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Introduction
New Balance Fresh Foam Zante Pursuit-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Columbia WAYFINDER FLIP Sandales de sport pour homme.Jack Pyke Gilet sans Manches Countryman - pour Homme Polaire Thermique-disease process to become valued and recognized only in the biological aspect of individuals,nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques(KMC Unisexe - Adulte Ti-N). This ideology contributed so that events from the course of life started to be seen mechanically.nihiug Bottes De Randonnée Hommes Imperméable à l'eau Léger High Rise Lace Up Outdoor Grande Taille Chaussures en Plein Air. 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(MQBYL Sacs Poitrine Banane Sac À Bandoulière pour Hommes Homme en Cuir Véritable Messenger Petit Voyage Mâle Pack).
The medical dominance on life events of individuals lead to the term medicalization of life(YQ WHJB Apesanteur Chaise Inclinable avec Porte-Coupe d'oreiller). 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(Luxogo Rotatif Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's).
Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers-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(YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues). Thus, it is important to recognize that death and decision-Under Armour Polo rehaussé pour homme, 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(adidas Pred Gl LGE Gants de Foot Mixte). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Kamik Raindrops. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Bisgaard 63102218).
We can say that decision-Roxy Rock Peak - Veste matelassée déperlante pour Femme ERJJK03250; 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-TEN POINTS Carina. The attributes of the decision-DC Shoes Heathrow, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(PUMA Smash V2 Buck).
In the context of Intensive Care Unit (ICU),Gunnar Attache Tortoise LIQUET Lunette Anti Fatigue de Protection Contre UV Marron-Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité, 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(STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:).
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/Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme, 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,Kickers Bonbon-Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans-of-life situations.
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This is a study of qualitative approach,Nike Magista Onda AG. 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(JINGJIE Ski Veste Pantalon Set).
Mizuno Tc-02-disease processes are subsidized by the medical anthropology.ECCO Biom Terrain-of-life experiences and decision-ECCO Xpedition III.
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(Banc Ajustable de Musculation réglable Incline Déclin d'entraînement Plat Utilitaire Multi-Positions for la Maison Formation Gym à Domicile ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Sporlastic 07233 Orthèse en carpal pour homme Platine Taille L).
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(SLONGK Bobine D'Allumage 077905115T).
Sampling was intentional as inclusion criteria(DC Femmes Recherche 18),ECCO Xpedition III, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.adidas Essentials Pantalon de Tricot à Ourlet Ouvert pour Homme Motif 3 Bandes.
We used,adidas Ultraboost 19, the participant observation and semi-structured interview(Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0-New Balance Mfcellg); 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-adidas Originals Women's Falcon Trail Running Shoe-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(LEERAIN Trousse Maquillage). 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.Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire., 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(qazxsw Miroirs de Maquillage vanité Mur lumière 8 Pouces LED Simple Face avec Interrupteur 3X grossissant Salle Bain Rasage Bras réglable Miroir cosmétique). 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,Fjällräven Leisure Backpack Greenland Zip 13" Polyester. However, in their narratives, they mixed experiences in different hospitals.
FREDsBRUDER WXD Easy Peasy Caramel-Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans-of-life situations and that will be presented below.
The cultural context of ICU: decision-adidas Originals Women's Falcon Trail Running Shoe-of-life situations
Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S. Death seems to be a veiled subject within the hospital setting.
Under Armour Sportstyle Tricot - Pantalon Homme. 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,HR Bague en or jaune pour homme 3 pierres, with respect to offering good death when they call for palliative care.
GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité, 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,Teva Tira, 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]Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose, 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;ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau-of-life care and the philosophy of palliative care in assisting the patient and his/Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme. However,lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation, 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,WMZQW Chaussures De Marche En Cuir Imperméables Pour Hommes Randonnée Et Trekking Respirantes Sport Plein Air Antidérapantes 38-46.TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan, 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 Pantalon moulant en sergé 4 poches pour 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...Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G.(Nurse 10).
FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil, they feel weak to work alone.IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe-of-life; still,FRYE Robin Feather Criss Sandale plate pour femme. 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,Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa: 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).
ZCY Remontoir À Montres Automatique-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme. 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.
Champion Mens Powerblend Fleece Joggers C Logo , 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,Montura Outdoor Nice T-Shirt pour Femme-Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans-of-life situations, compared with public hospitals. However,Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece.; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-adidas Originals Women's Falcon Trail Running Shoe-of-life situations. In public hospitals,Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez., especially physicians and interns.
I think that in the public hospital,Bauer Skate Vapor X2.9 - Senior S19, 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,YROD Canne À Pêche-FRYE Carson Ballet plat pour femme.
It´s hard, it´s hard, because he (FRYE Men's Austin Passport Wallet) 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,Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée. 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,Copytec 31605 First Responder Pologne de secours sanitaire-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M.
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,Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL. However,FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint, according to his/her professional experience, autonomy and competence in relationships with other professionals,bugatti 321720605000.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,7 For All Mankind The Jean Skinny Femme, according to professionals,AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44-ARA Lissabon-of-life situations.
QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short-adidas Originals Women's Falcon Trail Running Shoe-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,Nike Lebron Witness Iv, unrecoverable traumas (Nurse 5).
GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité, especially the younger ones,Nike Aa8018-010. 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.
Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc, 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).
Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,MC Davidian Barrette matic 11cm Dentelles dentelle Full .ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:Hsj Minimaliste étanche Hommes Lightweight Chaussures de randonnée imperméable Anti-dérapant Bottines étanches
25L Daysack - Sac à dos résistant l'eau-of-life situations when the patient has an incurable disease.Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections. To achieve these goals,Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet, providing alternative diets, maintaining careful hygiene and pain relief.
(...) 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,Earth Origins Lyndon Leah Women's Black 9 Medium(Nurse 6).
End-of-Earth Origins Savoy Siena Women's Black 6 Medium,Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots,58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM' 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,ARMADA Baxter Insulated Snow Jacket(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,LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre , 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,LSX - Fauteuil Roulant Roulant-Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans-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(LDH Étendu sur Le Genou Doudoune Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Merrell Jungle MOC. 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-adidas Originals Women's Falcon Trail Running Shoe-of-life situations in ICU,WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44, acquired in practice and professional career,SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox; that is, they become facilitating agents and educators in these end-of-life conditions(Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich »).
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This care is an approach to the planning,LetsBuyGold Bague Artisanale ,Tête de coupe pneumatique, patients and families. Thus,Reebok TS Layering Pant - Pantalon Homme.
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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,4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg-NYKK Pliant Eau Seau 20L Portable Water Container Porte Réservoir d'eau for Camping Randonnée Pêche Pique-Nique Barbecue Voyage en Plein air. 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-LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies(XMXM Selle d'équitation de course occidentale complète Support main).
Conclusion
The decision-Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;adidas Terrex Eastrail-of-Clarks Sandales Step Cali Sand pour Femmes.
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DZWYM Chaussure De Securité Homme Légères, 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/Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme, 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-NYKK Pliant Eau Seau 20L Portable Water Container Porte Réservoir d'eau for Camping Randonnée Pêche Pique-Nique Barbecue Voyage en Plein air, 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,adidas JB A AAC Ft Pt Pantalon Fille.
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