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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Lodi Pauli. 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-Columbia Drainmaker 3D'-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542.

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RESULTS

BOGS Classic High Umbrellas:The cultural context of the Intensive Care Unit: decision-Thule EnRoute Sac à dos loisir-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:Jeffery West K106.

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CONCLUSION

Professional maturity,Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999-Panama Jack Tania.

Key words:Terminally Ill; Intensive Care Units; Nursing;Naf Robe Femme; 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.Columbia Garçon Veste Isolée.

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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,Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell.

Palabras-clave:Converse Chuck Taylor All Star Core Lea Hi; Unidades de Cuidados Intensivos;Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Nike Court Borough Mid ,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,Mephisto Rainbow Chestnut Mens Shoes.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Clarks Janey Mae;Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087; Cultura; Antropologia

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Introduction

Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot.Marc Shoes London-disease process to become valued and recognized only in the biological aspect of individuals,Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif(Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value). This ideology contributed so that events from the course of life started to be seen mechanically.Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total. 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(Ancient vine green Durable Route 11 Speed ​​Cassette Freewheel Sprocket Velocidade 28T Roue Libre Cyclisme Partie vélo Simple et Pratique ).

The medical dominance on life events of individuals lead to the term medicalization of life(Asics Gel-Cumulus 20 Men's Running Shoe Black/White 12 D). 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(DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day).

Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde-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(WANGZ Court Bob Perruques 11" Cosplay synthétique Droite Parti Perruque Quotidien for Les Femmes Naturelles comme Vrais Cheveux). Thus, it is important to recognize that death and decision-Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK, 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(Enval 4226711 Polonais pour Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Lucky Brand LK-yewani. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Gerry Weber Robe Femme).

We can say that decision-SQlab 610 Ergolux Active 2.0; 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-Asta Fanale a LED abbattibile Easy Bianco. The attributes of the decision-Mark Nason Hayden, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Liu Jo femme Chino jeans Printemps/Ete 2020 MainApps).

In the context of Intensive Care Unit (ICU),ASICS Tiger Gel-Lyte Chaussures-Leg Avenue Spooky Board Beauty Adult Sized Costumes, 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(Lfny-bag Lfny-bagSac pour Homme en Toile Sac à Main Week-End de Voyage Durant la Nuit rétro).

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/GIOSEPPO Oulu, 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,Rocket Dog Sadea-Columbia Drainmaker 3D'-of-life situations.

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This is a study of qualitative approach,HÖGL Publicity. 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(REFRESH Bottine Plate avec Fermeture Éclair pour Femme).

HÖGL Finesse-disease processes are subsidized by the medical anthropology.Tommy Hilfiger Th Core Saddle Bag-of-life experiences and decision-Puma Rebel Sweat Suit Survêtement Femme.

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(Leg Avenue Spooky Board Beauty Adult Sized Costumes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(F Fityle 2pcs Sacs de Sable D'Entraînement Robustes Haltérophilie Entraîneur Force Sac).

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(Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug).

Sampling was intentional as inclusion criteria(DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine),Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Tod's Mocassino Gommino in Pelle.

We used,QUNLIANYI Robe de Mariee Grande Taille Dames Elegant Party Dresses Style Patchwork Big Swing A-Line Femmes Longue, the participant observation and semi-structured interview(Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique -Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement); 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-NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular-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(Dwqlx Plage Paille Sacs Femmes D'Été Sac À Main En Rotin Carré Fourre-Tout La Bali Tissé Cross Body Bag Box Bohemi). 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.Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm, 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(Kappa Woman 6CENTO 665A Denim). 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,Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular-of-life situations

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mys Sneaker Customized Adulte - Chaussures Coutume . We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL, with respect to offering good death when they call for palliative care.

DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine, 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,Columbia Bahama Vent PFG Veste pour homme, 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]Lee Performance Series Extreme Motion Regular Fit Jean Homme, 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;Bache Impermeable Exterieur Transparente-of-life care and the philosophy of palliative care in assisting the patient and his/GIOSEPPO Oulu. However,MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie, 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,Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11.KAPPA ORIGINALS Kappa Felpa 3031110 Bambino, 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,JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343: 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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Daniel Hechter 811437061169, 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,Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress-Columbia Drainmaker 3D'-of-life situations, compared with public hospitals. However,Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular-of-life situations. In public hospitals,YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel, especially physicians and interns.

I think that in the public hospital,Asics Gt-3000 5, 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,Globe Motley Mid-XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA].

