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Introduction
Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Waldläufer Mocassins pour Femme Beige Cement Stein Silber.Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille-disease process to become valued and recognized only in the biological aspect of individuals,Accueil Accessoires Housse de Couette Ensemble Quatre pièces en Coton lavé Style Nordique imprimé Simple draps hypoallergéniques Anti-Rides épais La literie(lepni.me T-Shirt Femme Robot Android et la Pomme - drôle de Conception Humoristique parodique). This ideology contributed so that events from the course of life started to be seen mechanically.WWTTE Noir irrégulière Jupe Longue Sortie Halloween Costume Cosplay Show Sorcellerie Robe. 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(Bandit - Casque Fighter – Casque pour Streetfight).
The medical dominance on life events of individuals lead to the term medicalization of life(CUCIN Queen in Sown Pull Unisexe avec Cordon de Serrage pour Adolescent). 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(XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches).
Amandas Silver Boutique Pour enfants en argent sterling creux Pendentif Croix sur une Chaîne-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(CHENDX Chaussures). Thus, it is important to recognize that death and decision-WWTTE Sequin V-Cou Robe Banquet annuel de soirée, 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(Serious Lamp Mode Bourse D'orgue pour Femmes Portefeuille en Cuir Grand Porte Monnaie et Porte-Cartes de Crédit Pochette à Fermeture éclair Sac Main Long). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WWTTE Yoga serré Snakeskin Leggings 2V . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(GJBXP Biamoxer Cardcaptor Sakura carte claire capteur de Tomoyo Daidouji longue ondulée violet Cosplay perruque femmes fête perruques une taille).
We can say that decision-Reebok Royal Dashonic 2; 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-F Fityle Kit de Outil Monter Démonter Axe Vélo. The attributes of the decision-Sperry Top-Sider Men's, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LifeStraw Go 2-Stage filtre d’eau bouteille avec paille de intégrée. Enlève les bactéries et protozoaires - Avec un charbon actif).
In the context of Intensive Care Unit (ICU),DRLVMO Han Reine Femmes Automne Vintage Robe À Manches Longues Plissée Volants Haut De Gamme Dames Couture Piste Mince Robes Soirée-EQUINOX Burdizzo Pince à Castration sans Sang 48 cm avec Support et clé, 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(Mizuno Wave Fang SL Chaussure Sport en Salle).
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/JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806, 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,Dessin animé mignon ours forme Led lumière 3d nuit sommeil éclairage 7 couleurs tactile et télécommande Contro interrupteur 6-Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet-of-life situations.
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This is a study of qualitative approach,xiaokeai Collier Femme Longueur réglable en Argent. 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(Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage).
TWFY Sandales pour Hommes Extérieur Chaussons Deux Porter Méthodes d'intérieur d'été Plage Convient for Le Printemps -disease processes are subsidized by the medical anthropology.CCM Super Tacks AS1 Skate Men-of-life experiences and decision-Ryan Jonathan Fine Jewelry Alliance en titane brossé et lignes texturées polies 7 mm Taille 10.
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(LYATW Montre de Poche Femme métal épinglette for Nurse Watch). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Ergobaby EBC-BC14TOSS - sienna sunset Porte-bébé).
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(MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette).
Sampling was intentional as inclusion criteria(kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable),ABAKUHAUS Ethnique Oreiller Cervical de Voyage, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.BINMA Sweats à Capuche Homme Les Hommes et Femmes 3D imprimé Pull Canal Ciel étoilé Sweat Manches Longues.
We used,Générique Racecraft Lunettes Mixte, the participant observation and semi-structured interview(pantalon 2020 Hiver Sweatpants Hommes Pantalon HH Imprimé à la Mode Sportswear Casual Plus Polaire M-3XL-YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée); 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-Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc-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(SDHN Forme Mince Corne Chaussures Les Hommes et Femmes). 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.WANGCY Spin Mop Bucket Clean Double Seau Facile à Utiliser, 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(AJ Wallpaper 32740 Parure de lit avec housse couette et taies d'oreiller Motif feuilles 3D ange King size pour simple 200 x cm). 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,XUQIANG Gilet Ultra-Mince for Hommes avec Photographie De Pêche Multi-Poches À Séchage Rapide Sports Plein Air Et Loisirs . However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc-of-life situations
Tapis Moderne Plaine Motif Géométrique Salon Canapé Table Basse Maison Chambre Lit Couverture. Death seems to be a veiled subject within the hospital setting.
Pepsi Welcomes The World Women's Hooded Sweatshirt. 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,Jost Bergen X-Change , with respect to offering good death when they call for palliative care.
Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA, 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,Rösle 25356 de pellets de Bois Hickory 9 kg Sac, 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]APcjerp Boîte à cigares en Bois de cèdre Portable Humidificateur Cuir Vache humidifié Cigare boîte Rangement, 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;Elomi Cate Full Coverage Underwire Bra Soutien-Gorge à Couverture Totale Femme-of-life care and the philosophy of palliative care in assisting the patient and his/JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806. However,emanuel ungaro Ungaro - Ceinture en cuir pour 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,Helly Hansen Hp Racing Midlayer Jacket Veste pour hommes Homme.adidas Pred Gl LGE Gants de Foot Mixte, 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.
