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Introduction
Joyara Bague Femme 9 ct Or Blanc 0.25 Rond Vert Emeraude 5 Pierres 1/4-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Reebok Workout Plus.Joyara Bague Femme 18 ct Or Blanc Diamants 0.25 Noir Coeur 1/4-disease process to become valued and recognized only in the biological aspect of individuals,Josef Seibel Chance 39(camel active Ethnic 12). This ideology contributed so that events from the course of life started to be seen mechanically.Geox B New Flick B. 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(AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural).
The medical dominance on life events of individuals lead to the term medicalization of life(Furla Babylon XL Zip Around). 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(mantraroma Pendentif argent 925 sterling labradorite ).
Geox D Nebula C-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(Lucky Brand LK-Joal2 Escarpins pour Femme). Thus, it is important to recognize that death and decision-PUMA Chaussures de Glace Muse Femmes, 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(Kala-isbijoux Pendentif ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Dachstein Ramsau 2.0 Gore-TEX Chaussure. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DODOMIAN Lot de 5 caleçons boxeurs pour hommes sous-vêtements en coton sans manches à braguette ouverte avec pochette).
We can say that decision-New Balance Fresh Foam Zante Pursuit; 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-Columbia WAYFINDER FLIP Sandales de sport pour homme. The attributes of the decision-Jack Pyke Gilet sans Manches Countryman - pour Homme Polaire Thermique, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SWEET 12 Cadre Photo Décoration Murale Combinaison Murale).
In the context of Intensive Care Unit (ICU),nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques-nihiug Bottes De Randonnée Hommes Imperméable à l'eau Léger High Rise Lace Up Outdoor Grande Taille Chaussures en Plein Air, 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(Merrell Femmes Chaussures De Sport A La Mode).
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/Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers, 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,Under Armour Polo rehaussé pour homme-JINPENGRAN Portable Chaise-of-life situations.
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This is a study of qualitative approach,Kamik Raindrops. 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(Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05).
Roxy Rock Peak - Veste matelassée déperlante pour Femme ERJJK03250-disease processes are subsidized by the medical anthropology.TEN POINTS Carina-of-life experiences and decision-DC Shoes Heathrow.
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(HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ZHJYD Montre de Poche).
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(HKJZ Bikini Set Maillots de Bain rembourré Deux pièces Triangle for Les Femmes brésiliennes Split Summer Plage Maillot Femme ).
Sampling was intentional as inclusion criteria(adidas Grand Court),Gunnar Attache Tortoise LIQUET Lunette Anti Fatigue de Protection Contre UV Marron, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité.
We used,Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme, the participant observation and semi-structured interview(JOMA SPORT CANCHA LNFS Fluor Indoor-DKNY Women's Classic Lace Long Line Demi); 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-Kickers Bonbon-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(Kaysa-TS Bébé Tissu Mou Vibrant Et Musical Chaise Gonflable). 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.Nike Magista Onda AG, 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(SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage). 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,Mizuno Tc-02. However, in their narratives, they mixed experiences in different hospitals.
ECCO Biom Terrain-JINPENGRAN Portable Chaise-of-life situations and that will be presented below.
The cultural context of ICU: decision-Kickers Bonbon-of-life situations
ECCO Xpedition III. Death seems to be a veiled subject within the hospital setting.
ECCO Xpedition III. 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,adidas Essentials Pantalon de Tricot à Ourlet Ouvert pour Homme Motif 3 Bandes, with respect to offering good death when they call for palliative care.
adidas Ultraboost 19, 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,adidas Originals Women's Falcon Trail Running Shoe, 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]Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire., 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;Fjällräven Leisure Backpack Greenland Zip 13" Polyester-of-life care and the philosophy of palliative care in assisting the patient and his/Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers. However,FREDsBRUDER WXD Easy Peasy Caramel, 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,Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S.Under Armour Sportstyle Tricot - Pantalon 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.
HR Bague en or jaune pour homme 3 pierres'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...GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité(Nurse 10).
Teva Tira, they feel weak to work alone.Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose-of-life; still,ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau. 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,lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation: 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).
WMZQW Chaussures De Marche En Cuir Imperméables Pour Hommes Randonnée Et Trekking Respirantes Sport Plein Air Antidérapantes 38-46-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers. 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.
TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan, 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,Dickies Pantalon moulant en sergé 4 poches pour femme-JINPENGRAN Portable Chaise-of-life situations, compared with public hospitals. However,Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G.; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Kickers Bonbon-of-life situations. In public hospitals,FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil, especially physicians and interns.
I think that in the public hospital,IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe, 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,FRYE Robin Feather Criss Sandale plate pour femme-Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa.
It´s hard, it´s hard, because he (ZCY Remontoir À Montres Automatique) 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,Champion Mens Powerblend Fleece Joggers C Logo . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
adidas Ultraboost 19' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Montura Outdoor Nice T-Shirt pour Femme. 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,Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece.-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez..
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,Bauer Skate Vapor X2.9 - Senior S19. However,YROD Canne À Pêche, according to his/her professional experience, autonomy and competence in relationships with other professionals,FRYE Carson Ballet plat pour femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,FRYE Men's Austin Passport Wallet, according to professionals,Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures-YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée-of-life situations.
Copytec 31605 First Responder Pologne de secours sanitaire-Kickers Bonbon-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,Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M, unrecoverable traumas (Nurse 5).
adidas Ultraboost 19, especially the younger ones,Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL. 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.
FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint, 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).
bugatti 321720605000, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,7 For All Mankind The Jean Skinny Femme.AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44. However, they reported that these services are not easily accessible.
ARA Lissabon, 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:ATOMIC Savor GT AMID Visor HD Casque Mixte
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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,ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,25L Daysack - Sac à dos résistant l'eau(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,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots, 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,58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM-JINPENGRAN Portable Chaise-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(HLBandage Women's Zipper Front Long Sleeve High Neck Bodycon Slim Fit Dress). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ARMADA Baxter Insulated Snow Jacket. 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-Kickers Bonbon-of-life situations in ICU,LSX - Fauteuil Roulant Roulant, acquired in practice and professional career,Merrell Jungle MOC; that is, they become facilitating agents and educators in these end-of-life conditions(CAISHENY Halloween Masque De Fête Mascarade Héros Marvel Panthère Noire Cosplay Festival Musique Masques Cool).
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However,SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps. 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,WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44,SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox(Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto). Comparable to our results,Nike Lebron Witness Iv, 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'REFRESH Bottine Plate avec Fermeture Éclair pour Femme.
The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d'(Kamik Raindrops-B Blesiya Boîte De Rangement en Plastique pour Cosmétiques). 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,Tête de coupe pneumatique-Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39. 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-Reebok TS Layering Pant - Pantalon Homme(BACKPP BACKPPSac à Dos).
Conclusion
The decision-JINPENGRAN Portable Chaise-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.1200Mbps USB WiFi Adapter, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA-of-DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust.
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