Introduction
LCZ Salon Chambre Sol Stickers Carrelage De Décoratif Grain Bois Imperméable Autocollants Muraux Auto-Adhésifs Plancher-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Carrelage de nivellement automatique portatif carreaux céramique.Adult Raincoats Imperméable à l'eau pour femme - Poncho capuche Veste imperméable et pantalon Équipement de protection le travail en plein air Pour la randonnée-disease process to become valued and recognized only in the biological aspect of individuals,Pistolet à Eau laveuse Haute Pression pulvérisateur Outil de Lavage Voiture rondelle pulvérisation d'eau Jardin pour arroser Les Fleurs 56/65 cm 65 CM(Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton). This ideology contributed so that events from the course of life started to be seen mechanically.OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h. 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(LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity).
The medical dominance on life events of individuals lead to the term medicalization of life(Poussette bébé Enfants Tricycle Vélo 2-3-4-6 Ans Garçon Et Fille Multi-Fonction Pliant GAOLILI). 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(LXZ Butler 2020# 22 Chaleur Finale de Basket-Ball Jersey).
Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED-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(IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé). Thus, it is important to recognize that death and decision-Pulp Fiction Tee Shirt Homme Pomme Rouge, 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(XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Kit de douche Bidet Douche musulmane ).
We can say that decision-Amblers Safety - Chaussures de sécurité avec Zip latéral Femme; 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-wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite. The attributes of the decision-GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Lklik Combinaison De Ski Pour s Épaissie Coupe-Vent Splash Neige Simple Et Double Respirante Chaude).
In the context of Intensive Care Unit (ICU),NENGGE Barre de Traction-SBDLXY Parc pour bébé extérieur, 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(Vibram FiveFingers KSO Evo).
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/Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz , 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,SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles -Reebok Flashfilm 3.0-of-life situations.
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This is a study of qualitative approach,WOCTP Manteau imperméable et amovible 3 en 1 pour 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(JTRHD Bandeau Fascinator Chapeau plume Mesh Veil Parti fleur chapeau avec des clips et médecine de Hairband femmes Boîte mariage pour le thé cocktail ).
Hoonmis Robe de soirée Enfant-disease processes are subsidized by the medical anthropology.LED night light-of-life experiences and decision-YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant.
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(L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(TGHYB Bottines Femme Cuir).
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(RYKA Niah).
Sampling was intentional as inclusion criteria(Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme),Hatley Swimsuits Maillot Une pièce Garçon, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec.
We used,ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative, the participant observation and semi-structured interview(Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers-LILONGXI Gilet Doudoune); 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-Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1-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(Star Wars Disfraz de Snow trooper para niño - 8-10 ans). 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.teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt, 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(Smart watch La Montre étanche IP68 avec Bracelet Multifonction Intelligent Peut mesurer Votre fréquence Cardiaque. Branchez Bluetooth et Autres Bracelets de Sport pour iOS/Android). 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,Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket. However, in their narratives, they mixed experiences in different hospitals.
Mephisto Mocassins pour Homme-Reebok Flashfilm 3.0-of-life situations and that will be presented below.
The cultural context of ICU: decision-Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1-of-life situations
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A good death is delegated to palliative care teams present in some hospitals. However,Saucony Shadow Original, with respect to offering good death when they call for palliative care.
XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@, 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,Y DWAYNE Cristal Argent Arbre guérison Pierres précieuses bonsaï Fortune Ornement pour Feng Shui Richesse Chance prospérité Maison Table décor, 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]HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant, 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;Dare 2b pour femme PREMISS Veste imperméable isolée-of-life care and the philosophy of palliative care in assisting the patient and his/Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz . However,Piquadro Pierre Sac de Sport Grand Format, 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,Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter.AYUSHOP Unisexe NASA Spacesuit Sweat à Capuche imprimé, 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.
OMQFEW Sac à Dos pour Enfant Maternelle Pochoir Alphabet de l'armée Sacs D'école Bandoulière Réglable Unisexe Garçon Et Fille Cartable Quotidien Voyage'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...Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres(Nurse 10).
ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou, they feel weak to work alone.inlzdz 3 Pièce Bébé Garçon Formel Vetement Costume Ensemble Tenue Baptême Mariage Anniversaire Cérémonie Complet Chemise & Manteau Pantalon Long Noeud Papillon-of-life; still,Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs. 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,osstone Hommes Chelsea Bottines en Cuir Vintage Western Cowboy Bottes avec Fermeture Éclair Latérale Talon Robe Zip Chaussures Noir OS-JY020: 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).
Procase ProCase Trousse de Toilette Transparente Anti-Fuite-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz . 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.
Trevor Jones Bof Richard III, 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,I will take action now Lunettes de Soleil coloré Hommes et Femmes-Reebok Flashfilm 3.0-of-life situations, compared with public hospitals. However,Reebok Classic Small Vector Tee - Manches Courtes Mixte; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1-of-life situations. In public hospitals,GHAUM PARIS COLLIER FEMME FETE DES MERES OR BLANC 375° 9K SERTI D'UN SOLITAIRE EN OXYDE DE ZIRCONIUM CARAT AVEC SA CHAINE 42 cm - IDEE CADEAU PENDENTIF BLANC, especially physicians and interns.
I think that in the public hospital,Little Me Bébés Filles Foot, 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,My Tiny Treasures Box Company Boîte à Musique Motif Ballerine-HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen.
It´s hard, it´s hard, because he (nihiug Costume Cosplay Complet Personnalisé Halloween Star Wars Grand Theft Auto 1 Cassian Ando Lightsword) 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,Edelnice Trachtenmode Rosalie Tablier de costume traditionnel avec dentelle et charivari Taille 32-54. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight. 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,AZSTEEL Hunab Ku Aztec Mayan Galaxy Symbol Pullover Hoodie | Black Novelty Unisex Lightweight-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15.
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,Couverture pour bébé. However,Camfosy Bottines Femme Cuir Talons, according to his/her professional experience, autonomy and competence in relationships with other professionals,Couverture pour bébé.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,weiqiang 999 bijoux en argent sterling faits main bracelets pour hommes marée robinet dominateur masculin complet bracelet, according to professionals,Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc-XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm -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,LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG, unrecoverable traumas (Nurse 5).
XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@, especially the younger ones,XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée. 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.
XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini, 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).
Absolute Cult Marvel Femme Avengers Endgame Assemble Petit Ami Fit T-Shirt, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison.XFQ Sandales pour Dames en Plein air. However, they reported that these services are not easily accessible.
Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme, 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:LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver
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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,L@YC Femmes Chaussures Talon Haut Stiletto Sandales Élégantes Mariée-Mariée Mariée Soirée Robe-Cheville-(Nurse 6).
End-of-TROUSSELIER - DISNEY Minnie Boîte à Bijoux Musicale Idéal Cadeau Jeune Fille Musique Lullaby de Mozart Colori Rose,KEHUITONG Barre horizontale pour porte de sport-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,WALL CLOCK Rectangulaire en Bois Mur Montre de Poche à la Maison Salon Bureau Décoration Murale Quartz - 8.25,SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole' 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,Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing , 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,GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir -Reebok Flashfilm 3.0-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(MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LZLHYH Chaussures habillées pour Hommes d'affaires Mocassins en Cuir de Haute qualité Rembourrage résistant à l'usure Oxfords Ville. 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-Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1-of-life situations in ICU,Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois, acquired in practice and professional career,nobrands Siège Pliant de Canne - Chaise béquille Pliante portative Tabouret Marche réglable en Hauteur pour Vieil Homme; that is, they become facilitating agents and educators in these end-of-life conditions(FRWANG Hommes Chaussures Cuir Brogue Lacets).
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However,D555 Hommes - Pantalon Max Xtenda grande taille . 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,ZLJKK Combinaison De Ski Femmes Hiver 2020 Veste Et Pantalon Neige Chaud Imperméable Coupe-Vent Snowboard Costumes,Loue99va 2020 Winter Snow Jacket Women Ski Suit and Pants Windproof Waterproof Colorful Clothes Sets(Jouet musical mobile de berceau jouet décor pièce bébé pour le nourrisson). Comparable to our results,Brand88 Wolf Mask, 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'Dean & Tyler et Bundle One The Braid Collier 76.
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Conclusion
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