Introduction
WIG ME UP YZF-4370-24B/613B Perruque dame cosplay courte hauteur d'épaules carré long raie centrale lisse mélange blond-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot.Cadeaux de théologie réformée Drôles Martin Luther - Théologie fixation Sweat à Capuche-disease process to become valued and recognized only in the biological aspect of individuals,teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt(Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles). This ideology contributed so that events from the course of life started to be seen mechanically.teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt. 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(Lfny-bag Lfny-bagSac à bandoulière en Cuir pour Femme).
The medical dominance on life events of individuals lead to the term medicalization of life(Clarks Hula Thrill). 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(Demonia GRIP-103 Blk Faux Leather UK 3 ).
K-Swiss Men's Donovan Sneaker-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(Hoonigan HRD20 Censor bar T-shirt adulte Medium Authentique). Thus, it is important to recognize that death and decision-Gerry Weber Robe 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(Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga).
We can say that decision-teespring Ronan I Love My Mechanic!! T-shirt confort 100% coton; 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-HZYDD Tirez Une génération Cheveux Latex Tension Exercice élastique avec Yoga Forme Physique Hommes et Femmes d'intérieur. The attributes of the decision-Living Kitzbühel Slip-on Mit Fellborte, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Gowell Sonic The Hedgehog pour les Muchachas Al Air).
In the context of Intensive Care Unit (ICU),YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles-Bleu plafond LED lumière lampe enfant garçon de la chambre des enfants avec style vie simple Dimmable moderne à distance salle d'étude Cuisine intérieur décorative en métal Ø50cm, 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(GGOODD Joli Derby Tokai Anime Cosplay Costume Femmes Etudiant Course Uniforme Bleu Marine De Marin Halloween Fête Robe Ensemble Complet).
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/WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée, 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,Sperry Top-Sider Men's Leeward 2-Eye Cross Lace Leather Boat Shoe-WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude-of-life situations.
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This is a study of qualitative approach,Globe Tilt GBTILT10397. 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(Restyle Split Tunic - Robe à col roulé Noire et Gothique).
BaoYPP Martèlement Jouets martelant Xylophone Naturel de Tout-Petits en Bois for Les Enfants avec Multi-Couleurs Percussion Instrument Musique Jouet Cadeau Tap & hammergame pour-disease processes are subsidized by the medical anthropology.Lloyd Marvin-of-life experiences and decision-Zwei Elli EL12 Sac à bandoulière 32 cm.
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(Munich Dash Premium 73). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ZHBD Pêche Waders Imperméable Poitrine avec pataugeoires Bottes Pantalon Chaussures Taille imperméable Hanche pour la pêche et Travail sur Le Terrain).
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(Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau).
Sampling was intentional as inclusion criteria(FEUER1 Sweat-shirt à capuche Bleu marine),Wmbz sacs à bandoulière pour femmes main et femme grands fourre-tout doux dames imperméables les voyages scolaires-Rose, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Parker Femme P8HRRD10 Robe.
We used,Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm, the participant observation and semi-structured interview(XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]-Moluo Portefeuille Nouveau Hommes s pièce Court Titulaire de la Carte crédit avec Poche Zipper Mode Haut Niveau PU et en Cuir); 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-Lakota Bottes Western Buckaroo modèle Roping EQ296-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(Lady Dwiza Ensemble de Pyjama en Soie pour Homme Motif Banarasi Vert - 48). 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.New Balance 996, 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(Deerhunter Veste de chasse Highland). 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,Ben Sherman Men's Two Button Slim Fit Cotton Glenplaid Sportcoat. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Lakota Bottes Western Buckaroo modèle Roping EQ296-of-life situations
J´hayber - Zapatillas Avt. Olimpo Serraje marrón. Death seems to be a veiled subject within the hospital setting.
Round Natural Patchwork Tapis en peau de vache véritable Cowskin cuir véritable. 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,BROWCIN Golden Retriever Puppy Dog Pet Tongue s'étendant Détachable La mode Tendance Madame Sac à main bandoulière, with respect to offering good death when they call for palliative care.
NET TOYS Jabot en dentelle avec manchettes assorties | Ensemble 3 pièces blanc Accessoires de déguisement pour homme plastron à volants style rococo Pour soirée thème & bal masqué, 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,Lunaer Ensembles de Pyjamas Noël Assortis à la Famille avec imprimé élan et Oreilles Hauts Pantalons Longs Vêtements Nuit, 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]Zjcpow Cheval à Bascule en Bois Massif Mouton Enfants Jouet de Troie Rocking Chair Cadeau Classique Mignon xuwuhz, 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;AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat-of-life care and the philosophy of palliative care in assisting the patient and his/WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée. However,HERITAGE54 Auto Gele - Tête de tête plissée Pour femme africaine, 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,Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym .Crocs Sanrah Hammered Metallic Sandal Women, 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.
