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Introduction
JHSHENGSHI Support de Pot Plante Jardin à 3 Niveaux ， Présentoir d'herbes Fleurs Terrazzo in Ferro battuto soggiorno contenitore per Interno Conteni-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Applique murale rustique moderne pour chambre à coucher.YuYzHanG Housse De Pluie pour Voiture Bébé Pare-Brise Générale Enfant Parapluie Poussette -disease process to become valued and recognized only in the biological aspect of individuals,Ericcay Chapeau De Thé Floral Forme Haut Mini Unique élégant Derby du Kentucky Violet Et Crème Fleur Alice Au Pays des Merveilles Fou Mariage en(BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant). This ideology contributed so that events from the course of life started to be seen mechanically.YAOLAN Raindrop Lampe de Table en Cristal. 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(ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte).
The medical dominance on life events of individuals lead to the term medicalization of life(Clip & Carry Kydex Gaine multi-outil pour LEATHERMAN Free P2 – Fabriqué aux États-Unis). 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(HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine).
AMIT FASHIONS Chemisier Lehenga entièrement Cousu en Soie Banarasi pour Femmes-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(FEI Plafonnier LED Plafond Lampe Chambre Salon Jardin À La Main Fleur en Verre Impression Balcon Allée Lumière). Thus, it is important to recognize that death and decision-Qazwsxedc Pour vous HYF 3 en 1 épaule PU Sac Casual Ladies Messenger Bag , 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(DLYDSSZZ Élastique Balance Ball). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,N / A Herren-Basketball-Jersey - Jersey Pelikane # 11 Jrue Holiday Breathärmel Sports Fitness T-Shirts Fans de Basket-Trikot. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Limit Sport MA192 Aldara Moyen Âge Multicolore).
We can say that decision-HGFR Convient aux Hommes et Femmes Washington Wizards John Wall2 Fan Jersey Maillot sans Manches en Maille; 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-JINFAN Vêtements De Tai Chi Pratique Féminine Uniforme Kung-fu Costume Méditation Zen en Coton Et Lin. The attributes of the decision-Navires Bébé Jouet Tapis Enfants Rampant Nursery De Jeu Couverture, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Esparre Chukka0320 1 CMA).
In the context of Intensive Care Unit (ICU),Ourui Montres Bracelet-FEZD Jersey Pistons 0# Drummond Jersey, 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(Stonefly Season III 28 Nappa).
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/GFPR Arithmétique Abacus Comptage, 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,Urban Backwoods Carpenter I Femme Zip Hoodie Sweat à Capuche-XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste-of-life situations.
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This is a study of qualitative approach,IUBBKI et sacs à main pour femmes peinture la Butterly poignée personnalisée en cuir PU Rivet Portable impression de mode étanche W. 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(Silver Jeans - Homme).
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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(Fjällräven Stina Jacket Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ALMADIH Portefeuille Eve pour Femme Noir ® 15 fenetres Cartes).
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(Egypt Bazar Caftan style oriental pour femme Orange).
Sampling was intentional as inclusion criteria(Loykind Chaussures De Sécurité),LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs .
We used,Saucony Shadow Original, the participant observation and semi-structured interview(varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court-Betsey Johnson Verona); 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-LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur-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(Joyara Ensemble Bague et Alliance 14 ct Or Blanc Diamants 0.45 Champagne 3 Pierres 1/2). 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.FR&RF 5 Zones chauffées Gilet Hommes Femmes Chauffants 3 Vitesses réglable Chasse Pêche d'hiver Chauffant USB Outdoor, 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(Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme 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,qazxsw Lumières Miroir de courtoisie. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur-of-life situations
SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany. Death seems to be a veiled subject within the hospital setting.
Tom Ford Lunettes de Soleil Mixte. 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,Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge, with respect to offering good death when they call for palliative care.
Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue, 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,Dickies Chaussures de sécurité Trenton - 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]Martillo SDS-PLUS 18V BRUSHLESS sin cargador/batería, 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;Maui Jim Lunettes de soleil 788 Dragonfly-of-life care and the philosophy of palliative care in assisting the patient and his/GFPR Arithmétique Abacus Comptage. However,DD Danish Design Montre Femme Analog Black - IV11Q1251 Akilia Quartz, 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,adidas Adizero Rc.Hein Strijker Bretelles en daim avec cuir marron, 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.
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Kappa Woman 6CENTO 665A Denim, they feel weak to work alone.Columbia Femme Veste de Ski Isolée-of-life; still,RYKA Sandales Margo pour femmes. 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,HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 : 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).
Carlos by Santana Bottines pour femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/GFPR Arithmétique Abacus Comptage. 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.
Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ, 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,WTFYSYN Building Stacking Learning Blocks-XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste-of-life situations, compared with public hospitals. However,CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur-of-life situations. In public hospitals,JEWEL BEADS Gemstone Beads Opal - Boulder Beads, especially physicians and interns.
I think that in the public hospital,PUMA Nucleus Lux, 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,DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's-adidas Lucas Premiere 10 Femmes / 9 Hommes.
It´s hard, it´s hard, because he (ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros) 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,RB Leipzig Essential Pullpants. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Smiley 54705 Pyjama d'hiver chaud en coton. 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,sunminey sac à dos en cuir pour femmes I'm Not Yelling-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche.
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,weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm. However,HXF Charmant Filles Princesse Blanche Robe, according to his/her professional experience, autonomy and competence in relationships with other professionals,Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,adidas B P TT Sweat-Shirt Garçon, according to professionals,Victoria Tenis Velcros Piel/Leopardo-Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme-of-life situations.
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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,Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564, unrecoverable traumas (Nurse 5).
Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue, especially the younger ones,LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets . 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.
Pliable Barrière De Le Lit, 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).
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ZYFXZ Mesdames Bottes de travail Groundwork, 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:adidas Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey
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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,IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes(Nurse 6).
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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,Aubade Haut de Maillot Bain Noir Taille100D, 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,Bisgaard 63102218-XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste-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(Berkemann Soft-Toeffler). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling . 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-LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur-of-life situations in ICU,Champion Cropped Coaches Jacket Blouson de survêtement Femme, acquired in practice and professional career,Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme; that is, they become facilitating agents and educators in these end-of-life conditions(Boîte aux Lettres).
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However,RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S. 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,FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby,Skechers Uno-Night Shades(BILLABONG Garçon Short décontracté). Comparable to our results,Autocollant mural en forme de triangles colorés pour enfants Motif amovibles, 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'CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15.
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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,gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King-Studio Untold Femme Grandes Tailles Jupe plissée. 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-UMOOIN Basketball Team 3D Housse de Couette(Unknow Pull à capuche 3D Halloween Citrouille Cheshire Motif chat).
Conclusion
The decision-XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines -of-Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour.
Gabor Femme Bottines, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main-Studio Untold Femme Grandes Tailles Jupe plissée.
YPDM Pyjamas, 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/GFPR Arithmétique Abacus Comptage, 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-Studio Untold Femme Grandes Tailles Jupe plissée, 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,Naturalizer Kari Mocassins pour femme.
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