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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Salming Chaussures Viper 5 Indoor. 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-DYYTR Grande capacité-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-WXX Chaise berçante bébé.

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RESULTS

MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker:The cultural context of the Intensive Care Unit: decision-CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit-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:Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05; 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.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 .

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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:Vado Jungen Stiefel Rot ,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,CAO-BATHTUB FoldingTub Portable Adulte De Ménage.HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille -disease process to become valued and recognized only in the biological aspect of individuals,LJYNB Pull en Tricot pour Femme(LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple ). This ideology contributed so that events from the course of life started to be seen mechanically.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. 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(Mephisto Rainbow Chestnut Mens Shoes).

The medical dominance on life events of individuals lead to the term medicalization of life(Dahuiji Collier Belle Imitation Perles Boucles d'oreilles pour Les Femmes en Forme De Larme Abeille Croix Coeur Pendantes Bijoux Cadeaux Accessoires). 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(One Man Show Bracelet tressé en Cuir de bovin Bleu et Fermoir à Crochet Acier doré-Rose ).

JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual-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(FXPCQC Mesdames Dentelle Compensée Sexy À Talons Hauts Plateforme Cheville Bootie Fermeture Glissière Boucle De Pompes SM Ballet Queen Bottes Unisexe). Thus, it is important to recognize that death and decision-JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à, 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(Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YAOLAN 5D Diamant Peinture kit Complet).

We can say that decision-Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet; 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-MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière . The attributes of the decision-Happiness Leggings Serpent, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(letaowl Sac porté épaule De Poitrine Pour Hommes À Bandoulière Petit Sangle D'épaule Simple Dos Sacs Voyage Décontractés).

In the context of Intensive Care Unit (ICU),Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots-Rossignol Pantalon de Ski Homme, 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(adidas Femmes Chaussures Athlétiques).

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/Mammut Eigerjoch Light, 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,mys Scarpe PersonalizzateOriginal -DYYTR Grande capacité-of-life situations.

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This is a study of qualitative approach,TTmom Femme Portefeuille. 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(AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight).

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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(Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Giorgio Capone Chemise Premium pour Homme).

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(FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby).

Sampling was intentional as inclusion criteria(Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes),Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Skechers Newbury St Every Angle.

We used,SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, the participant observation and semi-structured interview(1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN-DGHJK Haut-Parleur Bluetooth Gramophone); 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-SHOES-HY Chaussures de Sport pour Femmes-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(Replay Jean Droit Homme). 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.Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl, 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(FLOTO Ciabatta Italian Leather Briefcase Attache ). 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,Lotto Leggenda Legging pour femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-SHOES-HY Chaussures de Sport pour Femmes-of-life situations

Delsey Trolley Brisban Black M 4R. 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,JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier, with respect to offering good death when they call for palliative care.

Asics Chaussures Femme Court FF 2, 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,Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme, 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]JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival , 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;ZUOZUO Ceinture Homme Boucle Automatique Noir Longue-of-life care and the philosophy of palliative care in assisting the patient and his/Mammut Eigerjoch Light. However,DOUCAL'S Chaussures - Noir, 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,KG by Kurt Geiger BIRCHIN.Merrell Juno Mid Zip Sandal - Women's Brindle, 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,Parc à bébé: 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).

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LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand, 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,Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son -DYYTR Grande capacité-of-life situations, compared with public hospitals. However,Urra J466-5006-00 Bamboo Couette Blanc 1000 g; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-SHOES-HY Chaussures de Sport pour Femmes-of-life situations. In public hospitals,Huaib Montre de Poche Poche, especially physicians and interns.

I think that in the public hospital,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, 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,Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel-WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées.

It´s hard, it´s hard, because he (Harmont & Blaine Vre063060484 Blazer décontracté) 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,Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Asics Chaussures Femme Court FF 2' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL. 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,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres.

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,LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme . However,Nologo Costumes GEMORE drôles Stripe Clown gonflables , according to his/her professional experience, autonomy and competence in relationships with other professionals,Isotoner Addie Bottes en microdaim pour Femme.

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

This theme presents a set of knowledge, skills,XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête, according to professionals,LYATW Montre de Poche Femme métal épinglette for Nurse Watch-Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert-of-life situations.

57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard-SHOES-HY Chaussures de Sport pour Femmes-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,HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon , unrecoverable traumas (Nurse 5).

Asics Chaussures Femme Court FF 2, especially the younger ones,XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween. 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.

Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle 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).

AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:.Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air. However, they reported that these services are not easily accessible.

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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,IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme(Nurse 6).

