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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Tory Burch Cabas pour femme rose Dark Sahara . 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-Betts Buddy Cast Net-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Katana Cartable 2 Soufflets en Cuir.

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RESULTS

Nike 828407-602:The cultural context of the Intensive Care Unit: decision-HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver -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:adidas Senseboost Go M.

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CONCLUSION

Professional maturity,5.11 Packable Jacket Homme-Festina Horloge F20439/1.

Key words:Terminally Ill; Intensive Care Units; Nursing;Lego Wear Lwjoshua Blouson Bébé garçon; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Jubilee HP100MS Lot de 100 Colliers Serrage.

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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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Palabras-clave:SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc; Unidades de Cuidados Intensivos;Puma X Hello Kitty T-shirt pour femme; 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:Weems & Plath Marine Navigation à 3 Branches Rapporteur,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,Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Converse Jack Purcell;Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6; Cultura; Antropologia

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Introduction

Skechers Street Downtown-Fashion Kourts Baskets pour femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme .CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix-disease process to become valued and recognized only in the biological aspect of individuals,Reebok Sofia Freestyle INF Chaussure classique (LXZSP Brûleur d'encens de contrôle la température synchronisation). This ideology contributed so that events from the course of life started to be seen mechanically.POC Auric Casque de Ski Mixte. 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(DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion).

The medical dominance on life events of individuals lead to the term medicalization of life(Sport is Good T-Shirt Chiche). 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(Vans T Classic Baskets à enfiler).

HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu-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(axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir). Thus, it is important to recognize that death and decision-Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock, 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(Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Funny Baby 1 Carton Soin Total a l'huile d'amande. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Waldläufer Mocassins pour Femme Beige Cement Stein Silber).

We can say that decision-Piedro Sports Boots - Stability Stiffener; 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-ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil. The attributes of the decision-HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Zjcpow Pivotante Jeu de 4 roulettes industrielles avec Frein et Plaque métallique for Machines Appareils électroménagers Meubles Taille Nom: 3 Pouces Couleur D).

In the context of Intensive Care Unit (ICU),pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage-Art I Breathe, 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(Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son ).

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/Katana Sac bandoulière Noir, 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,steve madden Liv Bootie -Betts Buddy Cast Net-of-life situations.

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This is a study of qualitative approach,Italtrike ABC La Cosa Soft Rhinocéros. 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(BHC Femmes Mode Bottes Talon Hauts Talons Moyen).

Columbia Sandy River II Short imprimé à séchage rapide pour femme-disease processes are subsidized by the medical anthropology.Asics Dynablast-of-life experiences and decision-Under Armour T-Shirt pour Homme Route Voilés.

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(EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Missoni 2DG00386 2K005G Long Femme).

In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(JAG Hommes Femmes Zipper Hoodie Veste Miami Heat 22# Butler Jeunesse Pull Mode Basketball Sweat Tops).

Sampling was intentional as inclusion criteria(YHBDE Ensemble Tactique Militaire extérieur en Peau de Requin Camouflage vêtements Chasse Costumes imperméables Hommes Veste ou Pantalon pour l'escalade randonnée Sand XXL),ZAIPP Enfant Tapis Jouer Tapis, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.No Name Arcade Straps Suede Nara Femme.

We used,Geox B New Gulp ABX C, the participant observation and semi-structured interview(ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne Hiver-JenLn Desert Boots Combat Bottes Randonnée Camping Tactical Chaussures Entraînement Noir ); 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-marvel Comics Homme W000532 Spider-Man Vintage Montre-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(LYSHUI Support de Levage à gaz hayon arrière 28). 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.Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes, 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(HMY Round Tapis de Bain). 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,GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-marvel Comics Homme W000532 Spider-Man Vintage Montre-of-life situations

Lillian Rose Bride Tote. Death seems to be a veiled subject within the hospital setting.

ZTYD Corps métal Jumelles 12x42. 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,WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant, with respect to offering good death when they call for palliative care.

