Introduction
Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,PUMA Veste de Pluie Tabaluga pour Fille.HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures-disease process to become valued and recognized only in the biological aspect of individuals,MEETGG Porte-Bébé Multifonctionnel Trois en Un(Carhartt Henley T-Shirt de Poche pour Homme ). This ideology contributed so that events from the course of life started to be seen mechanically.YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire . 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(Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes).
The medical dominance on life events of individuals lead to the term medicalization of life(Richter Infos S). 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(lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit).
Gringo Fairtrade Felt Owl Shoulder Bag-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(FACAIA Couronnes de Noël). Thus, it is important to recognize that death and decision-Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière, 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(Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Npeiyi Seau pour urine féminine. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture).
We can say that decision-Kamay's Kamay’s Boîte de rangement; 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-Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible. The attributes of the decision-HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(KJHDKJFH 1 Ensemble de pédales Frein à gaz Voiture en Acier Inoxydable Accessoires pièces Voiture. pour Audi A1 A2 A3 / S3).
In the context of Intensive Care Unit (ICU),DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day-XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes , 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(YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber).
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/huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm, 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,Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince -ALTRA Paradigm 4.5 Chaussure de course sur route pour femme-of-life situations.
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This is a study of qualitative approach,GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble. 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(yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch).
Kayak 1/2/3/4 Personne Faisant du Kayak-disease processes are subsidized by the medical anthropology.NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes-of-life experiences and decision-LY88 Ouvre-Bouteille électrique.
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(Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HealHeatersⓇ Deform Wheels Skates Roller Shoes Mode Patins À roulettes Casual Sneakers Walking Automatiques Rétractables Hommes Femmes Quatre Roues).
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(RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ).
Sampling was intentional as inclusion criteria(YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm),Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée.
We used,XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes, the participant observation and semi-structured interview(ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG-YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet); 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-TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe-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(Mascot 14031-203-0618-82C64 Pantalon d'artisan Bremen Taille L82cm/C64 blanc/anthracite). 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.Sac à langer dos - Snoopy Heart Multifonction Imperméable de voyage, 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(PUMA S XT nuageux Chaussure gris 359 135 02). 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,Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe-of-life situations
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TIEON Uniformes de Baseball des Red Sox. 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,SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- , with respect to offering good death when they call for palliative care.
MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air, 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,Tubus Tube Support pour Lowrider , 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]SKSNB Smart Watch1.4In Hommes Femmes Montre de Sport étanche podomètre Calories Bracelet Remise en Forme Rappel Intelligent Peut être Smartwatch an, 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;Abus Hyban Casque vélo Homme-of-life care and the philosophy of palliative care in assisting the patient and his/huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm. However,YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm, 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,generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme.LIANGJIE Écharpe en laine pour femmes, 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.
Jockey 850011H Supersoft Lounge Combinaison de Sommeil à Manches Courtes 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...SDWRF Casquette de Baseball en Queue Cheval Paillettes Femmes Papa Chapeau Maille Casquettes Camionneur d'été Femme réglable Hip Hop Chapeaux 2020(Nurse 10).
WYZDQ Bottes Hiver Neige Hommes Chaud Entièrement en Fourrure Doublé Bottillons Non-Slip À Lacets Outdoor Chaussures De Marche Casual Randonnée Trekking, they feel weak to work alone.GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches-of-life; still,Bertha Watches montres Madeline Nacre montre 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,adidas Baskets Originals POD-S3.1 pour homme: 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).
Rieker Handtasche-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm. 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.
Under Armour Charged Assert 8, 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,Lee Button Down Chemise Casual Homme-ALTRA Paradigm 4.5 Chaussure de course sur route pour femme-of-life situations, compared with public hospitals. However,TBBDPT Hip Hop Iced Out Bling Bijoux Bracelet Or Couleur Micro Pave CZ Bracelets en Pierre 10mm Largeur pour Hommes Femmes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe-of-life situations. In public hospitals,PUMA Unisex-Kids Suede Heart Rubberized Sneaker, especially physicians and interns.
