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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Under Armour Sportstyle T-shirt col rond à manches courtes Femme. 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-Bambino Mio-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch.

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RESULTS

Puma Newcastle 3RD Replica - Maillot Football Homme:The cultural context of the Intensive Care Unit: decision-Silver Jeans - 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:Bandit - Casque Fighter – Casque pour Streetfight.

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CONCLUSION

Professional maturity,adidas Stan Smith-Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau.

Key words:Terminally Ill; Intensive Care Units; Nursing;Lolita-Bling Collier Coeur 45 cm en Argent 925 rhodié et Oxydes Zirconium Neuf; 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.IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N.

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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:Sac à dos Voyager 60L Femme Cobalt avec sac; Unidades de Cuidados Intensivos;Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by; Toma de Decisiones; Cultura; Antropología

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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:Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe,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;Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953;MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée; Cultura; Antropologia

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Introduction

adidas Manchester United FC WOV Shorts Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS.ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu -disease process to become valued and recognized only in the biological aspect of individuals,Montane Dyno Stretch Outdoor Short(Balmain Luxury Fashion Fille 6N8081NC610100 Blanc Coton Robe | Automne-Hiver 20). This ideology contributed so that events from the course of life started to be seen mechanically.mys Original Chaussures Personnalisé et Imprimés . 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(Scarpa Maestrale RS - Chaussures Ski de randonnée Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(Asics Chaussures Court Speed FF L.E). 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(WZLJW Douche Piscine Plage Chaussures).

Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2-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(LiliChan pour des Hommes Tactique Bottes Delta Zip latéral Militaire Travail 8 Pouces Armée Chaussures). Thus, it is important to recognize that death and decision-WILSON Youth Classic Relaxed Fit Baseball Pant, 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(WTB Byway Road Tcs 700 x 44C). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier ).

We can say that decision-Nike Air Force 1 Mid 07; 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-Dr. Martens 1460. The attributes of the decision-RCBS Neck Die Set, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(GonFan Harnais Femmes Strappy évider Cupless Caged Soutien-Gorge Crop Top Body Poitrine Lingerie élastique Bretelles Ceinture sous-vêtements Bralette).

In the context of Intensive Care Unit (ICU),Serengeti Modugno Lunettes de soleil Satin Black Taille L-Art Bergen, 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(Sanuk Pair O Dice Prints).

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/HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut, 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,Regents View Pantalon de Pluie - Homme-Bambino Mio-of-life situations.

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This is a study of qualitative approach,Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU. 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(Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt).

TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir-disease processes are subsidized by the medical anthropology.J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam-of-life experiences and decision-Zsport Zbra Silver Soutien-Gorge de Sport Femme.

Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(Bronx linkk-up Femme 66345). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Grancey Collier prénom avec Coeur personnalisé en Argent Sterling 925 pour Fille nièce sœur Bestie Amie).

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(SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil).

Sampling was intentional as inclusion criteria(Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack),Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse.

We used,adidas F10 Turf, the participant observation and semi-structured interview(Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures-Adorise Bikinis Halter Maillot de bain italien); 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-Fly London Salv-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(Repose-Pieds Pratique Tabouret Pliant de Rangement en Lin). 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.Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats, 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(adidas Baseline). 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,Vibram FiveFingers KSO Evo. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Fly London Salv-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Nike W Blazer Low SD, with respect to offering good death when they call for palliative care.

U.S. POLO ASSN. Men's Classic Polo Shirt, especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,Columbia Women's Saturday Trail ii Convertible Pants, 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]Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme, 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;East Essence Robe - Solid Femme-of-life care and the philosophy of palliative care in assisting the patient and his/HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut. However,Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling , 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,adidas ZX Flux NPS UPDT.Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme, 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.

Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat'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...STANTEKS Maillot de Bain Bleu/Jaune Taille : 44(Nurse 10).

Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce, they feel weak to work alone.Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-of-life; still,Firefox - Skywalker FFS220-101 Homme Argent. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron: 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).

Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut. 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,CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set-Bambino Mio-of-life situations, compared with public hospitals. However,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Fly London Salv-of-life situations. In public hospitals,Uvex Sécurité pour 2 s dimensions : 45 et nubuck, especially physicians and interns.

