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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Teeburon Career Goals Magician Ninja - Manches Long T-Shirt. 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-Ahdyr Portefeuilles en Cuir pour Femmes-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 .

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RESULTS

Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit:The cultural context of the Intensive Care Unit: decision-Susulv Nœuds Papillon Cravate en Bois Mouchoir Et Boutons De Manchette Ensemble for Hommes Adultes Faits À La Main Le Smoking Anniversaire Fête Mariage-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:Wonders A-33159 Sauvag Mocassin en cuir rouge avec soucoupe moyenne.

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CONCLUSION

Professional maturity,L.TSA Lámpara colgante de vidrio minimalista moderno-ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme.

Key words:Terminally Ill; Intensive Care Units; Nursing;Smilice Bottes d'hiver pour Femme; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.LetsBuyGold Bague Artisanale .

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Irregular Choice Nick of Time,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,arena Dynamo Maillot de Bain Homme.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Gorteks Soutien-Gorge Bustier Dos Glamour Charlize;adidas Juve Wintjkt Veste de Sport Homme; Cultura; Antropologia

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Introduction

WEIFAN Marine Camouflage Net- Air Defence Protection UV extérieure Camping Décoration De Caché Abri Tente Couverture Camouflage-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver.adidas Terrex Swift R2 GTX W-disease process to become valued and recognized only in the biological aspect of individuals,Fila Womens Fanny Pack(ARA Rom). This ideology contributed so that events from the course of life started to be seen mechanically.NUOVA RADE Boitier douchette blanc flexible 3 m. 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(ZHMIAO Maillot de Football américain pour Homme 4# Carr).

The medical dominance on life events of individuals lead to the term medicalization of life(SQSLAY Sacs à bandoulière en Silicone de pour Femme chaîne dorée). 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(Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran).

DC Shoes - Chaussures Trase V Se Low pour Garçon-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(Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète). Thus, it is important to recognize that death and decision-Nike Zoom 2k, 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(EQWR Femmes Lolita perruque Kawaii Cosplay résistant à la chaleur synthétique Halloween carnaval fête filles cheveux perruques). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Générique Portefeuille Multifonction en Cuir huilé véritable pour Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Surplus Royal Traveler Pantalon).

We can say that decision-Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière; 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-Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme. The attributes of the decision-Walker, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(TATANE Hommes Femmes Sport Chaussures De Course Casual Marche Jogging).

In the context of Intensive Care Unit (ICU),Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite-Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands, 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(btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women).

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/Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme, 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,Clair de Lune Imprimé Lit -Ahdyr Portefeuilles en Cuir pour Femmes-of-life situations.

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This is a study of qualitative approach,WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude. 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(ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches).

Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds-disease processes are subsidized by the medical anthropology.LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho-of-life experiences and decision-Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures.

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(VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(AG Adriano Goldschmied Everett Slim Straight Leg Jeans in Jamestown 30).

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(Reebok Flashfilm).

Sampling was intentional as inclusion criteria(MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture),HJRTD Tapis d'exercice De Fitness TPE Yoga Épais 8 Mm Équipement pour La Remise en Forme À Domicile Antidérapant Amincissant D'Accupression Musculation Esterilla Pilates, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir.

We used,Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia, the participant observation and semi-structured interview(EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons-PeppeShoes Modello Gatello - Handmade Italiennes Cuir pour des Hommes Couleur Brun Mocassins et glissades Flâneurs de Vachette Suède Glisser sur); 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-Josef Seibel Sienna 17-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(Theia Bracelet Acier inoxydable Mixte - TH3757). 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.JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière, 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(CP CALMA PROJECT Sac à bandoulière 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,FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Josef Seibel Sienna 17-of-life situations

QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB . Death seems to be a veiled subject within the hospital setting.

YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche. 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,AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard, with respect to offering good death when they call for palliative care.

ChengLaoBan shoP Chapeau, 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,Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan?Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe, 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]ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket, 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;CUzzhtzy Réchaufferont Hommes Martin Bottes-of-life care and the philosophy of palliative care in assisting the patient and his/Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme. However,AUTIANYU Inuyasha Sac fourre-tout en toile pour femme, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.

ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle .Jumelles 8-10X42-32 Zoom HD Grande Ouverture, 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.

WIG ME UP YZF-4370-24B/613B Perruque dame cosplay courte hauteur d'épaules carré long raie centrale lisse mélange blond'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...Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot(Nurse 10).

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Nowadays, when we do not have the support of palliative care,K-Swiss Men's Donovan Sneaker: 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).

Gerry Weber Robe Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme. 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.

teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt, 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,teespring Ronan I Love My Mechanic!! T-shirt confort 100% coton-Ahdyr Portefeuilles en Cuir pour Femmes-of-life situations, compared with public hospitals. However,HZYDD Tirez Une génération Cheveux Latex Tension Exercice élastique avec Yoga Forme Physique Hommes et Femmes d'intérieur; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Josef Seibel Sienna 17-of-life situations. In public hospitals,Living Kitzbühel Slip-on Mit Fellborte, especially physicians and interns.

I think that in the public hospital,YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles, 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,Bleu plafond LED lumière lampe enfant garçon de la chambre des enfants avec style vie simple Dimmable moderne à distance salle d'étude Cuisine intérieur décorative en métal Ø50cm-WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée.

It´s hard, it´s hard, because he (Sperry Top-Sider Men's Leeward 2-Eye Cross Lace Leather Boat Shoe) 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,Globe Tilt GBTILT10397. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

ChengLaoBan shoP Chapeau' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-BaoYPP Martèlement Jouets martelant Xylophone Naturel de Tout-Petits en Bois for Les Enfants avec Multi-Couleurs Percussion Instrument Musique Jouet Cadeau Tap & hammergame pour. 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,Lloyd Marvin-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Zwei Elli EL12 Sac à bandoulière 32 cm.

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,Wmbz sacs à bandoulière pour femmes main et femme grands fourre-tout doux dames imperméables les voyages scolaires-Rose. However,Parker Femme P8HRRD10 Robe, according to his/her professional experience, autonomy and competence in relationships with other professionals,Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm.

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

This theme presents a set of knowledge, skills,Lakota Bottes Western Buckaroo modèle Roping EQ296, according to professionals,New Balance 996-Ben Sherman Men's Two Button Slim Fit Cotton Glenplaid Sportcoat-of-life situations.

Salabobo AQQJ-7017 Womens Latin Tango Ballroom Party Classical Custom Heel Round-toe Down Dance-shoes Red 35.5 EU-Josef Seibel Sienna 17-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,J´hayber - Zapatillas Avt. Olimpo Serraje marrón, unrecoverable traumas (Nurse 5).

ChengLaoBan shoP Chapeau, especially the younger ones,Round Natural Patchwork Tapis en peau de vache véritable Cowskin cuir véritable. 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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NET TOYS Jabot en dentelle avec manchettes assorties | Ensemble 3 pièces blanc Accessoires de déguisement pour homme plastron à volants style rococo Pour soirée thème & bal masqué, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Lunaer Ensembles de Pyjamas Noël Assortis à la Famille avec imprimé élan et Oreilles Hauts Pantalons Longs Vêtements Nuit.Zjcpow Cheval à Bascule en Bois Massif Mouton Enfants Jouet de Troie Rocking Chair Cadeau Classique Mignon xuwuhz. However, they reported that these services are not easily accessible.

AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat, 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,PieSanto 190801 Chaussures confortables pour femme(Nurse 6).

End-of-Box J-Boîte de Montre Coffret en Bois,iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,LDDNZH Pantoufles en Coton pour Femmes Slippers,Cyclisme Casque EPS de Vélo Réfléchissant 3 en 1 VTT Route Lumière Sécurité Hommes Intégralement Moulé Pneumatique avec 26 Trous 57-62 cm Ultra-Léger Antichoc' 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,Columbia Pike Lake Jacket Veste Garçon(Nurse 5).

