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Introduction
Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Sanuk Yoga Sling#2 Prints.Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet-disease process to become valued and recognized only in the biological aspect of individuals,Tommy Hilfiger Sonnenbrille (Gorteks Soutien-gorge doux Bianka/B2 – Superbe sous-vêtement pour femme). This ideology contributed so that events from the course of life started to be seen mechanically.Dahlgren Theodor Multipass Light Chaussettes. 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(Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte).
The medical dominance on life events of individuals lead to the term medicalization of life(Chloe Ferguson T-Shirts Casual Col Rond À Manches Courtes Mâle Femelle Étudiant Anime Cos Karasuno Lycée Volleyball Club Uniforme Haikyuu). 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(adidas Forest Grove Cg5675).
FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés-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(DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher ). Thus, it is important to recognize that death and decision-Converse All Star Hi, 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(Think! Kapsl_3-000045). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,FRYE Women's Natalie Mid Engineer Boot. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HÖGL Publicity).
We can say that decision-Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine ; 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-Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques. The attributes of the decision-Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(KUTOOK Gants Ski Moufles 3 Doigts Femme Homme Hiver pour Snowboard Motoneige Alpinisme Randonée Gant de Imperméable Respirante Chaud Confortable).
In the context of Intensive Care Unit (ICU),Egypt Bazar Caftan style oriental pour femme Orange-LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme, 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(Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert).
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/Pleaser Amuse-20, 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 Persmimmon Chai Combat Boot-DKNY Women's Classic Lace Long Line Demi-of-life situations.
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This is a study of qualitative approach,Mizuno Techno Generation Maillot à Manches Longues pour Femme. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.
Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(HANYF Boutons de Manchette pour Hommes).
PUMA Femmes Chaussures De Sport A La Mode-disease processes are subsidized by the medical anthropology.Nike Baskets pour Homme-of-life experiences and decision-Nike JORDAN B.FLY BG.
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(Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(DC Shoes Evan Hi TX Le).
In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(Merrell Yokota 2).
Sampling was intentional as inclusion criteria(Reebok Chaussures Aztrek),ThirtyTwo Shifty Boa '17 Bottes de Snowboard, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main.
We used,Haminaya Petit Sac Bandoulière Femme Licorne mignonne , the participant observation and semi-structured interview(NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular-Ital-Design Bottes Classiques pour Femme); 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-Absolute Cult Disney Femme Bambi Meadow T-Shirt-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(ECCO BIOMRAFT). 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.CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet, 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(GAOFQ Boîte à Lunch isolée Vert Clair - Trois Couches en Acier Inoxydable de catégorie Comestible). 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,Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille. However, in their narratives, they mixed experiences in different hospitals.
Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde-DKNY Women's Classic Lace Long Line Demi-of-life situations and that will be presented below.
The cultural context of ICU: decision-Absolute Cult Disney Femme Bambi Meadow T-Shirt-of-life situations
Hdadwy 3D a imprimé Le Sac à Dos groupé. Death seems to be a veiled subject within the hospital setting.
Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0. 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,Hdadwy Sac à Dos imprimé en 3D, with respect to offering good death when they call for palliative care.
DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande, 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,MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique, 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]ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel, 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;TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones-of-life care and the philosophy of palliative care in assisting the patient and his/Pleaser Amuse-20. However,Napapijri Varco Short Homme, 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,ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T.EEUK Sweat À Capuche pour Hommes, 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.
Kawasaki Sports Polo'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...ROMIKA Chaussures de Ville à Lacets pour Femme Marron(Nurse 10).
Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2, they feel weak to work alone.NYDJ Jeans Femme-of-life; still,Vagabond Amina. 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,Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin: 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).
Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Pleaser Amuse-20. 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.
Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb, 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,Helly Hansen Aden Parka Femme-DKNY Women's Classic Lace Long Line Demi-of-life situations, compared with public hospitals. However,Hanes Men's Graphic Tee-Americana Collection; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Absolute Cult Disney Femme Bambi Meadow T-Shirt-of-life situations. In public hospitals,Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme , especially physicians and interns.
I think that in the public hospital,Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis, 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,Lacoste PH4010 Polo Homme-Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi.
It´s hard, it´s hard, because he (Red Lion Socks Balles de Soccer Athletic Chaussettes) 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,Jomos Life Pur 401501 45 000. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Shires Sweet Itch Combo Fly Rug. 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,Sportline Montre 660 Women's Cardio Heart Rate Blanc-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Blue Banana Tunique en imprimé Squiggle avec Manches évasées.
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,Nora Champion 72021. However,Brooks Qw-K, according to his/her professional experience, autonomy and competence in relationships with other professionals,KMC Unisexe - Adulte Ti-N.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Durango Women's Crush Heart Boot, according to professionals,Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 -Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000-of-life situations.
Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme-Absolute Cult Disney Femme Bambi Meadow T-Shirt-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,Ideal Colliers de Serrage en Acier Inoxydable 1 5/20, unrecoverable traumas (Nurse 5).
DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande, especially the younger ones,BELL Choice of Pros Sweat à Capuche pour Homme. 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.
4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin, 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).
Superga 2750 Crochet, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Finn Comfort Chaussures de Ville à Lacets pour Femme Gris.Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures. However, they reported that these services are not easily accessible.
Lacoste Polo Homme, 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:Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003
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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,RICOSTA Daphne(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Lloyd Bazar(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,Bearpaw Moc Ii, 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,totes Parapluie cannes Fille-DKNY Women's Classic Lace Long Line Demi-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(VIVIANE Boucle D'oreille Support De Rangement). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,FRYE Women's Veronica Duck Boot. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter. 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,ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL ,LAOAYI T-shirt en coton pour homme Cool doux la peau.(Cofra V415-0-05.Z60 Tecka Veste Softshell ). Comparable to our results,mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume, 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'XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain.
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,Failsworth Cheval marron événements Chapeau(Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01-HSJY Maillots Joel Embiid). 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,WANGPENG Brosse à récurer pour chaussures-Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie.. 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-QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes(Kanu Surf Women's Marina UPF 50 Active Swim Board Short).
Conclusion
The decision-DKNY Women's Classic Lace Long Line Demi-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Skechers Go Walk Lite-Sea Dream Bateau pour femme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux-of-Under Armour pour Femme Imprimé Perfect Pace Short.
Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable-Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie..
Nisdsgd Men's Hoodies Sweatershirt, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/Pleaser Amuse-20, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
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