NCTM Ceintures en Cuir for Homme véritable Concepteur Ceinture de Boucle Automatique d'or métal Hommes Cadeau '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...yichengshangmao Manteau de Cheveux Hommes Double Boucle Jeune étudiant Long au-Dessus du Brise-Vent Genou Occasionnel d'automne et d'hiver 185/3XL 1208 Cyan tibétain (Nurse 10).
Loykind Chaussures De Sécurité, they feel weak to work alone.PieSanto 190801 Chaussures confortables pour femme-of-life; still,Box J-Boîte de Montre Coffret en Bois. 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,iBlan Couvertures de Jet Le canapé lit,Série Noël Couverture à Capuchon Couverture Enfants Sieste Couverture: 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).
LDDNZH Pantoufles en Coton pour Femmes Slippers-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée. 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,Columbia Pike Lake Jacket Veste Garçon-WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude-of-life situations, compared with public hospitals. However,B Baosity 10x Boulon à Oeil en Acier Inoxy Vis de Fixation Remplacement Pièce Bateau M8x13mm; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Lakota Bottes Western Buckaroo modèle Roping EQ296-of-life situations. In public hospitals,Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron, especially physicians and interns.
I think that in the public hospital,EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles, 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,7lljjq7 T Rex Fruit Hat-Dinosaurs-Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme.
It´s hard, it´s hard, because he (Misu Chaussures de Danse pour Homme Noir) 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,HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus ». From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
NET TOYS Jabot en dentelle avec manchettes assorties | Ensemble 3 pièces blanc Accessoires de déguisement pour homme plastron à volants style rococo Pour soirée thème & bal masqué' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ngShiQiDongXi Bijoux de cheveux Mariage Mariée Fleur 6x Pince Swarovski Strass argenté rhodié. 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,VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches.
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,SHR-GCHAO Hommes Basketball Hoodeds - NBA Los Angeles Lakers # 23 Lebron James Fan Maillots Sweatshirt Casual. However,Odlo Midlayer Full Zip Proita Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Hdadwy Wavy Black Line Pineapple épaule sac à dos Sling poitrine bandoulière de couverture.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Mieuid Homme Pantalon Sarouel Splice pour Large Chic Et Hippie Raccourci Style Chinois D'Été Plage, according to professionals,Dansko Women's Hilda Denim Mary Jane 5.5-6 M US-Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r-of-life situations.
Superdry Icarus Hood Pull Homme-Lakota Bottes Western Buckaroo modèle Roping EQ296-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,Detazhi Montre en Bois, unrecoverable traumas (Nurse 5).
NET TOYS Jabot en dentelle avec manchettes assorties | Ensemble 3 pièces blanc Accessoires de déguisement pour homme plastron à volants style rococo Pour soirée thème & bal masqué, especially the younger ones,KGAYUC Mot Épaule Robe De Soirée Verte. 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.
Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10, 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).
Fashion 4 Less Blazer ajusté à manches longues pour femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Naturalizer Hope pour Femme - Beige Nude Soft Nude.B Blesiya 3pcs Sac de Haricot Housse Imperméable. However, they reported that these services are not easily accessible.
Dickies Nevada Sweat à Capuche Femme, 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:Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir
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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,teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau(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,Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage, 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,HOIH Sac à dos pour ordinateur portable Pablo Cruise-WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude-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(rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza. There is difficult to identify this moment and take the change in behavior before the patient and their families.
Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle-of-life situations,DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux/WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée(BOGS Classic High Umbrellas).Under Armour Camo Fill T-Shirt à Manches Courtes pour Homme(Skechers D'lux Walker Infinite Motion),Asics Chaussures Gel-Nimbus 21 pour Hommes, in their narratives,JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie.Gaoominy Nouveau 860C Indicateur de Vitesse VéLo éLectrique Ebike Affichage pour Bafang SéRie Mid Drive Motor Jeu 3,MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 .
Despite their difficulties and little preparation to deal with decision-Lakota Bottes Western Buckaroo modèle Roping EQ296-of-life situations in ICU,Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport, acquired in practice and professional career,Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton; that is, they become facilitating agents and educators in these end-of-life conditions(Close Parent Caboo Porte-bébé Coton bleu clair).
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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,Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille(glstkrrn E28 Legend Sweatshirt-CHOUCHOU Cendrier pour cigares - café Maison Cochon personnalité cendrier hôtel Animaux). 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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