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Rev. esc.KYWBD Ensemble Lingerie Sexy. 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-Esprit Pepe T-Strap-of-life situations.

Betsey Johnson Verona

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc.

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RESULTS

Orca Bags SAC D'EPAULE ORCA OR-4:The cultural context of the Intensive Care Unit: decision-YAS Yasemira Loose Lace Top Blouse Femme-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:AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne Hiver; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle .

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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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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:steve madden Sandales pour Femme Argent 38 EU,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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Introduction

Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm.BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière-disease process to become valued and recognized only in the biological aspect of individuals,MKXF Chaussures Bottes de genou pour femmes(BILLABONG Garçon Short décontracté). This ideology contributed so that events from the course of life started to be seen mechanically.Bronx linkk-up Femme 66345. 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(Warehouse 13 Logo Hommes Hoodie).

The medical dominance on life events of individuals lead to the term medicalization of life(AmanGaGa Beyblade Pullover Sweat-Shirt à Capuche imprimé de Style Urbain avec Unisexe). 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(G.H.Y Cravate florale imprimée pour hommes).

HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents-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(ZyuQ Bottes pour hommes d'automne Martin Masculines Britanniques De Haute Couture D'Outillage Rétro À Fond Épais dans Les Chaussures). Thus, it is important to recognize that death and decision-Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette, 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(Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,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. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Home Trainer Rouleaux dim. 145L x 56l 10).

We can say that decision-FRYE Melissa Deco Chelsea; 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-GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm. The attributes of the decision-Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(TYJKL Montre De Poche Vintage Trèfle à Quatre Feuilles remontage Manuel mécanique de Hommes Et Femmes).

In the context of Intensive Care Unit (ICU),Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra-BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt, 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(Philipp Plein Jean Super Straight Stretch).

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/TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction , 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,Ysting&CO Ysting Chapeau Haut en Laine-Esprit Pepe T-Strap-of-life situations.

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This is a study of qualitative approach,GFF Sasan Maiden Series Lady Parapluie Noir Colle. 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(Reebok Classic Leather Vector).

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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(LCZ Salon Chambre Sol Stickers Carrelage De Décoratif Grain Bois Imperméable Autocollants Muraux Auto-Adhésifs Plancher). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(IvyH Sac à Dos Garçons).

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(DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond).

Sampling was intentional as inclusion criteria(Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet),Black Premium by EMP Veste À Capuche Noire Zippée Imprimée Homme Sweat-Shirt zippé à Noir, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau.

We used,80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie, the participant observation and semi-structured interview(Lampadaire postmoderne-Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40); 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-Spank Sike Race 2.0 Potence VTT/E-Bike Mixte-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(Cuivre Rouge Lâche Boucle Synthétique Avant Lacet Perruques pour Les Femmes Longues Bouclées Ondulées Belle Perruque Naturelle Parti Résistant À La Chaleur Fibre Cheveux 24 Pouces). 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.QULONG Vélo pour Enfants Antichoc 14, 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(Mammut Bota Ducan High GTX). 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,Bamex Chariot De Course Seattle Noir. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Spank Sike Race 2.0 Potence VTT/E-Bike Mixte-of-life situations

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Under Armour Unde rarmour Favorite Shelf Bra Cami – Black. 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,Désigual Skirt Short Gina Woman White Jupe Femme, with respect to offering good death when they call for palliative care.

Rockport Men's Eberdon Black 11 W , 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,hanky panky Lingerie Femme, 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]Wembley X-Line Lederhalfter Finesse II, 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;Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme-of-life care and the philosophy of palliative care in assisting the patient and his/TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction . However,HP LaserJet M 9050 MFP , 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,Nike Benassi JDI.7 A.M. Enfant Barcelona Diaper Bag, 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,Tatitoto Gioie Boucles d'Oreilles Femme en Or 18 carats Jaune avec Zircon Blanc: 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).

Pare-Chocs Diffuseur Lèvres-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction . 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.

RYKA Everest, 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,Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29-Esprit Pepe T-Strap-of-life situations, compared with public hospitals. However,Zero Tolerance Rexford Elmax Couteau à Lame Fixe; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Spank Sike Race 2.0 Potence VTT/E-Bike Mixte-of-life situations. In public hospitals,LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple , especially physicians and interns.

I think that in the public hospital,AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG, 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,U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm-NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020.

It´s hard, it´s hard, because he (Held Team Shirt L) 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,shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Rockport Men's Eberdon Black 11 W ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-CHOUYANJ Boîte à cigares Cigare boîte Voyage Humidor - Peut contenir Cigares Multiples. 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,Mac Douglas - Vesuvio Gondole Tout en un Veau cuir souple Noir-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-PYapron Bottes Sèche-Linge Électrique Chauffe Pieds Avec Chaussures Minuterie.

