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Introduction
TOHHOT Casque OF570 ¨¤ Double Objectif pour d'¨¦quitation Femmes et Hommes de Moto-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Carter's Baby Ensemble de body et pantalon pour bébé garçon.WMZQW Homme Chaussures de Confort Automne Hiver Classique British Bottes Marche Chaud Mi-mollet Fashion Boots 39-44-disease process to become valued and recognized only in the biological aspect of individuals,ZyuQ Bottes pour hommes d'automne Martin Masculines Britanniques De Haute Couture D'Outillage Rétro À Fond Épais dans Les Chaussures(Haltère Long en Caoutchouc METIS [10kg-30kg] | Barre de Musculation Monobloc avec Poignée Ergonomique Matériel Fitness pour Homme et Femme). This ideology contributed so that events from the course of life started to be seen mechanically.lepni.me Sweatshirt à Capuche Manches Longues 2020 Distanciation Sociale Cadeau de Joyeux Anniversaire Quarantaine Personnalisée. 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(vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron).
The medical dominance on life events of individuals lead to the term medicalization of life(Saucony Triumph Iso 4). 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(Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode ).
Ciesse Generation 80' Giubbotto Wham Uomo Mod. 205C8MJ01237-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(Clarks Kitna Vibe). Thus, it is important to recognize that death and decision-Intéressant Cuisiner rôle de cuisine Jouets enfants Play Set jeux for les Cuisine Garçons Filles Pretend Jouet Jeux la maternelle et tout-petits fille, 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(Brooks pour Femme Juno Soutien-Gorge de Sport). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SUGARHILL JS0049 Clara Paradise Parrot Playsuit NAVYMULTI. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(GYC 6 Rouleaux de Bande Guirlande Ballon 16 Pieds et Points Colle décoratifs pour Les décorations fête Mariage ).
We can say that decision-adidas Response It Hommes Synthétique Chaussure de Course; 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-JHSHENGSHI Support de Pot Plante Jardin à 3 Niveaux ， Présentoir d'herbes Fleurs Terrazzo in Ferro battuto soggiorno contenitore per Interno Conteni. The attributes of the decision-Applique murale rustique moderne pour chambre à coucher, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(YUXINCAI Faux Ventre Silicone Bionique Peau Type Adhésif Creux Concave Fond Photo Accessoires Femmes Enceintes).
In the context of Intensive Care Unit (ICU),YuYzHanG Housse De Pluie pour Voiture Bébé Pare-Brise Générale Enfant Parapluie Poussette -Ericcay Chapeau De Thé Floral Forme Haut Mini Unique élégant Derby du Kentucky Violet Et Crème Fleur Alice Au Pays des Merveilles Fou Mariage en, 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(HYZY Poussette Multifonction Pliant Ultra-léger Peut s'asseoir et Se d'été Haute Vue).
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/YAOLAN Raindrop Lampe de Table en Cristal, 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,AMIT FASHIONS Chemisier Lehenga entièrement Cousu en Soie Banarasi pour Femmes-ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL-of-life situations.
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This is a study of qualitative approach,Qazwsxedc Pour vous HYF 3 en 1 épaule PU Sac Casual Ladies Messenger Bag . 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(ZHLZH Balance de précision Laboratoire).
N / A Herren-Basketball-Jersey - Jersey Pelikane # 11 Jrue Holiday Breathärmel Sports Fitness T-Shirts Fans de Basket-Trikot-disease processes are subsidized by the medical anthropology.HGFR Convient aux Hommes et Femmes Washington Wizards John Wall2 Fan Jersey Maillot sans Manches en Maille-of-life experiences and decision-JINFAN Vêtements De Tai Chi Pratique Féminine Uniforme Kung-fu Costume Méditation Zen en Coton Et Lin.
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(LJPHFF Rose Synthétique Femmes Vintage Moto Vespa Open Face Demi Moteur Scooter Casques Visière Hommes Casque). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Hanes Sweat-shirt en coton molletonné 283 g).
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(ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale).
Sampling was intentional as inclusion criteria(DOUDOUMAOZI Bonnet Beanie Chapeau Casquette Double Face Utilisation Femmes Tricoté Automne Hiver Chaud Casquettes Hommes Chapeaux Chunky Bonnets Femme Homme),Navires Bébé Jouet Tapis Enfants Rampant Nursery De Jeu Couverture, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Ourui Montres Bracelet.
We used,FEZD Jersey Pistons 0# Drummond Jersey, the participant observation and semi-structured interview(AJH Ensemble électrique de cheminées-Stonefly Rock 1 Velour); 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-GFPR Arithmétique Abacus Comptage-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(GYPING Chaussures Hommes Cyclisme Route Pédale Lock Montagne de vélo Respirant Damping Loisirs en Plein air). 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.Urban Backwoods Carpenter I Femme Zip Hoodie Sweat à Capuche, 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(DC Shoes Boys' Court Graffik Skate Shoe). 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,IUBBKI et sacs à main pour femmes peinture la Butterly poignée personnalisée en cuir PU Rivet Portable impression de mode étanche W. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-GFPR Arithmétique Abacus Comptage-of-life situations
CHOUCHOU Cendrier pour cigares - Triangle Lampe cendrier en Acier Inoxydable Maison Pratique d'anniversaire. Death seems to be a veiled subject within the hospital setting.
