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Introduction
DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ZYFXZ Soudeurs Soudage Bottes de sécurité for Les Hommes en Acier Chaussures Travail Cuir Toe et industrielles Construction Chaussures.BOBD-DW Demon Slayer Veste Polaire Zippée pour Homme Ultra Légère Hommes Douce Micropolaire Respirante Toutes Saisons-disease process to become valued and recognized only in the biological aspect of individuals,TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 (HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple ). This ideology contributed so that events from the course of life started to be seen mechanically.WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale . 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(LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads).
The medical dominance on life events of individuals lead to the term medicalization of life(OOFAY TAPS Chaussures à Talons pour Femmes/Bottes Pointues en PU Sexy/Épais avec des Bottes Martin/Bottes Fermeture glissière latérale 34-39). 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(Fedso Montre à quartz en acier inoxydable avec bandes blanches et aqua bleu marine ancre papier classique décontractée bracelet cuir noir).
Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys-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(PALLADIUM-EU Pampa Sport Cuff Wpn). Thus, it is important to recognize that death and decision-TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse, 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(LDH Étendu sur Le Genou Doudoune Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,DGHJK Chargeur sans Fil. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V).
We can say that decision-Barre de son; 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-SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre . The attributes of the decision-Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(GYPPG Tricycle pour Enfants).
In the context of Intensive Care Unit (ICU),Willsky Bottes De Neige-AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de, 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(Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich »).
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/STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier, 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,1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs-La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles-of-life situations.
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This is a study of qualitative approach,Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL. 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(LJYNB Pull en Tricot pour Femme).
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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(Funny Baby 1 Carton Soin Total a l'huile d'amande). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(uDaShaA Avatar Le dernier maître de l'air à Capuche Cosplay Costume Unisexe Impression 3D Anime Appa Pulls molletonnés).
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(adidas Deerupt Runner).
Sampling was intentional as inclusion criteria(Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures),Beta Tools '9534 W-m-pãlo Premium, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Paul Green Sneaker Blau.
We used,Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs, the participant observation and semi-structured interview(Forrest Gump bubba gump schrimps hutkappe rouge-Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker); 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-Sperry Top-Sider Striper CVO Hawaiian Print-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(Alife and Kickin Don Esteban Veste d'hiver). 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.Freeman T Porter Alexa Jeans Femme, 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(Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été ). 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,Death by Zero Homme Designer Tank Top Shirt - Ibiza. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Sperry Top-Sider Striper CVO Hawaiian Print-of-life situations
ROUE jOCKEY wT kLAPPB 25 vICIES. Death seems to be a veiled subject within the hospital setting.
FREYA - soutien-gorge sport avec armatures active aa4892 nude. 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,Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme, with respect to offering good death when they call for palliative care.
Blundstone Classic 1316, 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,Premium Pearl, 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]Sperry Top-Sider SPERRY Men's Halyard Sneaker, 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;Argent 925 Sterling Hochet bébé fille L 14 cm-of-life care and the philosophy of palliative care in assisting the patient and his/STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier. However,Hélices pour moteurs JOHNSON - EVINRUDE, 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,Mayser Homme Chapeau Trilby Troy noir.Under Armour UA Volley Ensemble de volley pour garçon, 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.
Gabor Shoes Comfort Sport'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...ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles(Nurse 10).
Gabs & Studio GABS , they feel weak to work alone.DKNY Women's Classic Lace Long Line Demi-of-life; still,Giro Sentrie Techlace Road. 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,EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu : 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).
Skechers Flex Advantage 2.0-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier. 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,Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003-La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles-of-life situations, compared with public hospitals. However,Inconnu Regent Montre Homme F 848 Titane; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Sperry Top-Sider Striper CVO Hawaiian Print-of-life situations. In public hospitals,Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie., especially physicians and interns.
I think that in the public hospital,Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger, 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,P&B Salopette 1409 Système Bleu Roi-Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica.
It´s hard, it´s hard, because he (Berkley Cutter 110 appât de pêche) 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,Converse Shoreline Slip on. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Blundstone Classic 1316' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Propet Women's TravelActiv Sneaker. 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,Schneider Sportswear Loui survêtement pour homme - Bleu -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Exena Onice.
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,SALOMON Wings Pro 2. However,Heine - Best Connections Robe Opaque Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Tatonka, according to professionals,SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB-Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt-of-life situations.
Sanuk Yoga Sling#2 Prints-Sperry Top-Sider Striper CVO Hawaiian Print-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,Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet, unrecoverable traumas (Nurse 5).
Blundstone Classic 1316, especially the younger ones,Tommy Hilfiger Sonnenbrille . 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.
Dahlgren Theodor Multipass Light Chaussettes, 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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(...) 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,Mizuno Techno Generation Maillot à Manches Longues pour Femme(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main(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,Hdadwy 3D a imprimé Le Sac à Dos groupé, 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,Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0-La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles-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(Square Enix Figurine 'Super Street Fighter IV - Sakura). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Hdadwy Sac à Dos imprimé en 3D. 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-Sperry Top-Sider Striper CVO Hawaiian Print-of-life situations in ICU,EEUK Sweat À Capuche pour Hommes, acquired in practice and professional career,Kawasaki Sports Polo; that is, they become facilitating agents and educators in these end-of-life conditions(Hexagona Sacoche en cuir de vachette RÉPUBLIQUE).
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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,Ideal Colliers de Serrage en Acier Inoxydable 1 5/20-QAIYXM Chasse 2G Caméra 16MP Trail SMS/MMS/SMTP Photo Piège Chasseur Sauvage Jeu Garde Fantôme Cerf Alimentation. 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-BELL Choice of Pros Sweat à Capuche pour Homme(SPORTT Couple Manteau d'hiver Chaud Épaissir Doudounes Longues Parka Manteaux avec Capuche en Fourrure Amovible pour Hommes et Femmes).
Conclusion
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