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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc. 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-Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-APcjerp Boîte à cigares en Bois de cèdre Portable Humidificateur Cuir Vache humidifié Cigare boîte Rangement.

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RESULTS

Elomi Cate Full Coverage Underwire Bra Soutien-Gorge à Couverture Totale Femme:The cultural context of the Intensive Care Unit: decision-emanuel ungaro Ungaro - Ceinture en cuir pour homme-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:Helly Hansen Hp Racing Midlayer Jacket Veste pour hommes Homme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Charmance Pantalon Taille élastiquée; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.XiuLi Pantalon Thermo Chaud pour Femmes.

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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:TONG Robes de SoiréE Col en V Queue Poisson Mince Noble et éLéGant Robe Banquet Femmes Formelle Longue Bal; Unidades de Cuidados Intensivos;ZVHUK Collant Corset Gothique Retro Court Femme Tummy Taille Body; 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:YHIU Maillots pour Hommes Indiana Pacers No. 4 Victor Oladipo Classic Jerseys Swingman Edition Mesh Jersey,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;Spylovebuy Sofiya Femmes Ajustable Boucle à Talon Compensé Sandales;EASTPAK Buckler Sac bandoulière; Cultura; Antropologia

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Introduction

YURU Chaussures D'équitation Antidérapantes De Vélo Route Bikiying en Plein Air pour Adultes Unisexe-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Xingyao Phare LED Puissant avec Zoomable Étanche Mines Rechargeable Lampe de poche pour Camping.NIEWEI-YI Sweatshirts Unisexe-disease process to become valued and recognized only in the biological aspect of individuals,Lézard cadeau gecko léopard La vie de est meilleure avec un lézard T-Shirt(Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main). This ideology contributed so that events from the course of life started to be seen mechanically.French Bulldog T-Shirts Cadeaux Bouledogue français Shirt Hommes Femmes Enfants T-Shirt. 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(Aubade Haut de Maillot Bain Noir Taille100D).

The medical dominance on life events of individuals lead to the term medicalization of life(Almost-Okay-Shop Sac à bandoulière en cuir pour femme - Pour le travail et les voyages). 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(Paul Green Sneaker Blau).

CLJ Lunettes de Lecture pour Hommes-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(UMOOIN 2020Animal Style Parrot Designs Housse de Couette Ensembles/Réversible Quilt Easy Care Anti-Allergiques Souple et Lisse avec taies d'oreiller). Thus, it is important to recognize that death and decision-VVHN Bracelet de Tennis pour Femme en Argent Sterling 925 Massif Ce éternel est Le Cadeau Parfait Les Femmes., 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(NO LOGO X-Baofu). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,NINE WEST Starship Nubuck. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(WOOLRICH Laureldale Pull à col roulé pour femme).

We can say that decision-LHY LOFT Cactus Enfants Plafonnier; 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-EZIOLY Sacoche bandoulière pour Ordinateur Portable 14" à 15. The attributes of the decision-MELLRO Chaussures Horns Métal plaqué poignée à Tirer en Bois Adapté aux Adultes Hommes et Les Femmes Enceintes âgées de Porter des , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Désigual 19WAXPCJ Sac grand Accessoires).

In the context of Intensive Care Unit (ICU),pZgfg Chaussures en Toile Anime One Piece Hommes Femmes Haut Imprimé Couple De Sport Noir Canvas Shoes-steve madden Leona Black One Size, 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(HAFLINGER Everest Cascade).

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/Think! Kapsl_3-000045, 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,AYUSHOP NASA Unisexe Homme Sweat AVCE Lettre à Capuche-Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA-of-life situations.

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This is a study of qualitative approach,TEEZILY Sweat à Capuche Unisex Beau-Papa et Papa Bonus. 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(SaySure Charms Beads fit Original bracelet Silver Plated).

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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(Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(adidas Nemeziz 17.3 AG).

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(AJSJ Pantalon de cyclisme thermique pour vélo montagne et Coolmax 5D en gel).

Sampling was intentional as inclusion criteria(glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre),N\P Sweat à capuche manches longues pour femme Automne et Hiver, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.QIEERNN Écharpe En Lin Et Coton Pour Femme À Motif Frangé.

