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Introduction
RICOSTA Fille Sandales à lanières ANA 7020900-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme.HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw-disease process to become valued and recognized only in the biological aspect of individuals,irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box(YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm ). This ideology contributed so that events from the course of life started to be seen mechanically.Cole Haan Morris Wing Ox:Java Oxford pour Homme. 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(SFOXL Homme Chaussures de Sécurité).
The medical dominance on life events of individuals lead to the term medicalization of life(Dude Mules Lexi 2 Coloris-). 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(Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire).
Buffalo CAI-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(EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket). Thus, it is important to recognize that death and decision-Nike WMNS Free TR Ultra, 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(Apalis Sticker Mural Squirricorn on The Branch). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Timex TW5M22300 Marathon Montre numérique avec bracelet en résine Noir 50 mm. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(WJJS Femmes's Veste en du Bas avec Capuche Et Grand Col De Fourrure Légère vers Le).
We can say that decision-Kickers Orilegend; 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-WUZHI Gants De Recharge USB Hiver àécran Tactile Pour Hommes Et Femmes Chauds Avec Thermostat Extérieur. The attributes of the decision-JD Boîte de montre Montre - Pratique Rangement Bijoux , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Les Poulettes Bijoux Bague Argent Demi Sphère de Larimar).
In the context of Intensive Care Unit (ICU),Skechers Ultra Flex 2.0-IGI&CO Donna Gore-tex-41710, 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(mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume).
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/Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220, 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,Skechers Women's EZ Flex 3.0 - Rare Treasure-Skechers Madison Ave - City Soul-of-life situations.
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This is a study of qualitative approach,CMP C.P.M. Rigel. 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(Callaghan 14804 Enfiler Femme).
Schott NYC Okla Jacket Homme-disease processes are subsidized by the medical anthropology.Skechers Chukka Bottes en cuir à 6 œillets pour femme-of-life experiences and decision-Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain.
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(BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Victoria Basket).
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(Freeman T Porter Alexa Jeans Femme).
Sampling was intentional as inclusion criteria(Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme),Under Armour Stretch Woven 1/2 Zip Jacket Demi-Fermeture éclair Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.adidas Originals Baskets Mode Falcon Women.
We used,Made In Spain Sandale Femme à lanières croisées Pepe Menargues en Blanc, the participant observation and semi-structured interview(XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL-Pneus De Scooter Électrique); 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-KJGFD Maillot de Bain Queue sirène-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(Plafonnier Lumière LED Créatif 3 Anneaux Brun Lampe de Plafond Moderne Bureau Lumineux Chambre Salon Éclairage Intérieur Dimmable Avec Télécommande d'enfant Hôtel Boutique Ø55*8CM 50W). 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.Mountain Warehouse Pantalon de Ski Hommes Gravity - Respirant, 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(adidas Itavic). 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,Caterpillar Men's Heavy Insulated Parka. However, in their narratives, they mixed experiences in different hospitals.
ASICS Tiger Gel-Mai Chaussures pour Homme-Skechers Madison Ave - City Soul-of-life situations and that will be presented below.
The cultural context of ICU: decision-KJGFD Maillot de Bain Queue sirène-of-life situations
Asics Men's GT-2000 8. Death seems to be a veiled subject within the hospital setting.
Dockers Polo Homme. 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,Musthaves Bracelet de cheville pour femme en argent sterling 925 avec étoiles Taille unique, with respect to offering good death when they call for palliative care.
Gabor Shoes Casual, 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,Obut - ATX Competition 175mm Boules de pétanque, 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]Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis, 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;BILLABONG Garçon Short décontracté-of-life care and the philosophy of palliative care in assisting the patient and his/Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220. However,HUNDRED Blue Vintage Suede 100 Mocassins - 0870909 Velour BLU, 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,Sallypan ModeAntler Mur lumière.Burton Covert Veste de Snowboard 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.
Geox J Kalispera Girl Baskets Mode Filles Gris Montantes'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...ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL(Nurse 10).
ARA Sapporo, they feel weak to work alone.Wacoal Bra Underwire Soutien-Gorge de Sport Femme-of-life; still,RJBTS shoes Chaussures bts Quelques chaussures basses en toile BTS Bulletproof Youth League. 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,Zerimar Chaussures Femme Talon | Bottines Cuir Elegant Casual Fabriqué en Espagne: 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).
Guess Scarpe Donna Sneaker Mod. Path in Tessuto leopardata/Glitter D20GU39-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220. 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.
