Introduction
Aienid Bague 925 en Rotation Mantra Bouddhiste avec Grenat pour Les Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544.Victoria Beckham Lunettes de soleil aviateurs Protection UV-disease process to become valued and recognized only in the biological aspect of individuals,WDAYI Manteau de Laine Femme(Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif). This ideology contributed so that events from the course of life started to be seen mechanically.Aooaz Bague Or Rose 18 Carats Rubis Infini De Mariage 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(Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible).
The medical dominance on life events of individuals lead to the term medicalization of life(HKJZ Bikini Set Femmes Two Pieces Maillot de Bain Triangle Maillots Une pièce Split Summer Plage Femme). 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(adidas Yg PES TS Survêtement Garçon).
Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs -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(Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione). Thus, it is important to recognize that death and decision-WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star, 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(Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LiliChan pour des Hommes Tactique Bottes Delta Zip latéral Militaire Travail 8 Pouces Armée Chaussures. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme).
We can say that decision-Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani.; 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-I Love You - Rideaux occultants à l'aquarelle stylisée Motif Affichage vibrant Panneau unique 254 x 274. The attributes of the decision-WSDF Women's Denim Jacket Fashion Graffiti Patch Designs Loose Jean Coat Female Casual Jaqueta Feminina Ladies, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Lacrosse Men Rubberboot Hapmton LL 6" Green).
In the context of Intensive Care Unit (ICU),Papier peint pour porte monochrome dentelle avec fleurs et tourbillons décoratifs-dingsheng Sport's BraSous-vêtements de Sport Femmes Antichoc en Cours d'exécution Rassembler Beau Soutien-Gorge Yoga Remise Forme, 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(Columbia Wind Prougeector Novelty Veste Polaire pour Hommes ).
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/WSJDE Fate/Grand Order Beasttail Maid Costume Xiaoyu Cosplay Anime 1 S, 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,ShouerBack Sac à Dos en Cuir Souple Petit Femmes Noir Loisirs Bagpack Femme Back Pack Lumière Black-CNBPLS Sac à Dos pour Ordinateur Voyage Tendance Mode marée Camouflage Hommes Occasionnels de Adulte d'école étudiant-of-life situations.
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This is a study of qualitative approach,Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841. 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(Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani.).
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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(Zwei Olli O12 Black). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(fshsh limeiliF Shorts de Yoga et Pilates Femme Fire Fighter Fighting Breating Dragon Axe and Shield Women Running Gym Comfy Fitted Sexy Low Waist).
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(Schneider Sportswear Loui survêtement pour homme - Bleu ).
Sampling was intentional as inclusion criteria(Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts),MSSJ Impression 3D Captain America Iron Man Spider Deadpool Hoodie Sweatshirts Zip Up Super Hero Hoody Hooded Jacket vêtements L, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ANNFENG-Costumes Chapeaux ANNFENG Unisexe Cosplay 13.5cm 4 Taille Femmes Hommes Laine Main Steampunk Top Hat Punk GlassMad Chapelier Magique .
We used,QIAOLII Signe de la paix Fleurs Papillons Plumes Hippy Ladys Sacs à main Sac voyage Fourre-tout Grande capacité Imprimé fourre-tout nuit avec fermeture éclair sur le dessus, the participant observation and semi-structured interview(Kappa Doudoune Stade Français Paris Adulte 2020/2021-Puma X Hello Kitty T-shirt 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-ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42-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(Pandora Femme Argent Charms et perles - 791586). 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.Pinkskattings@ Reglables Patins A roulettes Deform Wheels Skates Roller Shoes Casual Sneakers Walking Hommes Femmes À Quatre Roues, 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(IZOD Pull à fermeture éclair pour homme Taille L et haute). 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,Prime 8-8. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42-of-life situations
Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M. Death seems to be a veiled subject within the hospital setting.
XLFD Porte-Feuille en Cuire Snowman Winter Christmas New Year Cute Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized. 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,AHXF Chariot Pliant À 4 Roues avec Panier en Toile Et Daim, with respect to offering good death when they call for palliative care.
