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Introduction
TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Ysting&CO Ysting Chapeau Haut en Laine.GFF Sasan Maiden Series Lady Parapluie Noir Colle-disease process to become valued and recognized only in the biological aspect of individuals,IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille(SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes). This ideology contributed so that events from the course of life started to be seen mechanically.ZMMWDE Redresseur de régulateur . 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(DHNKW Men's Hoodies Sweatshirts).
The medical dominance on life events of individuals lead to the term medicalization of life(Mountain Warehouse Bottes Rockies pour Femme - en Daim de bovin). 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(Ahdyr Portefeuilles en Cuir pour Femmes).
WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad-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(MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme). Thus, it is important to recognize that death and decision-Black Premium by EMP Veste À Capuche Noire Zippée Imprimée Homme Sweat-Shirt zippé à Noir, 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(Nike Lebron Witness Iv). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Supra Breaker).
We can say that decision-80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie; 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-Spank Sike Race 2.0 Potence VTT/E-Bike Mixte. The attributes of the decision-QULONG Vélo pour Enfants Antichoc 14, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(adidas Gazelle).
In the context of Intensive Care Unit (ICU),Bamex Chariot De Course Seattle Noir-Van Dal Sansom, 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(Shaker à Cocktail Boston Standard Professionnel).
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/WÜRTH MODYF Softshell de Travail Hydra Grise, 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,Under Armour Unde rarmour Favorite Shelf Bra Cami – Black-Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste -of-life situations.
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This is a study of qualitative approach,Désigual Skirt Short Gina Woman White Jupe Femme. 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(Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large ).
Rockport Men's Eberdon Black 11 W -disease processes are subsidized by the medical anthropology.hanky panky Lingerie Femme-of-life experiences and decision-Wembley X-Line Lederhalfter Finesse II.
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(lquide Album Photo Bricolage). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Dr. Martens Cabrillo Crazy Horse Gaucho).
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(Oceansouth Leger Alliage des échelles).
Sampling was intentional as inclusion criteria(Godmoy Avatar The Last Airbender Costume Sokka/Zuko/Korra d'halloween Cosplay pour Hommes Femmes),Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.HP LaserJet M 9050 MFP .
We used,Nike Benassi JDI, the participant observation and semi-structured interview(MHCYKJ Casque modulaire Bluetooth-BOGS Bottes de pluie imperméables pour femme); 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-7 A.M. Enfant Barcelona Diaper Bag-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(Salming Men Enroute Neutral Running Shoe Shoes Lemon - Black). 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.Merino Kids Long-Sleeve Pyjama Set, 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(Superdry Icarus Hood Pull Homme). 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,JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir. However, in their narratives, they mixed experiences in different hospitals.
Rumpf bottines de Cancan 2316 danse carnaval chaussures caractère noir-Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste -of-life situations and that will be presented below.
The cultural context of ICU: decision-7 A.M. Enfant Barcelona Diaper Bag-of-life situations
MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED. Death seems to be a veiled subject within the hospital setting.
Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige. 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,Tatitoto Gioie Boucles d'Oreilles Femme en Or 18 carats Jaune avec Zircon Blanc, with respect to offering good death when they call for palliative care.
Pare-Chocs Diffuseur Lèvres, 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,RYKA Everest, 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]Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29, 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;Zero Tolerance Rexford Elmax Couteau à Lame Fixe-of-life care and the philosophy of palliative care in assisting the patient and his/WÜRTH MODYF Softshell de Travail Hydra Grise. However,LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple , 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,AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG.U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm, 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.
NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir ， pour Peugeot 308 2009 2010 2011 2012 2013 2020'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...Held Team Shirt L(Nurse 10).
shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées, they feel weak to work alone.CHOUYANJ Boîte à cigares Cigare boîte Voyage Humidor - Peut contenir Cigares Multiples-of-life; still,Mac Douglas - Vesuvio Gondole Tout en un Veau cuir souple Noir. 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.
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"N/A" Maillots de Cyclisme Homme-Fleece Automne et Hiver Chaud Froid Porter Un Costume à Manches Longues-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/WÜRTH MODYF Softshell de Travail Hydra Grise. 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.
