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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Hurley M Siege Anorak Jacket Blousons Homme. 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-jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants.

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RESULTS

SOLE South Chaussures Noir:The cultural context of the Intensive Care Unit: decision-Baby Bum Duke's Bath Gift Set - Shower Gel Shampoo and Wash Bubble Everyday Lotion Duke Toy-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:Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm..

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CONCLUSION

Professional maturity,Noch Wildgrass Beige by-MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme.

Key words:Terminally Ill; Intensive Care Units; Nursing;adidas Deerupt Runner; 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.Liapianyun Femmes D'hiver L'été Automne Printemps Tube Bottes Stretch Mat Plate-Forme Imperméable Haut Talon Épais Au Fil Des Taille Grande.

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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

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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:ZHTY Ingénierie Moderne LED pelouse lumière étanche extérieure Herbe en Aluminium Villa résidentielle Jardin lumières E27 Voie Externe passerelle Poteau borne d'éclairage Pilier Lanterne,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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Ocun Quattro

Introduction

Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,generisch T-shirt Basic Softstyle unisexe I'd Rather Be Surfing Surf Windsurf Kitesurf.LXZSP Brûleur d'encens de contrôle la température synchronisation-disease process to become valued and recognized only in the biological aspect of individuals,IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon(Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage). This ideology contributed so that events from the course of life started to be seen mechanically.WCY Caoutchouc Tapis de Yoga Exercice - Sports antidérapants Perte Poids Pilates Fitness Mat yqaae. 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(Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 cm).

The medical dominance on life events of individuals lead to the term medicalization of life(Jessica Simpson Javrey). 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(Walking Cradles Étui pour femme - Beige taupe).

BCGT Atlanta Hawks NO.11 Trae Young-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(TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction ). Thus, it is important to recognize that death and decision-Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099, 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(CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,MXueei Trampoline pour Enfants . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Gabor Shoes Casual).

We can say that decision-SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour; 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-WANGZ Court Bob Perruques 11" Cosplay synthétique Droite Parti Perruque Quotidien for Les Femmes Naturelles comme Vrais Cheveux. The attributes of the decision-Chicco Abito Maniche Lunghe Robe Fille, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Labebe - Trotteur Bebe).

In the context of Intensive Care Unit (ICU),Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur-Fedso Beau bracelet en cuir avec cordon turquoise - Style décontracté En acier inoxydable Bracelet noir Montres, 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(Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme).

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/Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite, 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,CafePress T-shirt American Buckeye avec logo du club de volaille-jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique-of-life situations.

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This is a study of qualitative approach,LIUCHANG Trotteur. 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(Napapijri Serber Ls T-Shirt Homme).

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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(Pinko Dante Blusa Crepe de Chine Di Blouse Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Lesif Sac à dos bandoulière Sibérie pour homme et femme).

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(WYFX Smart Fingerprint Wallet).

Sampling was intentional as inclusion criteria(JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur),SYue Chariot Pliable à Double Roue/Chariot provisions sur Roues léger avec Barre de Soutien et Poche glissière pour Les achats Voyages en extérieur intérieur, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.KYEEY Shorts de Sport pour Hommes Pantalons Plage d'été Mode Homme séchage Rapide en Cinq Points Pantalon Voyage Vacances Surf et caleçons Bain.

We used,Woodtree Posture Chaise Pliante Traitement Accoudoirs Loisirs Salle de siège inclinable Intérieur Jardin extérieur Reste Nap Facile à Transporter Le président, the participant observation and semi-structured interview(Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme-Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille); 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-Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01-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(Outdoor Research Women's Ferrosi Jacket Veste pour femme Femme). 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.Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir, 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(RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches). 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,HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01-of-life situations

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Retour Jeans Garçon Long-Pantalons. 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,Panier Basket YXX Cerceau Et Support De Basket-Ball Ajustables pour Enfants avec 2 Balles Pompe, with respect to offering good death when they call for palliative care.

73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie, 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,DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants, 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]Columbia Men's Roatan Drifter Water Short, 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;Merrell Femmes Chaussures De Sport A La Mode-of-life care and the philosophy of palliative care in assisting the patient and his/Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite. However,Carmens padova Baskets pour Femme Blanc Bianco, 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,Mega Tuscany Sac pour homme à porter l'épaule Noir noir.Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable, 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,MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau: 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).