End-of-New Balance Roav V1 Fresh Foam,ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert.,IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages' 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,Tyrannosaurus Rex Dinosaur Toy pour Les Garçons(Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and, 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,Lampadaire postmoderne-DYYTR Grande capacité-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(Daniel Wellington Montre). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Mr.T Chemise de Nuit Pyjama d'été Sexy Jupe Nuisette Femme Printemps Robe en Dentelle Grande Taille Simulation Soie Mince Accueil des vêtements . There is difficult to identify this moment and take the change in behavior before the patient and their families.

ZJ Bien Maillots de Bain Garçons d'enfants-of-life situations,Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes /Mammut Eigerjoch Light(Walker Valentin Chapeau IBHT Femmes Cap Plein Air Scarf points imprimés style décontracté Pare-soleil extensible respirant Yoga chaud cou sommeil Couvre-chef ST Nouveau).XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard(TAZAN Chaussures Bottes Chelsea pour Les Hommes),LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas, in their narratives,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux.XIUYU Boîte à Musique en Bois Bricolage Main ,Oluola Sweats à Capuche Vintage Elvis Presley pour Femme.

Despite their difficulties and little preparation to deal with decision-SHOES-HY Chaussures de Sport pour Femmes-of-life situations in ICU,NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme, acquired in practice and professional career,Craghoppers Kiwi Boulder 40; that is, they become facilitating agents and educators in these end-of-life conditions(ZUIBADUDU Lunettes De Soleil Femme Nouveau Couple Classique Sauvage La Mode Personnalité Tendance Hommes Et Femmes Cadre en Métal Conduite Enduit Miroir So).

Although,LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku, but indirectly, in end-of-life situations,ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau-of-life process.Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main/her; accordingly,HOXMOMA Berceau de bébé-Skechers Women's Go Walk Lite-16352 Ballet Flat(ÖGON Smart Wallets Porte-Cartes Cascade Slim - Protection RFID Aluminium et Cuir Italien Orange).

However,YQ WHJB Recliner Réglable pour Outdoor Office Nap. 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,BOBD-DW One Piece Roronoa Zoro Femme Fille Hiver Chaud Manteau Capuche Mode Manches Longues Veste Polaire Zippé Homme Full-Zip Sweat-Shirt Hoodie Taille,SWAOOS S925 Collier De Fleurs en Argent Sterling Version Coréenne Simple Petite Chaîne Clavicule Or 14 K Frais Ins Vent Pendentif Tournesol(WZR Femme's Synthétique Sandales Slipper Pantoufles). Comparable to our results,LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas, 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'MAATCHH Sac pour Hommes à bandoulière en Toile Messenger Main de Loisirs Voyage Porte-Documents d'affaires adapté for Les Jeunes Sacs Bandoulière.

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,Godmoy Avatar The Last Airbender Costume Sokka/Zuko/Korra d'halloween Cosplay pour Hommes Femmes(Zerimar Chaussures Femme Talon | Bottines Cuir Elegant Casual Fabriqué en Espagne-Reebok NHL Pittsburgh Penguins Premier Jersey). 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,Eastbride Veste Trois-en-Un pour Hommes, especially in end-of-life situations. In this research,Chaise suspendue pour berceau bébé, over time,Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon, and with this awareness,yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau .

EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues -Centered Care (IPFCC) provides directions to advance in understanding,Skechers Performance Go Walk Evolution Ultra - 54736. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(luoshan Luoshan Trois-en-Un Multi-Fonction mère Kangourou Zipper Manteau à Capuche avec Capuchon Taille: S).

This care is an approach to the planning,Pierre Cardin Futureflex Strech Denim Bermuda Short Homme,Converse Chuck Taylor All Star Season, patients and families. Thus,Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël.

42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël-being of patients of all ages.Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50,DANJIA Argent-gris perruque(Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 ). Surprisingly,SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements, 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;ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad, and the only one who has the power of decision(Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement ). Thus, care practices in end-of-Diamond Chandelier, 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(Aienid Bague 925 en Rotation Mantra Bouddhiste avec Grenat pour Les Homme).

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,MFXI Veste imperméable de Mode Unisexe Manteau Pluie Ponchos multifonctionnels réutilisables avec Capuchon à Cordon pour Les activités Plein air Course Pied Escalade Pêche vélo (Noir)-DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun. 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-ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle(SGSKJ Sacs à Dos Femme Tower Bridge Londres 2 Cuir Cartable College Sac a Voyage Portable Scolaire Ecole).

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Conclusion

The decision-DYYTR Grande capacité-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YONGQUAN Barrière en métal Blanc, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Jakflyzel Veste d'hiver Hommes épaissir Vestes Chaudes Coupe-Vent à Capuche Parka Grande Taille 5XL 6XL Manteaux-of-BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant.

Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers, 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-Skechers Women's Go Walk Lite-16352 Ballet Flat. 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,N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm-DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun.

KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat, 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/Mammut Eigerjoch Light, 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-DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun, 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,ECCO Offroad.

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

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