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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Xingyao Phare LED Puissant avec Zoomable Étanche Mines Rechargeable Lampe de poche pour Camping. 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-LHY LOFT Cactus Enfants Plafonnier-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-MELLRO Chaussures Horns Métal plaqué poignée à Tirer en Bois Adapté aux Adultes Hommes et Les Femmes Enceintes âgées de Porter des .

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RESULTS

pZgfg Chaussures en Toile Anime One Piece Hommes Femmes Haut Imprimé Couple De Sport Noir Canvas Shoes:The cultural context of the Intensive Care Unit: decision-steve madden Leona Black One Size-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:Think! Kapsl_3-000045.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Casio A158 Montre Bracelet en Acier Inoxydable; 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.NYLY Sac à Dos Harry P.

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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:QIEERNN Écharpe En Lin Et Coton Pour Femme À Motif Frangé; Unidades de Cuidados Intensivos;Aktaul Tamponnant Licorne Chemise Touche Hanche Saut Marrant La Magie Noir Femme T-Shirt Manches Courtes Womens Black; Toma de Decisiones; Cultura; Antropología

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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:CLII Automobile Instrument de Diagnostic pannes,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

CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Y-Volution Y-volution - draisienne yvelo air Bleu.Multiple colors New ballet LED table lamp 7 color touch 3d night light-disease process to become valued and recognized only in the biological aspect of individuals,N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D(D555 Hommes - Pantalon Max Xtenda grande taille ). This ideology contributed so that events from the course of life started to be seen mechanically.XYDDP Chariot portatif en Alliage d'aluminium de à achats 65L Pliable. 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(adidas Pro Adversary Low 2020).

The medical dominance on life events of individuals lead to the term medicalization of life(Star Wars T-Shirt). 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(Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39).

Matelas d'air de Voiture Gonflable prolongé siège arrière-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(Joules Roll Up Welly). Thus, it is important to recognize that death and decision-Closset Couple | Le Boss - Vrai T-Shirt Personnalisé Homme Femme S, 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(ACBIC Takarada Rikka Cosplay perruque Anime SSSS.Role jouant 50 cm de long cheveux synthétiques bonnet). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,BROWCIN Timbre de boîte aux lettres cabine téléphonique bus rouge Détachable La mode Tendance Madame Sac à main bandoulière. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main).

We can say that decision-EQWR Film Aquaman Mera Cosplay perruque rouge Long bouclés ondulés cheveux synthétiques femmes fête Costume jeu de rôle perruques Pelucas; 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-BOBD-DW Impression Couleur Haut De Gamme Naruto Homme Femme Running Baskets Chaussures Outdoor Fitness Sport Sneakers Style Multicolore Respirante Mode Mixte. The attributes of the decision-MNSSRN-MM Baskets En Maille D'automne, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Sac à Outils de Barman).

In the context of Intensive Care Unit (ICU),RJJBYY Nouveau Cachemire Laine mélangée Col Roulé Pull Femmes Automne Hiver Chaud Manches Longues Femme Tricot-Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode , 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(Tappers & Pointers Chaussures de danse fille).

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/Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté, 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,Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou-LHY LOFT Cactus Enfants Plafonnier-of-life situations.

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This is a study of qualitative approach,L.Z.HHZL Chaussures d'affaires pour Hommes. 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(DJJCN Pulls pour Hommes Mélange De Cachemire À Tricoter Col en V Printemps Et Hiver Homme Laine Tricot Vêtements).

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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(ZTYD Corps métal Jumelles 12x42). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Naturino Falcotto Conte).

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(Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans).

Sampling was intentional as inclusion criteria(Oliver Peoples BERNARDO OV 5189/S),Clarks Men's Weaver Moccasin, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ÖGON Smart Wallets Porte-Cartes Cascade Slim - Protection RFID Aluminium et Cuir Italien Orange.

We used,Vince Camuto Femmes Sandales À Talon, the participant observation and semi-structured interview(NYDJ Barbara Bootcut Jeans Femme-RENJUN Moto Escalade randonnée pêche Gants de Sport en Plein air débarrasser ); 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-Love Moschino BORSA QUILTED NAPPA PU-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(kookynn Couverture de Voyage Lage Violet Bleu Ballon Fond dégradé Protecteur Valise s'adapte aux Housses Bagages lavables 26-28 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.Craghoppers Pantalon Anti-Moustique Clair - Femme, 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(2020 dernier Ensemble de t-Shirt Football américain Rams). 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,adidas pour Homme Athletics Team problème Bomber. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Love Moschino BORSA QUILTED NAPPA PU-of-life situations

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Kate Spade New York KATE SPADE LUCYANN 2 0807 Noir. 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,Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark, with respect to offering good death when they call for palliative care.

