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Introduction
Merrell Vapor Glove 4-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Columbia Youth Firecamp Mid 2 WP.Sorel Out N About Plus Conquest-disease process to become valued and recognized only in the biological aspect of individuals,Love Moschino Borsa Quilted Nappa Pu(Hassia Bologna). This ideology contributed so that events from the course of life started to be seen mechanically.Asics Chaussures Gelsaga Gel-Saga Sou. 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(XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux).
The medical dominance on life events of individuals lead to the term medicalization of life(Urban Classics Hooded Camo Puffer Jacket Homme). 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(Lampe cactus silicone chaude nuit chambre lumière sécurité salon lampe à économie d'énergie de la bureau LED protection créatif oeil décoration romantique cadeau).
ALTRA Superior 4.0 Black-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(Kappa Chaussettes de sport pour Homme ). Thus, it is important to recognize that death and decision-Sperry Top-Sider Femmes Bottes, 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(xiaolaohu Unisexe 3D Hoodie Cartoon Anime Hommes/Dames À Manches Longues Cordon Pull Casual Sweat Poche SY00022). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Merrell Yokota 2. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Picard Senses Sac fourre-tout brun).
We can say that decision-Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir; 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-adidas Superstar. The attributes of the decision-Northland Kosh Veste Garçon Gitane FR: 6A , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Napapijri Polo Homme).
In the context of Intensive Care Unit (ICU),adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt -Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure, 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(Chauffe-biberon USB).
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/Stonefly Season III 28 Nappa, 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,Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure-Jack Wolfskin Cloudburst Veste pour Hommes-of-life situations.
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This is a study of qualitative approach,Nike Court Vision Mid. 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(57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard).
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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(Pediconfort sans-gêne Largeur Confort aérosemelle - Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(FDCJK Professionnel Salon Cheveux Vapeur Sèche avec Roulant Base pour Teinture).
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(Lora di Collier Indi Celebrate. court).
Sampling was intentional as inclusion criteria(Cylficl Parcs bébé Aire de Jeux for Portable à 6 Panneaux avec Ballon),Chie Mihara Queran, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.XZDXR Boîte À Chaussures Rose.
We used,Nike Air Max 97 Essential, the participant observation and semi-structured interview(Champion 112418 F19 KK001 NBK Jogger Femme Noir-Alpine Advance Keela Pantalon Imperméable Homme); 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-TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes -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(Hanes Men's Sport Cool DRI Performance Tee). 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.Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings, 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(Mountain Equipment Randonee Gant 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,Tommy Hilfiger Leon 21. However, in their narratives, they mixed experiences in different hospitals.
Le Parc de bébé-Jack Wolfskin Cloudburst Veste pour Hommes-of-life situations and that will be presented below.
The cultural context of ICU: decision-TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes -of-life situations
Sanuk Yoga Joy Sparkle. Death seems to be a veiled subject within the hospital setting.
SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021. 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,Maxim Creation Dubai Fustan Abaya Jellebiya Hand Embroidered Daraat Lebssa Jabodar Maxi Dress 6420, with respect to offering good death when they call for palliative care.
Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal, 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,JEWEL BEADS Beads Gemstone Natural Blue Sapphire Bracelet Faceted Rondelle/September Birthstone Gift/Women's, 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]Esprit Sweater Femme, 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;ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG-of-life care and the philosophy of palliative care in assisting the patient and his/Stonefly Season III 28 Nappa. However,lquide Album Photo Bricolage, 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,Dickies Performance Chino Pantalon plat pour homme.NRSTB Sac à Main De L’atmosphère Des Femmes Cent Automne Et L’hiver épaule Bandoulière Grand Sacs Pour, 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.
Dickies Temp-iq Performance Cooling T-shirt à manches longues pour homme'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...JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40(Nurse 10).
Fila Baskets Femme, they feel weak to work alone.Skechers Summits-Forton 52813/BBK Chaussures basses pour homme-of-life; still,Sanita Saskia Sport Flex Sandale. 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,CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon: 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).
SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Stonefly Season III 28 Nappa. 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.
