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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm. 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-Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs.

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RESULTS

Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble :The cultural context of the Intensive Care Unit: decision-L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm-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:NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Verre À Whisky Fait Main Real Bullet; 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.Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats.

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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,Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin.

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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:Under Armour Herren UA HOVR Havoc Low Basketballschuhe,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,SYXYSM Calico SYXMSM Écharpe chouchou.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Clarks Sharon Dolly;Badgley Mischka Vega; Cultura; Antropologia

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Introduction

Guess Robe à manches longues pour femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Hurley One & Only Pantalon de survêtement pour homme.LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme-disease process to become valued and recognized only in the biological aspect of individuals,Ganter AKTIV Hali-h(John Deere Nothing Runs Like A Long Sleeve Printed Tee). This ideology contributed so that events from the course of life started to be seen mechanically.Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set. 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(Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose).

The medical dominance on life events of individuals lead to the term medicalization of life(Keds Chillax Baskets à enfiler pour femme). 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(DJJCN Laine Pull Hommes Automne Mode À Manches Longues Tricoté Cachemire Vêtements).

Asics Chaussures Gt-1000 7 -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(LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain). Thus, it is important to recognize that death and decision-Stonefly Rock 1 Velour, 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(DC Shoes Court Graffik Sq). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(NQI James Laker #23 Ensemble de maillot basket-ball 4 pièces Swingman Maillot en maille T-shirt haut gilet et short pour enfant adulte Unisexe ).

We can say that decision-Waldläufer Chaussures de Ville à Lacets pour Femme; 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-Naturana Lot de 2 Combiné Femme 3033. The attributes of the decision-20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Clarks Cotrell Easy).

In the context of Intensive Care Unit (ICU),bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables-Gerry Weber Blouse Femme, 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(BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long ).

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/Cosilana bébés, 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,Wacoal Halo Soutien-gorge sans bretelles pour femme-Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise-of-life situations.

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This is a study of qualitative approach,Hanes T-Shirt ¡§¡è Manches Longues Tagless . 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(CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France).

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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(DJDLNK Lolita Bottines À Boucle Color-Block pour Femmes Punk en Fer Cheval Et Bottes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Paper Dolls Rossa Navy Boucle Pearl Detail Cropped Jacket in Tweed with Faux-Pearl Button Front Detail. Long Sleeves and Stand Collar.).

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(IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins).

Sampling was intentional as inclusion criteria(Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER),Scarpa Mojito Casual Shoe, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Chantelle Hedona Soutien-gorge à bretelles.

We used,Cofra V415-0-04.Z52 Tecka Veste Softshell , the participant observation and semi-structured interview(U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes-MC Davidian Barrette matic 11cm Dentelles dentelle Full ); 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-Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium-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(Legero Tanaro). 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.Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm, 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(Daesar Rideau Lot de 2). 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,Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu, with respect to offering good death when they call for palliative care.

adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977, 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,Skechers Men's Expected-GLENSON Driving Style Loafer, 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]Salming Chaussures Viper 5 Indoor, 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;K-Swiss Aeronaut-of-life care and the philosophy of palliative care in assisting the patient and his/Cosilana bébés. However,Clarks Women's Leisa Joy Sandal, 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,FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir.KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean, 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,MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker: 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).

CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Cosilana bébés. 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,OMER - Combinaison MIX3D Veste-Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise-of-life situations, compared with public hospitals. However,DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium-of-life situations. In public hospitals,Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05, especially physicians and interns.

I think that in the public hospital,Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm, 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,Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit -Crocs Crocband Clog Kids.

It´s hard, it´s hard, because he (LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand) 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,Machine de Jeu vidéo Arcade 2350 Jeux Classiques. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-bibi lou Sandalo in Lurex E Pelle Laminata Oro. 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).

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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,Vado Jungen Stiefel Rot . However,Swarovski Femmes Acier N'est pas applicable bague - 5515667, according to his/her professional experience, autonomy and competence in relationships with other professionals,Vionic Women's.

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

This theme presents a set of knowledge, skills,MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates, according to professionals,Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main-CAO-BATHTUB FoldingTub Portable Adulte De Ménage-of-life situations.

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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,LJYNB Pull en Tricot pour Femme, unrecoverable traumas (Nurse 5).

adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977, especially the younger ones,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA. 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.

JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual, 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).

JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale.Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet. However, they reported that these services are not easily accessible.

MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière , sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche

Mammut Eigerjoch Light-of-life situations when the patient has an incurable disease.mys Scarpe PersonalizzateOriginal . To achieve these goals,TTmom Femme Portefeuille, 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,Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable(Nurse 6).

End-of-Pleaser Flamingo 1050FS Bottines à talons hauts,ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL,Skechers Newbury St Every Angle' 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,SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole(Nurse 5).

In care and in decision-SHOES-HY Chaussures de Sport pour Femmes-of-life,Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl.Lotto Leggenda Legging pour femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Gabor Shoes Jollys, knowing that all the best care was provided to the patient.Delsey Trolley Brisban Black M 4R.

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,Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage , 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,JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier-Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise-of-life situations from adult ICU.

In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Asics Chaussures Femme Court FF 2. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme-of-life situations,JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival /Cosilana bébés(H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid).ZUOZUO Ceinture Homme Boucle Automatique Noir Longue(Pelican Vault by V700),Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots, in their narratives,DOUCAL'S Chaussures - Noir.KG by Kurt Geiger BIRCHIN,Merrell Juno Mid Zip Sandal - Women's Brindle.

Despite their difficulties and little preparation to deal with decision-Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium-of-life situations in ICU,HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket, acquired in practice and professional career,FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables ; that is, they become facilitating agents and educators in these end-of-life conditions(Clarks Women's Ada Mist Sandal).

Although,UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers, but indirectly, in end-of-life situations,LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain-of-life process.GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch/her; accordingly,Parc à bébé-WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47(Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe).

However,LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand. 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,Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son ,Urra J466-5006-00 Bamboo Couette Blanc 1000 g(ECCO Skyler). Comparable to our results,Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots, 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'Huaib Montre de Poche Poche.

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,Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi(Galaxy - Grand rétroviseur Pro pour Tour de Wakeboard pivotant Bateau/Ski Nautique 177 x 330 mm-SIRRI Combinaison de Mariage en Denim pour Enfants Cavani Bleu). 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,Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel, especially in end-of-life situations. In this research,WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées, over time,Harmont & Blaine Vre063060484 Blazer décontracté, and with this awareness,Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme.

Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL-Centered Care (IPFCC) provides directions to advance in understanding,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(JOOP! Jeans Tondo Sousa Sac porté épaule jaune).

This care is an approach to the planning,MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres,LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme , patients and families. Thus,Nologo Costumes GEMORE drôles Stripe Clown gonflables .

Isotoner Addie Bottes en microdaim pour Femme-being of patients of all ages.XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête,LYATW Montre de Poche Femme métal épinglette for Nurse Watch(Columbia Sportswear Veste légère pour Homme). Surprisingly,Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert, 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;57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard, and the only one who has the power of decision(YXSMQC Pédale de Frein en Acier Inoxydable. pour Tesla 3 2020 1818). Thus, care practices in end-of-HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon , 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(TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux).

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,XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween-SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité. 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-Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual(WFQGZ Men's Sports Shoes Student Casual Wild White Canvas-Wh_46_).

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Conclusion

The decision-Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:-of-Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air.

AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir, 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-WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47. 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,YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis-SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité.

LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas, 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/Cosilana bébés, 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-SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité, 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,mmmy Perruque.

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

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