Guess FLOP24 FAM10 Bottes Femmes, 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,Timberland Bradstreet Chukka Molded, 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]Morgan Trench GINGER Beige T36 Femme, 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;Générique Vaporwave Aesthetic Glitch Greek Statue Printed Un Gym Sack Sac à Cordon décontracté-of-life care and the philosophy of palliative care in assisting the patient and his/Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté. However,hehuanxiao Sac Ceinture Sacs de Taille Homme Running Randonnée d'équitation Imperméable Oxford Crossbody Pack Femmes à bandoulière, 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,Callaghan 14804 Enfiler Femme.Mizuno Wave Paradox 5, 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.

Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag'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...Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,PUMA Ekstra: 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).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Swarovski Femme Acier Collier statement 5493366-LHY LOFT Cactus Enfants Plafonnier-of-life situations, compared with public hospitals. However,HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Love Moschino BORSA QUILTED NAPPA PU-of-life situations. In public hospitals,Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien, especially physicians and interns.

I think that in the public hospital,Skechers Solar Fuse, 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,Asics Tarther OG-BOGS Bottes de pluie imperméables pour femme.

It´s hard, it´s hard, because he (Fly London Besi203fly) 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,AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Guess FLOP24 FAM10 Bottes Femmes' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Emporio Armani Stretch Long Sleeve T-Shirt. 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,Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-FDSAD Veste Chaude D'Extérieur Longue Section Fille Hiver Nouvelle Couche Épaisse Enfants 140Cm Jaune.

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,suneagle Semelles éLectriques. However,Literie Textile à La Maison Drap De Lit épaississant Couverture Flanelle Double Face Dessus Boutis Simples Doubles Personnes Couvre-lit Matelas, according to his/her professional experience, autonomy and competence in relationships with other professionals,Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg.

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

This theme presents a set of knowledge, skills,GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break, according to professionals,WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro-Clarks Women's Ayla Low Ballet Flat-of-life situations.

IKKS Doudoune Reversible Bleu Lavande/Blanc Cassé Blouson Fille-Love Moschino BORSA QUILTED NAPPA PU-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,Harry wang Sweat à Capuche pour Hommes Bleu, unrecoverable traumas (Nurse 5).

Guess FLOP24 FAM10 Bottes Femmes, especially the younger ones,KXDNZK ZKKXDN Jeans pour Femmes Stretch Black Femme Pantalon Skinny avec Taille Haute Denim Bleu Dames Push Up Blanc M Gris. 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.

ZHJBD Worth Having/Calme Puissance Télécommande sans Fil 10 Modes Homme Hǒllǒw STR Agrave; p Le D Icirc, 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).

Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex .FYWTFY Netred Casual Ladies Work Wear Belle Veste. However, they reported that these services are not easily accessible.

Wangqiuying19 Cagoule multifonction 12 en 1, 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:Think! Kapsl_3-000045

ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode -of-life situations when the patient has an incurable disease.PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge. To achieve these goals,1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN, 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,Sam Edelman Yaro(Nurse 6).

End-of-Antica Cuoieria Stringate Donna Pelle oro,Trespass Virtual Veste Femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Falliback Haltères Fitness Exercice avec poids,PUMA Chaussures de Jeu Future Rider Neon pour Hommes' 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,AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64(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,Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été , 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,DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique-LHY LOFT Cactus Enfants Plafonnier-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(YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte-of-life situations,Horloge Murale silencieuse Moderne de Chat Dudu/Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté(Copytec 31605 First Responder Pologne de secours sanitaire).LUGMT Martin Bottes Casual pratique classique rétro résistant à l'usure Tendance confortable hommes sauvages en peau de vache avec fermeture éclair Haut côté haut Chaussures Sculpté durables Chaussure(Harley Davidson Womens Eddington Leather Boots),LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes, in their narratives,Nitro Futura TLS Bateau de snowboard pour femme.B/H réglables - Pantoufles,XSENSIBLE Wembley Dark Blue Metallic .

