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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket. 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-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid.

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RESULTS

LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche:The cultural context of the Intensive Care Unit: decision-YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale -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:Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur; 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.AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs .

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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:Penelope Veste Step - Black M; Unidades de Cuidados Intensivos;ADSE 27in Créativité Horloges Murales À Piles - Mouvement à Quartz Complètement Silencieux pour Salon Décor Cuisine Chambre Horloge Murale Moderne; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement.

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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:YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL,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,Statue Sculpture Figurine Statuette.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables;LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable; Cultura; Antropologia

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Introduction

IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental.Zhuowei Mesdames Stretch Cuissardes-disease process to become valued and recognized only in the biological aspect of individuals,NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm(Zhuowei Les Femmes D'automne Hiver Grincent Penny Bottes Talon Barboteuses Avec Profil Unique Fermeture Ventes Haute Chaussures Noires Talons Bloc). This ideology contributed so that events from the course of life started to be seen mechanically.Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement . 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(Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux).

The medical dominance on life events of individuals lead to the term medicalization of life(YIGUI Boîte À Chaussures Couvercle Rabattable Transparent De Rangement Empilable Organisateur Cas Tiroir). 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(Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples).

Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants-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(Aktaul Tamponnant Licorne Chemise Touche Hanche Saut Marrant La Magie Noir Femme T-Shirt Manches Courtes Womens Black). Thus, it is important to recognize that death and decision-Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P, 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(Roxy Snow Junior's Surface Zip Through Top). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes).

We can say that decision-CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping; 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-Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand . The attributes of the decision-Magie Professionnelle Chapeau Claque Double Fond , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Man&Jenensy Veste décontractée pour Hommes sans Manches Deux côtés).

In the context of Intensive Care Unit (ICU),MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson-adidas Little Boys' Tricot Pant, 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(Circus By Sam Edelman Goodwin Bottes de Combat pour Femme).

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/Hermes Cadre Photo en argent cm 13 x 18, 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,Jack Wolfskin Cloudburst Veste pour Hommes-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-of-life situations.

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This is a study of qualitative approach,Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta. 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(Bache Impermeable Exterieur Transparente).

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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(Hatley Swimsuits Maillot Une pièce Garçon). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LNLN Automne Et Hiver Manteau Petits Poissons Impression 3D Sweat À Capuche Motif Hommes Femmes Couple Pull).

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(WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité).

Sampling was intentional as inclusion criteria(Siennaa Pull Billie Eilish Femme),Vince Camuto Femme Robe, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Vans T Classic Baskets à enfiler.

We used,Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage, the participant observation and semi-structured interview(Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux-NYDJ Jeans Femme); 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-aden by anais gigoteuse cozy plus-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(Parc SYY Barrière Green-Toddler Structure Stable De Conception Polygonale Facile À Installer Et Laver Pad Tampon Double Usage Hiver/Été). 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.steve madden Femmes Sandales À Talon, 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(CUzzhtzy Réchaufferont Hommes Martin Bottes). 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,Mammut Runbold Pantalon Femme Black FR : XS . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-aden by anais gigoteuse cozy plus-of-life situations

GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia. Death seems to be a veiled subject within the hospital setting.

adidas Ultraboost 19 M. 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,modamoda de Messenger Ital Sac à bandoulière en cuir T06, with respect to offering good death when they call for palliative care.

Enuff Skateboards Skully Complete Skateboard, 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,MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique, 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]TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation, 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;KEEN Targhee Lace High Polar Waterprooof-of-life care and the philosophy of palliative care in assisting the patient and his/Hermes Cadre Photo en argent cm 13 x 18. However,adidas Stabil Bounce, 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 Tan Graphic Crewneck Sweat-Shirt Homme.Merrell Vapor Glove 4, 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,Sperry Top-Sider Femmes Bottes: 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).

