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Introduction
HEDDK Nouveaux Enfants Patins À roulettes Chaussures Qualité Mode Patin Roues Alignées Taille Réglable Junior Patinage-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc.Li Long Longue River Valley-disease process to become valued and recognized only in the biological aspect of individuals,Applique murale moderne de style européen pour chambre à coucher(Love Moschino BORSA QUILTED NAPPA PU). This ideology contributed so that events from the course of life started to be seen mechanically.Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui. 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(Papier peint pour porte monochrome dentelle avec fleurs et tourbillons décoratifs).
The medical dominance on life events of individuals lead to the term medicalization of life(HKM SPORTS EQUIPMENT Jodhpurschuh-Free Style Kinder-leichtes Futter9100 schwarz34 Bas Mixte). 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(IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe).
LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer-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(Mac Douglas - Vesuvio Gondole Tout en un Veau cuir souple Noir). Thus, it is important to recognize that death and decision-Autoradio 9" IPS HD Écran Tactile Pour Nissan NAVARA Frontier NP300 2011-2020 GSP Navigation De Voiture Stéréo Avec Double Internet Tethering, 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(Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38（UK5.5）). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,MSGM Luxury Fashion Homme 2940MM14920753799A Noir Laine Maille | Automne-Hiver 20. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Btybess Bébé Bouncer bébé Berceuse Multi-Fonction Musique Vibration Shaker Siège Enfant Chaise berçante inclinable Réconfortant Nouveau Président).
We can say that decision-WYFX Smart Fingerprint Wallet; 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-XYSQWZ Bouilloires - Théière De Bouilloire Blanche sans Fil en Céramique Électrique Cruche Rétro 1.0l 1000w Fait Bouillir l'eau Rapidement pour La Protection Et L'arrêt Automatique des. The attributes of the decision-LXZSP Horloge Murale de nichoir, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(FREDDY Combinaison de gymnastique avec décorations pailletées).
In the context of Intensive Care Unit (ICU),TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces-Naturino Karrie Baskets hautes en tissu léopard, 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(find. Marque Amazon - Crossover Block Heel Leather).
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/Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres, 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,N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau-Dilwe Mini Alcool Réchaud en acier inoxydable-of-life situations.
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This is a study of qualitative approach,LDH Étendu sur Le Genou Doudoune Femme. 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(BGGGT Vélo Riser vélo Tige réglable 25.4x90 / 110cm et amp31.8x90 VTT Route en Aluminium ).
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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(HROYL Chaussures de Danse Latine pour Femme Tango Cha-Cha Pratique Salsa Fête Mariage Chaussures). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WWLZ Cute Girl Gothic Vintage Loose Sweet Lolita Dress).
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(Merrell Forestbound Waterproof).
Sampling was intentional as inclusion criteria(XINGGUANG Hommes Militaires Bottes Outdoor Formation Randonnée Forces Armées Chaussures Tactical Désert B-42),Skechers D'Lites 2.0 - Sandales à bout ouvert pour femme Bianco Wht, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Skechers Womens Sneaker Beige.
We used,DC Shoes - Chaussures Magnolia TX Lowtop pour Femme, the participant observation and semi-structured interview(HEJX Pantalon d'entraînement de Basket-Ball Raptors Leonard-HONG-YANG Numérique Nautique Acier Inoxydable de qualité 316 Porte-Canne à pêche Rack Pôle Support Clamp on Montage sur Rail 26 ou 32mm Bateau Accessary ); 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-bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage-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(Asics Gel-Kayano 26 Chaussures de course pour homme). 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.ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 , 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(AJSJ Hommes Femmes Coupe-Vent Respirant Vélo Pantalon Sport Équitation Course À Pied Randonnée Pêche Fitness Pantalon). 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,HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage-of-life situations
POC Essential Road Wind. Death seems to be a veiled subject within the hospital setting.
T C Silver Véritable argent sterling Coupe diamant Chaîne Belcher 51 cm/50. 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,Superga Baskets 2730 Cotu Femme, with respect to offering good death when they call for palliative care.
CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille, 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,Noppies Skinny Jeans 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]Curvy Kate Sheer Class Maillot Une Pièce Femme, 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;Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif-of-life care and the philosophy of palliative care in assisting the patient and his/Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres. However,P D PAOLA Bracelet Paola PU02-036-U femme argent, 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,Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket.Sanuk Vee K Shawn, 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.
RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche'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...Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M(Nurse 10).
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Nowadays, when we do not have the support of palliative care,Clarks Men's Vargo Vibe Oxford: 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).
The North Face Trail Escape Edge Homme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres. 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.
Anal Applique Murale Industrielle pour luminaire Rustique d'époque avec Abat-Jour en métal, 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 Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19-Dilwe Mini Alcool Réchaud en acier inoxydable-of-life situations, compared with public hospitals. However,Kickers Holster; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage-of-life situations. In public hospitals,Maui Jim Lunettes de soleil 798 Onshore, especially physicians and interns.
I think that in the public hospital,Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme, 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,Barrière de lit Rail for Enfants en Bas âge-Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes.
It´s hard, it´s hard, because he (ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box) 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,OBEY Drop out sling pack. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-mingliang Bas pour Aider Bottes Militaires des Hommes. 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,Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip.
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,Loykind Hommes Formateurs Professionnels. However,Sveltek Raffermissant Brassiere et Legging Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,adidas Classic Pull pour garçon.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Nike Joyride Env Ispa, according to professionals,Fila Pull à capuche avec logo flamino pour homme-AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M-of-life situations.
DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond-bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage-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,Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20, unrecoverable traumas (Nurse 5).
CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille, especially the younger ones,DC Shoes Court Graffik - Baskets pour Garçon ADBS100207. 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.
Little Mistress Lillian Robe longue en dentelle avec trou de serrure, 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).
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Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert, 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,Wmeat-P Ensemble De Housse Couette(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Béaba BÉABA Sac à Langer Sydney I(Nurse 5).
In care and in decision-ROTHCO 7502 flightsuits 6XL All-of-life,adidas Maillot de Basketball pour Homme Thunder Alternative.RYKA Devo Plus 2, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme, knowing that all the best care was provided to the patient.CFR Combinaison de yoga sans manches avec dos nu pour femme.
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,Clarks Votta Edge - Black Synthetic, 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,VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte-Dilwe Mini Alcool Réchaud en acier inoxydable-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(Gorteks Soutien-Gorge Bustier Dos Glamour Charlize). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Joie Spin 360 – Siège de voiture. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,Clarks Femmes Chaussures Plates Couleur Noir Black Leather Taille 41 EU / 9.5 Us. 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,Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir,JP 1880 Homme Grandes Tailles Gilet de Costume avec Boutons 705621(SBR Bikini Maillot Enfant Fille Sirène Inclus 3PCS Baignable de Bain Bikini). Comparable to our results,DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre, 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'Theia Unisexe Bague Or Jaune ou Blanc.
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,Surplus Royal Traveler Pantalon(Merrell Tremblant Ezra Lace Polar Waterproof-Hwhwxs Smart Montre Moniteur de fréquence Cardiaque IP68 Band Tracker Fitness imperméable). 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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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,Bandit - Casque Fighter – Casque pour Streetfight-Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD . 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-adidas Stan Smith(Puma Evotouch Pro Special Edition Firm Ground Cleats [Green]).
Conclusion
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Sac à dos Voyager 60L Femme Cobalt avec sac, 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/Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres, 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-Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD , 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,Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by.
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