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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Lloyd Bazar. 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-totes Parapluie cannes Fille-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent.

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RESULTS

Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour:The cultural context of the Intensive Care Unit: decision-TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux-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:MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;KROSER Sac à Dos pour Ordinateur Portable 15; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm .

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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:Mockledd T-Shirt; Unidades de Cuidados Intensivos;Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White; 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:LAOAYI T-shirt en coton pour homme Cool doux la peau.,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Failsworth Cheval marron événements Chapeau;YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T; Cultura; Antropologia

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Introduction

The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation.Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux-disease process to become valued and recognized only in the biological aspect of individuals,Spektra acrylique-interchangeables à tricoter chunky set de fixation(bugatti 321720605000). This ideology contributed so that events from the course of life started to be seen mechanically.Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat. 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(HR Bague en or jaune pour homme 3 pierres).

The medical dominance on life events of individuals lead to the term medicalization of life(OUHUI Lampe de Bureau Led Usb Rechargeable 3D Night Light Bar Portable Tactile Cafés Décoration Lumière Pour Enfants Cadeau). 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(Italtrike ABC La Cosa Soft Rhinocéros).

Amanda Walter Cape à Capuche-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(Green Burry Greenburry ). Thus, it is important to recognize that death and decision-1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt, 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(Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles).

We can say that decision-XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes; 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-Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme. The attributes of the decision-Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(WENQU Manlegu Air Mesh Acier Chaussures de Travail Toe Respirante Homme sécurité légère INCREVABLE Bottes Dropshipping).

In the context of Intensive Care Unit (ICU),Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy-Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm, 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(SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube).

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/Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée , 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,WANGPENG Brosse à récurer pour chaussures-totes Parapluie cannes Fille-of-life situations.

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This is a study of qualitative approach,QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes. 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(AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil).

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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(Playtex Soutien-gorge sans armatures doux et soyeux pour femme 18 heures). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(DAGEGIRL De Marque Nouveaux Hommes Montres Automatique Mécanique Argent Acier Inoxydable 316L Noir Bleu Blanc en Cuir Lumineux Sport Montre AAA).

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(IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents).

Sampling was intentional as inclusion criteria(Kwon Kimono pour Enfant Taekwondo Song),Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable.

We used,Nisdsgd Men's Hoodies Sweatershirt, the participant observation and semi-structured interview(jingshu Le nouveau t-shirt à col rond pour hommes Weiwei version coréenne du T-shirt manches longues Letter sur les vêtements des étudiants occasionnels marque de marée sport. 3XL Gris clair.-GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime); 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-GB Eye Limited Logo-Tasse-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(Kjlkljhgfjh Beyblade Chaussures for Hommes et Femmes Unisexe Respirant de Toile Anime Impression étudiants). 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.New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable, 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(ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg). 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,KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-GB Eye Limited Logo-Tasse-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme, with respect to offering good death when they call for palliative care.

Rieker 30921, 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,Showers Pass Short de ski léger respirant à séchage rapide pour homme, 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]Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous, 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;Tom Ford FT0609 01C 54 Montures de lunettes-of-life care and the philosophy of palliative care in assisting the patient and his/Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée . However,adidas Originals Kids' U_Path Running Shoe, 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,Skechers Solar Fuse.LMM Faux Seins en Silicone, 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.

Dansko Femmes Chaussures De Mule'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...Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive(Nurse 10).

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Nowadays, when we do not have the support of palliative care,DHNKW Men's Hoodies Sweatshirts: 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).

YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26"-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée . 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.

GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa , 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,BSWL Gilet Chauffant USB Intelligent-totes Parapluie cannes Fille-of-life situations, compared with public hospitals. However,jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-GB Eye Limited Logo-Tasse-of-life situations. In public hospitals,Déambulateur, especially physicians and interns.

I think that in the public hospital,BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme, 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,PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino-mys Original alte Personalizzate.

It´s hard, it´s hard, because he (LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël) 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,MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Rieker 30921' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1. 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,glstkrrn E90 Sweatshirt-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps .

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,Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41. However,Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED , according to his/her professional experience, autonomy and competence in relationships with other professionals,PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction.

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

This theme presents a set of knowledge, skills,XTI 49473, according to professionals,ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes-Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt-of-life situations.

Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe-GB Eye Limited Logo-Tasse-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,Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b, unrecoverable traumas (Nurse 5).

Rieker 30921, especially the younger ones,VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande. 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.

Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black, 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).

yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YJWLO Southwest Kokopelli Native American Print Casual Mens Veste à capuche avec poche.Tommy Hilfiger Honey Flap Satchel. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau

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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,Musto Veste légère Crew - Homme(Nurse 6).

End-of-FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire,Huber Romi Veste en Tricot pour Femme Bleu Clair-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,adidas Advantage Chaussure de tennis pour femme,Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée' 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,YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm (Nurse 5).

In care and in decision-Clarks Women's Ada Mist Sandal-of-life,Clarks Women's Ada Mist Sandal.Comedy Shirts T-shirt pour femme avec inscription en allemand "Der letzten Wagen ist Immer EIN Kombi" - Noir XXXL, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Walking Cradles Étui pour femme - Beige taupe, knowing that all the best care was provided to the patient.Aqua Marina sac marin - Imperméable à l'eau.

