapèze Femme, they feel weak to work alone.KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1-of-life; still,pZgfg Re：Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C. 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,LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage: 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).
CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat. 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.
YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain, 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,YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse-ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu -of-life situations, compared with public hospitals. However,HMY Round Tapis de Bain; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER-of-life situations. In public hospitals,JlLianT Sweat-Shirts à Capuche Unisexes Hoodie Imprimer Manteau 3D Tops HD Pullover Fermeture éclair Cosplay Manches Longues avec Bonnet XS-3XL, especially physicians and interns.
I think that in the public hospital,Chemises Ananas Aloha Beaches Pineapple Dab Pose Dabbing Hawaiian Surf Débardeur, 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,MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale-ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux .
It´s hard, it´s hard, because he (Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket) 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,Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon. 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,Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Cerdá Ligera Lady Bug.
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,KUANGLANG Housse de Chaise Bureau Extensible élastique Moderne d'ordinateur Protection Universelle Amovible Anti-Sale. However,MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau, according to his/her professional experience, autonomy and competence in relationships with other professionals,Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Glamorousky en Élégantes boucles d'oreilles plaqué or géométrique chrysobéryl oeil de chat ovale opale , according to professionals,AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable-LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage Homme-of-life situations.
Boon Catch Bowl with Spill Catcher-Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER-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,Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s, unrecoverable traumas (Nurse 5).
Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL, especially the younger ones,XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold. 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.
XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, 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).
JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à.Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme. However, they reported that these services are not easily accessible.
FANTAZIO Sac à dos en toile avec fermeture Éclair Motif cactus, 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:Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé
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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,RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,YAOLAN 5D Diamant Peinture kit Complet(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,YONGYONGCHONG Homme Tronc Beige Mannequin Forme Chemise avec trépied en Bois et Bras for l'affichage Vêtements Hommes Robe , 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,GCX Imperméable Poncho imperméable for Femmes en extérieur-ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu -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(Napapijri Serber Ls T-Shirt Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Moshow Sweat à Capuche Homme Shark Whale 2 Sweatshirt. 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-Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER-of-life situations in ICU,GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes, acquired in practice and professional career,LOVEKUSH Beautiful AAA Quality Rose Quartz Bracelet Handmade 8mm Grade AA Cream Pink White Gemstone Stack Unisex; that is, they become facilitating agents and educators in these end-of-life conditions(WYFX Smart Fingerprint Wallet).
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Conclusion
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Skechers Go Walk Joy-15615, 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/Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat, 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-Dr. Martens 1460, 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,Sanuk Pair O Dice Prints.
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