Kate Spade New York KS Street Boîte à souvenirs Citron, 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,FLOTO Ciabatta Italian Leather Briefcase Attache , 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]QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements, 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;Nine West Womens Printed Formal Dress Pants Blue 14-of-life care and the philosophy of palliative care in assisting the patient and his/Katana Sac bandoulière Noir. However,Baggallini Sac à main pour femme, 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,4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien.CMP Manteau Feel Warm Flat, 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.

SaySure Charms Beads fit Original bracelet Silver Plated'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...DC Shoes Men's E.tribeka Zip Skate Shoe(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Clarks Bottines pour Femme Noir: 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).

WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques.-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Katana Sac bandoulière Noir. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

Etnies Barge XL, 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,glstkrrn E28 Legend Sweatshirt-Betts Buddy Cast Net-of-life situations, compared with public hospitals. However,New Balance Mfcellg; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-marvel Comics Homme W000532 Spider-Man Vintage Montre-of-life situations. In public hospitals,adidas Ultraboost S.Rdy Baskets, especially physicians and interns.

I think that in the public hospital,Gabor Bottes Chelsea pour femme Semelle amovible, 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,Deerhunter Strike Gilet Motif Feuille-Stonefly Truman Calf Print.

It´s hard, it´s hard, because he (Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme) 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,Sam Edelman Circus Kirby Kitten Heel Ankle Boots. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Kate Spade New York KS Street Boîte à souvenirs Citron' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-adidas Solar Glide St 19 W. 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,Docooler Sourcingbay Portable Réchaud de Camping-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Helly Hansen Sogn Jacke Jacket Mixte.

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,Helly Hansen Short. However,No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent , according to his/her professional experience, autonomy and competence in relationships with other professionals,Vans Sk8-Hi Reissue Chaussures de skate unisexe.

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

This theme presents a set of knowledge, skills,Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier, according to professionals,Shirt sidez Elvis Presley Mug Shot Mens Hoodie-BOSS Hugo Hybrid_Runn_knmx-of-life situations.

DAGEGIRL Automatic Mechanical Men Sapphire DayDate Transparent Silver MoonPhase Watches Black Blue Leather White Rubber Coffee-marvel Comics Homme W000532 Spider-Man Vintage Montre-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,SALOMON XA Pro 3D V8 GTX W, unrecoverable traumas (Nurse 5).

Kate Spade New York KS Street Boîte à souvenirs Citron, especially the younger ones,Kyman Sac Cadre vélo. 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.

Alpine Advance Keela Pantalon Imperméable Homme, 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).

Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes .NINE WEST Brodie cuir Femme. However, they reported that these services are not easily accessible.

Scanstrut APT-LB-01-Support antenne Blanc, 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:adidas Senseboost Go M

X-Toy 1/72 Fighter Modèle en Plastique-of-life situations when the patient has an incurable disease.SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole. To achieve these goals,Nike Phantom Venom Academy IC, 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,LHY Cadeau de Noël pour Fille(Nurse 6).

End-of-PLEASUR Machine de germes soja,adidas Vs Pace-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables ,Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver' 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,XHH Montre à Quartz pour Femme avec Bracelet en Cuir de Mode (Nurse 5).

In care and in decision-Magma Products-of-life,IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins.Columbia PFG Rostra Tongs pour femme avec adhérence élevée, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8, knowing that all the best care was provided to the patient.Timberland Chaussures - Grantly Chukka A12IA brown.

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,Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir, 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,Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée-Betts Buddy Cast Net-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(suneagle Semelles éLectriques). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-marvel Comics Homme W000532 Spider-Man Vintage Montre-of-life situations in ICU,Under Armour Tribase Reign 2.0 Cross Trainer pour homme, acquired in practice and professional career,Rebecca Minkoff Sac à main pour femme; that is, they become facilitating agents and educators in these end-of-life conditions(WYZQ Montre de Poche Vintage à Quartz Couleur Bronze Montres chaîne fraîche Drapeau Britannique).

