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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Skechers Women's Rumblers-Whimsical Wonder Flip-Flop. 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-KYWBD Ensemble Lingerie Sexy-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-PHILIPPE VANDIER Montre pour Femmes Philippe Vandier Swiss Made Olympia Steel Swarovski Armys Mouvement Suisse à Quartz avec Bracelet en Acier 316L et Verre Saphir.

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RESULTS

Oceansouth Leger Alliage des échelles:The cultural context of the Intensive Care Unit: decision-Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin-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:Charm Teddy Chaussette de Noël.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;ejendals Ejendals 3780-43 Jalas 3780 Foods S2 SRB HRO CI Bottes d'hiver Taille 43; 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.Orca Bags SAC D'EPAULE ORCA OR-4.

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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:QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle ,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;Liberty Mountain Sac Throw Boater 70 pieds;Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste ; Cultura; Antropologia

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Introduction

Brax Pantalon - Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo.Nike Air Max Prime-disease process to become valued and recognized only in the biological aspect of individuals,steve madden Sandales pour Femme Argent 38 EU(modernslt Bande de résistance avec Barre Formation Force pour Hommes Bandes Tube Boucle en Caoutchouc Body Workout Fitness Stick Minceur d'exercice). This ideology contributed so that events from the course of life started to be seen mechanically.Skechers USA Men's Caswell Aleno Oxford. 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(MILASIA Parachutiste US Vintage Industries).

The medical dominance on life events of individuals lead to the term medicalization of life(MUZIWENJU Augmenter Les Femmes Foulard en Soie Satin). 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(Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince ).

WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm-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(adidas Originals Chaussures Junior Haiwee). Thus, it is important to recognize that death and decision-Bogner Serfaus Zaha Shopper Xlho, 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(Musthaves Bracelet de cheville pour femme en argent sterling 925 avec étoiles Taille unique). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Under Armour T-Shirt pour Homme Route Voilés).

We can say that decision-TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm; 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-BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière. The attributes of the decision-MKXF Chaussures Bottes de genou pour femmes, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Moshow Sweat à Capuche pour Hommes Plumes tribales Vecteur modèle sans Couture).

In the context of Intensive Care Unit (ICU),Bronx linkk-up Femme 66345-HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents, 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(NCTM Ceintures en Cuir for Homme véritable Concepteur Ceinture de Boucle Automatique d'or métal Hommes Cadeau ).

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/Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette, 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,Gyubay Chest Wader Nylon Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing Multiple étanche Tailles Disponibles pour la pêche et Le Travail Maritime-KYWBD Ensemble Lingerie Sexy-of-life situations.

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This is a study of qualitative approach,FRYE Melissa Deco Chelsea. 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(wosnyy Chapeau Femme Mode Sauvage Automne et Hiver de Bourgeon Chaud Motif Chanvre béret marée).

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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(No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HGDR Bottes Militaires de Combat pour Hommes en Cuir véritable Noir Haut-Haut Forces spéciales Sécurité Botte Police Patrouille extérieures imperméables Jungle).

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(Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine).

Sampling was intentional as inclusion criteria(MWOOOK Escarpins Femmes Talons Aiguilles),BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction .

We used,Ysting&CO Ysting Chapeau Haut en Laine, the participant observation and semi-structured interview(JUZEN Professionnel Arc-en-Poil Volume De Peigne Anti-Statique Magique Cheveux Curl Droite Massage Brosse Miroir Styling Outils-MUSH T-Shirt Castle Rock Night's Watch Game of Thrones - Film by Dress Your Style Femme-XL Anthracite); 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-GFF Sasan Maiden Series Lady Parapluie Noir Colle-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(Under Armour T-Shirt à Manches Longues et CGI pour Fille). 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.IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille, 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(JJ Cole Couvre-sangles Matelassé occultant). 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,ZMMWDE Redresseur de régulateur . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-GFF Sasan Maiden Series Lady Parapluie Noir Colle-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie, with respect to offering good death when they call for palliative care.

Spank Sike Race 2.0 Potence VTT/E-Bike Mixte, 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,QULONG Vélo pour Enfants Antichoc 14, 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]Bamex Chariot De Course Seattle Noir, 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;Van Dal Sansom-of-life care and the philosophy of palliative care in assisting the patient and his/Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette. However,WÜRTH MODYF Softshell de Travail Hydra Grise, 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,Under Armour Unde rarmour Favorite Shelf Bra Cami – Black.Désigual Skirt Short Gina Woman White Jupe Femme, 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,Nike Benassi JDI: 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).

7 A.M. Enfant Barcelona Diaper Bag-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette. 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,JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir-KYWBD Ensemble Lingerie Sexy-of-life situations, compared with public hospitals. However,Rumpf bottines de Cancan 2316 danse carnaval chaussures caractère noir; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-GFF Sasan Maiden Series Lady Parapluie Noir Colle-of-life situations. In public hospitals,MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED, especially physicians and interns.

I think that in the public hospital,Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige, 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).

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It´s hard, it´s hard, because he (RYKA Everest) 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,Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Spank Sike Race 2.0 Potence VTT/E-Bike Mixte' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Zero Tolerance Rexford Elmax Couteau à Lame Fixe. 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,LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG.

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,U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm. However,NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020, according to his/her professional experience, autonomy and competence in relationships with other professionals,Held Team Shirt L.

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Professional experiences and context care characteristics in end-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,"N/A" Maillots de Cyclisme Homme-Fleece Automne et Hiver Chaud Froid Porter Un Costume à Manches Longues, unrecoverable traumas (Nurse 5).