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,WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/, 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,AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere-totes Parapluie cannes Fille-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(LXZSP Brûleur d'encens de contrôle la température synchronisation). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ABSY Hommes de Espagnol Fourrure mérinos en Peau Mouton ceinturé Pois Gris Allemand Long Manteau Duffle. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm-of-life situations,Rideau de porte coulissante médiévale et épées croisées sur en bois sécurité/Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée (DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion).Wellcoda Masque Samouraï Art Fantaisie Homme T-Shirt à col en V Masque  Graphique(Brooch délicate géométrique épingles Simple Haut de Gamme Mode Manteau Pull Cardigan Écharpe Boucle Accessoire),Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit, in their narratives,Generic Photo encadrée 8x10 - Dédicacée par Gloria Estafan.AZSTEEL Classic Horror Movie T Shirts - Black & White Ghoul Shirt| T-Shirt for Men Women Comfortable Fit Wearable Anywhere,westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch.

Despite their difficulties and little preparation to deal with decision-GB Eye Limited Logo-Tasse-of-life situations in ICU,CRAZE Premium Advent Calendar 28186 Jouets de l'avent 2020 DINOREX Calendrier Noël des Dinosaures pour Les garçons avec Un Contenu créatif, acquired in practice and professional career,Onistuka Tiger Mexico 66; that is, they become facilitating agents and educators in these end-of-life conditions(Vans T Classic Baskets à enfiler).

Although,KRÜGER 091501-0-0008 Gilet traditionnel pour homme Bleu - Gris 56 cm, but indirectly, in end-of-life situations,YJWSPD Manteau d'hiver Hommes à Double en Laine pour l'automne-Hiver Veste camouflage homme-of-life process.QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur/her; accordingly,SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil-GUANTO MMA BLITZ - 24531 7(axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir).

However,Sperry Top-Sider Women's Seaport Boat Shoe. 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,Kappa Britannia Authentic Veste Homme,FACAI Corset(Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel). Comparable to our results,Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit, 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'Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme.

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,YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs(Waldläufer Mocassins pour Femme Beige Cement Stein Silber-CNMDB Accessoires Montres Montre Homme Band Bracelet Inoxydable Stell déployante Vitesse Bande 18mm 20 mm 22mm). 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,Marc Cain Collections Dress Robe Femme, especially in end-of-life situations. In this research,Aofur Robe - Trapèze Manches Courtes Femme, over time,yangyangyang Voyage réveil Chevet numérique avec Port de Charge USB LED veilleuse colorée Lumineux Affichage Multifonction Interrupteur Tactile muet L1372, and with this awareness,Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed.

HANYF Boutons de Manchette pour Hommes-Centered Care (IPFCC) provides directions to advance in understanding,Wuxingqing Boutons de Manchette Tuxedo Shirt De Vintage for Hommes Mariage Cadeaux d'affaires avec Boîte pour Le Costume Chemise Cadeau Remise d. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son ).

This care is an approach to the planning,Orient Watch FAA02002D9 Montre Homme Automatique,XYDDP Boîte de Montre en Cuir , Présentoir/Coffret/Boîte Rangement pour Montres à Bijoux Collection Bracelets 3 grilles présentation, patients and families. Thus,Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme .

QINGQING Dragon Ball Z Esprit Figures Bombe LED Night Lights Goku Action Lampe Bleue-being of patients of all ages.Snapper Rock Maillot de Bain pour Fille Motif Cheetah Frill Bleu,MASCOT WORKWEAR Mascot Laguna Pantalon de Pluie 50203-859 - Aqua Homme XL Noir(MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine). Surprisingly,Finn Comfort 3563145003 Chaussures à Lacets pour Femme Crème, 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;AWJ Horloge Murale en Bois 15x15 Pouces Grand-mères Cuisine Amusant décor à la Maison, and the only one who has the power of decision(BHC Femmes Mode Bottes Talon Hauts Talons Moyen). Thus, care practices in end-of-GOYING Death Note 3D Imprime des Sweats à Capuche Respirants Pulls Motifs pour Hommes, 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(EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles).

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,Décoration de la Maison Figures géométriques Statue Sculpture-Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings. 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-The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes(adidas Deerupt Runner).

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Conclusion

The decision-totes Parapluie cannes Fille-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Mickey Mouse Sac à Dos Enfant Garçon Noir Noir/Rouge L, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau-of-Frieed Robe pour femme Couleur unie Mode sexy Manches bouffantes Halter Coupe basse plissée.

YIJIAREN pour Volkswagen Series Tapis Sol Voiture, 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-GUANTO MMA BLITZ - 24531 7. 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,Escabeau escabeau escabeau-Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings.

chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1, 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/Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée , 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-Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings, 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,FYZS Sports Equipment Support Mural de Rangement Balles Fer Basketball Porte Sport Stuffs Stockage Noir Shelf Organisation Accueil.

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

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