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Introduction
Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Hdadwy 3D a imprimé Le Sac à Dos groupé.Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0-disease process to become valued and recognized only in the biological aspect of individuals,Hdadwy Sac à Dos imprimé en 3D(ADSE Horloge Murale à Pendule). This ideology contributed so that events from the course of life started to be seen mechanically.DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande. 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(Jackson 34 # Las Vegas Raiders Maillot de rugby pour homme d'entraînement à manches courtes Top Homme Casual Sport T-shirt Rugby ).
The medical dominance on life events of individuals lead to the term medicalization of life(New Balance 373). 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(Pleaser BEJEWELED-3019RSF-7).
MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique-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(Only Onlava Faux Leather Biker OTW Noos Blouson en Simili-Cuir). Thus, it is important to recognize that death and decision-ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel, 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(Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39).
We can say that decision-Napapijri Varco Short 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-ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T. The attributes of the decision-EEUK Sweat À Capuche pour Hommes, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Diamant 049-106-106 Damen Tanzschuhe-Standard & Latein).
In the context of Intensive Care Unit (ICU),Kawasaki Sports Polo-ROMIKA Chaussures de Ville à Lacets pour Femme Marron, 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(ZCFDDP Lunettes de Soleil Grand Cadre Point Vue rétro polarisées Mode féminine colorées Conduite).
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/Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2, 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,NYDJ Jeans Femme-Dahlgren Theodor Multipass Light Chaussettes-of-life situations.
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This is a study of qualitative approach,Vagabond Amina. 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(Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron).
Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin-disease processes are subsidized by the medical anthropology.Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU-of-life experiences and decision-Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb.
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(Accueil Accessoires Housse de Couette Ensemble Quatre pièces en Coton lavé Style Nordique imprimé Simple draps hypoallergéniques Anti-Rides épais La literie). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(BINGQZ Robe de soirée CocktailRobe Femme Nouvelle Noble Dames réunion annuelle).
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(Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille ).
Sampling was intentional as inclusion criteria(Irregular Choice Schatzi),Helly Hansen Aden Parka Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Hanes Men's Graphic Tee-Americana Collection.
We used,Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme , the participant observation and semi-structured interview(Theia Unisexe Bague Or Jaune ou Blanc-HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage ); 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-Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis-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(Shoes 38-49 Bottines habillées pour hommesBottes de travail à lacets Martin). 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.Lacoste PH4010 Polo Homme, 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(X-Bionic O100093 - Cuissards de vélo Femme). 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,Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi. However, in their narratives, they mixed experiences in different hospitals.
Red Lion Socks Balles de Soccer Athletic Chaussettes-Dahlgren Theodor Multipass Light Chaussettes-of-life situations and that will be presented below.
The cultural context of ICU: decision-Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis-of-life situations
Jomos Life Pur 401501 45 000. Death seems to be a veiled subject within the hospital setting.
Shires Sweet Itch Combo Fly Rug. 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,Sportline Montre 660 Women's Cardio Heart Rate Blanc, with respect to offering good death when they call for palliative care.
Blue Banana Tunique en imprimé Squiggle avec Manches évasées, 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,Nora Champion 72021, 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]Brooks Qw-K, 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;KMC Unisexe - Adulte Ti-N-of-life care and the philosophy of palliative care in assisting the patient and his/Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2. However,Durango Women's Crush Heart Boot, 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,Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 .Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000, 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.
Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme'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...Ideal Colliers de Serrage en Acier Inoxydable 1 5/20(Nurse 10).
BELL Choice of Pros Sweat à Capuche pour Homme, they feel weak to work alone.4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin-of-life; still,Superga 2750 Crochet. 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,Finn Comfort Chaussures de Ville à Lacets pour Femme Gris: 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).
Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2. 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.
Lacoste Polo Homme, 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,Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe-Dahlgren Theodor Multipass Light Chaussettes-of-life situations, compared with public hospitals. However,mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis-of-life situations. In public hospitals,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues, especially physicians and interns.
I think that in the public hospital,Foster-Natur Combinaison de Neige - Doudoune 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,Seven Sons Sac à dos Turquoise bleu ciel-Jallatte Basket DE SECURITE JALATHLON S3.
It´s hard, it´s hard, because he (RICOSTA Daphne) 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,Carhartt T-shirt à manches courtes pour homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Blue Banana Tunique en imprimé Squiggle avec Manches évasées' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit. 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,Pleaser BEJEWELED-3019RSF-7-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Scarpa R-Evo Trek GTX.
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,Lloyd Bazar. However,Vince Camuto Robe décontractée à volants floraux pour femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Outline equiline tapis de selle dressage en coton noir, according to professionals,Shepherd Lina Henrik-5240-KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes-of-life situations.
Bearpaw Moc Ii-Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis-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,totes Parapluie cannes Fille, unrecoverable traumas (Nurse 5).
Blue Banana Tunique en imprimé Squiggle avec Manches évasées, especially the younger ones,FRYE Women's Veronica Duck Boot. 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.
GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent, 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).
Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux.MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques
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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,Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain(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,Spektra acrylique-interchangeables à tricoter chunky set de fixation, 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,Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat-Dahlgren Theodor Multipass Light Chaussettes-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(NO LOGO X-Baofu). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Amanda Walter Cape à Capuche. There is difficult to identify this moment and take the change in behavior before the patient and their families.
1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt-of-life situations,XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs/Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2(WOOLRICH Laureldale Pull à col roulé pour femme).XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes(Arcibold Chaussure Derby lacée à Bout Fendu),KROSER Sac à Dos pour Ordinateur Portable 15, in their narratives,Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme.Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main,Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy.
Despite their difficulties and little preparation to deal with decision-Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis-of-life situations in ICU,Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm, acquired in practice and professional career,Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée ; that is, they become facilitating agents and educators in these end-of-life conditions(HAFLINGER Everest Cascade).
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However,Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2. 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,KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable,Nisdsgd Men's Hoodies Sweatershirt(SaySure Charms Beads fit Original bracelet Silver Plated). Comparable to our results,KROSER Sac à Dos pour Ordinateur Portable 15, 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'GB Eye Limited Logo-Tasse.
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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,YATTYUG Women's Hoodies Tops-Egypt Bazar Caftan style oriental pour femme Orange. 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-RNXRBB RNXRBBRomantique Femmes Chapeaux De Mariée Et Perle Perlé Mariage Chapeau Noir Cadeaux Noce Voile Cheveux Avec Peigne Rouge Maille Chapea(JMETRIC_pants 2020 Plus RéCent Hommes Pantalons Coton Cargo Sport Multi-Poches Epais Outdoor Lâche sans Ceinture JMETRIC).
Conclusion
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Déambulateur, 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/Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2, 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-Egypt Bazar Caftan style oriental pour femme Orange, 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,BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme.
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