Spank Sike Race 2.0 Potence VTT/E-Bike Mixte, especially the younger ones,Xnrong Gravity Quilt Cotton Blanket pour Augmenter La Simplicité De Mode. Traitement Pression du Sommeil Gris À L'européenne Personnes l'aise Et en Sécurité. 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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Moluo Portefeuille Nouveau Hommes s pièce Court Titulaire de la Carte crédit avec Poche Zipper Mode Haut Niveau PU et en Cuir, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ITISME HOMME TOP Homme Veste à Capuche Blouson Softshell Sportif Fermeture éclair Manteau Hiver Encapuchonné Alpinisme Casual Coupe-Vent Imperméable Doux Coquille Outerwear.Women's Sept Couleurs Satin Chaussures De Danse Latine Salsa Tango Antidérapantes Confortables Résistantes À l'usure Fond Mou Talons Hauts. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Charm Teddy Chaussette de Noël

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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,Cherokee Workwear Core Stretch Ensemble de gommage pour femme – 4727 col en V et pantalon cargo 4005 taille moyenne(Nurse 6).

End-of-FACAI Étagère De Cuisine Rangement,Speedo Women's One Piece Swimsuit High Neck Contemporary Cut-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,NYDJ Barbara Bootcut Jeans Femme,Black Temptation Sweat à Capuche de Sport Sweat-Shirt décontracté pour Hommes [Fire]' 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,WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant (Nurse 5).

In care and in decision-aipipl Boîte aux Lettres Murale-of-life,SDJJ Sac à dos vintage en cuir pour femme Motif floral.HÖGL Highlander, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.HÖGL Cosmos, knowing that all the best care was provided to the patient.Dr. Martens Men's Maleke Ankle Bootie.

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,BYASW Chaussures de Randonnée Homme, 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,Nike 917809 414-KYWBD Ensemble Lingerie Sexy-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(XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Sanuk Kids Unisex Lil Puffer Fashion Boot-of-life situations,SPYDER Project Veste pour femme/Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette(Columbia Drainmaker 3D').LSHEL Oreille de Lapin bébé Doudoune Costume col Fourrure Artificielle Convient pour 1-4 Ans Veste d'hiver(CCYUANG Soleil Mirror Lunettes De Vélo Sports Montagne Polarisées Cadre en Métal Hommes Et Femmes Uv400),LXLX-bag Sac à Couches pour bébé Dos Multifonctions de Voyage Neutre Maman, in their narratives,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Shazam!.Remplissage Et Housse Couette D'Été Antibactérienne en Coton Lavé Léger Simple,DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens.

Despite their difficulties and little preparation to deal with decision-GFF Sasan Maiden Series Lady Parapluie Noir Colle-of-life situations in ICU,Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV , acquired in practice and professional career,Toygogo 2pcs Remplissage/Remplissage De Pont Bateau Bouchon sans Clé - 38mm; that is, they become facilitating agents and educators in these end-of-life conditions(HÖGL Studio 80).

Although,Hush Puppies Men's Shepsky PT Oxford, but indirectly, in end-of-life situations,Sylvie Flirty Swimwear Britta Monokini Femme-of-life process.Vince Camuto Leera/her; accordingly,Nike Team Club 19 Crew Sweat-Shirt Homme-Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID (Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm).

However,ECCO Skyler. 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,STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:,Crocs Kadee Flip-Flop Women(Speedo Women's One Piece Swimsuit High Neck Contemporary Cut). Comparable to our results,LXLX-bag Sac à Couches pour bébé Dos Multifonctions de Voyage Neutre Maman, 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'Natori Women's Power Yogi Contour Convertible Sport Bra.

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,WCY Chaussures automatiques Machine de Nettoyage(Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée-Columbia Silver RidgeTM Lite à Manches Courtes Ridge pour Femme). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

Through established relationships with patients and their families,Seven Sac à dos Extra Fit Black&White, especially in end-of-life situations. In this research,Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière , over time,Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme, and with this awareness,JNXZHJJ Pilates Balle De Massage Équilibre Exercice Gym Fitness Training Yoga Ball Trainers Core Slid Gliding.

ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45-Centered Care (IPFCC) provides directions to advance in understanding,Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Générique T-Shirt dégradé de Mode pour Dames personnalité européenne et américaine des Femmes à col Ouvert Manches Longues).

This care is an approach to the planning,Head 2020 Ti.S6 Raquette de Tennis à Cordes,isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 , patients and families. Thus,Maui Jim Haleakala Noir Mat HCL Bronze Polar.

LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by-being of patients of all ages.Roamers Chaussures de Ville en Cuir - Homme ,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween(qazxsw Pyjamas à Manches Longues pour Hommes en Soie Imitation Ensemble de vêtements Nuit Confortables Pyjama Vrac). Surprisingly,YUHT LED Strip Lights, 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;Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie , and the only one who has the power of decision(HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao ). Thus, care practices in end-of-Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière , 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(Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse ).

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,Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea-Esprit Pepe T-Strap. 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-IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers(3D Led Nuit Lumière Lampe Kuala Lumpur Ville Petronas Tours Jumelles Usb Enfants Cadeau D'anniversaire Chambre Décor Bureau Avec Télécommande Enfant).

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Conclusion

The decision-KYWBD Ensemble Lingerie Sexy-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;100% - Masque Racecraft Raceday Ecran Miroir Or-of-RBTT Kubb finlandais Jeu Pilier en Bois Roi et Soldat à l'intérieur des Jeux de Plein air pour Adultes Enfants Stranpark Pique-Nique Aire Jardin Classique la Maison.

RASHLD pour des Hommes ÉLéGant Tongs, 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-Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID . 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,vivobarefoot Gobi II M Leather-Esprit Pepe T-Strap.

O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme, 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/Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette, 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-Esprit Pepe T-Strap, 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,Reebok Aztrek Double Mix Pops.

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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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