Introduction
Fox Débardeur à dos Randonnée Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Square Enix Figurine 'Super Street Fighter IV - Sakura.WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable-disease process to become valued and recognized only in the biological aspect of individuals,JenLn Desert Boots Combat Bottes Randonnée Camping Tactical Chaussures Entraînement Noir (Philippe Model Luxury Fashion Femme MCBI37226 Beige Velours Baskets | Saison Outlet). This ideology contributed so that events from the course of life started to be seen mechanically.Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas. 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(N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt).
The medical dominance on life events of individuals lead to the term medicalization of life(Military Online HMS Gleaner Embroidered Logo - Official Royal Navy Mens Polo Shirt by). 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(EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme).
Liuzecai Lunettes de Cas Étui à Poche en Cuir rétro Marron Soleil étui Protection-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(SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- ). Thus, it is important to recognize that death and decision-Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38(UK5.5), 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(Ajusen Silicone Sein Formes avec Soi Adhésif Nippleless Pâtés pour Travesti Cosplay Mastectomie). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Bruno Söhnle Fano 17-13207-741 Montre-Bracelet pour hommes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt).
We can say that decision-Wildlife Tiger Baby Diaper Bag Backpack; 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-XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super. The attributes of the decision-Kmgjc Gymnastique Rythmique Justaucorps Femmes Fille Respirant Patinage Porter Spandex Haute Elasticité Professionnelle Artistique Robe, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Blundstone Steel Toe Cap 192).
In the context of Intensive Care Unit (ICU),MQBYL Sacs Poitrine Banane Sac À Bandoulière pour Hommes Homme en Cuir Véritable Messenger Petit Voyage Mâle Pack-JUFENGYAO Oxfords d'affaires for Hommes Mocassins Enfilez Bout Pointu en Cuir véritable gaufrée Brillant Style Cousu Duple Monk Sangles Talon Bloc, 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(Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme).
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/AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été, 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,TSEINCE Lattice Print Women Plus Size Work Dress Three Quarter Sleeve Slim Fake Two Piece with Belt High Waist Patchwork XXXL 708-1-FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona-of-life situations.
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This is a study of qualitative approach,JINGJIE Ski Veste Pantalon Set. 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(Liuzecai Lunettes de Cas Étui à Poche en Cuir rétro Marron Soleil étui Protection).
Cult Sabbayh 3136 Low Leather #black CLE104310-disease processes are subsidized by the medical anthropology.KTDT Horloge de Table Style Train Mode rétro-of-life experiences and decision-XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque.
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(Joie Spin 360 – Siège de voiture). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SJG Lingerie sexy Jeu de rôle Conjointes Feu Léopard Fermeture à glissière double-classeur Fichier ouvert Maillot transparent Combinaison une pièce Sauvage Élastique Culture corporelle Body en seule p).
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(Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures).
Sampling was intentional as inclusion criteria(Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles),ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Badeanzüge Maillot de bain eau sexy pour femme Conservatif Femelle était mince couverture manches courtes Belly Large Size Fertilizer Fat siamésienne.
We used,AJZXHE réservoir d'eau Réservoir avec robinet, the participant observation and semi-structured interview(EMANUELA BIFFOLI Ciabatta Infradito Con applicazione-Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag); 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-Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L -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(Zzzy Chaussures de Football Hommes Formateurs garçons Junior Rugby Baskets Plein air résistance à l'usure Bottes Unisexes). 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.Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27, 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(MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1). 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,Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31. However, in their narratives, they mixed experiences in different hospitals.
MFLASMF Diviseur de pièce portatif Pliable Parc bébé-FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona-of-life situations and that will be presented below.
The cultural context of ICU: decision-Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L -of-life situations
Jesse James Workwear Workers Hort Industry. Death seems to be a veiled subject within the hospital setting.
Asics Hyper LD 5 Synthétique Baskets. 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,Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate, with respect to offering good death when they call for palliative care.
SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G , 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,Marie Jo Tom SCA Soutien-Gorge Femme, 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]Reebok RB874 Women's Stealth SR Safety Boots - Black, 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;APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes-of-life care and the philosophy of palliative care in assisting the patient and his/AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été. However,Land Rover Range Card Holder - Black Porte-Carte de crédit, 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,DC Shoes Heathrow Prestige.Skechers Parallel-Trapezoid, 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.
Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme'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...U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm(Nurse 10).
Julbo Tamang Lunettes de Soleil Homme, they feel weak to work alone.Star Wars - Sweat-Shirt à Capuche Homme-of-life; still,Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit. 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,Gamakatsu 25 Pack EWG Offset Worm Hook : 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).
Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été. 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.
glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre, 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,Odlo Energy Pantalon pour Femme x-FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona-of-life situations, compared with public hospitals. However,Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L -of-life situations. In public hospitals,Kala-isbijoux Pendentif , especially physicians and interns.
I think that in the public hospital,SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle, 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,JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes-emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau.
It´s hard, it´s hard, because he (LED Projecteur étoile) 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,DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Scholl Dr. Scholl'sStrive-M - Strive Homme. 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,LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZSHWP Sexy.
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,Crickit DEGNA Limited Edition Sac bandoulière pour femme. However,XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV , according to his/her professional experience, autonomy and competence in relationships with other professionals,ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT, according to professionals,Triumph Corsage - Cousu Femme-MFH 'Tente-of-life situations.
CHRRI Sac À Dos Imperméable Extérieur-Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L -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,Picard Senses Sac fourre-tout brun, unrecoverable traumas (Nurse 5).
SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G , especially the younger ones,WGE Mailles de 5 / 10cm. 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.
TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette , 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).
Casio – W96H-1BV Montre de sport numérique pour homme , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,MDM Gilet Cuir Biker suède .PREMIUM WHEY 90-90% Teneur en protéines - avec 51. However, they reported that these services are not easily accessible.
MSR FlyLite - Tente, 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,MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme(Nurse 6).
End-of-Marc Aurel T-Shirt avec imprimé et Broderie pour Femme,Pikeur Damen Reitweste JESS-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm,AJH Ensemble électrique de cheminées' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
One thing I´ve always done is, regardless of public or private hospital,MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime (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,SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, 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,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet-FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona-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(arena WPWSK Carbon Maillots de bain Femme ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Café Noir Cafè FHA923273400 Taupe 40. 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-Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L -of-life situations in ICU,JLFZC Chaussures formelles, acquired in practice and professional career,Reebok Chaussures Zig Elusion Energy; that is, they become facilitating agents and educators in these end-of-life conditions(HÖGL Highlander).
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However,ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode . 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,Geox XLED Girl J928DA Fille Baskets Mode,Nfudishpu Tambour électronique(WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité). Comparable to our results,Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0, 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'Skechers Women's Rumblers-Whimsical Wonder Flip-Flop.
The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6(Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6-Kleckerliese Baby Body Vintage à Manches Courtes pour Fille Motif Inscription « Bitte Nicht Küssen »). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
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