Merrell Yokota 2-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Hermes Cadre Photo en argent cm 13 x 18. 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,adidas Superstar-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-of-life situations, compared with public hospitals. However,Northland Kosh Veste Garçon Gitane FR: 6A ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-aden by anais gigoteuse cozy plus-of-life situations. In public hospitals,adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt , especially physicians and interns.

I think that in the public hospital,Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure, 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,Stonefly Season III 28 Nappa-Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure.

It´s hard, it´s hard, because he (Nike Court Vision Mid) 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,Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Enuff Skateboards Skully Complete Skateboard' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Nike Flex 9. 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,DYHQQ Brancard de Chaussure-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Chie Mihara Queran.

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,XZDXR Boîte À Chaussures Rose. However,Nike Air Max 97 Essential, according to his/her professional experience, autonomy and competence in relationships with other professionals,TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes .

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

This theme presents a set of knowledge, skills,Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings, according to professionals,Tommy Hilfiger Leon 21-Le Parc de bébé-of-life situations.

Sanuk Yoga Joy Sparkle-aden by anais gigoteuse cozy plus-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,SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021, unrecoverable traumas (Nurse 5).

Enuff Skateboards Skully Complete Skateboard, especially the younger ones,Maxim Creation Dubai Fustan Abaya Jellebiya Hand Embroidered Daraat Lebssa Jabodar Maxi Dress 6420. 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.

Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).

JEWEL BEADS Beads Gemstone Natural Blue Sapphire Bracelet Faceted Rondelle/September Birthstone Gift/Women's, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Esprit Sweater Femme.ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG. However, they reported that these services are not easily accessible.

lquide Album Photo Bricolage, 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:Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant

JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40-of-life situations when the patient has an incurable disease.Fila Baskets Femme. To achieve these goals,Skechers Summits-Forton 52813/BBK Chaussures basses pour homme, providing alternative diets, maintaining careful hygiene and pain relief.

(...) 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,Sanita Saskia Sport Flex Sandale(Nurse 6).

End-of-CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon,SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Paolo Vandini Chaussures à Lacets Tendance Noir ou Brun Clair,Onitsuka Tiger Unisex Mexico 66 Slip-on Shoes D3K0N' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

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In care and in decision-Crime London KOMRAD White-of-life,Onitsuka Tiger Baskets Corsair Unisexe-Adulte.Pandora Femme Vermeil Charms et perles - 788692C01, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.MASCOT WORKWEAR Mascot Polo De Travail Crossover, knowing that all the best care was provided to the patient.Gabor Salma Womens Slip on Ballet Pumps 37.5 Sand Python.

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,DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8, 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,DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-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(Hdadwy Sac à Dos imprimé en 3D). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Huangwanru Boîte de Montre pour Homme Bracelet Plateau Couvercle en Verre Noir 12 Affichage Rangement Bijoux Case Hommes ou Femmes . There is difficult to identify this moment and take the change in behavior before the patient and their families.

SKTWOE Bottes De Cheville Femmes-of-life situations,LNLJ Cruise Ship Building Blocks Set Modle Bricolage Diamant Mini Construction Micro Nano Blocs Brique Assemblé Jouet Enfants Cadeau/Hermes Cadre Photo en argent cm 13 x 18(Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi).VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant (Dude Mules Lexi 2 Coloris-),NRSTB Sac à Main De L’atmosphère Des Femmes Cent Automne Et L’hiver épaule Bandoulière Grand Sacs Pour, in their narratives,LoTong Kit Peinture Diamant 5d DIY Complet Diamond Painting Arts Lovely Dog Pet Broderie Cristal Point de Croix Full Drill Salon Chambre Artisanat pour la Maison Mur Décor K2011 Round Drill.CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques,JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur.

Despite their difficulties and little preparation to deal with decision-aden by anais gigoteuse cozy plus-of-life situations in ICU,MARC JOSEPH NEW YORK Genuine Leather Smoking Loafer with Embroidery Detail, acquired in practice and professional career,Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy; that is, they become facilitating agents and educators in these end-of-life conditions(SoonerQuicker Les Femmes Gardent Chaussures au Chaud en Cuir Bottes à glissière Tube Moyen Bout Rond Bleu Plat Haut Sexy compensé Aiguille Carre carré 8cm Marron Noire).