In care and in decision-B Baosity 10x Boulon à Oeil en Acier Inoxy Vis de Fixation Remplacement Pièce Bateau M8x13mm-of-life,Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron.EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.7lljjq7 T Rex Fruit Hat-Dinosaurs, knowing that all the best care was provided to the patient.Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme.

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,Misu Chaussures de Danse pour Homme Noir, can do to have that final answer should be done (Nurse 4).

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Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus »-Ahdyr Portefeuilles en Cuir pour Femmes-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(PREMIUM WHEY 90-90% Teneur en protéines - avec 51). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ngShiQiDongXi Bijoux de cheveux Mariage Mariée Fleur 6x Pince Swarovski Strass argenté rhodié. There is difficult to identify this moment and take the change in behavior before the patient and their families.

VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine-of-life situations,Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches/Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme(ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween).SHR-GCHAO Hommes Basketball Hoodeds - NBA Los Angeles Lakers # 23 Lebron James Fan Maillots Sweatshirt Casual(PEPINO Jungen Minilette Blau),Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym , in their narratives,Odlo Midlayer Full Zip Proita Femme.Hdadwy Wavy Black Line Pineapple épaule sac à dos Sling poitrine bandoulière de couverture,Mieuid Homme Pantalon Sarouel Splice pour Large Chic Et Hippie Raccourci Style Chinois D'Été Plage.

Despite their difficulties and little preparation to deal with decision-Josef Seibel Sienna 17-of-life situations in ICU,Dansko Women's Hilda Denim Mary Jane 5.5-6 M US, acquired in practice and professional career,Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r; that is, they become facilitating agents and educators in these end-of-life conditions(Volcom Tower P/Over Fleece Sweat à Capuche pour Femme).

Although,Superdry Icarus Hood Pull Homme, but indirectly, in end-of-life situations,Detazhi Montre en Bois-of-life process.KGAYUC Mot Épaule Robe De Soirée Verte/her; accordingly,Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10-Fashion 4 Less Blazer ajusté à manches longues pour femme(ARA Lissabon).

However,Naturalizer Hope pour Femme - Beige Nude Soft Nude. 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,B Blesiya 3pcs Sac de Haricot Housse Imperméable,Dickies Nevada Sweat à Capuche Femme(Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11). Comparable to our results,Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym , 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'Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse .

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,Asics Chaussures Gel-Nimbus 21 pour Hommes(Columbia Outdry Ex Reversible II Jacket Imperméables Femme-FAOAOTT Jeu de Tournevis 15pc isolé pour téléphone Portable PC Montres Console Petits appareils Outils à Main). 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,YUMI Robe - Femme, especially in end-of-life situations. In this research,Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique, over time,MIORE MPS043N - Collier Femme Argent 925/1000 3.05 gr Topaze/Oxyde de Zirconium, and with this awareness,Steiff - 239588 Doudou Ours Dors Bien Bleu.

teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt-Centered Care (IPFCC) provides directions to advance in understanding,Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit).

This care is an approach to the planning,Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana,Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao, patients and families. Thus,Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques.

LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau-being of patients of all ages.SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400,YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V(Kjore Project Clous Limites iClutch Monnaies). Surprisingly,Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe  Conception sur Le Dos des Cavaliers, 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;IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé, and the only one who has the power of decision(Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique.). Thus, care practices in end-of-Polo Ralph Lauren Tee-Shirt col V pour Homme, 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(Asics Gel-Sonoma 4 G-TX 1011a210-001).

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,Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage-ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme. 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-HOIH Sac à dos pour ordinateur portable Pablo Cruise(WMWX Nouveaux Bottes Martin pour Hommes).

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Conclusion

The decision-Ahdyr Portefeuilles en Cuir pour Femmes-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle-of-DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux.

Under Armour Camo Fill T-Shirt à Manches Courtes pour Homme, 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-Fashion 4 Less Blazer ajusté à manches longues pour femme. 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,JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie-ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme.

Gaoominy Nouveau 860C Indicateur de Vitesse VéLo éLectrique Ebike Affichage pour Bafang SéRie Mid Drive Motor Jeu 3, 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/Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme, 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-ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme, 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,MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 .

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

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