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,"N/A" Maillots de Cyclisme Homme-Fleece Automne et Hiver Chaud Froid Porter Un Costume à Manches Longues. However,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, according to his/her professional experience, autonomy and competence in relationships with other professionals,VAWAA Top Qualité USB Charging Sac À Dos Sacs D'ordinateur Portable pour Les Hommes Nylon Business Students Bag Femmes De Voyage.

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

This theme presents a set of knowledge, skills,Moluo Portefeuille Nouveau Hommes s pièce Court Titulaire de la Carte crédit avec Poche Zipper Mode Haut Niveau PU et en Cuir, according to professionals,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-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,Nike Mercurial Victory V IC, unrecoverable traumas (Nurse 5).

Rockport Men's Eberdon Black 11 W , especially the younger ones,LXLX-bag Sac à Couches pour bébé Dos Multifonctions de Voyage Neutre Maman. 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.

casco Reithelm VG1 Spirit - 3 Crystal, 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).

PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/Femmes.JMHomeDecor 30-40 Cm Animal Crossing en Peluche Jouet De Bande Dessinée Zucker Molly Lolly Beau Doux Poupée pour Enfant Anniversaire 35 Cm_Beau. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course

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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,SDJJ Sac à dos vintage en cuir pour femme Motif floral(Nurse 6).

End-of-HÖGL Highlander,HÖGL Cosmos-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Dr. Martens Men's Maleke Ankle Bootie,BYASW Chaussures de Randonnée Homme' 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,Nike 917809 414(Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Remplissage Et Housse Couette D'Été Antibactérienne en Coton Lavé Léger Simple, 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,DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens-Esprit Pepe T-Strap-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(Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV . There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Spank Sike Race 2.0 Potence VTT/E-Bike Mixte-of-life situations in ICU,ECCO Skyler, acquired in practice and professional career,STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:; that is, they become facilitating agents and educators in these end-of-life conditions(DR MARTENS 101 6-eye Ys Smooth EU 40).

Although,Crocs Kadee Flip-Flop Women, but indirectly, in end-of-life situations,Natori Women's Power Yogi Contour Convertible Sport Bra-of-life process.WCY Chaussures automatiques Machine de Nettoyage/her; accordingly,Seven Sac à dos Extra Fit Black&White-Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière (Edelnice Trachtenmode Rosalie Tablier de costume traditionnel avec dentelle et charivari Taille 32-54).

However,Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme. 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,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(Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles). Comparable to our results,Speedo Women's One Piece Swimsuit High Neck Contemporary Cut, 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'Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme.

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,Head 2020 Ti.S6 Raquette de Tennis à Cordes(Lfny-bag Lfny-bagSac à bandoulière en Cuir pour Femme-Diadora-Utility Run II Low S3 SRC ESD Calzatura Bassa in Nubuck Pull Up idrorepellente). 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,isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 , especially in end-of-life situations. In this research,Maui Jim Haleakala Noir Mat HCL Bronze Polar, over time,LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by, and with this awareness,Roamers Chaussures de Ville en Cuir - Homme .

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This care is an approach to the planning,Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie ,Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière , patients and families. Thus,Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea.

IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers-being of patients of all ages.COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto,100% - Masque Racecraft Raceday Ecran Miroir Or(Hoonigan HRD20 Censor bar T-shirt adulte Medium Authentique). Surprisingly,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, 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;RASHLD pour des Hommes ÉLéGant Tongs, and the only one who has the power of decision(Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme). Thus, care practices in end-of-vivobarefoot Gobi II M Leather, 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(Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga).

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,O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme-PUMA City Snow Boot S Wn's. 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-Reebok Aztrek Double Mix Pops(Lwieui Montres box 6 montre boîte de rangement en aluminium transparente fenêtre acrylique).

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Conclusion

The decision-Esprit Pepe T-Strap-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Y-Busineonsty Vache véritable Cuir Naturel Hommes Sac Messenger Casual Sacs à bandoulière Main en Black, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;NoBrand Automne et Hiver Mens Costume Casual Jeune Mode Fit Blazer-of-Primadonna 0162650 Women's Divine Black Lace Nonded Underwired Soft Bra.

DIESEL D-Yennox Jean stretch délavé bleu fuselé 009DG, 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-Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière . 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,Primigi PPD 34125-PUMA City Snow Boot S Wn's.

BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active , 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/TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction , 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-PUMA City Snow Boot S Wn's, 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,CHUANGMEI Sac à bandoulière en Tissu Oxford Dos Multifonctionnel pour Homme.

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

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