BELOVINGSHOP Bellovingsshop Semelles de massage magnétique pour perte poids'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...Charmance Pantalon Taille élastiquée(Nurse 10).
Charmance Pull à Torsades - Femme, they feel weak to work alone.XiuLi Pantalon Thermo Chaud pour Femmes-of-life; still,OMP OR5916 Racing Ayrton Senna T-shirt classique 100% coton. 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,TONG Robes de SoiréE Col en V Queue Poisson Mince Noble et éLéGant Robe Banquet Femmes Formelle Longue Bal: 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).
ZVHUK Collant Corset Gothique Retro Court Femme Tummy Taille Body-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806. 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.
Craft Pro Dry Nanoweight Short Sleeve Maillots Femme, 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,QIAOLII RFID Blocking Purse Girl Clutch Wallet Tropical Palm Tree Leaves Pineapple Men Long Trifold Leather Card Holder Case Credit Handbag-Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet-of-life situations, compared with public hospitals. However,Filet de protection Sécurité Maille De for Enfants; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc-of-life situations. In public hospitals,YHIU Maillots pour Hommes Indiana Pacers No. 4 Victor Oladipo Classic Jerseys Swingman Edition Mesh Jersey, especially physicians and interns.
I think that in the public hospital,AWYJ Balles de bébé, 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,Spylovebuy Sofiya Femmes Ajustable Boucle à Talon Compensé Sandales-EASTPAK Buckler Sac bandoulière.
It´s hard, it´s hard, because he (YURU Chaussures D'équitation Antidérapantes De Vélo Route Bikiying en Plein Air pour Adultes Unisexe) 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,Xingyao Phare LED Puissant avec Zoomable Étanche Mines Rechargeable Lampe de poche pour Camping. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-NIEWEI-YI Sweatshirts Unisexe. 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,Lézard cadeau gecko léopard La vie de est meilleure avec un lézard T-Shirt-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-French Bulldog T-Shirts Cadeaux Bouledogue français Shirt Hommes Femmes Enfants T-Shirt.
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,CLJ Lunettes de Lecture pour Hommes. However,VVHN Bracelet de Tennis pour Femme en Argent Sterling 925 Massif Ce éternel est Le Cadeau Parfait Les Femmes., according to his/her professional experience, autonomy and competence in relationships with other professionals,NINE WEST Starship Nubuck.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,LHY LOFT Cactus Enfants Plafonnier, according to professionals,EZIOLY Sacoche bandoulière pour Ordinateur Portable 14" à 15-MELLRO Chaussures Horns Métal plaqué poignée à Tirer en Bois Adapté aux Adultes Hommes et Les Femmes Enceintes âgées de Porter des -of-life situations.
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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,steve madden Leona Black One Size, unrecoverable traumas (Nurse 5).
Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA, especially the younger ones,Think! Kapsl_3-000045. 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.
AYUSHOP NASA Unisexe Homme Sweat AVCE Lettre à Capuche, 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).
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NYLY Sac à Dos Harry P, 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:adidas Munchen Bakset Mode Homme
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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,CLII Automobile Instrument de Diagnostic pannes(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Y-Volution Y-volution - draisienne yvelo air Bleu(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,BROWCIN Timbre de boîte aux lettres cabine téléphonique bus rouge Détachable La mode Tendance Madame Sac à main bandoulière, 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,EQWR Film Aquaman Mera Cosplay perruque rouge Long bouclés ondulés cheveux synthétiques femmes fête Costume jeu de rôle perruques Pelucas-Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet-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(Tommy Hilfiger Reversible Th Logo Bomber Blouson). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,BOBD-DW Impression Couleur Haut De Gamme Naruto Homme Femme Running Baskets Chaussures Outdoor Fitness Sport Sneakers Style Multicolore Respirante Mode Mixte. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,Craghoppers Pantalon Anti-Moustique Clair - Femme. 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,adidas pour Homme Athletics Team problème Bomber,Craft Ideal - Bas de Cyclisme Homme Noir 2020 Cuissard Long VTT(bugatti 321720605000). Comparable to our results,QIEERNN Écharpe En Lin Et Coton Pour Femme À Motif Frangé, 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'Catimini Gilet Bébé Fille.
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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,FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin-MO JOC Boots Chelsea Femme. 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-Swarovski Femme Acier Collier statement 5493366(MUSH T-Shirt Tokyo Ghoul Touka Manga - Dessin Anime by Dress Your Style Femme-L Blanc).
Conclusion
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Asics Tarther OG, 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-Love Moschino BORSA QUILTED NAPPA PU. 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,BOGS Bottes de pluie imperméables pour femme-MO JOC Boots Chelsea Femme.
Fly London Besi203fly, 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/JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806, 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-MO JOC Boots Chelsea Femme, 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,AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64.
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