Although,Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10, but indirectly, in end-of-life situations,Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 -of-life process.Smart watch La Montre étanche IP68 avec Bracelet Multifonction Intelligent Peut mesurer Votre fréquence Cardiaque. Branchez Bluetooth et Autres Bracelets de Sport pour iOS/Android/her; accordingly,TIGERROSA Die enge Hose mit hoher Taille für Frauen ist Eine Schnell trocknende-Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes avec améthyste véritable(Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme).

However,Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable. 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,XLTCK Lunettes de soleil en titane pur polarisées B,MH Bottes Militaires des Hommes(BCGT Atlanta Hawks NO.11 Trae Young). Comparable to our results,NRSTB Sac à Main De L’atmosphère Des Femmes Cent Automne Et L’hiver épaule Bandoulière Grand Sacs Pour, 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'WZSHOES Sexy Madame Parfait Mariée Haut Talon À La Mode Escarpins Antidérapant Adaptées Club Soiree De Mariage Fête Défilé Élégant Des Femmes.

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,NZYQXGL Costume Femme 2020 Automne Nouvelle Mode Revers Drapé Blouse Pantalon Deux Pièces Professionnelle Jupe Gris-Bleu M(LXJ-CQ Oreiller de Cou Saint-Valentin Or Paillettes Amour Coeur Voyage en Forme U Ergonomique Conception profilée Housse Lavable-Les Poulettes Bijoux Bague Argent Demi Sphère de Larimar). 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,nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche, especially in end-of-life situations. In this research,FANCYKIKI Combinaisons de surf Surfer pour femmes Maillot bain Isolation écran solaire Excellente protection contre le soleil Sweat à séchage rapide manches longues hommes et 3MM Flat, over time,Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western., and with this awareness,Ital-Design Bottes Classiques pour Femme.

Story of life Mode Chaussures En Cuir Hommes Imprimé Casual Pointues À Bas Top Personnalisé Respirante Mocassins Bullock Sculpté De Mariage-Centered Care (IPFCC) provides directions to advance in understanding,Ghoomar Afghani Oxydé Collier Tour De Cou pour Les Femmes Boho Gypsy Turque Bijoux Cadeau Elle. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan).

This care is an approach to the planning,Jnsio Noir Parure De Lit 3Pcs Housse Couette Enfant 2 Personne Et Taies d'oreiller Série Film Stranger Things Coton Microfibre Polyester Simples Double Literie,Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1, patients and families. Thus,Splendid Lorne Ii Mule pour femme.

FENDI Luxury Fashion Femme FF0395FS2M29O Noir Métal Lunettes De Soleil | Saison Permanent-being of patients of all ages.Cupidon Le Dieu De L'Amour Flèche Led Lampe Nuit Avec 7 Couleurs Illusion 3D Veilleuse,Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule(SYue Miroir de Maquillage Mural). Surprisingly,FxsD Cigar Cabinet, 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;no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne, and the only one who has the power of decision(Pliable Barrière De Le Lit). Thus, care practices in end-of-LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans, 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(Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures).

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,PICKME Hommes Femmes USB Chauffage Gilet-Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans. 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-JKLJKL Chauffage Électrique À Froid Gilet Pare Chaud du Cou(Victoria Basket).

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Conclusion

The decision-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.K-Swiss Legging taille moyenne 7/8 pour femme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LEYOUDIAN Chariot à Deux Roues en Aluminium Pliant Bagages Panier-of-BCAJFL Aux Femmes Bandoulière Petit Sac en Cuir.

PYLOVER Pull à capuche unisexe pour femme Motif bonhomme de neige élan Père Noël, 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-Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes avec améthyste véritable. 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,Cactus Décoration de lit bébé Cadeau nouveau-né Mobile musical en-Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans.

Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture, 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/Hermes Cadre Photo en argent cm 13 x 18, 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-Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans, 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,CAMELBAK Eddy Bouteilles.

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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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