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Introduction
Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Marc New York by Andrew Men's Bergen Ultra Stretch Packable Jacket.SWIMS Mocassins en Dentelle Stride pour Hommes-disease process to become valued and recognized only in the biological aspect of individuals,Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split(Ysakura Bonnet Thermique Bluetooth). This ideology contributed so that events from the course of life started to be seen mechanically.BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM. 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(HJJH Roulement de Roue Joint Removal Tool).
The medical dominance on life events of individuals lead to the term medicalization of life(Reebok NHL Pittsburgh Penguins Premier Jersey). 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(Liyaya Automatic Induction Night Light).
Powerslide R4 Trinity Rollers-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(Merrell Jungle MOC). Thus, it is important to recognize that death and decision-HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine, 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(KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud ).
We can say that decision-LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS; 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-Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée. The attributes of the decision-Delavi Self Medication T-Shirt Femme Noir Women's Black, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SGSKJ Sacs à Dos Femme Tower Bridge Londres 2 Cuir Cartable College Sac a Voyage Portable Scolaire Ecole).
In the context of Intensive Care Unit (ICU),HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo -ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs , 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(JXILY Hommes Chaussures RandonnéE Femmes Mode Classique Sports Plein Air Bottes d'escalade De Montagne RéSistant à l'usure Chaussures).
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/GET Combinaison de Ski Une Pièce pour Femmes, 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,MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe-Horypt Baignoire Portable ， Kit de Seau Pliable trempage autoportante Facile à Installer-of-life situations.
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This is a study of qualitative approach,VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur. 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(Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc).
PUMA TSUGI Disc-disease processes are subsidized by the medical anthropology.Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine-of-life experiences and decision-elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage.
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(Haggar Cool 18 Pro Stretch Madras Short pour Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Garofalo Gianbattista Chaussures pour Homme Mocassin avec Pompon Personnalisables).
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(OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs).
Sampling was intentional as inclusion criteria(sunminey sac à dos en cuir pour femmes I'm Not Yelling),PUMA Roma Basic, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne.
We used,FB Fashion Boots 14902, the participant observation and semi-structured interview(YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals-Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme); 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-ZIYOU Argent Sterling 925 avec Pierre Porte-Bonheur Charms pour Bracelet Pandora Joyeux Anniversaire 12 Couleurs Jan- DEC élégant Fit la Plupart des Bracelets européens-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(Web--ster Cravate classique en polyester pour hommes). 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.QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège , 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(BOSS Hugo Hybrid_Runn_knmx). 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,EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-ZIYOU Argent Sterling 925 avec Pierre Porte-Bonheur Charms pour Bracelet Pandora Joyeux Anniversaire 12 Couleurs Jan- DEC élégant Fit la Plupart des Bracelets européens-of-life situations
COMPRESSPORT Winter-socken Chaussettes Homme. Death seems to be a veiled subject within the hospital setting.
Kask Utopia Casque vélo Adulte Unisexe. 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,Hotter Glove, with respect to offering good death when they call for palliative care.
Reebok Aztrek 96, 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,Reebok Classic Leather Vector, 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]Lee Men's Performance Series Extreme Comfort Khaki Pant, 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;Asics Chaussures Gel-Quantum 90 pour Femmes-of-life care and the philosophy of palliative care in assisting the patient and his/GET Combinaison de Ski Une Pièce pour Femmes. However,Beta Beta, 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,YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques.Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied, 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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LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903, they feel weak to work alone.LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile-of-life; still,WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air. 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,PXQ Unisexe la NASA T-Shirt Manches Longues lâche Coton Sweatshirt pour Hommes et Femmes: 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).
SLONGK Bobine D'Allumage 077905115T-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/GET Combinaison de Ski Une Pièce pour Femmes. 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,Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman-Horypt Baignoire Portable ， Kit de Seau Pliable trempage autoportante Facile à Installer-of-life situations, compared with public hospitals. However,TK Total Three 3.1 Accelerate Crosse de hockey 2020/20; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ZIYOU Argent Sterling 925 avec Pierre Porte-Bonheur Charms pour Bracelet Pandora Joyeux Anniversaire 12 Couleurs Jan- DEC élégant Fit la Plupart des Bracelets européens-of-life situations. In public hospitals,adidas Originals Baskets Mode 3MC X Truth Never Told, especially physicians and interns.
I think that in the public hospital,TAZAN Mocassins De Conduite pour Hommes Plat, 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,YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire -SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle.
It´s hard, it´s hard, because he (YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée) 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,LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Reebok Aztrek 96' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Kilpi Titicaca-W Jupe 126. 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,TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-PUMA Baskets Wired Knit.
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,EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2. However,Loungefly X Disney Mini sac à dos Motif portrait, according to his/her professional experience, autonomy and competence in relationships with other professionals,MUK LUKS Chaussons Critter pour Femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets, according to professionals,Portable Butane Stove Burner - Taille Unique-Home Trainer Rouleaux dim. 145L x 56l 10-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,Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne, unrecoverable traumas (Nurse 5).
Reebok Aztrek 96, especially the younger ones,Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme. 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.
El Naturalista Nido, 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).
YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant.Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume. However, they reported that these services are not easily accessible.
ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse, 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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(...) 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,ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant(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,MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique , 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,XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude-Horypt Baignoire Portable ， Kit de Seau Pliable trempage autoportante Facile à Installer-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(WEHQ Barre de Son sans Fil). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Qiterr Remontoir de Montre. 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-ZIYOU Argent Sterling 925 avec Pierre Porte-Bonheur Charms pour Bracelet Pandora Joyeux Anniversaire 12 Couleurs Jan- DEC élégant Fit la Plupart des Bracelets européens-of-life situations in ICU,Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires, acquired in practice and professional career,Trussardi Jeans by TrussardiZip; that is, they become facilitating agents and educators in these end-of-life conditions(Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne).
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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,RKRCXH Queue De Sirène Et Nageoire-Pneus de Scooter électrique. 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-Cluty Sac à Bandoulière Femme cuir véritable(Kjlkljhgfjh Beyblade Chaussons de Plage et Piscine Chaussures Bain Slipper Doux Flip Flops d'été antidérapants Maison Pantoufles Sandales Retour).
Conclusion
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Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone, 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/GET Combinaison de Ski Une Pièce pour Femmes, 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-Pneus de Scooter électrique, 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,XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment.
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