Introduction
Adult Raincoats Imperméable à l'eau pour femme - Poncho capuche Veste imperméable et pantalon Équipement de protection le travail en plein air Pour la randonnée-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Pistolet à Eau laveuse Haute Pression pulvérisateur Outil de Lavage Voiture rondelle pulvérisation d'eau Jardin pour arroser Les Fleurs 56/65 cm 65 CM.OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h-disease process to become valued and recognized only in the biological aspect of individuals,Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED(Jack Wolfskin Cloudburst Veste pour Hommes). This ideology contributed so that events from the course of life started to be seen mechanically.Pulp Fiction Tee Shirt Homme Pomme Rouge. 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(LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans).
The medical dominance on life events of individuals lead to the term medicalization of life(Amanda Walter Cape Adulte pour Halloweenn pêche Jaune Unisexe Longue Robe Halloween Costume Uniforme). 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(Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid).
GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo-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(MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 ). Thus, it is important to recognize that death and decision-Amblers Safety - Chaussures de sécurité avec Zip latéral Femme, 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(DPX-1 Hommes Death Row Records T-Shirt ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover).
We can say that decision-GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur; 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-NENGGE Barre de Traction. The attributes of the decision-SBDLXY Parc pour bébé extérieur, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(WeeLion Oreiller de Voyage à Double Appui-tête - Un Gonflable Multifonctionnel dort au Bureau des Bus Train Avion).
In the context of Intensive Care Unit (ICU),Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz -SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles , 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(Retour Jeans Garçon Long-Pantalons).
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/WOCTP Manteau imperméable et amovible 3 en 1 pour femme, who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,Hoonmis Robe de soirée Enfant-Reebok Flashfilm-of-life situations.
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This is a study of qualitative approach,LED night light. 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(Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit).
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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(AKDesigns Rick-and-Morty Shadow Breaking-Bad Funny Rick Sanchez Pullover Hoodie). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Désigual T- Shirt Audrie Femme).
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(HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet).
Sampling was intentional as inclusion criteria(TONG Robes de SoiréE Col en V Queue Poisson Mince Noble et éLéGant Robe Banquet Femmes Formelle Longue Bal),ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1.
We used,teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt, the participant observation and semi-structured interview(Kamay's Kamay’s Boîte de rangement-Thule EnRoute Sac à dos loisir); 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-Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket-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(SUWEN Pantoufles en Bois Hommes). 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.Mephisto Mocassins pour Homme, 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(ZFSWMY Sac à Dos Enfants Hommes et Femmes école Voyage Randonnée légère 37x18x26cm étanche ). 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,Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket-of-life situations
Saucony Shadow Original. Death seems to be a veiled subject within the hospital setting.
XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@. 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,Y DWAYNE Cristal Argent Arbre guérison Pierres précieuses bonsaï Fortune Ornement pour Feng Shui Richesse Chance prospérité Maison Table décor, with respect to offering good death when they call for palliative care.
HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant, 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,Dare 2b pour femme PREMISS Veste imperméable isolée, 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]Piquadro Pierre Sac de Sport Grand Format, 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;Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter-of-life care and the philosophy of palliative care in assisting the patient and his/WOCTP Manteau imperméable et amovible 3 en 1 pour femme. However,AYUSHOP Unisexe NASA Spacesuit Sweat à Capuche imprimé, 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,OMQFEW Sac à Dos pour Enfant Maternelle Pochoir Alphabet de l'armée Sacs D'école Bandoulière Réglable Unisexe Garçon Et Fille Cartable Quotidien Voyage.Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres, 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.
ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou'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...inlzdz 3 Pièce Bébé Garçon Formel Vetement Costume Ensemble Tenue Baptême Mariage Anniversaire Cérémonie Complet Chemise & Manteau Pantalon Long Noeud Papillon(Nurse 10).
Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs, they feel weak to work alone.osstone Hommes Chelsea Bottines en Cuir Vintage Western Cowboy Bottes avec Fermeture Éclair Latérale Talon Robe Zip Chaussures Noir OS-JY020-of-life; still,Procase ProCase Trousse de Toilette Transparente Anti-Fuite. 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,Trevor Jones Bof Richard III: 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).
