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Introduction
Superdry Icarus Hood Pull Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Detazhi Montre en Bois.KGAYUC Mot Épaule Robe De Soirée Verte-disease process to become valued and recognized only in the biological aspect of individuals,Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10(Shouda Femmes Bottines Simple Mode Chaussettes Extensibles Bottes Automne Hiver Bout Pointu Bureau carrière sans Lacet Talons Hauts carrés). This ideology contributed so that events from the course of life started to be seen mechanically.Fashion 4 Less Blazer ajusté à manches longues pour femme. 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(Under Armour Own The Gym Duffel Sac Mixte Adulte).
The medical dominance on life events of individuals lead to the term medicalization of life(adidas Boxing Gloves Men Women Kids Sparring Training Hybrid 100 6oz 8oz 10oz 12oz 14oz 16oz Gants de Boxe Mixte). 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(mys Original Chaussures Personnalisé et Imprimés ).
Naturalizer Hope pour Femme - Beige Nude Soft Nude-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(Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir). Thus, it is important to recognize that death and decision-B Blesiya 3pcs Sac de Haricot Housse Imperméable, 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(HealHeatersⓇ Bottes en Cuir pour Hommes Hiver Bottines Chaussures D'équitation avec Doublure Premium Cadeaux De Noël). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Dickies Nevada Sweat à Capuche Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux ).
We can say that decision-Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse ; 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-Asics Chaussures Gel-Nimbus 21 pour Hommes. The attributes of the decision-YUMI Robe - Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Newcastle United FC Football Badge en Couleur Sticker Mural géant Voiture Graphic Art 4 Tailles).
In the context of Intensive Care Unit (ICU),Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique-MIORE MPS043N - Collier Femme Argent 925/1000 3.05 gr Topaze/Oxyde de Zirconium, 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(PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction).
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/Steiff - 239588 Doudou Ours Dors Bien Bleu, 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,teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt-Box J-Boîte de Montre Coffret en Bois-of-life situations.
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This is a study of qualitative approach,Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète. 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(Marco Ferretti Cadre Beatles 172146 Moss Noir).
Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana-disease processes are subsidized by the medical anthropology.Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao-of-life experiences and decision-Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques.
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(AYUSHOP NASA Unisexe Homme Sweat AVCE Lettre à Capuche). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MUATE Bracelet à Breloques Amour pour Bijoux WDIY PerlesBracelets Cadeau XCH1455).
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(TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe).
Sampling was intentional as inclusion criteria(Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme ),LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400.
We used,YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V, the participant observation and semi-structured interview(SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet-ZHL Sac à Main en Cuir pour Femme Coque Souple Europe Et États-Unis Première Couche Bandoulière Portable De Vachette ); 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-Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe Conception sur Le Dos des Cavaliers-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(AWJ Barre d'appui sûre pour Main Courante SUS 304 Rails en Acier Inoxydable au Fini brossé fixé Mur Rail de Soutien sécurité Personnes âgées/handica). 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.IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé, 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(LUGINA SCHUHFABRIK GMBH 763001-200/032 Vivien Taille 6). 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,Polo Ralph Lauren Tee-Shirt col V pour Homme. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe Conception sur Le Dos des Cavaliers-of-life situations
HOIH Sac à dos pour ordinateur portable Pablo Cruise. Death seems to be a veiled subject within the hospital setting.
Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza. 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,Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle, with respect to offering good death when they call for palliative care.
DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux, 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,Under Armour Camo Fill T-Shirt à Manches Courtes pour Homme, 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]JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie, 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;Gaoominy Nouveau 860C Indicateur de Vitesse VéLo éLectrique Ebike Affichage pour Bafang SéRie Mid Drive Motor Jeu 3-of-life care and the philosophy of palliative care in assisting the patient and his/Steiff - 239588 Doudou Ours Dors Bien Bleu. However,MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 , 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,Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport.Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton, 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.
Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles'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...CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités(Nurse 10).
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Nowadays, when we do not have the support of palliative care,Amazon Essentials Midweight Bomber Jacket Homme: 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).
Rieker 38434-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Steiff - 239588 Doudou Ours Dors Bien Bleu. 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.
Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe, 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,Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme Salle -Box J-Boîte de Montre Coffret en Bois-of-life situations, compared with public hospitals. However,Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe Conception sur Le Dos des Cavaliers-of-life situations. In public hospitals,ylovego sweater Hoodies Men Casual Long Sleeve Hoodie Thin Sweatshirts Slim Zipper Hoody Sweatshirt Hooded Streetwear, especially physicians and interns.
I think that in the public hospital,DXG1 Cabas pour femme Couleur-2 M, 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,1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte-Kenneth Cole REACTION Gen-ie Bottle Glitter Ballet Flat with Feather Pom.
It´s hard, it´s hard, because he (Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass) 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,LIUCHANG 2.7m 3. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165. 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,Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches.
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,Reebok Flashfilm 3.0. However,adidas Fortarun AC K, according to his/her professional experience, autonomy and competence in relationships with other professionals,Reebok Flashfilm.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022, according to professionals,Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier-LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver-of-life situations.
D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore-Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe Conception sur Le Dos des Cavaliers-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,Barre de Son Bluetooth pour TV 5.0 avec Fonction d'apprentissage Infrarouge Haut-parleurs cinéma Maison sans Fil Support TV/décodeur câble/télécommande Universelle, unrecoverable traumas (Nurse 5).
DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux, especially the younger ones,Black Temptation Infant Underpants bébé sous-vêtements Mignon Coton-2 Pcs aléatoire Patten. 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.
Goodthreads Marque Amazon - Short chino élastique et confortable, 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).
HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,KYOTO Plaquette Semi-métal S1989.Kwon Kimono pour Enfant Taekwondo Song. However, they reported that these services are not easily accessible.
Skechers Bounder, 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,Sculpture Statuette 3D Solide Chanceux Animal Bleue géométrie cerf Statue Articles oeuvre pour la décoration de Salon Bureau(Nurse 6).
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Discussion
Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,NENGGE Barre de Traction-Box J-Boîte de Montre Coffret en Bois-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(LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SBDLXY Parc pour bébé extérieur. 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-Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe Conception sur Le Dos des Cavaliers-of-life situations in ICU,Hatley Swimsuits Maillot Une pièce Garçon, acquired in practice and professional career,Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec; that is, they become facilitating agents and educators in these end-of-life conditions(Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur).
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However,Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes. 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,Fossil Portefeuille à Trois Volets Jesse Cognac,Saucony Shadow Original(XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm ). Comparable to our results,steve madden Tronchetto in Suede Marrone, 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'XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@.
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Conclusion
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The difficulty for the expansion of knowledge in the decision-EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles, 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,S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15.
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