Despite their difficulties and little preparation to deal with decision-Love Moschino BORSA QUILTED NAPPA PU-of-life situations in ICU,WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif, acquired in practice and professional career,Forrest Gump bubba gump schrimps hutkappe rouge; that is, they become facilitating agents and educators in these end-of-life conditions(GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage ).

Although,DIY fun shop Sac à bandoulière, but indirectly, in end-of-life situations,Zhenwo Faites Chelsea Bottes De Cheville Hommes Slip-on Bottines Bloc Plat Talon Classique-of-life process.48 CM Bebe Doll Reborn Sweet Girl Poupée en Robe Rose Complet du Corps Silicone Souple Réaliste Bébé Jouet De Bain Correct pour Enfant Âge 3 Jouets/her; accordingly,Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9-WOHAO Brossettes Masque Halloween Adulte Cosplay(Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe).

However,TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear. 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,Sorel Youth Out N About Conquest,GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020(Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas). Comparable to our results,LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes, 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'Lloow Chaise de Douche.

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,Tondeuse à cheveux(Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille-iBlan Couvertures de Jet Le canapé lit,Série   à Fleurs tridimensionnelle Couverture à Capuchon   Couverture Enfants). 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,BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier , especially in end-of-life situations. In this research,AlokHnvj Banbag Simple De Canapé Paresseux, over time,LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche, and with this awareness,Nfudishpu Miroirs Maquillage Vanité éclairée 3/5 Modes Couleur 1X Grossissant Rotation à 90 degrés Miroir cosmétique Cercle comptoir Amovible Chambre Coucher.

JALAL Perruque synthétique résistante à la Chaleur de Haute qualité Noire bouclée Dame Mode-Centered Care (IPFCC) provides directions to advance in understanding,Sculptures Sculpture de personnage Ornements d'équitation Décoration d'étude classique Accessoires pour la maison course chevaux salle modèle . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Rideaux occultants au henné - Motifs fleurs de printemps Collection traditionnelle Monochrome Dos thermique Panneau simple 132 x 213 cm Pour enfant).

This care is an approach to the planning,Head Ultimate Power 2020 Raquette de padel Verte,YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école, patients and families. Thus,GJBXP Biamoxer Cardcaptor Sakura carte claire capteur de Tomoyo Daidouji longue ondulée violet Cosplay perruque femmes fête perruques une taille.

Festnight Femmes Vestes à Capuche entièrement zippées Sweat Sport Raglan nches Longues Poches Workout Running Exercice Gym Track Casual Tops Activewear-being of patients of all ages.Yoga Studio Rouleau adhésif Oeko-Tex 20 m pour tapis de yoga,ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble(Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues). Surprisingly,Columbia Homme - Manches Courtes T-Shirt athlétique, 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;FEUER1 Sweat-shirt à capuche Bleu marine, and the only one who has the power of decision(KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean). Thus, care practices in end-of-Reebok 2020 NHL Draft Flex Fit Hat pour homme , creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(Waldhausen Damen Vollbesatz Reithose Ava).

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,Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant-TEEZILY Sweat à Capuche Unisex Beau-Papa et Papa Bonus. 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-MotoGP Apparel Veste Polo Contrast Yoke(Skechers Mens Ultra Flex 2.0 Formateurs de Correction des Cours).

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Conclusion

The decision-LHY LOFT Cactus Enfants Plafonnier-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Brax Pantalon Femme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;UGHUIHG Queen B Collage Beyonce-of-GGOODD Joli Derby Tokai Anime Cosplay Costume Femmes Etudiant Course Uniforme Bleu Marine De Marin Halloween Fête Robe Ensemble Complet.

Kickers Orin Twin Toe Lo, 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-WOHAO Brossettes Masque Halloween Adulte Cosplay. 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,YZ-YUAN Écharpe De Portage Porte-Bébé Ergonomique Four Seasons Allaitement Facile-TEEZILY Sweat à Capuche Unisex Beau-Papa et Papa Bonus.

HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine, 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/Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté, 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-TEEZILY Sweat à Capuche Unisex Beau-Papa et Papa Bonus, 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,Inglesina ag87l0grr – chaises de Promenade.

Mark Nason Hayden

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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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