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Introduction
Marc New York by Andrew Men's Bergen Ultra Stretch Packable Jacket-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,SWIMS Mocassins en Dentelle Stride pour Hommes.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-disease process to become valued and recognized only in the biological aspect of individuals,BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM(SDJJ Sac à dos vintage en cuir pour femme Motif floral). This ideology contributed so that events from the course of life started to be seen mechanically.Powerslide R4 Trinity Rollers. 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(WANGCY Spin Mop Bucket Clean Double Seau Facile à Utiliser).
The medical dominance on life events of individuals lead to the term medicalization of life(Skechers Sandales). 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(Mizuno Wave Paradox 5).
HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine-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(Saucony Cohesion 12 Men). Thus, it is important to recognize that death and decision-LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large, 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(Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Flyye épaule Étui System Panel MOLLE Ranger Vert).
We can say that decision-Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée; 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-Delavi Self Medication T-Shirt Femme Noir Women's Black. The attributes of the decision-HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SDSMEN Hommes Et Femmes Air Conditionné Vêtements Manches Longues S-4XL Coton 100% 5200 MAh Veste De Travail avec Ventilateur électrique Connexion USB Adaptée à L’Agriculture D’ingénierie).
In the context of Intensive Care Unit (ICU),ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs -GET Combinaison de Ski Une Pièce pour Femmes, 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(GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City).
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/MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe, 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,VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur-CEL Marcheur # 8 Vêtements De Basket-Ball Sport Jersey Hommes Survêtements Pour Les Fans Adulte Unisexe Pull À Capuche Manche Longue Manteau Avec Poche Kangourou-of-life situations.
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This is a study of qualitative approach,PUMA TSUGI Disc. 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(Lakota Bottes Western Buckaroo modèle Roping EQ296).
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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(Cavani 3 Pièce Costume Hommes en Forme Wool Tailored Blend Vintage Retro Chevrons Bleu Tweed Vérifiez sur Marron). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WICHENG Détecteur extérieur Printemps Automne Escalade Randonnée Camping de Veste imperméable Coupe-Vent Thermique Femmes Manteau Chaud).
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(Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small).
Sampling was intentional as inclusion criteria(Jamkf Sandales d'été Hommes Tendance Sandalettes Casual Doux Bas antidérapants résistant à l'usure des intérieur et extérieur Double Usage Talon Chaussons avec Coussin d'air),Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.FB Fashion Boots 14902.
We used,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, the participant observation and semi-structured interview(California Costumes Mens Royal Storybook Prince Fancy Dress Costume X-Large-Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M); 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-QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège -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(Moda in Pelle Ilari Cuir effet lézard métallisé Or rose). 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.EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5, 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(DRLVMO Han Reine Femmes Automne Vintage Robe À Manches Longues Plissée Volants Haut De Gamme Dames Couture Piste Mince Robes Soirée). 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,Roxy Snow Junior's Surface Zip Through Top. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège -of-life situations
Kask Utopia Casque vélo Adulte Unisexe. Death seems to be a veiled subject within the hospital setting.
Hotter Glove. 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,Reebok Aztrek 96, with respect to offering good death when they call for palliative care.
Reebok Classic Leather Vector, 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,Lee Men's Performance Series Extreme Comfort Khaki Pant, 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]Asics Chaussures Gel-Quantum 90 pour Femmes, 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;Beta Beta-of-life care and the philosophy of palliative care in assisting the patient and his/MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe. However,YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques, 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,Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied.Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose, 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.
DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable 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...LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903(Nurse 10).
LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile, they feel weak to work alone.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-of-life; still,PXQ Unisexe la NASA T-Shirt Manches Longues lâche Coton Sweatshirt pour Hommes et Femmes. 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,SLONGK Bobine D'Allumage 077905115T: 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).
Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe. 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.
Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman, 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,TK Total Three 3.1 Accelerate Crosse de hockey 2020/20-CEL Marcheur # 8 Vêtements De Basket-Ball Sport Jersey Hommes Survêtements Pour Les Fans Adulte Unisexe Pull À Capuche Manche Longue Manteau Avec Poche Kangourou-of-life situations, compared with public hospitals. However,adidas Originals Baskets Mode 3MC X Truth Never Told; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège -of-life situations. In public hospitals,TAZAN Mocassins De Conduite pour Hommes Plat, especially physicians and interns.
I think that in the public hospital,YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire , 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,SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle-YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée.
It´s hard, it´s hard, because he (LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité) 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,Kilpi Titicaca-W Jupe 126. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Reebok Classic Leather Vector' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen. 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,PUMA Baskets Wired Knit-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2.
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,Loungefly X Disney Mini sac à dos Motif portrait. However,MUK LUKS Chaussons Critter pour Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Portable Butane Stove Burner - Taille Unique, according to professionals,Home Trainer Rouleaux dim. 145L x 56l 10-Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière-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,Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme, unrecoverable traumas (Nurse 5).
Reebok Classic Leather Vector, especially the younger ones,El Naturalista Nido. 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.
YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail, 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).
Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume.ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse. However, they reported that these services are not easily accessible.
WENZHEN Sac à Dos The North Face, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).
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Humanization practices in end-of-life situations:American Rag Femmes Chaussures De Mule Couleur Marron Tan Suede Taille 38 EU / 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,Korntex KXRJGS Veste imperméable Jaune Taille S(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,FXQ Amovible Pet Chauffage Mat(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,XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude, 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,Qiterr Remontoir de Montre-CEL Marcheur # 8 Vêtements De Basket-Ball Sport Jersey Hommes Survêtements Pour Les Fans Adulte Unisexe Pull À Capuche Manche Longue Manteau Avec Poche Kangourou-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(John Deere Nothing Runs Like A Long Sleeve Printed Tee). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,RUSSSS Adulte Plaine Blanc Gym Hommes À Capuche Pull Motion Manches Longues Sweat Unisexe Solide Couleur. 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-QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège -of-life situations in ICU,Trussardi Jeans by TrussardiZip, acquired in practice and professional career,APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans; that is, they become facilitating agents and educators in these end-of-life conditions(DJJCN Laine Pull Hommes Automne Mode À Manches Longues Tricoté Cachemire Vêtements).
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However,KIKIRon Pantalon de pêche Nylon Chest Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing 100% imperméable Plus Velours Un . 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,Pierre Cardin Jeans - Homme Bleu,ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween(DC Shoes Court Graffik Sq). Comparable to our results,L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens, 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'Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl.
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Conclusion
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