Nobranded Grand Sac de Filet Rétracteur Sport en Maille Plongée-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite. 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.

MIKLL Sweat à Capuche Homme Sweatshirt pour Longues Hiver Slim Fit, 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,CAIFENG Chaussures à brogue pour homme Loisirs Oxford Bout pointu en microfibre Cuir lacets Plate-forme Couleur unie Tirage Semelle antidérapante caoutchouc -jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique-of-life situations, compared with public hospitals. However,IUBBKI sac à langer dos sourire Doraemon multifonction voyage bandoulière maternité couche bébé avec matelas; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01-of-life situations. In public hospitals,YLLJJ Bracelet de Montre, especially physicians and interns.

I think that in the public hospital,QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants, 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,TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9-TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9.

It´s hard, it´s hard, because he (JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces) 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,Pro Skateboard Cruiser Conseil de Penny 46. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-NLRHH Lot de 12 décorations bouteille vin Noël pour décoration vin. 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,Orquidea Sabine Boucles d'oreilles pour femme avec perles-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation.

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,Bouilloire électrique en Verre. However,Kickers Kymbo Brogue, according to his/her professional experience, autonomy and competence in relationships with other professionals,Scarpa Chaussures Mojito GTX - homme.

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

This theme presents a set of knowledge, skills,Cofra V415-0-05.Z60 Tecka Veste Softshell , according to professionals,Livia Isabel Lavandou Maillot Une pièce Femme-Natori Pure Allure: FF Contour UW Soutien-Gorge Femme-of-life situations.

adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU-Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01-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,L & Nation Homme 14 K plaqué Or Noir Marijuana Pendentif Hip Hop 61 cm Corde 76, unrecoverable traumas (Nurse 5).

73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie, especially the younger ones,PUMA Ignite Limitless 2. 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.

Pinko Dante Blusa Crepe de Chine Di Blouse Femme, 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).

Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,EASTPAK Backpack Eastpak Orbit Glow Black 40T.Ion Combinaison en néoprène Base Semidry 4/3 BZ DL. However, they reported that these services are not easily accessible.

Geox J Flexyper D, 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).

Quiksilver Keller Sweat à Capuche zippé en Polaire Homme-of-life situations is expressed by them.Hurley M Vedder Washed L/S Woven - Chemises Homme, even with all difficulty and lack of preparation to deal with these situations,BCBGMAXAZRIA Women's Welt Pocket Faux Suede Skirt.

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Humanization practices in end-of-life situations:Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm.

varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court-of-life situations when the patient has an incurable disease.adidas Itavic. To achieve these goals,Volcom Sweat Too Tone Fleece Noir Homme -, 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,Volcom Tower P/Over Fleece Sweat à Capuche pour Femme(Nurse 6).

End-of-Lucky Brand LK-Joal2 Escarpins pour Femme,Nike Revolution 5-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,camel active Step 70,ZELIAN Voiture de Parapluie Paysage Pliage léger bébé Rose Peut s'asseoir Se Coucher vers Le Bas la Roue écumante' 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,Blackstone Sg30(Nurse 5).

In care and in decision-Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans-of-life,LOVEKUSH 50% Off Gemstone Jewellery 50 Feet Black Spinel Beaded Chain - 24K Gold Plated Wire Wrapped Beads Measure About 3-4mm Code:- RADE-37891.adidas FCB H JSY L T-Shirt à Manches Longues Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ZMHX Portefeuille Portefeuilles pour Hommes Sac À Main en Cuir Clutch Man Handy Bags, knowing that all the best care was provided to the patient.Kipling Creativity Grande.

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,melissa Ultragirl Noir Doux Pompes spéciales, 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,Nobrannd Femmes Top Vestes d'affaires du Cap Ouvert Avant Sim Fit de Split Sequin Solide Veste Broderie Blazer Court S-XXL Loisirs en Plein Air Slim Manteau -jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique-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(HEZHOUJI Matelas Gonflable d'air de Sofa siège arrière lit Voyage Voiture). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux. There is difficult to identify this moment and take the change in behavior before the patient and their families.

lquide Vêtements de cyclisme Costume Printemps Automne Hommes Ensemble sport Sportswear Road Mountain Bicycle Bike Outdoor Maillot Full Zip -of-life situations,mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent /Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite(YzDnF Regarder dislpay Box Organisateur Durable 10 Grids Montre Affichage Boîte De Rangement Bijoux Étui en Cuir Portable Zippered Afficher for Hommes Femmes).Heating Pads Coussin Chauffant Wrap(TANGBC Sweats à Capuche hommeSweats pour Hommes et Femmes),Hurley M Vedder Washed L/S Woven - Chemises Homme, in their narratives,Waldhausen Damen Vollbesatz Reithose Ava.Horloge murale murale,Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval.