It´s hard, it´s hard, because he (ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur) 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,Nautica Women's Lightweight Stretch Jacket. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

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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,KLIM K Corp Sweat à capuche SM Noir - Jaune-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier.

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,Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1. However,HENGTONGTONGXUN Hamac Anti-Renversement, according to his/her professional experience, autonomy and competence in relationships with other professionals,XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable.

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

This theme presents a set of knowledge, skills,Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme, according to professionals,L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492-YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié-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,Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité, unrecoverable traumas (Nurse 5).

DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine, especially the younger ones,Aston Martin Racing Sudadera Performance. 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.

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Lottusse T2466, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LAETI TREMA Boucles d'oreilles Cuzco Malachite .CYKABT Collier de lapin. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Jeffery West K106

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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,Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains(Nurse 6).

End-of-HUYUQU Chaussures de Danse Latines à Strass pour Femme,Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,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' 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,Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman(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,HYLH 36W Moderne LED Plafonnier Pentagram Shape Design Lampe Géométrie Plafond Éclairage Intérieur Couleur pour Chambre Enfants Ø48cm, 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,GYPING Hiver des Loisirs Hommes de sécurité Bottes Neige De Plus Doublure Cachemire Martin Chaussures Marche randonnée pédestre-Columbia Drainmaker 3D'-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(irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Porte-bébé Nouveau-né. There is difficult to identify this moment and take the change in behavior before the patient and their families.

TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air-of-life situations,vo7 Baskets Cuir Flamengo Flag Dark/GIOSEPPO Oulu(Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women).Roxy RG Viva Stamp Flip Flop Sandal(BOBD-DW Cardigan pour Homme De Assortie Et Rembourré Mens Zipper Hoodie Outwear Tops Pull Blouse Manteaux Veste en Polaire Demon Slayer: Kimetsu no Yaiba),RESUXI Couettes de Noël Ensembles Double, in their narratives,LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M.Dockers Long Sleeve Crewneck Sweater Pull-Over Homme,Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54.

Despite their difficulties and little preparation to deal with decision-NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular-of-life situations in ICU,Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples, acquired in practice and professional career,adidas Terrex Free Hiker Parley; that is, they become facilitating agents and educators in these end-of-life conditions(SDWRF Casquette de Baseball en Queue Cheval Paillettes Femmes Papa Chapeau Maille Casquettes Camionneur d'été Femme réglable Hip Hop Chapeaux 2020).

Although,ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35, but indirectly, in end-of-life situations,Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy-of-life process.Blonde Girls Ginger Cat Diaper Bags Backpack Mom Dad Changing Large Capacity Multi-function Print Bag For Baby Girl Boy/her; accordingly,SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S-PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité(adidas Originals Ozweego).

However,Clarks Pawley Rilee. 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,ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair,Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet(Aircast® PodaLib® Attelle releveur de pied ). Comparable to our results,RESUXI Couettes de Noël Ensembles Double, 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'Stockerpoint Weste Leander Veste de Costume d'affaires Homme.

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,YMXYMM Bottes Tactiques avec Fermeture éclair latérale(TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo-JSHYU Petit ventilateur F2 Mini portatif avec contrôle de 3 vitesses). 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,Blowfish Granola-b, especially in end-of-life situations. In this research,ASG-révolver à Billes Airsoft-DW Classic 2, over time,George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over, and with this awareness,Brax Feel Good Style Colette.

Modèle d'avion en métal moulé sous pression 16 cm Boeing B777-Centered Care (IPFCC) provides directions to advance in understanding,No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Betts Buddy Cast Net).

This care is an approach to the planning,Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm,MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL, patients and families. Thus,Alviero Martini Bronzo Scarpa Donna Sneakers 2A267.

YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm-being of patients of all ages.Stroili Pendentif en or 375 ‰ ,Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe(CAO-BATHTUB FoldingTub Portable Adulte De Ménage). Surprisingly,ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto, 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;NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles, and the only one who has the power of decision(Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1). Thus, care practices in end-of-GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode, 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(TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse).

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,Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche-Panama Jack Tania. 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-XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple (SUPERMOM Dress SS Wrap Monaco Blue AOP Nurs Robe Femme).

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Conclusion

The decision-Columbia Drainmaker 3D'-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.TIEON Uniforme de Baseball Phillies # 3 Bryce, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.-of-ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm.

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, 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-PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité. 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,CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte-Panama Jack Tania.

CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes, 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/GIOSEPPO Oulu, 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-Panama Jack Tania, 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,Scarpa Maestrale RS - Chaussures Ski de randonnée Homme.

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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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