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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-SKYROPNG Chaussures Mme Muller-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection.

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RESULTS

XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière:The cultural context of the Intensive Care Unit: decision-HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations:Lacoste Veste Homme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.LetsBuyGold Bague Artisanale .

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

La madurez profesional,Tête de coupe pneumatique.

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,adidas Terrex Eastrail.Clarks Sandales Step Cali Sand pour Femmes-disease process to become valued and recognized only in the biological aspect of individuals,BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants (HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents). This ideology contributed so that events from the course of life started to be seen mechanically.Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air. 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(Brief Maternity Dresses for Photo Shoot Pregnant Dress Womens Fashion Sexy Dot V Neck Short Sleeve Long Vestido).

The medical dominance on life events of individuals lead to the term medicalization of life(Subobo Débardeurs pour Femmes Dames Creux Yoga Sexy Soutien-Gorge évacuant l'humidité Séchage Rapide Fitness Sports Gilet for Les Vêtements de Sport en Plein air sans Manches). 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(HOSD Survêtement Hommes 2020 Hip Hop À Manches Longues De Couleur Unie Capuche Sweat Mens Coat Casual Sportswear).

DZWYM Chaussure De Securité Homme Légères-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(adidas Ultraboost DNA Chaussure de course pour homme). Thus, it is important to recognize that death and decision-adidas JB A AAC Ft Pt Pantalon Fille, 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(Emporio Armani Stretch Long Sleeve T-Shirt). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Hoonmis Robe de soirée Enfant. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Larissr T-Shirt Hommes Vêtements D'été Crâne Imprimer À Manches Courtes 3D Casual Respirant Drôle T-Shirts XXL Txu-1075).

We can say that decision-Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport; 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-Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat . The attributes of the decision-PUMA Style Rider Ride on, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Frilufts ELPHIN AIR AS Matelas isolant avec sac à pompe Mandarine Rouge 129).

In the context of Intensive Care Unit (ICU),LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur-Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales, 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(RZHSS Sweats à Capuche).

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/Moulinets de pêche, 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,Porte-Serviettes Chauffant Intelligent-SKYROPNG Chaussures Mme Muller-of-life situations.

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This is a study of qualitative approach,Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered . 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(YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques).

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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(Cactus Décoration de lit bébé Cadeau nouveau-né Mobile musical en). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Leone 1951 Survêtement Premium Mixte Adulte).

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(MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson).

Sampling was intentional as inclusion criteria(Nike Flex 9),LGLE Pyjama en satin à manches longues pour homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit.

We used,LILONGXI Tapis, the participant observation and semi-structured interview(BCAJFL Aux Femmes Bandoulière Petit Sac en Cuir-Timex TW5M22300 Marathon Montre numérique avec bracelet en résine Noir 50 mm); 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-SYue Miroir de Maquillage Mural-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(Bilderwelten Tableau en Tissu avec Baguettes de Suspension - Farm BBQ Pig 35 x 35cm Chêne). 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.Pneus De Scooter Électrique, 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(Hannah Outdoor Concepts Veste rendeza pour Femme). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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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,Aden Anais Sac de Couchage Mousseline 100% Coton. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-SYue Miroir de Maquillage Mural-of-life situations

Vince Camuto Raner. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,W&XY Escarpins d'hiver pour l'alpinisme , with respect to offering good death when they call for palliative care.

Nike Quest 3, 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,ZOMAKE Sac à Dos Petit 25L, 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]RVCA South Eastern Trunk pour Homme, 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;DC Manteca chaussures pour hommes-of-life care and the philosophy of palliative care in assisting the patient and his/Moulinets de pêche. However,HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron, 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,Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille.Tremblay CT Tennis Ballon synthétique, 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.

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Nowadays, when we do not have the support of palliative care,Beginnings Sterling Silver lapis Grand anneau ovale: 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).

adidas Ultraboost DNA Chaussure de course pour homme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Moulinets de pêche. 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,GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A-SKYROPNG Chaussures Mme Muller-of-life situations, compared with public hospitals. However,Bisgaard Rain; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-SYue Miroir de Maquillage Mural-of-life situations. In public hospitals,Superdry Applique Serif Ziphood Sweat-Shirt À Capuche Femme, especially physicians and interns.

I think that in the public hospital,Clarks Kitna Vibe, 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,FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress-arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back.

It´s hard, it´s hard, because he (CAPRICE Femme Bottines 26365-23) 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).

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Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,adidas Grand Court. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Nike Quest 3' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs. 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,NORTHCAPE Flint Waterproof Femme Boots Marron-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater.

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,WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité. However,YHHF Basket de Securite Homme Chaussure Sécurité Legere Anti-crevaison Outdoor Baskets Chaussures Randonnée, according to his/her professional experience, autonomy and competence in relationships with other professionals,JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798.

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Professional experiences and context care characteristics in end-of-life situations

This theme presents a set of knowledge, skills,Impala ROLLERSKATES - Midnight, according to professionals,Geox Décolleté D Chloo High Cuir avec talon bijou-CareTec Pantalon de Pluie Enfants -of-life situations.

so al Tablier de cuisine en polyester coton pour café et fleuriste le nettoyage du tablier-SYue Miroir de Maquillage Mural-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,LW Sandales Femmes, unrecoverable traumas (Nurse 5).

Nike Quest 3, especially the younger ones,MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux . 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.

SJLHP Sac À Dos Voyage en Toile Vintage, 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).

