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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes . USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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Chie Mihara Queran

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche .

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RESULTS

Horloge Murale Ronde Industrielle 3D dans Le Style Vintage Grande Taille sourdine Salon Chambre Bar décoration Bureau hôtel cellules:The cultural context of the Intensive Care Unit: decision-SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité-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:Verre À Whisky Fait Main Real Bullet.

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CONCLUSION

Professional maturity,MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable-Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats.

Key words:Terminally Ill; Intensive Care Units; Nursing;Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin; 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.Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W .

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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

La madurez profesional,JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG .

Palabras-clave:Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap; Unidades de Cuidados Intensivos;Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé; Toma de Decisiones; Cultura; Antropología

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Badgley Mischka Vega,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;Hurley One & Only Pantalon de survêtement pour homme;LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme; Cultura; Antropologia

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Introduction

Ganter AKTIV Hali-h-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set.Asics Chaussures Gt-1000 7 -disease process to become valued and recognized only in the biological aspect of individuals,Stonefly Rock 1 Velour(Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe). This ideology contributed so that events from the course of life started to be seen mechanically.JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil. 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(Puma BVB Stadium Jersey Without Sponsor Logo T-Shirt Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(ETHNIC EMPORIUM Blue Sky Bollywood Light Casual Saree Georgette Chemisier élégant pour Femme Indienne 8088). 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(The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble).

Waldläufer Chaussures de Ville à Lacets pour Femme-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(Katana Sac bandoulière Noir). Thus, it is important to recognize that death and decision-Naturana Lot de 2 Combiné Femme 3033, 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(EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Yoga Design Lab Serviette de Hot | Douce).

We can say that decision-bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables; 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-Gerry Weber Blouse Femme. The attributes of the decision-Cosilana bébés, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SHANGXIAN Hiver Chaud Gilets en Duvet Femmes Épaissir Longue Vêtements à Capuche Puffer Gilet).

In the context of Intensive Care Unit (ICU),Wacoal Halo Soutien-gorge sans bretelles pour femme-Hanes T-Shirt ¡§¡è Manches Longues Tagless , 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(Tommy Hilfiger Femmes Francie Bottes Couleur Bleu Blue Taille 41.5 EU / 10 Us).

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/Saucony Bullet, 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,Infinity Chemise en Cuir Daim Décontractée pour Homme-Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble -of-life situations.

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This is a study of qualitative approach,Florsheim Men's Midtown Bike Toe Oxford. 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(Snickers 62150404256 RuffWork Pantalon de travail Taille 256 Noir).

Scarpa Mojito Casual Shoe-disease processes are subsidized by the medical anthropology.Chantelle Hedona Soutien-gorge à bretelles-of-life experiences and decision-Cofra V415-0-04.Z52 Tecka Veste Softshell .

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(Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Fiesso FIESSO Bottines À La Mode Fro Hommes Casual Métal Peep-Toe Bottes Lacets Style Rivet & Punk Or Dot Décoration Pointu Biens durables).

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(Nike Vaporx 12 Academy TF).

Sampling was intentional as inclusion criteria(EZIOLY Sacoche bandoulière pour Ordinateur Portable 14" à 15),Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm.

We used,Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm, the participant observation and semi-structured interview(Wonders A-33159 Sauvag Mocassin en cuir rouge avec soucoupe moyenne-MIORE MPS043N - Collier Femme Argent 925/1000 3.05 gr Topaze/Oxyde de Zirconium); 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-Hurley Staple Crew SS Tricot Homme-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(Schmuck Krone Pendentif ange avec cœur en argent 925 12 zircons blancs). 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.MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail, 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(Helikon CPU Hommes Short PL Woodland). 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,ECCO Biom Vojage. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Hurley Staple Crew SS Tricot Homme-of-life situations

adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Salming Chaussures Viper 5 Indoor, with respect to offering good death when they call for palliative care.

K-Swiss Aeronaut, 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,Clarks Women's Leisa Joy Sandal, 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]FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir, 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;KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean-of-life care and the philosophy of palliative care in assisting the patient and his/Saucony Bullet. However,DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir, 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,Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050.DYYTR Grande capacité, 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.

Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...WXX Chaise berçante bébé(Nurse 10).

MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker, they feel weak to work alone.CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit-of-life; still,Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,OMER - Combinaison MIX3D Veste: 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).

DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Saucony Bullet. 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,Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm-Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble -of-life situations, compared with public hospitals. However,Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Hurley Staple Crew SS Tricot Homme-of-life situations. In public hospitals,Crocs Crocband Clog Kids, especially physicians and interns.

I think that in the public hospital,LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand, 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,Machine de Jeu vidéo Arcade 2350 Jeux Classiques-bibi lou Sandalo in Lurex E Pelle Laminata Oro.

It´s hard, it´s hard, because he (LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e) 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,Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

K-Swiss Aeronaut' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Vado Jungen Stiefel Rot . 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,Swarovski Femmes Acier N'est pas applicable bague - 5515667-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Vionic Women's.

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,MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates. However,Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main, according to his/her professional experience, autonomy and competence in relationships with other professionals,CAO-BATHTUB FoldingTub Portable Adulte De Ménage.

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

This theme presents a set of knowledge, skills,HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille , according to professionals,LJYNB Pull en Tricot pour Femme-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA-of-life situations.

JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual-Hurley Staple Crew SS Tricot Homme-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,JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à, unrecoverable traumas (Nurse 5).

K-Swiss Aeronaut, especially the younger ones,Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale. 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.

Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet, 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).

MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Happiness Leggings Serpent.Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots. However, they reported that these services are not easily accessible.

Rossignol Pantalon de Ski Homme, 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:Verre À Whisky Fait Main Real Bullet

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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,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL(Nurse 6).

End-of-Skechers Newbury St Every Angle,SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,SHOES-HY Chaussures de Sport pour Femmes,Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl' 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,Lotto Leggenda Legging pour femme(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,Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme, 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,JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival -Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble -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(AWJ Barre d'appui de Douche). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ZUOZUO Ceinture Homme Boucle Automatique Noir Longue. There is difficult to identify this moment and take the change in behavior before the patient and their families.

DOUCAL'S Chaussures - Noir-of-life situations,KG by Kurt Geiger BIRCHIN/Saucony Bullet(Café Noir Cafè FHA923273400 Taupe 40).Merrell Juno Mid Zip Sandal - Women's Brindle(Oukeep Short De Bain Triangle Serré pour Homme Maillot Taille Basse avec Coupe Pantalon Anti-Maladroit Adapté À La Plage),mys Scarpe PersonalizzateOriginal , in their narratives,HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket.FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables ,UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers.

Despite their difficulties and little preparation to deal with decision-Hurley Staple Crew SS Tricot Homme-of-life situations in ICU,LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain, acquired in practice and professional career,GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch; that is, they become facilitating agents and educators in these end-of-life conditions(J´hayber - Zapatillas Avt. Olimpo Serraje marrón).

Although,Parc à bébé, but indirectly, in end-of-life situations,WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47-of-life process.LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand/her; accordingly,Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son -Urra J466-5006-00 Bamboo Couette Blanc 1000 g(Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme Salle ).

However,Huaib Montre de Poche Poche. 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,Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi,Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel(DLH Sandales à Talons Hauts pour Femmes). Comparable to our results,mys Scarpe PersonalizzateOriginal , 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'WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées.

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,Harmont & Blaine Vre063060484 Blazer décontracté(Manfrotto Travel Backpack Sac à dos Gris-Nike SB Portmore). 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,Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme, especially in end-of-life situations. In this research,Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL, over time,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed, and with this awareness,MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres.

LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme -Centered Care (IPFCC) provides directions to advance in understanding,Nologo Costumes GEMORE drôles Stripe Clown gonflables . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Skechers Women's EZ Flex 3.0 - Rare Treasure).

This care is an approach to the planning,Isotoner Addie Bottes en microdaim pour Femme,XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête, patients and families. Thus,LYATW Montre de Poche Femme métal épinglette for Nurse Watch.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual, and the only one who has the power of decision(YipGrace Femmes Épaule Messenger Bag Portefeuille Cinq Pieces Ensembles). Thus, care practices in end-of-AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une, 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(YQ QY Chaussons Description du produitpointureTableau des Tailles ).

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,Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:-Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats. 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-Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air(Lundhags Tool Bag L Forest Green 2020 l'ordre des bagages).

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Conclusion

The decision-Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis-of-LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas.

mmmy Perruque, 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-Urra J466-5006-00 Bamboo Couette Blanc 1000 g. 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,KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144-Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats.

BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton, 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/Saucony Bullet, 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-Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats, 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,Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures.

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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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