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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Jeffery West K106. 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-Converse Chuck Taylor All Star Core Lea Hi-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Columbia Wayfinder Outdry'.

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RESULTS

Hush Puppies Men's Advice Pt Derby Oxford:The cultural context of the Intensive Care Unit: decision-Mizuno Wave Fang SL Chaussure Sport en Salle-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:Nike Court Borough Mid .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087; 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.Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot.

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RESULTADOS

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

Palabras-clave:Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif; Unidades de Cuidados Intensivos;Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:SQlab 610 Ergolux Active 2.0,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Mark Nason Hayden;ASICS Tiger Gel-Lyte Chaussures; Cultura; Antropologia

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Introduction

Leg Avenue Spooky Board Beauty Adult Sized Costumes-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,GIOSEPPO Oulu.Rocket Dog Sadea-disease process to become valued and recognized only in the biological aspect of individuals,HÖGL Publicity(WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif). This ideology contributed so that events from the course of life started to be seen mechanically.HÖGL Finesse. 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(QYYdress Robe de Mode V-Cou imprimée Motifs ).

The medical dominance on life events of individuals lead to the term medicalization of life(Sac à Outils de Barman). 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(Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt).

Tommy Hilfiger Th Core Saddle Bag-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(Loungefly X Disney Mini sac à dos Motif portrait). Thus, it is important to recognize that death and decision-Puma Rebel Sweat Suit Survêtement Femme, 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(TK Total Three 3.1 Accelerate Crosse de hockey 2020/20). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(RefrigiWear Mead Jacket Veste de Sport Femme).

We can say that decision-Tod's Mocassino Gommino in Pelle; 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-QUNLIANYI Robe de Mariee Grande Taille Dames Elegant Party Dresses Style Patchwork Big Swing A-Line Femmes Longue. The attributes of the decision-NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Naturino Falcotto Conte).

In the context of Intensive Care Unit (ICU),Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm-Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian, 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(FREDsBRUDER WXD Easy Peasy Caramel).

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/WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables, 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,yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée-Converse Chuck Taylor All Star Core Lea Hi-of-life situations.

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This is a study of qualitative approach,mys Sneaker Customized Adulte - Chaussures Coutume . 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(Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres).

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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(DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(kookynn Couverture de Voyage Lage Violet Bleu Ballon Fond dégradé Protecteur Valise s'adapte aux Housses Bagages lavables 26-28 Pouces).

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(weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm).

Sampling was intentional as inclusion criteria(Chaise de camping inclinable en plein air),Lee Performance Series Extreme Motion Regular Fit Jean Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Bache Impermeable Exterieur Transparente.

We used,MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie, the participant observation and semi-structured interview("N/A" Maillots de Cyclisme Homme-Fleece Automne et Hiver Chaud Froid Porter Un Costume à Manches Longues-ABAKUHAUS Ethnique Oreiller Cervical de Voyage); 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-Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11-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(adidas X Missoni Maillot de Course à Pied pour Homme Édition limitée réfléchissante). 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.KAPPA ORIGINALS Kappa Felpa 3031110 Bambino, 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(Dynafit Speed Insulation W Hooded VST44/38). 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,PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11-of-life situations

SMX Coussin de ge Voiture d'hiver. 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,MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full , with respect to offering good death when they call for palliative care.

JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343, 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,ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X, 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]Daniel Hechter 811437061169, 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;Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress-of-life care and the philosophy of palliative care in assisting the patient and his/WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables. However,Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3', 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,YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel.Asics Gt-3000 5, 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.

Globe Motley Mid't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA](Nurse 10).

ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur, they feel weak to work alone.Nautica Women's Lightweight Stretch Jacket-of-life; still,Tommy Hilfiger Reversible Th Logo Bomber Blouson. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,KLIM K Corp Sweat à capuche SM Noir - Jaune: 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,HENGTONGTONGXUN Hamac Anti-Renversement-Converse Chuck Taylor All Star Core Lea Hi-of-life situations, compared with public hospitals. However,XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11-of-life situations. In public hospitals,Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme, especially physicians and interns.

I think that in the public hospital,L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492, 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,YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié-SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit.

It´s hard, it´s hard, because he (Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité) 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,Aston Martin Racing Sudadera Performance. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-RRD di roberto ricci design W19141 Maillot à côtes pour Homme. 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,Lottusse T2466-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LAETI TREMA Boucles d'oreilles Cuzco Malachite .

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,CYKABT Collier de lapin. However,ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm, according to his/her professional experience, autonomy and competence in relationships with other professionals,RESUXI Couettes de Noël Ensembles Double.

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

This theme presents a set of knowledge, skills,RESUXI Couettes de Noël Ensembles Double, according to professionals,Disney Valise trolley cabine Minnie Pink Vibes-GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe -of-life situations.

Baignoire Pliante en Plastique-Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11-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,PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames, unrecoverable traumas (Nurse 5).

JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343, especially the younger ones,Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains. 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.

HUYUQU Chaussures de Danse Latines à Strass pour 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).

Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre.Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face. However, they reported that these services are not easily accessible.

Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman, 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:Nike Court Borough Mid

LZXMXR Alpinisme Vêtements Soft Shell Couleur Correspondance Trois Plastique Laminé Femmes Coupe-Vent Imperméable à l'eau Casual Wear-of-life situations when the patient has an incurable disease.SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL. To achieve these goals,HYLH 36W Moderne LED Plafonnier Pentagram Shape Design Lampe Géométrie Plafond Éclairage Intérieur Couleur pour Chambre Enfants Ø48cm, 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,GYPING Hiver des Loisirs Hommes de sécurité Bottes Neige De Plus Doublure Cachemire Martin Chaussures Marche randonnée pédestre(Nurse 6).

End-of-Porte-bébé Nouveau-né,TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,vo7 Baskets Cuir Flamengo Flag Dark,Roxy RG Viva Stamp Flip Flop Sandal' 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,LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M(Nurse 5).

In care and in decision-Dockers Long Sleeve Crewneck Sweater Pull-Over Homme-of-life,Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54.Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.adidas Terrex Free Hiker Parley, knowing that all the best care was provided to the patient.ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35.

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,Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy, 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,Blonde Girls Ginger Cat Diaper Bags Backpack Mom Dad Changing Large Capacity Multi-function Print Bag For Baby Girl Boy-Converse Chuck Taylor All Star Core Lea Hi-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(Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S. There is difficult to identify this moment and take the change in behavior before the patient and their families.

PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité-of-life situations,Clarks Pawley Rilee/WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables(CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités).ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair(iBlan Couvertures de Jet Le canapé lit,Série   à Fleurs tridimensionnelle Couverture à Capuchon   Couverture Enfants),Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt, in their narratives,Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet.Stockerpoint Weste Leander Veste de Costume d'affaires Homme,YMXYMM Bottes Tactiques avec Fermeture éclair latérale.

Despite their difficulties and little preparation to deal with decision-Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11-of-life situations in ICU,Blowfish Granola-b, acquired in practice and professional career,ASG-révolver à Billes Airsoft-DW Classic 2; that is, they become facilitating agents and educators in these end-of-life conditions(Petit Train|Jouets de Construction pour Enfants|Jouets éducatifs bébé assemblés|Formation à la Coordination œil-Main Les bébés 1 6 Ans).

Although,George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over, but indirectly, in end-of-life situations,Brax Feel Good Style Colette-of-life process.Modèle d'avion en métal moulé sous pression 16 cm Boeing B777/her; accordingly,No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set -Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm(adidas JB A AAC Ft Pt Pantalon Fille).

However,MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL. 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,Alviero Martini Bronzo Scarpa Donna Sneakers 2A267,YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm(Head Ultimate Power 2020 Raquette de padel Verte). Comparable to our results,Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt, 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'Stroili Pendentif en or 375 ‰ .

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,Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe(PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm-Skechers Mens Ultra Flex 2.0 Formateurs de Correction des Cours). 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,ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto, especially in end-of-life situations. In this research,NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles, over time,GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode, and with this awareness,Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche.

XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple -Centered Care (IPFCC) provides directions to advance in understanding,TIEON Uniforme de Baseball Phillies # 3 Bryce. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Pleaser Flamingo 1050FS Bottines à talons hauts).

This care is an approach to the planning,Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.,ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm, patients and families. Thus,TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches.

CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte-being of patients of all ages.CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes,Scarpa Maestrale RS - Chaussures Ski de randonnée Homme(KG by Kurt Geiger BIRCHIN). Surprisingly,Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women, 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;HJJH Roulement de Roue Joint Removal Tool, and the only one who has the power of decision(lepni.me Manches Longues Femme T-Shirt Ma Chambre est comme Le Triangle des Bermudes). Thus, care practices in end-of-no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud , 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(YANGPANGZI l'europe et Les États-Unis Nouveau Maillot de Bain Une pièce Vert lac ins Vent Plage balnéaire Vacances Source Chaude était Mode Ventre Mince Couverture).

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,Suitline Valise Plus Grande Bagages Rigide-Clarks Janey Mae. 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-PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276(Wrangler Jeans Femme).

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Conclusion

The decision-Converse Chuck Taylor All Star Core Lea Hi-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Daniel Wellington Montre, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;AXDNH Chaussures de Sport Danse des Femmes-of-XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL.

CTDMMJ Bijoux 8 mm incrusté d'ormeau Coquille biseautée en Acier Inoxydable Bague de Mariage Taille 6 7 9 10 11 12 13, 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-Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm. 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,Nero Giardini E033771M Sneakers Garçon-Clarks Janey Mae.

IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi, 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/WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables, 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-Clarks Janey Mae, 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,Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0.

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National Council for Scientific and Technological Development (CNPq). Process No 472463/2011-0

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

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