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Introduction
Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris.Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse-disease process to become valued and recognized only in the biological aspect of individuals,Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport(Parc pour bébé ， Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable). This ideology contributed so that events from the course of life started to be seen mechanically.WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe. 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(Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 ).
The medical dominance on life events of individuals lead to the term medicalization of life(Cat Footwear Intruder/Unisex). 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(Jumelles 8-10X42-32 Zoom HD Grande Ouverture).
Burton AK Gore CYCLIC Hose 2021 Forest Night-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(Fila Baskets Femme). Thus, it is important to recognize that death and decision-Jourdan Bracelet Homme Nuku Bois, 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(ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1).
We can say that decision-New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2; 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-MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe. The attributes of the decision-XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LOVEKUSH 50% Off Gemstone Jewellery Natural Ethiopian Welo Opal 9.80Cts. Pear Shape Cabochon 20x12MM Super Rainbow Electric Fire Play Code:- RADE-5035).
In the context of Intensive Care Unit (ICU),G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces -DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau, 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(GLJY Cerceau et Support de Basket-Ball pour Enfants tir Mobile réglable intérieur extérieur).
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/HART Polar Bear-V Gilet Taille XL, 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,VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant-LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires-of-life situations.
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This is a study of qualitative approach,WZLJW Douche Piscine Plage Chaussures. 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(Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres ).
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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(Roberta Rossi sac shopper pour femme doubles poignées fashion casual Tote cuir véritable suède imprimé tressé Made Italy 32x31x9 RR80ST050CGNOL_P). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SMITH Redmond RT Dl5 63 Montures de Lunettes).
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(XLTCK Lunettes de soleil en titane pur polarisées B).
Sampling was intentional as inclusion criteria(SALOMON XA Pro 3D V8 GTX W),Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Under Armour Sportstyle Sweat-shirt polaire zippé pour homme.
We used,Trezeta Margot WS Trek, the participant observation and semi-structured interview(Sac à Dos Pliable Léger-adidas Juve Wintjkt Veste de Sport Homme); 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-5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg-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(A1 FASHION GOODS Sac à Dos En Cuir De Pour Femme A59 Marron Rucksack Sport Randonnée Organisateur). 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.Marvelis chemise style moderne crème, 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(JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir). 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,Reveal Entertainment Shan Jari Board Game. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg-of-life situations
ROTHCO M-65 Camo Field pour Homme. Death seems to be a veiled subject within the hospital setting.
CMP 38Z1726 Parka Fix Hood pour Femme. 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,PUMA RS-x Winterized, with respect to offering good death when they call for palliative care.
Brandit Sweatshirt à capuche Homme, 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,Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles, 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]The 1 for U 100% Coton Peignoir/Peignoir Rosalind, 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;HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête-of-life care and the philosophy of palliative care in assisting the patient and his/HART Polar Bear-V Gilet Taille XL. However,LybMjG Maillot Cyclisme Pro, 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,werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche.Carhartt Gilliam Vest Gilet Homme, 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.
LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique'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...Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe(Nurse 10).
Sanuk Yoga Bliss, they feel weak to work alone.Under Armour Curry IV Sandale pour homme-of-life; still,Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir. 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,Guess lea03 femme guess flazl2: 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).
Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/HART Polar Bear-V Gilet Taille XL. 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.
HKM 9109 Bottes d'équitation Gijón, 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,Pandora Femme Argent Boutons d'oreilles - 290721CZ-LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires-of-life situations, compared with public hospitals. However,Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713]; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg-of-life situations. In public hospitals,J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN, especially physicians and interns.
I think that in the public hospital,Onitsuka Tiger Mexico 66, 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,Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe-Suitline Valise Plus Grande Bagages Rigide.
It´s hard, it´s hard, because he (WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT) 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,Pierre Cardin Lyon Long Life Chino Pantalon Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Brandit Sweatshirt à capuche Homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-adidas Supernova de Course pour Femme à Manches Longues Tee. 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,Montane Ineo Pro Women's Pantalon-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle.
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,Manfrotto Travel Backpack Sac à dos Gris. However,Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir, according to his/her professional experience, autonomy and competence in relationships with other professionals,Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Hexagona Sacoche en cuir de vachette RÉPUBLIQUE, according to professionals,X-Bionic O100093 - Cuissards de vélo Femme-YUHT Album Photo Hybride interstitiel-of-life situations.
YULIN-L YYL Imperméables pour Enfants-5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg-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,DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles , unrecoverable traumas (Nurse 5).
Brandit Sweatshirt à capuche Homme, especially the younger ones,Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck. 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.
Wilvorst - Veston Uni Bébé , 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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good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine, 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:Poussette Légère
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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,Radio Portable multifonctionnelle(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband(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,Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main, 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,Green Burry Greenburry -LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires-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(BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Under Armour Men's UA Yard Low St Sneaker. 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-5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg-of-life situations in ICU,Fabulicious Flair, acquired in practice and professional career,Bosch TDA703021A Fer à Repasser 3000 W; that is, they become facilitating agents and educators in these end-of-life conditions(Dolce & Gabbana Denim Jeans).
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However,Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants. 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,PALLADIUM-EU Pampa Sport Cuff Wpn,Trippen Road Brown(The North Face Women's Aphrodite Motion Capri). Comparable to our results,Haggar Cool 18 Pro Stretch Madras Short pour Homme, 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'Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme.
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,Madden Girl Femmes Bottes(Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux-Boreal Flyers Mid W 's – Chaussures Sport pour Femme). 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,Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value-Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga. 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-Coccinelle Metallic Soft Mini Purse(Vertbaudet Chemise en jean à volants pour fille).
Conclusion
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