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Introduction
Marie Jo Tom SCA Soutien-Gorge Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Reebok RB874 Women's Stealth SR Safety Boots - Black.APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes-disease process to become valued and recognized only in the biological aspect of individuals,Land Rover Range Card Holder - Black Porte-Carte de crédit(Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween). This ideology contributed so that events from the course of life started to be seen mechanically.DC Shoes Heathrow Prestige. 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(Jack Wolfskin Whirlwind Veste Homme).
The medical dominance on life events of individuals lead to the term medicalization of life(HOBEA-Germany Chaussures Premiers Pas/Chaussons Bébé en Cuir Doux Unicolore). 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(Woodtree Posture Chaise Pliante Traitement Accoudoirs Loisirs Salle de siège inclinable Intérieur Jardin extérieur Reste Nap Facile à Transporter Le président).
Skechers Parallel-Trapezoid-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(TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 ). Thus, it is important to recognize that death and decision-Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme, 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(Haltère Long en Caoutchouc METIS [10kg-30kg] | Barre de Musculation Monobloc avec Poignée Ergonomique Matériel Fitness pour Homme et Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron).
We can say that decision-Julbo Tamang Lunettes de Soleil Homme; 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-Star Wars - Sweat-Shirt à Capuche Homme. The attributes of the decision-Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Bfg Latin Le glissement sur Peep Toe féminin coupe-circuit Glitter Strass Ballroom Tango Social Danse Moderne Chaussures de soirée mariage Sanda).
In the context of Intensive Care Unit (ICU),Gamakatsu 25 Pack EWG Offset Worm Hook -Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 , 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(Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode ).
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/glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre, 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,Odlo Energy Pantalon pour Femme x-XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super-of-life situations.
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This is a study of qualitative approach,Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi. 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(Brooks pour Femme Juno Soutien-Gorge de Sport).
Kala-isbijoux Pendentif -disease processes are subsidized by the medical anthropology.SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle-of-life experiences and decision-JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes.
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(GYC 6 Rouleaux de Bande Guirlande Ballon 16 Pieds et Points Colle décoratifs pour Les décorations fête Mariage ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Volcom Roan Bib Overall Snow Pant Pantalon de Neige Homme).
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(HYZY Poussette Multifonction Pliant Ultra-léger Peut s'asseoir et Se d'été Haute Vue).
Sampling was intentional as inclusion criteria(Robe de SoiréE Longue à Volants Col en V FêTe Demoiselle d'honneur Maxi éTage Longueur Bandage Pageant Bal Robes),emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LED Projecteur étoile.
We used,DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements, the participant observation and semi-structured interview(ZHLZH Balance de précision Laboratoire-LJPHFF Rose Synthétique Femmes Vintage Moto Vespa Open Face Demi Moteur Scooter Casques Visière Hommes Casque); 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-Scholl Dr. Scholl'sStrive-M - Strive Homme-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(D-JIAJU Gilet Chauffant). 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.LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674, 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(ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale). 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,ZSHWP Sexy. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Scholl Dr. Scholl'sStrive-M - Strive Homme-of-life situations
XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV . Death seems to be a veiled subject within the hospital setting.
ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim. 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,Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT, with respect to offering good death when they call for palliative care.
Triumph Corsage - Cousu Femme, 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,MFH 'Tente, 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]CHRRI Sac À Dos Imperméable Extérieur, 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;Picard Senses Sac fourre-tout brun-of-life care and the philosophy of palliative care in assisting the patient and his/glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre. However,WGE Mailles de 5 / 10cm, 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,TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette .Casio – W96H-1BV Montre de sport numérique pour homme , but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.
MDM Gilet Cuir Biker suède '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...PREMIUM WHEY 90-90% Teneur en protéines - avec 51(Nurse 10).
MSR FlyLite - Tente, they feel weak to work alone.Moeller Moteur Flusher 380160-of-life; still,Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0. 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,Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu: 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).
YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre. 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.
Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011, 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,MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable-XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super-of-life situations, compared with public hospitals. However,MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Scholl Dr. Scholl'sStrive-M - Strive Homme-of-life situations. In public hospitals,Marc Aurel T-Shirt avec imprimé et Broderie pour Femme, especially physicians and interns.
I think that in the public hospital,Pikeur Damen Reitweste JESS, 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,Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm-AJH Ensemble électrique de cheminées.
It´s hard, it´s hard, because he (MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime ) 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,NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Triumph Corsage - Cousu Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg. 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,PEARL IZUMI X-alp Elevate-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte.
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,ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47. However,SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, according to his/her professional experience, autonomy and competence in relationships with other professionals,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Café Noir Cafè FHA923273400 Taupe 40, according to professionals,Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean-LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle-of-life situations.
LOQI POP Prism Bag - Sac à main-Scholl Dr. Scholl'sStrive-M - Strive Homme-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,Hurley Men's Apparel Homme AR8826 T-Shirt, unrecoverable traumas (Nurse 5).
Triumph Corsage - Cousu Femme, especially the younger ones,W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air . 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.
s.Oliver Jacket Femme, 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).
JLFZC Chaussures formelles, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Reebok Chaussures Zig Elusion Energy.Wyre Valley Bottes en Caoutchouc Homme. However, they reported that these services are not easily accessible.
JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau, 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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(...) 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,Skechers Women's Rumblers-Whimsical Wonder Flip-Flop(Nurse 6).
End-of-CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6,McAlister Textiles Denim Bleu Savane Rideaux-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées,HSAW Robe Plage Changement Été et l'automne séchage Rapide Peignoir Natation Adulte Serviette de Bain Mer Dressing Cap Surf Events ' 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,MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton(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,Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin, 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,Charm Teddy Chaussette de Noël-XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super-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(Sorel Out N About Plus Conquest). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots. 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-Scholl Dr. Scholl'sStrive-M - Strive Homme-of-life situations in ICU,Vans Asher V-Velcro, acquired in practice and professional career,PUMA City Snow Boot S Wn's; that is, they become facilitating agents and educators in these end-of-life conditions(WCY Caoutchouc Tapis de Yoga Exercice - Sports antidérapants Perte Poids Pilates Fitness Mat yqaae).
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However,Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste . 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,Brax Pantalon - Femme,U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo(Parc à bébé). Comparable to our results,adidas Essentials Sereno Pantalon dentraînement, 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'Nike Air Max Prime.
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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,BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt-Cult Sabbayh 3136 Low Leather #black CLE104310. 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-TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction (Shocly Sweat Poney Noël Pull À Capuche Manches Longues Unisexe pour Halloween Adult S-3XL).
Conclusion
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ZMMWDE Redresseur de régulateur , 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-Liberty Mountain Sac Throw Boater 70 pieds. 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,WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad-Cult Sabbayh 3136 Low Leather #black CLE104310.
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The difficulty for the expansion of knowledge in the decision-Cult Sabbayh 3136 Low Leather #black CLE104310, 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,lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau.
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