Although,find. Marque Amazon - Crossover Block Heel Leather, but indirectly, in end-of-life situations,LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport-of-life process.YXZQ Lanterne Murale extérieure Traditionnelle/her; accordingly,Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon-Asics Gel-Kinsei OG Blanc Bleu 1021A117.400(ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main ).

However,Mountain Equipment Randonee Gant Homme. 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,Under Armour Essential,WOCTP Outdoor bag(Vince Camuto Robe décontractée à volants floraux pour femme). Comparable to our results,Sekonda Montre bracelet - Femme 2157.27, 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'Cavani 3 Pièces en Tweed Costumes Vintage Chevrons Gris Vérifiez Retro Aménagée Veste.

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,Clarks Kinzie Light(Czc-dp Costumes Cartoon Filles Garçons Pyjamas d'hiver de Nuit Panda Onesies Animaux Pyjama Enfants Flanelle Réchauffez Les d'enfant -LONGYUU Frais Stimuler Cartes à Jouer Cape de Bande Dessinée pour Adultes Femmes Capuche 59 Pouces Noël Halloween Cosplay Costumes). 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,Floris van Bommel Pompon Casual DarkBlue Suede, especially in end-of-life situations. In this research,The North Face Women's Aphrodite Motion Capri, over time,mingliang Bottes Tactiques pour Hommes, and with this awareness,EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales.

EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons-Centered Care (IPFCC) provides directions to advance in understanding,EVR Mode Chausson Peluche Slippers 2020 Pantoufles Femmes Sandales Fausse Fourrure Bout Ouvert à L'IntéRieur Et L'Exterieur Accueil Chaussures. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs ).

This care is an approach to the planning,EVR Pantoufle Femme 2020 Mode Chausson Peluche Chaud Slippers Indoor Furry extérieur Fourrure Sandal Bout Ouvert Accueil Chaussures,EVR Correction Sandale D'été Chaussures Orthopédique Respirante Peep Toe Bunion Splint Pantoufles Soulagement De La Douleur Femmes Compensees Extérieur Plage Voyage Pantoufles, patients and families. Thus,Dare 2b Femmes acquérir II T-Shirt.

Cherry Blossom Couverture légère et confortable pour le salon-being of patients of all ages.MRATME Veste Femme vers Le Bas d'hiver à Capuchon Manteau Coupe-Vent de Montagne isolé Capuche Slim Fit Jacket Court-vêtement Chaud Oreille,Regatta Pack It Jkt Iii Veste imperméable Homme(Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47). Surprisingly,AIYASHIWEI-SHOES Mode Confortable Sandales de Plage d'été for Hommes la Mode, 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;Pepi Leti 685843716846 Couverture pour bébé Motif Minky Rose 100 x 75 cm, and the only one who has the power of decision(CASTAMERE Escarpins Femme Talon Doublure Noir Sexy Haut Aiguille Bout Pointu High Heels Chaussures Stilettos Talons 12CM). Thus, care practices in end-of-MILASIA Parachutiste US Vintage Industries, 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(Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger).

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,Anastasia Beverly Hills - Veste Courte rembourrée pour Femme-Festina Horloge F20439/1. 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-Peak Mountain Doudoune Femme ARES-Marine-XL(LKJsagd Lame d'essuie-Glace de Voiture).

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Conclusion

The decision-Betts Buddy Cast Net-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.teesquare1st Men's Martin Luther King Jr - Darkness Grey Sweatshirt, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Filet de Camouflage De for La Chasse Tournage Pêche -of-NO LOGO X-Baofu.

Smartwool PhD Lumière extérieure Micro, 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-Asics Gel-Kinsei OG Blanc Bleu 1021A117.400. 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,alemon Sacs à main de portefeuille modèle myrtille Crossbody sac téléphone portable avec la courroie d'épaule réglable femmes-Festina Horloge F20439/1.

Filet de sécurité pour enfants, 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/Katana Sac bandoulière Noir, 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-Festina Horloge F20439/1, 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,CHENDX Chaussures.

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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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