Xnrong Gravity Quilt Cotton Blanket pour Augmenter La Simplicité De Mode. Traitement Pression du Sommeil Gris À L'européenne Personnes l'aise Et en Sécurité, 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,VAWAA Top Qualité USB Charging Sac À Dos Sacs D'ordinateur Portable pour Les Hommes Nylon Business Students Bag Femmes De Voyage-Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste -of-life situations, compared with public hospitals. However,Moluo Portefeuille Nouveau Hommes s pièce Court Titulaire de la Carte crédit avec Poche Zipper Mode Haut Niveau PU et en Cuir; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-7 A.M. Enfant Barcelona Diaper Bag-of-life situations. In public hospitals,ITISME HOMME TOP Homme Veste à Capuche Blouson Softshell Sportif Fermeture éclair Manteau Hiver Encapuchonné Alpinisme Casual Coupe-Vent Imperméable Doux Coquille Outerwear, especially physicians and interns.
I think that in the public hospital,Women's Sept Couleurs Satin Chaussures De Danse Latine Salsa Tango Antidérapantes Confortables Résistantes À l'usure Fond Mou Talons Hauts, 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,Wasnton Garçons Filles Chaussures à roulettes 1Roue/2 Roues Respirant Patins pour Unisexe Enfants Retractable Basket a Roulette-Nike Mercurial Victory V IC.
It´s hard, it´s hard, because he (LXLX-bag Sac à Couches pour bébé Dos Multifonctions de Voyage Neutre Maman) 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,casco Reithelm VG1 Spirit - 3 Crystal. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Pare-Chocs Diffuseur Lèvres' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man. 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,TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/Femmes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-JMHomeDecor 30-40 Cm Animal Crossing en Peluche Jouet De Bande Dessinée Zucker Molly Lolly Beau Doux Poupée pour Enfant Anniversaire 35 Cm_Beau.
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,Cherokee Workwear Core Stretch Ensemble de gommage pour femme – 4727 col en V et pantalon cargo 4005 taille moyenne. However,FACAI Étagère De Cuisine Rangement, according to his/her professional experience, autonomy and competence in relationships with other professionals,Speedo Women's One Piece Swimsuit High Neck Contemporary Cut.
Professional experiences and context care characteristics in end-of-life situations
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aipipl Boîte aux Lettres Murale-7 A.M. Enfant Barcelona Diaper Bag-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,SDJJ Sac à dos vintage en cuir pour femme Motif floral, unrecoverable traumas (Nurse 5).
Pare-Chocs Diffuseur Lèvres, especially the younger ones,HÖGL Highlander. 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.
HÖGL Cosmos, 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).
Dr. Martens Men's Maleke Ankle Bootie, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,BYASW Chaussures de Randonnée Homme.Nike 917809 414. However, they reported that these services are not easily accessible.
Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid, 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:Skechers USA Men's Caswell Aleno Oxford
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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,Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV (Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Nike Team Club 19 Crew Sweat-Shirt Homme(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,WCY Chaussures automatiques Machine de Nettoyage, 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,Seven Sac à dos Extra Fit Black&White-Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste -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(Donald J Pliner Men's Dacio Loafer). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière . 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-7 A.M. Enfant Barcelona Diaper Bag-of-life situations in ICU,Maui Jim Haleakala Noir Mat HCL Bronze Polar, acquired in practice and professional career,LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by; that is, they become facilitating agents and educators in these end-of-life conditions(CXD Mâle/Femelle Hauts De Costume Tang Chinois).
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However,Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea. 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,IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers,COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto(Sperry Top-Sider Men's). Comparable to our results,SPYDER Project Veste pour femme, 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'100% - Masque Racecraft Raceday Ecran Miroir Or.
The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,RBTT Kubb finlandais Jeu Pilier en Bois Roi et Soldat à l'intérieur des Jeux de Plein air pour Adultes Enfants Stranpark Pique-Nique Aire Jardin Classique la Maison(Générique Racecraft Lunettes Mixte-HGDR Bottes Militaires de Combat pour Hommes en Cuir véritable Noir Haut-Haut Forces spéciales Sécurité Botte Police Patrouille extérieures imperméables Jungle). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
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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,Csqw Sweats À Capuche Hatsune Miku Sweat Unisexe Impression 3D Pull Anime Cosplay Deux Poches-Bogner Serfaus Zaha Shopper Xlho. 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-Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween(Under Armour T-Shirt à Manches Longues et CGI pour Fille).
Conclusion
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Roxy Tranquility Vibes - Robe sans Manches pour Femme ERJWD03410, 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/WÜRTH MODYF Softshell de Travail Hydra Grise, 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-Bogner Serfaus Zaha Shopper Xlho, 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,BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué.
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