Daesar Rideau Lot de 2. 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,LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins, with respect to offering good death when they call for palliative care.
LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs , 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,Saucony Shadow Original, 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]LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur, 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;FR&RF 5 Zones chauffées Gilet Hommes Femmes Chauffants 3 Vitesses réglable Chasse Pêche d'hiver Chauffant USB Outdoor-of-life care and the philosophy of palliative care in assisting the patient and his/YAOLAN Raindrop Lampe de Table en Cristal. However,qazxsw Lumières Miroir de courtoisie, 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,Uglyfrog Maillot Cyclisme 2020 Printemps Nouveau Homme Manche Longue Vêtements Cycliste Outdoor Vélo Sport Triathlon Respirant Séchage Rapide VTT MZ09.SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany, 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.
Tom Ford Lunettes de Soleil Mixte'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...Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge(Nurse 10).
Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue, they feel weak to work alone.Dickies Chaussures de sécurité Trenton - Homme-of-life; still,Martillo SDS-PLUS 18V BRUSHLESS sin cargador/batería. 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,Maui Jim Lunettes de soleil 788 Dragonfly: 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).
DD Danish Design Montre Femme Analog Black - IV11Q1251 Akilia Quartz-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/YAOLAN Raindrop Lampe de Table en Cristal. 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 Adizero Rc, 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,Hein Strijker Bretelles en daim avec cuir marron-ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL-of-life situations, compared with public hospitals. However,QMKJ Haut Sac de Haricots Dos Toute déformation Chaise Changement Gratuit Sacs Contient Un Tabouret Pied intérieur et extérieur pour Les Adultes Enfant 90CM * 110CM; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-GFPR Arithmétique Abacus Comptage-of-life situations. In public hospitals,LYWIR Artificielle Poitrine Forme Sexy Faux Seins Gilet De en Silicone Coton Et Soie pour Transgenres Mastectomie, especially physicians and interns.
I think that in the public hospital,Kappa Woman 6CENTO 665A Denim, 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,Columbia Femme Veste de Ski Isolée-RYKA Sandales Margo pour femmes.
It´s hard, it´s hard, because he (HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 ) 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,Carlos by Santana Bottines pour femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ. 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,WTFYSYN Building Stacking Learning Blocks-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit.
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,JEWEL BEADS Gemstone Beads Opal - Boulder Beads. However,PUMA Nucleus Lux, according to his/her professional experience, autonomy and competence in relationships with other professionals,DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,adidas Lucas Premiere 10 Femmes / 9 Hommes, according to professionals,ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros-RB Leipzig Essential Pullpants-of-life situations.
Smiley 54705 Pyjama d'hiver chaud en coton-GFPR Arithmétique Abacus Comptage-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,sunminey sac à dos en cuir pour femmes I'm Not Yelling, unrecoverable traumas (Nurse 5).
LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs , especially the younger ones,Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche. 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.
weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm, 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).
HXF Charmant Filles Princesse Blanche Robe, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche.adidas B P TT Sweat-Shirt Garçon. However, they reported that these services are not easily accessible.
Victoria Tenis Velcros Piel/Leopardo, 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:Guess Scarpe Donna Sneaker Mod. Path in Tessuto leopardata/Glitter D20GU39
LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets -of-life situations when the patient has an incurable disease.Pliable Barrière De Le Lit. To achieve these goals,Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL, providing alternative diets, maintaining careful hygiene and pain relief.
(...) 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,QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème (Nurse 6).
End-of-Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection,ZYFXZ Mesdames Bottes de travail Groundwork-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue,Autocollant mural en forme de triangles colorés pour enfants Motif amovibles' 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,GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime(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,Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine, 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,GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable -ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL-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(Parc à bébé). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LDH Mi-Longueur Doudoune Femme Hiver. 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-GFPR Arithmétique Abacus Comptage-of-life situations in ICU,Aubade Haut de Maillot Bain Noir Taille100D, acquired in practice and professional career,Bisgaard 63102218; that is, they become facilitating agents and educators in these end-of-life conditions(ZCY Remontoir À Montres Automatique).
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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,adidas Originals KXT21 Pro Modèle Blanc Taille 14-Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479. 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-MATEIN Sac à dos roulettes pour ordinateur portable(QIANWEIXI Chapka Homme Hiver Bomber Chapeaux Vintage Russe Ushanka Casquettes Hommes Femmes Trappeur Chapeau PU Vent Preuve Earflap Trooper).
Conclusion
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The difficulty for the expansion of knowledge in the decision-Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479, 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,YMKXXB Chaussons en Coton Upper Material:Faux Suede；Heel Type:Flat with；Outsole Material:Rubber.
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