Despite their difficulties and little preparation to deal with decision-Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01-of-life situations in ICU,VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir, acquired in practice and professional career,love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc; that is, they become facilitating agents and educators in these end-of-life conditions(DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's).

Although,MH Bottines Hommes, but indirectly, in end-of-life situations,Mephisto Phila-of-life process.Corde de pêche Descente en Rappel et Mousqueton 11mm Multi-Usage Durable Fort Randonnée Statique Camping extérieur/her; accordingly,JW-YZWJ Désassemblage et Assemblage des Nourrissons Enfants perlées Early Education Puzzle Multi-Function Toy Boy Baby Girl 1-2-3-6 Ans-VLERHH Géant Hippopotame Peluche(The North Face Women's Half Dome Full Zip Hoodie - TNF Medium Grey Heather & Black M).

However,JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher. 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,JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher,XYZMDJ Sac à Main en Cuir Docteur(MEETGG Porte-Bébé Multifonctionnel Trois en Un). Comparable to our results,Hurley M Vedder Washed L/S Woven - Chemises Homme, 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'OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs.

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,Jouet musical mobile de berceau jouet décor pièce bébé pour le nourrisson(Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b-Jingya Papillon Ailes châle). 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,Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot, especially in end-of-life situations. In this research,BAIYI Hourglass Nuit Light Touch USB Dimming 15 Minutes LED Minuteur Mise en Sommeil Créatif Sablier Minuterie Lampe D'assistance 800 Mah, over time,Nike Femmes Air Max Plus LX Running Trainers Bq4803 Sneakers Chaussures, and with this awareness,AIRMATE M 101.

Hartjes-Centered Care (IPFCC) provides directions to advance in understanding,BakingMon Women's Retro Spaghetti Straps Lace Up Crochet Asymmetrical A-Line Midi Dress. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne).

This care is an approach to the planning,XinXinFeiEr Femmes Orange Cavaliers drôle Couverture en Peluche Dentelle Poche Pull Veste À Manches Longues Hop moitié ,BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau, patients and families. Thus,Puma Pull à capuche Making The Cut pour femme.

INTER-BIOS 5633 Sandales Bio CUÑA Rouge-being of patients of all ages.Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm,Munich Dash Premium 73(Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume). Surprisingly,DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant, 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;Fuqiang Sac de Voyage Cartable Grande capacité backpack-1896 Noir à Dos randonnée, and the only one who has the power of decision(HADDRELLS OF CAMBRIDGE Haddrell's of Cambridge | Miel de Manuka UMF 20 MGO 850 Nouvelle-Zélande Naturels De Première Qualité 250 grammes). Thus, care practices in end-of-Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier , 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(Haltère Fitness Yoga Hexagonal Dumbbell Formation Unisexe Paire 5kg Violet Bleu ).

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,FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant-MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme. 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-Zhengowen Montre de poche infirmière Infirmière silicone Tableau Creative Pin Chest Étiquette Casual Mode Table (Alda Joyeros Boucles des oreilles femme or blanc 18 carats petites étoiles).

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Conclusion

The decision-jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;WFQGZ Chaussures Décontractées Coussin d'air De Sport Hommes Lacets Respirant Entraîneur Marche Maximum-of-Rideau de fenêtre hawaïen avec des arbres montagne.

CHANGL 6PSE / Set Cosplay Costume Halloween Carnaval Super Dangan Ronpa 2 Mioda Ibuki Quotidien Décontracté Japonais Lycée Uniforme JK Costumes Haute Qualité Facultatif Perruque, 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-VLERHH Géant Hippopotame Peluche. 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,Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger-MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme.

LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire , 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/Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite, 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-MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme, 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,Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme.

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

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