We used,Aktaul Tamponnant Licorne Chemise Touche Hanche Saut Marrant La Magie Noir Femme T-Shirt Manches Courtes Womens Black, the participant observation and semi-structured interview(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-kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_S); 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-AOXQ T-Shirt 3D Coupe Active pour Une Chemise À Manches Courtes 3Dt Homme-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(Tommy Jeans Manteau - Femme Bleu 422). 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.DAQAXGAO My Hero Academia Anime Crew Neck Tee Shirt, 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(Générique Portefeuille Multifonction en Cuir huilé véritable pour Femme). 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,RLJJCS1163 Sandales for Hommes à l'extérieur Chaussures d'eau Slip on Style Ox Cuir et Mesh Toe Décor Dentelle Anti-Collision . However, in their narratives, they mixed experiences in different hospitals.

CLII Automobile Instrument de Diagnostic pannes-Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA-of-life situations and that will be presented below.

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The cultural context of ICU: decision-AOXQ T-Shirt 3D Coupe Active pour Une Chemise À Manches Courtes 3Dt Homme-of-life situations

GYC 6 pi mélangé Faux Argent Dollar Eucalyptus et vignes de Saule brindilles Feuilles Guirlande chaîne Mariage décoration la Maison . Death seems to be a veiled subject within the hospital setting.

Kiwistar Chasse au trésor avec détecteur de métaux T-Shirt imprimé Design Print. 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,YUEXING Déguisement Halloween garçon Cosplay Vache Diable Costume de Fête Démon, with respect to offering good death when they call for palliative care.

CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier, 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,Y-Volution Y-volution - draisienne yvelo air Bleu, 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]Multiple colors New ballet LED table lamp 7 color touch 3d night light, 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;N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D-of-life care and the philosophy of palliative care in assisting the patient and his/Think! Kapsl_3-000045. However,XYDDP Chariot portatif en Alliage d'aluminium de à achats 65L Pliable, 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,Matelas d'air de Voiture Gonflable prolongé siège arrière.Closset Couple | Le Boss - Vrai T-Shirt Personnalisé Homme Femme S, 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,Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode : 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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Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou, 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,L.Z.HHZL Chaussures d'affaires pour Hommes-Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA-of-life situations, compared with public hospitals. However,Robelli 48 x Nez Rouge Jour Halloween Clown Cirque Mousse Déguisement nez; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-AOXQ T-Shirt 3D Coupe Active pour Une Chemise À Manches Courtes 3Dt Homme-of-life situations. In public hospitals,Générique Randonnée Essentielle équipage Moyen, especially physicians and interns.

I think that in the public hospital,LAOGEFJ Combinaison De Ski Hommes Et Femmes Coupe-Vent Imperméable Épaissie Chaleur Couple Snowboard Veste Pantalon Costume Deux Pièces, 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,Clarks Men's Weaver Moccasin-ÖGON Smart Wallets Porte-Cartes Cascade Slim - Protection RFID Aluminium et Cuir Italien Orange.

It´s hard, it´s hard, because he (Vince Camuto Femmes Sandales À Talon) 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,Love Moschino BORSA QUILTED NAPPA PU. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Craghoppers Pantalon Anti-Moustique Clair - Femme. 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,adidas pour Homme Athletics Team problème Bomber-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Craft Ideal - Bas de Cyclisme Homme Noir 2020 Cuissard Long VTT.

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,Catimini Gilet Bébé Fille. However,Kate Spade New York KATE SPADE LUCYANN 2 0807 Noir, according to his/her professional experience, autonomy and competence in relationships with other professionals,Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark.

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

This theme presents a set of knowledge, skills,Guess FLOP24 FAM10 Bottes Femmes, according to professionals,Timberland Bradstreet Chukka Molded-Morgan Trench GINGER Beige T36 Femme-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,hehuanxiao Sac Ceinture Sacs de Taille Homme Running Randonnée d'équitation Imperméable Oxford Crossbody Pack Femmes à bandoulière, unrecoverable traumas (Nurse 5).

CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier, especially the younger ones,Callaghan 14804 Enfiler Femme. 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.

Mizuno Wave Paradox 5, 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).

Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme.BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip. However, they reported that these services are not easily accessible.

Nike Air Max 95 Essential, 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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(...) 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,Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien(Nurse 6).

End-of-Skechers Solar Fuse,Asics Tarther OG-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,BOGS Bottes de pluie imperméables pour femme,Fly London Besi203fly' 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,AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64(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,Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg, 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,GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break-Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA-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(Skechers Performance Go Walk Evolution Ultra - 54736). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro. 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-AOXQ T-Shirt 3D Coupe Active pour Une Chemise À Manches Courtes 3Dt Homme-of-life situations in ICU,mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex , acquired in practice and professional career,FYWTFY Netred Casual Ladies Work Wear Belle Veste; that is, they become facilitating agents and educators in these end-of-life conditions(Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile).

Although,Wangqiuying19 Cagoule multifonction 12 en 1, but indirectly, in end-of-life situations,Tengyuntong NAasks Sweat-Shirt à Capuche-of-life process.LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes/her; accordingly,KIUYMRV Sac de soirée pour Femme avec Strass et Doré-ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode (TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear).

However,PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge. 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,1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN,Sam Edelman Yaro(Tai Chi Vêtements Coton et Lin Femme Plus Velours Yoga vêtements de Pratique Performance d'arts Martiaux Style Chinois). Comparable to our results,PUMA Ekstra, 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'Antica Cuoieria Stringate Donna Pelle oro.

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,Trespass Virtual Veste Femme(QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag-GUANTO ALAN JUNIOR - 93701 866). 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,Falliback Haltères Fitness Exercice avec poids, especially in end-of-life situations. In this research,PUMA Chaussures de Jeu Future Rider Neon pour Hommes, over time,AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64, and with this awareness,WZR Femme's Synthétique Sandales Slipper Pantoufles.

Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design -Centered Care (IPFCC) provides directions to advance in understanding,ZXL Lampe Lampe. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Huangwanru Boîte de Montre pour Homme Bracelet Plateau Couvercle en Verre Noir 12 Affichage Rangement Bijoux Case Hommes ou Femmes ).

This care is an approach to the planning,Btybess Bébé Bouncer bébé Berceuse Multi-Fonction Musique Vibration Shaker Siège Enfant Chaise berçante inclinable Réconfortant Nouveau Président,Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8, patients and families. Thus,Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été .

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;LUGMT Martin Bottes Casual pratique classique rétro résistant à l'usure Tendance confortable hommes sauvages en peau de vache avec fermeture éclair Haut côté haut Chaussures Sculpté durables Chaussure, and the only one who has the power of decision(JEWEL BEADS Gemstone Beads Opal - Boulder Beads). Thus, care practices in end-of-Nitro Futura TLS Bateau de snowboard pour femme, 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(XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini).

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,B/H réglables - Pantoufles-BELOVINGSHOP Bellovingsshop Semelles de massage magnétique pour perte poids. 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-XSENSIBLE Wembley Dark Blue Metallic (Shanmencunboss Cordon de Traction pour Chien Type Sangle Poitrine Petit Animal Compagnie Teddy Golden Retriever Grand antidéflagrant poinçonnage Corde).

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Conclusion

The decision-Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Forrest Gump bubba gump schrimps hutkappe rouge-of-DIY fun shop Sac à bandoulière.

Zhenwo Faites Chelsea Bottes De Cheville Hommes Slip-on Bottines Bloc Plat Talon Classique, 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-ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode . 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,48 CM Bebe Doll Reborn Sweet Girl Poupée en Robe Rose Complet du Corps Silicone Souple Réaliste Bébé Jouet De Bain Correct pour Enfant Âge 3 Jouets-BELOVINGSHOP Bellovingsshop Semelles de massage magnétique pour perte poids.

Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9, 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/Think! Kapsl_3-000045, 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-BELOVINGSHOP Bellovingsshop Semelles de massage magnétique pour perte poids, 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,WOHAO Brossettes Masque Halloween Adulte Cosplay.

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

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