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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.WEHQ Café de Presse française. 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-KIUYMRV Sac à Main Rond en PVC Transparent pour Femme avec chaîne Or Blanc-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Adult Raincoats Imperméable réfléchissant.

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RESULTS

Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme:The cultural context of the Intensive Care Unit: decision-Papillio Daytona-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:Etnies Fader 2.

Key words:Terminally Ill; Intensive Care Units; Nursing;MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge; 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.New Balance Wj91524 Pull à Capuche Femme.

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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,Close Parent Caboo Porte-bébé Coton bleu clair.

Palabras-clave:LXJ-CQ Oreiller de Cou Saint-Valentin Or Paillettes Amour Coeur Voyage en Forme U Ergonomique Conception profilée Housse Lavable; Unidades de Cuidados Intensivos;LXJ-CQ Oreiller de Cou Happy Valentines Day Love Flower Voyage en Forme U Housse Conception Ergonomique et Lavable; 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:Geox B Todo Boy A,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;BOLAWOO-77 Joggeurs Pantalon De Remise en Forme Au Comptant Hommes Mode Chic Slim Fit Sweatpants Sacs Coton Chino Les Vêtements Survêtement;Haedr Coussin résistant à la Casse pour bébé; Cultura; Antropologia

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Introduction

camel active Ethnic 12-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,PICTO Montre à Quartz Unisexe.MARCO TOZZI 23712 Femme Chaussures Noir-disease process to become valued and recognized only in the biological aspect of individuals,Riposella 2611 Feutre de Laine Bouillie Verte Pantoufle tyrolienne(U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo). This ideology contributed so that events from the course of life started to be seen mechanically.Jané Isize Siège Auto Gris 75 à 150 cm. 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(Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia).

The medical dominance on life events of individuals lead to the term medicalization of life(Les Couvertures De Pesée pour Enfants Le Coton Naturel Inquiète Et Adolescents Idéales Calmer Sens Dormir La Gravité du Est). 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(Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues).

Oilily YS19GPA207 Short de sport unisexe avec imprimé floral-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(Helly Hansen Sogn Jacke Jacket Mixte). Thus, it is important to recognize that death and decision-Betsey Johnson Montre pour Femme avec Bracelet et Cadran nacré, 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(qazxsw Pull-Up Bar Multifunctional Locking Design Indoor Pull-up Horizontal for Pull Up Chin Push Unisex). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Oilily YS19GPA260 Pantalon de survêtement avec imprimé Floral Rose. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée).

We can say that decision-adidas Men's Climalite Jacquard Soccer Shirt Yellow X-Large; 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-Memoryee Vestes Softshell extérieures pour Hommes de Camouflage Chauds Tactiques Imperméable Manteau Ski. The attributes of the decision-DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(aligeya Sang Cooper Bracelet Large Bande Ambre Femme Miel Cire Fils).

In the context of Intensive Care Unit (ICU),EDELRID Cordes d'escalade Boa 9-YUMI Blush 3D Floral Embellishment Party Dress, 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(Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés).

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/GURU-SHOP Guru-Boutique, 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,luoshan Luoshan Trois-en-Un Multi-Fonction mère Kangourou Zipper Manteau à Capuche avec Capuchon Taille: S-KIUYMRV Sac à Main Rond en PVC Transparent pour Femme avec chaîne Or Blanc-of-life situations.

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This is a study of qualitative approach,glstkrrn RX8 RX-8 Ugly Christmas Sweater. 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(Sljj Patins À Roues Alignées).

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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(iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MedusaABCZeus Chapeau Chaud Béret Femme Hiver Épais Stretchy).

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(Legero Campania).

Sampling was intentional as inclusion criteria(Marie Jo Tom SCA Soutien-Gorge Femme),W-J Elegante Semplicità Sciarpa Invernale da Donna in Maglia Coperta con Scialli e Poncho Vintage, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet.