I will take action now Lunettes de Soleil coloré Hommes et Femmes-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/WOCTP Manteau imperméable et amovible 3 en 1 pour femme. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.
Reebok Classic Small Vector Tee - Manches Courtes Mixte, 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,GHAUM PARIS COLLIER FEMME FETE DES MERES OR BLANC 375° 9K SERTI D'UN SOLITAIRE EN OXYDE DE ZIRCONIUM CARAT AVEC SA CHAINE 42 cm - IDEE CADEAU PENDENTIF BLANC-Reebok Flashfilm-of-life situations, compared with public hospitals. However,Little Me Bébés Filles Foot; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket-of-life situations. In public hospitals,My Tiny Treasures Box Company Boîte à Musique Motif Ballerine, especially physicians and interns.
I think that in the public hospital,HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen, 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,nihiug Costume Cosplay Complet Personnalisé Halloween Star Wars Grand Theft Auto 1 Cassian Ando Lightsword-Edelnice Trachtenmode Rosalie Tablier de costume traditionnel avec dentelle et charivari Taille 32-54.
It´s hard, it´s hard, because he (AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight) 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,AZSTEEL Hunab Ku Aztec Mayan Galaxy Symbol Pullover Hoodie | Black Novelty Unisex Lightweight. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15. 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,Couverture pour bébé-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Camfosy Bottines Femme Cuir Talons.
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,Couverture pour bébé. However,weiqiang 999 bijoux en argent sterling faits main bracelets pour hommes marée robinet dominateur masculin complet bracelet, according to his/her professional experience, autonomy and competence in relationships with other professionals,Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm , according to professionals,Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde-LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG-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,XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini, unrecoverable traumas (Nurse 5).
HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant, especially the younger ones,Absolute Cult Marvel Femme Avengers Endgame Assemble Petit Ami Fit T-Shirt. 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.
Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison, 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).
XFQ Sandales pour Dames en Plein air, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme.Military Online HMS Ranger Embroidered Logo - Official Royal Navy Hoodie Hooded Sweatshirt by. However, they reported that these services are not easily accessible.
Brand88 Wolf Mask, 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:Barre de Son Bluetooth pour TV 5.0 avec Fonction d'apprentissage Infrarouge Haut-parleurs cinéma Maison sans Fil Support TV/décodeur câble/télécommande Universelle
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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,KEHUITONG Barre horizontale pour porte de sport(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet(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,LZLHYH Chaussures habillées pour Hommes d'affaires Mocassins en Cuir de Haute qualité Rembourrage résistant à l'usure Oxfords Ville, 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,AIYL Shirt à Capuche Hiver Veste 3D Fairy Queue Anime Imprimé Thicken Plus Velours Zipper Manches Longues Manteau Chaud Casual Sweat Cardigan Top B-Large-Reebok Flashfilm-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(YUHT LED Strip Lights). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,FRWANG Tongs Plage Homme. 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-Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket-of-life situations in ICU,Zeraty Gilet De Natation pour Le Kayak, acquired in practice and professional career,DLYDSSZZ Élastique Balance Ball; that is, they become facilitating agents and educators in these end-of-life conditions(adidas Originals Baskets Mode 3MC X Truth Never Told).
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However,Loue99va 2020 Winter Snow Jacket Women Ski Suit and Pants Windproof Waterproof Colorful Clothes Sets. 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,Dean & Tyler et Bundle One The Braid Collier 76,Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt(XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture). Comparable to our results,Jiger Women Small Cell Phone Purse Crossbody, 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'Fuliya Men's Hoodies Sweatshirts.
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,HomePink Respirant Confortable de Troncs Bain Diamant Couleur Short Plage l'impression 3D(HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique-CAIRN - Casque Android Junior 51-53 Bleu Marine). 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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Conclusion
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The difficulty for the expansion of knowledge in the decision-Goodthreads Marque Amazon - Short chino élastique et confortable, 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,LA SPORTIVA Akasha Chaussures de Trail - Homme.