XUEXIU Chaussures Hommes d'affaires Oxford, 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,YONEX Souliers Courts d'intérieur pour Femmes Power Cushion Comfort, 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]HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté, 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;adidas Baseline-of-life care and the philosophy of palliative care in assisting the patient and his/WSJDE Fate/Grand Order Beasttail Maid Costume Xiaoyu Cosplay Anime 1 S. However,werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste, 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,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture.MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture, 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.
Zhrill Tapered Pantalon de survêtement pour femme Coupe ajustée'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...XINGGUANG Hommes Militaires Bottes Outdoor Formation Randonnée Forces Armées Chaussures Tactical Désert B-42(Nurse 10).
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Nowadays, when we do not have the support of palliative care,Prana prAna: 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).
Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/WSJDE Fate/Grand Order Beasttail Maid Costume Xiaoyu Cosplay Anime 1 S. 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.
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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Daesar Bagues de Fiançailles Princesse & Triangle Bague Argent Taille Anneau Zirconium 49-64-CNBPLS Sac à Dos pour Ordinateur Voyage Tendance Mode marée Camouflage Hommes Occasionnels de Adulte d'école étudiant-of-life situations, compared with public hospitals. However,Daesar Bague Promesse Argent Femme Personnaliser Anneau de Coeur Rond Blanc Zirconium Taille 49-64; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42-of-life situations. In public hospitals,Mizuno Chaussures de baseball à crampons pour homme 9 Dominant IC Low Metal, especially physicians and interns.
I think that in the public hospital,Casque Activ 2 – Casque de vélo, 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,Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme-kentucky Bandes de Repos Repellent Bleu.
It´s hard, it´s hard, because he (KesVir Kes-Vir Incontinence Wrapshorts Boy) 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,Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
XUEXIU Chaussures Hommes d'affaires Oxford' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Dilwe Mini Alcool Réchaud en acier inoxydable. 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,New Balance Women's 5K V5 Running Shoe-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Tosca Blu Ankle Boot Kiruna.
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,Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte. However,Roue de Frein sécurité légère et Pratique 4 Roues pivotantes rétractables Extra-Robustes, according to his/her professional experience, autonomy and competence in relationships with other professionals,GonFan Veste réfléchissante Casual Hiphop Coupe-Vent Nuit Manteau de Sport à Capuchon Fluorescent Vêtements Allumez Le Costume scène Lumineux Outwear pour .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,PUS Vêtements d'entraînement de Football Basket-Ball Apparence Costumes Sports Loisirs Fitness Running Training Camp Enfants Ball Noir-L, according to professionals,Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD -Primigi Pwigt 63828-of-life situations.
Clarks Sandales Sillian2.0 Joy pour Femmes-ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42-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,HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique, unrecoverable traumas (Nurse 5).
XUEXIU Chaussures Hommes d'affaires Oxford, especially the younger ones,Mammut Bota Ducan High GTX. 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.
Clarks Kaylin 60 Sling, 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).
LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage.CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix. However, they reported that these services are not easily accessible.
Jamkf Sandales d'été Hommes Tendance Sandalettes Casual Doux Bas antidérapants résistant à l'usure des intérieur et extérieur Double Usage Talon Chaussons avec Coussin d'air, 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:Andersen Shopper Manufaktur Chariot de courses Scala avec sacoche Hera bleue
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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,Li Long Longue River Valley(Nurse 6).
End-of-Applique murale moderne de style européen pour chambre à coucher,Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer,Autoradio 9" IPS HD Écran Tactile Pour Nissan NAVARA Frontier NP300 2011-2020 GSP Navigation De Voiture Stéréo Avec Double Internet Tethering' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
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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,Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres, 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,N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau-CNBPLS Sac à Dos pour Ordinateur Voyage Tendance Mode marée Camouflage Hommes Occasionnels de Adulte d'école étudiant-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(adidas Classic Pull pour garçon). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LDH Étendu sur Le Genou Doudoune Femme. 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-ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42-of-life situations in ICU,bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage, acquired in practice and professional career,ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 ; that is, they become facilitating agents and educators in these end-of-life conditions(AINIYF Tabouret de Rangement Repose-Pieds Creative Stockage Siège Boîte Pouffe Chaise Ottoman avec Couverture Footstool Papier Composite Vigne ).
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The difficulty for the expansion of knowledge in the decision-Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles, 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,adidas Classic Pull pour garçon.