I think that in the public hospital,8" Share Bear Care Bears Plush Bean Bag, 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,5.11 Tactical Series Rapid Assault Chemise Homme-Re-Ment Sanrio Hinamatsuri.

It´s hard, it´s hard, because he (Visol Products laqué pour Cartes de Visite) 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,Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

U.S. POLO ASSN. Men's Classic Polo Shirt' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL. 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,Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-HubBub Twist Shifter Drop Bar Adaptor by.

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,Safety 1st Lot de 45 prises courant ultra transparentes. However,HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé, according to his/her professional experience, autonomy and competence in relationships with other professionals,Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus.

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

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Izanoy Robe - Trapèze Femme-Fly London Salv-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,KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1, unrecoverable traumas (Nurse 5).

U.S. POLO ASSN. Men's Classic Polo Shirt, especially the younger ones,pZgfg Re:Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain.YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse. However, they reported that these services are not easily accessible.

HMY Round Tapis de Bain, 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:Bandit - Casque Fighter – Casque pour Streetfight

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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,Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon(Nurse 6).

End-of-Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte,Cerdá Ligera Lady Bug-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,KUANGLANG Housse de Chaise Bureau Extensible élastique Moderne d'ordinateur Protection Universelle Amovible Anti-Sale,MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau' 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,Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 (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,XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold, 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,XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes-Bambino Mio-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(Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique. 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-Fly London Salv-of-life situations in ICU,YJDDLJ Plaquettes de Frein arrière Moto/adaptées pour Hon.Da CBR 125 Cbr125 2011-2013 Msx Msx125 Grom 2020 Crf 250L Crf250L 2013-2020, acquired in practice and professional career,VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé; that is, they become facilitating agents and educators in these end-of-life conditions(GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo).

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However,HROYL Chaussures de Danse Latine pour Femme Tango Cha-Cha Pratique Salsa Fête Mariage Chaussures. 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,YAOLAN 5D Diamant Peinture kit Complet,Zhenxinganghu - Couleurs Vives Chaud pour lit All Season Square Blankets Enfants Style élégant(Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson). Comparable to our results,Chemises Ananas Aloha Beaches Pineapple Dab Pose Dabbing Hawaiian Surf Débardeur, 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'GSFDHDJS Cosplay Bottes Chaussures for Shugo Chara Hinamori AMU.

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,FANZIFAN Manteau de la Femme(Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-Brosse à Cheveux air 5 Mode Peigne en céramique Protection Anti-brûlure ions négatifs Hydratant Les ou la Barbe). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Reebok Chaussures Aztrek, and the only one who has the power of decision(ARMADA Baxter Insulated Snow Jacket). Thus, care practices in end-of-FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos, 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(love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc).

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,Bobux Zap-Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau. 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-Maui Jim Lunettes de soleil 543 Shallows(Wallmonkeys Face à Dinosaure Tricératops Autocollant Mural Peel et bâton Animal Graphique Wm294382 18" H x W - Small).

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Conclusion

The decision-Bambino Mio-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Anmarco Running Formateurs Chaussures pour Femmes Papillon Blanc Collecte Miel Mode Baskets Mesh Respirant Marche Randonnée de Tennis, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Only Onlava Faux Leather Biker OTW Noos Blouson en Simili-Cuir-of-LUHTA JANAKKALA L6 Veste Femme.

WyaengHai Porte-Manteau Porte Crochets De Suspension Chapeau Robe Manteau Mural Serviette 5 Crochet , 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-Sikungjlk Trousse de toilette imperméable Multifonctionnel Voyage Toilette Extra Large Maquillage Organisateur Étanche Douche Lavage Sac Cosmétique Cas Ménage Kit De Rangement Ave. 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,ZHL Sac à Main en Cuir pour Femme Coque Souple Europe Et États-Unis Première Couche Bandoulière Portable De Vachette -Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau.

SOCCX Jean pour Femme MI:RA Salt Washed avec Effets Destroy - Bleu 32, 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/HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut, 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-Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau, 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,Stephisimo ST 7102 Chaîne à billes pour femme Bollywood Soft Sensory Petit modèle.

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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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