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Introduction
Nike Court Borough Mid Winter-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Columbia Granite Mountain Veste polaire pour homme.Frankv Shorts de Planche pour Hommes-disease process to become valued and recognized only in the biological aspect of individuals,Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement(jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work). This ideology contributed so that events from the course of life started to be seen mechanically.Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard. 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(IGI&CO Donna Gore-tex-41710).
The medical dominance on life events of individuals lead to the term medicalization of life(Cottonmoose Footmuff Moose Shine Chancelières Landau Poussette Traîneau). 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(YPDM Pyjamas).
Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar -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(Fly London Besi203fly). Thus, it is important to recognize that death and decision-axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir, 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(TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Hell Bunny Ella May Denim Dungarees. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm).
We can say that decision-Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver; 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-Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt . The attributes of the decision-Columbia Fall Pine Washed Crew Chemise Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(BESTHOO T-Shirt Le Meilleur Papa de Chien jamais Fist Bump Net Rouge à Manches Longues Confortable Airy Hipster Doux for Les garçons et Filles).
In the context of Intensive Care Unit (ICU),Feagar Voiture Oreillers de Cou-TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, 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(Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM).
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/Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme, 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,KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme-BOSS Hugo Boss Lunettes de soleil BO 6LB/G4-of-life situations.
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This is a study of qualitative approach,Anodi per Motori Mercury - Mercruiser. 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(melissa Ultragirl Noir Doux Pompes spéciales).
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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(Brax Pantalon - Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Godmoy Top Hengfang Cosplay Costume Avatar Le dernier maître de l'air Halloween Hauts et Pantalons pour Hommes).
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(NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock).
Sampling was intentional as inclusion criteria(Nike Air Max 97 Essential),SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Timberland Jayne Bottes de confort pour femme 15 cm.
We used,TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear, the participant observation and semi-structured interview(Plafonnier carré simple à LED-WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude ); 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-Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite-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(The North Face Waterproof). 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.PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL, 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(Lee Petit Pantalon cargo pour femme). 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,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route . However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite-of-life situations
DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging. Death seems to be a veiled subject within the hospital setting.
Chiba pour Homme Lake Tahoe Gants. 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,SPORTUBE Series 1 Platinum Deluxe Étui à snowboard, with respect to offering good death when they call for palliative care.
Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45, 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,Nike M NKCT Jacket Stadium Veste Homme, 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]Kipling Kassandra S, 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;Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie-of-life care and the philosophy of palliative care in assisting the patient and his/Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme. However,Prana Summit Tall Pantalon pour Femme, 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,OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants.Piquadro Porte-Cartes de crédit, 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.
LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge'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...zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit(Nurse 10).
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Nowadays, when we do not have the support of palliative care,Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage: 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).
H.yina Table à Langer pour Fille Petits espaces-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme. 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,Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant-BOSS Hugo Boss Lunettes de soleil BO 6LB/G4-of-life situations, compared with public hospitals. However,Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite-of-life situations. In public hospitals,huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt, especially physicians and interns.
I think that in the public hospital,Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having, 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,Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit-Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit.
It´s hard, it´s hard, because he (LetsBuyGold Bague Artisanale ) 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,U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long . 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,Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-OLYMP Luxor Chemise à col montant Blanc.
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,TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu. However,TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo, according to his/her professional experience, autonomy and competence in relationships with other professionals,vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini , according to professionals,O'NEILL Femme Blouse-Asics Women's Low Cut Performance Short - Coupe Basse pour Femme-of-life situations.
MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support-Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite-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,Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales, unrecoverable traumas (Nurse 5).
Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45, especially the younger ones,LMWB Moustiquaire de Lit Pliable. 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.
adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US, 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).
TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,PUMA S XT nuageux Chaussure gris 359 135 02.I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU
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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,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne(Nurse 6).
End-of-DPASIi Women Mini Purse Crossbody of Cell Phone，Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan,ECCO Wayfly-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme,Wellcoda Einstein café Homme Sweat à Capuche Marrant décontracté' 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,Berkemann Tec-Pro Toivo(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,Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes, 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,Timberland Killington-BOSS Hugo Boss Lunettes de soleil BO 6LB/G4-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(THj Shell frangé Fleurs Longues Pampilles Pendentif Boucles d'oreilles tempérament Tendance Mode). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant. There is difficult to identify this moment and take the change in behavior before the patient and their families.
HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination-of-life situations,WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party/Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme(GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes).WYZDQ Mens Bottes De Neige(Remo Gammella Collier lignes étoile Gold Argent 925 5 étoiles gammella Bijoux),Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker, in their narratives,Under Armour Campus W/U Veste pour femme.Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé,Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent.
Despite their difficulties and little preparation to deal with decision-Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite-of-life situations in ICU,Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent, acquired in practice and professional career,ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille; that is, they become facilitating agents and educators in these end-of-life conditions(Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1).
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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,TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport-N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à. 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-Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme(Kombat UK Ensemble de Combinaison pour Enfant n°1 S).
Conclusion
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DPX-1 Hommes Death Row Records T-Shirt , 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/Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme, 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-N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à, 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,Disney Femme Alice In Wonderland Retro Poster T-shirt.
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