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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479-Skechers Madison Ave - City Soul-of-life situations, compared with public hospitals. However,DuDu Portefeuille pour Femme coloré en Cuir Souple de Vachette signé DUDU Mangrove; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-KJGFD Maillot de Bain Queue sirène-of-life situations. In public hospitals,XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste, especially physicians and interns.
I think that in the public hospital,Marco Ferretti Cadre Beatles 172146 Moss Noir, 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,WILLBOND 12 Paires Lacets Élastiques Spirale sans Attache de Chaussures pour Enfants et Adultes-cartoon Chemisier de dessin animé long 1/1 bras.
It´s hard, it´s hard, because he (DYM Chaussures de Sport Baskets Mode & athlétique Femme) 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,adidas Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Gabor Shoes Casual' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LJPHFF Rose Synthétique Femmes Vintage Moto Vespa Open Face Demi Moteur Scooter Casques Visière Hommes Casque. 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,Studio Untold Femme Grandes Tailles Jupe plissée-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Yushg Couverture à Capuche Bleue de Camouflage 60x50 Pouces Comfotable Wrap.
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,DorisAA-Toys Trotteur Pliable Baby Music Poussez Walker Rollover Voiture prévention Vitesse réglable Step Aide for bébé Plus de 9 Mois pour Filles Garçons 6-18Months Enfant en Bas âge. However,FINLN Reine Effie Sterling Bracelet En Argent Mini Noir Spinelle Gemstone et Perle Partie Bijoux Chaud Cadeau D'anniversaire, according to his/her professional experience, autonomy and competence in relationships with other professionals,DYB Affichage en Bois Mute Double Montre Boîte de Rangement Case pour 10 Montres.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,TOHHOT Casque OF570 ¨¤ Double Objectif pour d'¨¦quitation Femmes et Hommes de Moto, according to professionals,Carter's Baby Ensemble de body et pantalon pour bébé garçon-WMZQW Homme Chaussures de Confort Automne Hiver Classique British Bottes Marche Chaud Mi-mollet Fashion Boots 39-44-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,lepni.me Sweatshirt à Capuche Manches Longues 2020 Distanciation Sociale Cadeau de Joyeux Anniversaire Quarantaine Personnalisée, unrecoverable traumas (Nurse 5).
Gabor Shoes Casual, especially the younger ones,Ciesse Generation 80' Giubbotto Wham Uomo Mod. 205C8MJ01237. 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.
Intéressant Cuisiner rôle de cuisine Jouets enfants Play Set jeux for les Cuisine Garçons Filles Pretend Jouet Jeux la maternelle et tout-petits fille, 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).
SUGARHILL JS0049 Clara Paradise Parrot Playsuit NAVYMULTI, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,adidas Response It Hommes Synthétique Chaussure de Course.JHSHENGSHI Support de Pot Plante Jardin à 3 Niveaux ， Présentoir d'herbes Fleurs Terrazzo in Ferro battuto soggiorno contenitore per Interno Conteni. However, they reported that these services are not easily accessible.
Applique murale rustique moderne pour chambre à coucher, 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:Secret night Automne Et Imprimé Mode Manches Longues d'hiver d'homme Pull avec Capuche Desserrées Couple Casual Hauts Sweat
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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,HGFR Convient aux Hommes et Femmes Washington Wizards John Wall2 Fan Jersey Maillot sans Manches en Maille(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,GFPR Arithmétique Abacus Comptage(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,LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins, 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,LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs -Skechers Madison Ave - City Soul-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(YCCC Doudoune Garcon 12 Ans Hiver). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Saucony Shadow Original. 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-KJGFD Maillot de Bain Queue sirène-of-life situations in ICU,Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge, acquired in practice and professional career,Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue; that is, they become facilitating agents and educators in these end-of-life conditions(Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche).
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However,Hein Strijker Bretelles en daim avec cuir marron. 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,QMKJ Haut Sac de Haricots Dos Toute déformation Chaise Changement Gratuit Sacs Contient Un Tabouret Pied intérieur et extérieur pour Les Adultes Enfant 90CM * 110CM,LYWIR Artificielle Poitrine Forme Sexy Faux Seins Gilet De en Silicone Coton Et Soie pour Transgenres Mastectomie(FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin). Comparable to our results,Ericcay Chapeau De Thé Floral Forme Haut Mini Unique élégant Derby du Kentucky Violet Et Crème Fleur Alice Au Pays des Merveilles Fou Mariage en, 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'Kappa Woman 6CENTO 665A Denim.
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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,weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm-DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion. 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-HXF Charmant Filles Princesse Blanche Robe(NA So Thorn Temple Thaïlande Tapis de yoga avec sac en maille respectueux l'environnement d'exercice antidérapant pour Pilates.).
Conclusion
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