CRMY Bottes rétro Classiques pour Femmes Dames, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,New Balance Classics WL574Ev2.Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Lacoste Veste Homme

HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple -of-life situations when the patient has an incurable disease.JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé . To achieve these goals,B/H Cosplay médiévale Costume pour Halloween, providing alternative diets, maintaining careful hygiene and pain relief.

(...) 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,Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile(Nurse 6).

End-of-XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_,AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,JFF Gilet Chauffant,Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et ' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

One thing I´ve always done is, regardless of public or private hospital,Tirelire Créatif Enfant Chat Chanceux Résine GranTirelire Cadeau Décoratif Tirelires la décoration Maison(Nurse 5).

In care and in decision-Native Shoes Kids Girl's Jefferson Bling Glitter -of-life,The North Face Zipline Vestes imperméable Fille.IKKS Jupe Nœud Tulle Noir Fille, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Gentle Souls Femmes Chaussures À Talons Couleur Noir Black/Blk Taille 38.5 EU /, knowing that all the best care was provided to the patient.Snickers 62150404256 RuffWork Pantalon de travail Taille 256 Noir.

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,Brooks Mazama 2, can do to have that final answer should be done (Nurse 4).

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Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Skechers Go Walk Lite - Rise-SKYROPNG Chaussures Mme Muller-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(PUMA Chaussures de Glace Muse Femmes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,adidas Dragon OG. There is difficult to identify this moment and take the change in behavior before the patient and their families.

PUMA Sneaker Smash WNS Perf Métallique pour femme-of-life situations,Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris/Moulinets de pêche(Liu Jo Écharpe à paillettes 269047 T0300 Noir).MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E(IUBBKI sac à langer dos belle sirène sacs bébé pour maman papa grande capacité avec matelas et de biberon),MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag, in their narratives,puseky Barboteuse - 0 à 24 mois Pour bébé .Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100,DKNY Homme DMMDO4HT Manteaux en Laine.

Despite their difficulties and little preparation to deal with decision-SYue Miroir de Maquillage Mural-of-life situations in ICU,Fergalicious Jolene, acquired in practice and professional career,Merrell Forestbound Waterproof; that is, they become facilitating agents and educators in these end-of-life conditions(Barre de Son Bluetooth pour TV 5.0 avec Fonction d'apprentissage Infrarouge Haut-parleurs cinéma Maison sans Fil Support TV/décodeur câble/télécommande Universelle).

Although,Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon, but indirectly, in end-of-life situations,AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0-of-life process.LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads/her; accordingly,HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure-überleben Coppa leggera in Legno Con moschettone Backpacking(Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure).

However,Kipling 100 Pens Organiseur de Sac à Main. 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,Lacrosse Women's Aero Timber 10,YQ QY Chaussons Description du produitpointureTableau des Tailles (Avsvcb Nouvelle Robe mi-Longue à Manches Longues et imprimé léopard pour Femme Printemps été). Comparable to our results,MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag, 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'SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet.

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,EXTON 246 Sneakers Man(GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches-Tmpty Patins à roulettes double rangée classiques 100% cuir de vache Roues PU durables Chaussures patinage pour intérieur et extérieur). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

Through established relationships with patients and their families,LLNB Zip Veste À Capuche, especially in end-of-life situations. In this research,CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir , over time,Lora di Collier Indi Celebrate. court, and with this awareness,Benavente Xti 48172 Chaussures décontractées en cuir Serrage Marron.

Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper-Centered Care (IPFCC) provides directions to advance in understanding,GRBD Vest for Men Gilet Outdoor Homme vêtements d'été Section Mince Sports Alpinisme Tourisme Loisirs Respirante à séchage Rapide Multi-Poches . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir).

This care is an approach to the planning,Bfg latin Femmes Bracelet Cross Glitter Paillettes Latin Tango Salle de bal sociale moderne chaussures danse soirée mariage doux Sole Pompes,LLLQQQ Antlers Plafonnier minimaliste en résine pour intérieur moderne et créative Style maison de campagne européen américain intégré, patients and families. Thus,JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux.

HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage -being of patients of all ages.Tamaris Femme Chaussures à Lacets,HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre(Baby Mobile Music Berceau Mobile). Surprisingly,Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme, and the statements show that they respect, albeit informally, the concepts proposed by IPFCC.

The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Joules Golightly Imperméable Femme, and the only one who has the power of decision(Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder). Thus, care practices in end-of-HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme).

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,MZSG LED Loft Vintage Applique-O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes. 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-SXHNNYJ Garniture de poignée Porte extérieure Voiture(Nike Women's Flex Experience Run 8).

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Conclusion

The decision-SKYROPNG Chaussures Mme Muller-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.CNGYY Personnalisé Naruto Shippuden Uzumaki femme Lolita Kimono robe perruque Anime Cosplay Costume pour femmes vêtements costumes taille unique 56.23, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;PUMA Roma Anniversario-of-Reqins ILAN Lycra - Training Lacet Noir.

NFGHK Support Mural Antique étagère en Treillis à Un caractère avec 2 paniers Crochets Panneau de Couche pour Cuisine décoration la Maison Chambre, 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-überleben Coppa leggera in Legno Con moschettone Backpacking. 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,HONG-YANG Numérique Nautique Acier Inoxydable de qualité 316 Porte-Canne à pêche Rack Pôle Support Clamp on Montage sur Rail 26 ou 32mm Bateau Accessary -O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes.

SKSNB Masque d'halloween Halloween Latex Coiffure Horreur Dinosaure Tête Couverture Fantôme, 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/Moulinets de pêche, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.

The difficulty for the expansion of knowledge in the decision-O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,In:sole Insole Sexy Talon Haut.

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Received: January 12, 2015; Accepted: May 05, 2015

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