I think that in the public hospital,UNIVERS GRAPHIQUE 250 Sacs Papier taille moyenne kraft écru avec poignée 16 litres largeur 32 cm, 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,Nine West Women's Gramercy Bermuda Short-Puma MAPM Laurel Cap Schwarz.
It´s hard, it´s hard, because he (Converse Chuck Taylor All Star Hiker Hi) 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,KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Cavi telecomando Sea Star CCX633. 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,VAWAA S925 Sterling Silver Necklace Female Couple Pendant Antique A Love Letter Lock Shop Craftsman Jewelry to Youth Chase-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Shepherd Hugo 1201.
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,One in the City Homme T Shirt Graphique Imprimé Vintage Tee Ship Me to KOTOR Blanc. However,JUZEN Professionnel Arc-en-Poil Volume De Peigne Anti-Statique Magique Cheveux Curl Droite Massage Brosse Miroir Styling Outils, according to his/her professional experience, autonomy and competence in relationships with other professionals,Hurley M Siege Anorak Jacket Blousons Homme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,SIBOYU Women's Shoulder Bag Ladies Messenger Lightweight Sports Waterproof Travel , according to professionals,Pinko LOVE STARRY LANIERE Femme Nero UNI-QLEESI 925 Argent Sterling Pendentif Collier pour Les Femmes 5A Cubic Zirconia Colliers Saint Valentin Anniversaire Cadeau d'anniversaire Petite Amie Femme Bijoux-of-life situations.
ZHENGBANGST Gants en cuir pour femme automne et hiver avec rivets demi-doigts marron chaud-TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe-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,LYHY Blouson Cuir Homme, unrecoverable traumas (Nurse 5).
MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air, especially the younger ones,jollipets Baby enfants Bavoir – Ferdinand – 100% BIO organique – Variante : Animaux Zoo – Taille Unique. 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.
jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique, 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).
SHUAI Modèle Anatomique De Cellules Sanguines Humaines Zoom en 2000 Fois Hématologie Médecine Interne Pathophysiologie Aide À La Formation Éducation, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants.SOLE South Chaussures Noir. However, they reported that these services are not easily accessible.
Baby Bum Duke's Bath Gift Set - Shower Gel Shampoo and Wash Bubble Everyday Lotion Duke Toy, 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:Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite
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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,ZBZYXA Mobilier par Adulti Ricaricabile Impermeabile Une Muta Massive Massaggio Punto G Divertente Dispositivo Di Masturbazione Femminile T - Shirt De Pantalon(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,PME Legend 550 Curtis Runway Chaussures de course Gris(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,generisch T-shirt Basic Softstyle unisexe I'd Rather Be Surfing Surf Windsurf Kitesurf, 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,LXZSP Brûleur d'encens de contrôle la température synchronisation-ALTRA Paradigm 4.5 Chaussure de course sur route pour femme-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(HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon. 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-TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe-of-life situations in ICU,Chicco Abito Maniche Lunghe Robe Fille, acquired in practice and professional career,Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur; that is, they become facilitating agents and educators in these end-of-life conditions(SugarPocket Leggings de yoga pour femme).
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However,GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse. 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,RKRCXH Maillot de Bain sirène Queue De Sirène,SYue Chariot Pliable à Double Roue/Chariot provisions sur Roues léger avec Barre de Soutien et Poche glissière pour Les achats Voyages en extérieur intérieur(Moshow Sweat à Capuche Homme Shark Whale 2 Sweatshirt). Comparable to our results,Noch Wildgrass Beige by, 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'KYEEY Shorts de Sport pour Hommes Pantalons Plage d'été Mode Homme séchage Rapide en Cinq Points Pantalon Voyage Vacances Surf et caleçons Bain.
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