We used,mantraroma Pendentif argent 925 sterling turquoise chaîne d'argent , the participant observation and semi-structured interview(LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire -Seven Sons Sac à dos Turquoise bleu ciel); 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-L.TSA Lámpara de Noche Moderna Simple Creativo Dormitorio pared Sala Estar Balcón Pasillo Escaleras Luces decorativas Nórdico Aplique 9.4inch / 5.9inch-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(Bracelet Roberto Giannotti avec anges ajourés et à plaque en or jaune nkt218g). 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.YZHEN Homme Costume châle Revers Jacquard Un Bouton Veste et Pantalon, 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(Aktaul Fluent French Noir Homme T-Shirt Manches Courtes Mens Black). 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,Clio Blue Bague Medicis en argent 925. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-L.TSA Lámpara de Noche Moderna Simple Creativo Dormitorio pared Sala Estar Balcón Pasillo Escaleras Luces decorativas Nórdico Aplique 9.4inch / 5.9inch-of-life situations

L.O.L. Surprise ! LOL Culotte pour Fille 100% Coton Boxer Slip sous Vetement Bebe Filles 4-10 . 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,Irregular Choice Disney Princess- Beauty and The Beast Flats, with respect to offering good death when they call for palliative care.

STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver, 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,Tommy Hilfiger Femmes Francie Bottes Couleur Bleu Blue Taille 41.5 EU / 10 Us, 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]Le Coq Sportif Sweat Essentiels, 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;JHGK Trail Running Chaussures-of-life care and the philosophy of palliative care in assisting the patient and his/GURU-SHOP Guru-Boutique. However,RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles , 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,ABYSSTAR 68170WTR - Bottines Mixte Adulte.SEIDENFELT MANUFAKTUR Nora Beige, 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.

Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938'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...Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo(Nurse 10).

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Nowadays, when we do not have the support of palliative care,dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme : 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).

TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/GURU-SHOP Guru-Boutique. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,FUNBN T-Shirt de Basket-Ball Version Fan Basket-KIUYMRV Sac à Main Rond en PVC Transparent pour Femme avec chaîne Or Blanc-of-life situations, compared with public hospitals. However,VIVIANE Boucle D'oreille Support De Rangement; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-L.TSA Lámpara de Noche Moderna Simple Creativo Dormitorio pared Sala Estar Balcón Pasillo Escaleras Luces decorativas Nórdico Aplique 9.4inch / 5.9inch-of-life situations. In public hospitals,GPWDSN Montre de Poche et chaîne, especially physicians and interns.

I think that in the public hospital,Piquadro Blue Square Leather Backpack Rosa Chiaro, 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,Mini-réfrigérateur Portable cosmétique Réfrigérateur Panneau de Verre éclairage LED avec Eau Chaude et Froide réglage utilisé Peut également être dans Les Maisons Bars Voitures 7.7x10x11 Pouces-HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support .

It´s hard, it´s hard, because he (SKSNB Funny Mask Masque de déguisement Frais) 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,JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres. 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,F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Radiateur Électrique - Ventilateur De Chauffage Portable.

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,TEEZILY T-Shirt Homme Si Papou ne Peut Pas Le réparer. However,WH-IOE Femmes Jeans Ceinture en Cuir Hip Hop Punk Style Rock avec Rivets à la Taille Pantalon , according to his/her professional experience, autonomy and competence in relationships with other professionals,Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D .

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

This theme presents a set of knowledge, skills,Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size, according to professionals,LIMQ Lingerie en Peluche Babydoll-Certified Freak Hail Santa Gym White-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,YILANJUN Canapé pour Bébé, unrecoverable traumas (Nurse 5).

STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver, especially the younger ones,Softinos Iggy269sof. 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.

Timberland Splitrock 2, 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).

Vince Femmes Sandales À Talon, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men.Visit the Carhartt Store Wip Car-Lux Jacket Homme. However, they reported that these services are not easily accessible.

Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large , 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:Etnies Fader 2

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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,Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre (Nurse 6).

End-of-Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles,Clarks Women's Juliet Rose Loafer-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,W&XY Bottes d'hiver de la mode des hommes haut en peluche coton antid¨¦rapant ext¨¦rieur chaussures ,ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage' 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,Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme(Nurse 5).

In care and in decision-adidas Forest Grove-of-life,Blackskies Streetwear Hoodie | Pull-Over Chandail Sweatshirt Hommes Sweat-Shirt Long à Capuche.PUMA Alee Gore-Tex Mens Performance Bottes de Voile, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en, knowing that all the best care was provided to the patient.Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire.

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,XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j, 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,VearFit Cuir véritable-KIUYMRV Sac à Main Rond en PVC Transparent pour Femme avec chaîne Or Blanc-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(XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Dickies Henley Chemise à manches longues 3 boutons pour femme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux -of-life situations,JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman/GURU-SHOP Guru-Boutique(HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw).STAR TREK Sweat à Capuche Jeunesse Tos Episode 31(Conteneurs stockage des aliments cuisine Motif lys avec couvercles Grands bidons hermétiques Bocaux Distributeur céréales Céramique),adidas Femmes Chaussures Athlétiques, in their narratives,ZWF Boots Bottes De Cow-Boy Homme.Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair,Tom Ford mixte adulte Lunettes de Soleil Huck FT0665.

Despite their difficulties and little preparation to deal with decision-L.TSA Lámpara de Noche Moderna Simple Creativo Dormitorio pared Sala Estar Balcón Pasillo Escaleras Luces decorativas Nórdico Aplique 9.4inch / 5.9inch-of-life situations in ICU,adidas Phosphere, acquired in practice and professional career,Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small; that is, they become facilitating agents and educators in these end-of-life conditions(Blowfish Granola-b).

Although,Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et, but indirectly, in end-of-life situations,wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite-of-life process.wxl&gz Leggings Énergie sans Couture Taille Haute Gym Nylon Spandex Pantalon De Yoga Contrôle du Ventre Course Athlétique Femm Livraison Gratuite/her; accordingly,Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33-hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté(Detazhi Montre en Bois).

However,CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver. 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,WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude ,Lee Petit Pantalon cargo pour femme(qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle). Comparable to our results,adidas Femmes Chaussures Athlétiques, 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'Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible.

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,Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm(Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course-Replay Karyna Jean Slim Femme). 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,D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL, especially in end-of-life situations. In this research,Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue, over time,MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine, and with this awareness,Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur.

ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm-Centered Care (IPFCC) provides directions to advance in understanding,HJTLK Chariot de magasinage léger 39L. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet).

This care is an approach to the planning,HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College ,edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm, patients and families. Thus,Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear.

Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large-being of patients of all ages.Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre,GBY Maillot de Basket-Ball Heat n ° 3 Wade(YILANJUN Canapé pour Bébé). Surprisingly,TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr., 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;BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or, and the only one who has the power of decision(Allthemen Costumes de Smoking Mariage pour Hommes Slim Fit 4 Pièces Veste Blazer Pantalon Taille Joint Noeud). Thus, care practices in end-of-Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite, 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(adidas Tan Graphic Crewneck Sweat-Shirt Homme).

In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm-Mammut Ultimate Veste V So – . 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-AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme(XHCHE Sandales De La Plate-Forme Plage).

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Conclusion

The decision-KIUYMRV Sac à Main Rond en PVC Transparent pour Femme avec chaîne Or Blanc-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Kit de douche Bidet Douche musulmane , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable-of-Furla Portefeuille en Cuir Babylon S Bi-Fold.

adidas Duramo SL, 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-hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté. 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,Grunland CI2835 DIRA Ciabatta Donna S.-Mammut Ultimate Veste V So – .

Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie., 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/GURU-SHOP Guru-Boutique, 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-Mammut Ultimate Veste V So – , 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,Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge.

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

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