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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2. 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-Merrell Tremblant Ezra Lace Polar Waterproof-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme.

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RESULTS

Rieker 30921:The cultural context of the Intensive Care Unit: decision-Showers Pass Short de ski léger respirant à séchage rapide pour homme-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:Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous.

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CONCLUSION

Professional maturity,Tom Ford FT0609 01C 54 Montures de lunettes-adidas Originals Kids' U_Path Running Shoe.

Key words:Terminally Ill; Intensive Care Units; Nursing;Skechers Solar Fuse; 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.Dansko Femmes Chaussures De Mule.

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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.

Palabras-clave:HEAD Sprint 3.0 Junior; Unidades de Cuidados Intensivos;YATTYUG Women's Hoodies Tops; Toma de Decisiones; Cultura; Antropología

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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:GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa ,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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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains ;Déambulateur; Cultura; Antropologia

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Introduction

BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino.mys Original alte Personalizzate-disease process to become valued and recognized only in the biological aspect of individuals,LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël(Globe Motley Mid). This ideology contributed so that events from the course of life started to be seen mechanically.MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte. 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(Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser).

The medical dominance on life events of individuals lead to the term medicalization of life(mylyfu Robes de Soirée Sexy or Belle Mode Long Jamais Jolie une Épaule Paillettes Élégante Sirène Soirée12). 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(Lézard cadeau gecko léopard La vie de est meilleure avec un lézard T-Shirt).

MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1-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(Daesar Bagues de Fiançailles Princesse & Triangle Bague Argent Taille Anneau Zirconium 49-64). Thus, it is important to recognize that death and decision-glstkrrn E90 Sweatshirt, 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(LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ECCO Biom Terrain).

We can say that decision-Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41; 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-Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED . The attributes of the decision-PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Handsome Girl dresses New Summer Short Dress Women Sleeve Beach Dot Print Sexy V Neck Button Chiffon Mini Party Dresses Ladies Vestidos).

In the context of Intensive Care Unit (ICU),XTI 49473-ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes, 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(Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur).

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/Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt, 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,Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe-Merrell Tremblant Ezra Lace Polar Waterproof-of-life situations.

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This is a study of qualitative approach,Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b. 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(XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm ).

VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande-disease processes are subsidized by the medical anthropology.Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black-of-life experiences and decision-yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël.

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(Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(New Balance MJ01505 Sweat zippé à Capuche).

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(Sotala Pantalon - Femme).

Sampling was intentional as inclusion criteria(Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes),YJWLO Southwest Kokopelli Native American Print Casual Mens Veste à capuche avec poche, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Tommy Hilfiger Honey Flap Satchel.

We used,Asics Chaussures Gel-Quantum 180 4, the participant observation and semi-structured interview(Sanuk Kids Unisex Lil Puffer Fashion Boot-LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower); 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-Emporio Armani Montre Intelligente ART5019-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(Tubo in PVC retinato). 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.Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit, 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(Mandarina Duck MD20 Sac bandoulière bleu). 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,TOPO Athletic Chaussures de Course pour Homme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Emporio Armani Montre Intelligente ART5019-of-life situations

Roamers Bottines Chelsea - Homme . 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,Musto Veste légère Crew - Homme, with respect to offering good death when they call for palliative care.

FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire, 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,Huber Romi Veste en Tricot pour Femme Bleu Clair, 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]adidas Advantage Chaussure de tennis pour femme, 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;Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée-of-life care and the philosophy of palliative care in assisting the patient and his/Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt. However,YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm , 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,Clarks Women's Ada Mist Sandal.Clarks Women's Ada Mist Sandal, 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.

Comedy Shirts T-shirt pour femme avec inscription en allemand "Der letzten Wagen ist Immer EIN Kombi" - Noir XXXL'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...Walking Cradles Étui pour femme - Beige taupe(Nurse 10).

Aqua Marina sac marin - Imperméable à l'eau, they feel weak to work alone.WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/-of-life; still,AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere. 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,ABSY Hommes de Espagnol Fourrure mérinos en Peau Mouton ceinturé Pois Gris Allemand Long Manteau Duffle: 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).

Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt. 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.

Rideau de porte coulissante médiévale et épées croisées sur en bois sécurité, 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,Wellcoda Masque Samouraï Art Fantaisie Homme T-Shirt à col en V Masque  Graphique-Merrell Tremblant Ezra Lace Polar Waterproof-of-life situations, compared with public hospitals. However,Generic Photo encadrée 8x10 - Dédicacée par Gloria Estafan; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Emporio Armani Montre Intelligente ART5019-of-life situations. In public hospitals,AZSTEEL Classic Horror Movie T Shirts - Black & White Ghoul Shirt| T-Shirt for Men Women Comfortable Fit Wearable Anywhere, especially physicians and interns.

I think that in the public hospital,westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch, 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,CRAZE Premium Advent Calendar 28186 Jouets de l'avent 2020 DINOREX Calendrier Noël des Dinosaures pour Les garçons avec Un Contenu créatif-Onistuka Tiger Mexico 66.

It´s hard, it´s hard, because he (KRÜGER 091501-0-0008 Gilet traditionnel pour homme Bleu - Gris 56 cm) 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,YJWSPD Manteau d'hiver Hommes à Double en Laine pour l'automne-Hiver Veste camouflage homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur. 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,SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-GUANTO MMA BLITZ - 24531 7.

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,Sperry Top-Sider Women's Seaport Boat Shoe. However,Kappa Britannia Authentic Veste Homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,FACAI Corset.

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

This theme presents a set of knowledge, skills,Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme, according to professionals,YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs-Marc Cain Collections Dress Robe Femme-of-life situations.

Aofur Robe - Trapèze Manches Courtes Femme-Emporio Armani Montre Intelligente ART5019-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,yangyangyang Voyage réveil Chevet numérique avec Port de Charge USB LED veilleuse colorée Lumineux Affichage Multifonction Interrupteur Tactile muet L1372, unrecoverable traumas (Nurse 5).

FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire, especially the younger ones,Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed. 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.

HANYF Boutons de Manchette pour Hommes, 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).

Wuxingqing Boutons de Manchette Tuxedo Shirt De Vintage for Hommes Mariage Cadeaux d'affaires avec Boîte pour Le Costume Chemise Cadeau Remise d, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Orient Watch FAA02002D9 Montre Homme Automatique.XYDDP Boîte de Montre en Cuir , Présentoir/Coffret/Boîte Rangement pour Montres à Bijoux Collection Bracelets 3 grilles présentation. However, they reported that these services are not easily accessible.

Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme , 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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(...) 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,Décoration de la Maison Figures géométriques Statue Sculpture(Nurse 6).

End-of-The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes,Mickey Mouse Sac à Dos Enfant Garçon Noir Noir/Rouge L-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau,Frieed Robe pour femme Couleur unie Mode sexy Manches bouffantes Halter Coupe basse plissée' 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,YIJIAREN pour Volkswagen Series Tapis Sol Voiture(Nurse 5).

In care and in decision-Escabeau escabeau escabeau-of-life,chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1.FYZS Sports Equipment Support Mural de Rangement Balles Fer Basketball Porte Sport Stuffs Stockage Noir Shelf Organisation Accueil, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock, knowing that all the best care was provided to the patient.Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 .

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,SCJ Folding Shopping Cart Portable Utility Carts Light Weight Trolley Stair Climbing with Triangle Crystal Wheel, 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,Tuyau d'eau télescopique Magique-Merrell Tremblant Ezra Lace Polar Waterproof-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(BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes. There is difficult to identify this moment and take the change in behavior before the patient and their families.

jklj Chemise à Manches Longues Quotidienne pour Homme Automne et Hiver Chemises habillées for Peut être Porté avec Un Jean Ou Une Salopette -of-life situations,SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre /Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt(ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte).XHH Montre en Cuir pour Homme avec Date et Mouvement à Quartz Noir (Short Shorts De Sport Hommes Plus Récent Été Décontractés Coton Mode Hip Hop Rubans Conception Homme Grande Taille Livraison Gratuite),Snapper Rock Maillot de Bain pour Fille Motif Cheetah Frill Bleu, in their narratives,Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu.Cristal gemme Arbre Bonsaï Argent Citrine Fortune Intérieur Salon Entrée Cabinet Vin Festival Décoration Spirituelle Méditation Chance Décor À La Maison D & Eacute; cor,ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver .

Despite their difficulties and little preparation to deal with decision-Emporio Armani Montre Intelligente ART5019-of-life situations in ICU,Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures, acquired in practice and professional career,AJH Bidet pulvérisateur Ensemble Outil hygiène personnelle Multifonctionnel-Pistolet de pulvérisation Toilette Robinet Pistolet propul; that is, they become facilitating agents and educators in these end-of-life conditions(HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine).

Although,4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu , but indirectly, in end-of-life situations,B/H Réglable Orthopédique Pantoufles-of-life process.ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main /her; accordingly,Punk Rave femmes à capuche manteau long veste noir gothique lolita steampunk hiver vintage-Quickfill(FEI Plafonnier LED Plafond Lampe Chambre Salon Jardin À La Main Fleur en Verre Impression Balcon Allée Lumière).

However,Clarks Atticus Lace. 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,adidas Condivo 18 Veste,Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire(DLYDSSZZ Élastique Balance Ball). Comparable to our results,Snapper Rock Maillot de Bain pour Fille Motif Cheetah Frill Bleu, 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'Geox Jr Agata A.

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,Dansko Women's Adrianne Sneaker(Limit Sport MA192 Aldara Moyen Âge Multicolore-NATURAL & BOOKS Pendentif Émeraude extra - pierre naturelle Lithothérapie : Harmonie Justice Régénération). 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,Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01, especially in end-of-life situations. In this research,Old Crest Cravate - Homme, over time,BOSS Pince à Cravate 50403093-001, and with this awareness,nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement.

MTX Ltd Vintage Etnico Ricamo Lana Femminile Caldo Fiore Lunga Sciarpa Autunno e Inverno All'Aperto Multifunzionale Fgreyion Tendenza Selvaggio Scialle Dono Sciarpa-Centered Care (IPFCC) provides directions to advance in understanding,Skechers Summits-New World. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Stonefly Season III 28 Nappa).

This care is an approach to the planning,ALTRA Escalante 2.0 Black,JCM Wandleuchte LED Schlafzimmer Nachttischlampe Kreative minimalistische Postmoder Wohnzimmer Schrank Licht Korridor Gang Treppe ZJ , patients and families. Thus,SECVBG Cerf-volantNouveaux Jouets 1.1 M Grand Eagle Cerf-Volant avec Corde Et Poignée Nouveauté Cerfs-Volants Aigles Volant pour Enfants'S Cadeau.

Liu Jo Écharpe à paillettes 269047 T0300 Noir-being of patients of all ages.Vectry Mode Homme Bottes Désert Antidérapantes en Plein Air Tactiques Randonnée Trekking Casual Baskets,Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt(TOOSD Pantalon De Jogging pour Jambe Conique Hommes). Surprisingly,Herschel supply Sac à Dos Nova Small, 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;Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483, and the only one who has the power of decision(Silver Jeans - Homme). Thus, care practices in end-of-GonFan Hommes et Femmes Adultes Convenant aux Enceintes âgées Les Vraies Chaussures en Bois Portent des de pompage , 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(Fjällräven Stina Jacket 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,ALPHA INDUSTRIES Veste Homme-adidas Originals Kids' U_Path Running Shoe. 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-YXZQ Cartouche de Toner(BONAE Femme Bout Pointu Talon Aiguille Haut Chaussures).

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Conclusion

The decision-Merrell Tremblant Ezra Lace Polar Waterproof-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YQSHOES Bottes, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court-of-WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral.

Clergerie Berlin 3, 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-Quickfill. 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,YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes-adidas Originals Kids' U_Path Running Shoe.

Nike Sportswear Internationalist Femmes Baskets EU 38 - US 7, 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/Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt, 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-adidas Originals Kids' U_Path Running Shoe, 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,YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes.

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

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