Paolo Vandini Chaussures à Lacets Tendance Noir ou Brun Clair, 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,Onitsuka Tiger Unisex Mexico 66 Slip-on Shoes D3K0N-Jack Wolfskin Cloudburst Veste pour Hommes-of-life situations, compared with public hospitals. However,Kuingbhn Chapeau Fascinant Femmes Fascinators Cheveux Accessoire De Épingle À Plume Cocktail Mariage Thé Fête Et pour Les Accessoires de Balle; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes -of-life situations. In public hospitals,Crime London KOMRAD White, especially physicians and interns.
I think that in the public hospital,Onitsuka Tiger Baskets Corsair Unisexe-Adulte, 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,Pandora Femme Vermeil Charms et perles - 788692C01-MASCOT WORKWEAR Mascot Polo De Travail Crossover.
It´s hard, it´s hard, because he (Gabor Salma Womens Slip on Ballet Pumps 37.5 Sand Python) 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,DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4. 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,Huangwanru Boîte de Montre pour Homme Bracelet Plateau Couvercle en Verre Noir 12 Affichage Rangement Bijoux Case Hommes ou Femmes -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-SKTWOE Bottes De Cheville Femmes.
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).
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Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques, according to professionals,JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur-MARC JOSEPH NEW YORK Genuine Leather Smoking Loafer with Embroidery Detail-of-life situations.
Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy-TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes -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,Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10, unrecoverable traumas (Nurse 5).
Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal, especially the younger ones,Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 . 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.
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, 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).
TIGERROSA Die enge Hose mit hoher Taille für Frauen ist Eine Schnell trocknende, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes avec améthyste véritable.Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable. However, they reported that these services are not easily accessible.
XLTCK Lunettes de soleil en titane pur polarisées B, 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:Vince Camuto Femme Robe
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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,Ital-Design Bottes Classiques pour Femme(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Splendid Lorne Ii Mule pour femme(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,LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans, 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,PICKME Hommes Femmes USB Chauffage Gilet-Jack Wolfskin Cloudburst Veste pour Hommes-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(Vince Femmes Sandales À Talon). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,JKLJKL Chauffage Électrique À Froid Gilet Pare Chaud du Cou. 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-TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes -of-life situations in ICU,CAMELBAK Eddy Bouteilles, acquired in practice and professional career,YPDM Peignoir; that is, they become facilitating agents and educators in these end-of-life conditions(NYDJ Jean pour femme).
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However,AXDNH Chaussures de Danse Femme. 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,ADSE Horloge Murale à Pendule,Dead Threads - Four Pockets Men's Slim-Fit Punk Pants(LybMjG Maillot Cyclisme Pro). Comparable to our results,WZSHOES Sexy Madame Parfait Mariée Haut Talon À La Mode Escarpins Antidérapant Adaptées Club Soiree De Mariage Fête Défilé Élégant Des Femmes, 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'HAFLINGER Everest Cascade.
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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,GSFDHDJS Cosplay Bottes Chaussures for Love Live Hoshizora Rin Valentine's Day-Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage. 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-Modus Vivendi Chemise Jeans Manches Courtes Marine 12941(JJZZ Fille Garçon Étudiant Adolescent avec Mon Voisin Totoro Impression Anime Cartable École Sac À Dos De Voyage pour Ordinateur Portable en Tissu Oxford 7).
Conclusion
The decision-Jack Wolfskin Cloudburst Veste pour Hommes-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YOLL Bébé Baignoire, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Gpzj Lesung Torchiere Stehlampe Acryl Lampenschirm Solide Basis Wohnzimmer Schlafzimmer Nachttischlampe Decora Kreative-of-XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier.
LED Dessins animés Lumière décorative avec télécommande bleu violon design Plafonnier Dimmable lampe de plafond Chambre d'enfant Kindergarten restaurant The Living Room Éclairage Chambre, 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-PENGSHAO Plateau à Fromage en Bambou. 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,FZC-YM Verre à Whisky en Cristal sans Plomb avec Bouchon-Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage.
SHOPAMZ Chaussure de Securité Homme Femmes, 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/Stonefly Season III 28 Nappa, 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-Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage, 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,YUIOLIL Children's Microscope 1200x with LED Lights.
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