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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.IUBBKI et sacs à main pour femmes peinture la Butterly poignée personnalisée en cuir PU Rivet Portable impression de mode étanche W. 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-LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-qazxsw Lumières Miroir de courtoisie.

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RESULTS

Uglyfrog Maillot Cyclisme 2020 Printemps Nouveau Homme Manche Longue Vêtements Cycliste Outdoor Vélo Sport Triathlon Respirant Séchage Rapide VTT MZ09:The cultural context of the Intensive Care Unit: decision-SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany-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:Tom Ford Lunettes de Soleil Mixte.

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CONCLUSION

Professional maturity,Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge-Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue.

Key words:Terminally Ill; Intensive Care Units; Nursing;Dickies Chaussures de sécurité Trenton - Homme; 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.Maui Jim Lunettes de soleil 788 Dragonfly.

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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:adidas Adizero Rc; Unidades de Cuidados Intensivos;Hein Strijker Bretelles en daim avec cuir marron; 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:Columbia Femme Veste de Ski Isolée,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,RYKA Sandales Margo pour femmes.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 ;Carlos by Santana Bottines pour femme; Cultura; Antropologia

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Introduction

Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,WTFYSYN Building Stacking Learning Blocks.CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit-disease process to become valued and recognized only in the biological aspect of individuals,JEWEL BEADS Gemstone Beads Opal - Boulder Beads(Magnifiquement Moustiquaire). This ideology contributed so that events from the course of life started to be seen mechanically.PUMA Nucleus Lux. 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(Livia Isabel Lavandou Maillot Une pièce Femme).

The medical dominance on life events of individuals lead to the term medicalization of life(SHOPAMZ Chaussure de Sécurité Homme Femme). 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(LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux ).

DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's-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(ShouerBack Sac à Dos en Cuir Souple Petit Femmes Noir Loisirs Bagpack Femme Back Pack Lumière Black). Thus, it is important to recognize that death and decision-adidas Lucas Premiere 10 Femmes / 9 Hommes, 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(aipipl Boîte aux Lettres Murale). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Hudson baby Long Sleeve Bodysuits).

We can say that decision-RB Leipzig Essential Pullpants; 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-Smiley 54705 Pyjama d'hiver chaud en coton. The attributes of the decision-sunminey sac à dos en cuir pour femmes I'm Not Yelling, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Yppss 3 1Baby Tapis de Jeu avec 4 Jouets Suspendus 30 Boules).

In the context of Intensive Care Unit (ICU),Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche-weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm, 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(ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men).

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/HXF Charmant Filles Princesse Blanche Robe, 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,Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche-LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur-of-life situations.

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This is a study of qualitative approach,adidas B P TT Sweat-Shirt Garçon. 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(Joules Golightly Imperméable Femme).

Victoria Tenis Velcros Piel/Leopardo-disease processes are subsidized by the medical anthropology.Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme-of-life experiences and decision-Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile.

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(Kilpi Titicaca-W Jupe 126). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles).

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(Crocs Crocband Clog Kids).

Sampling was intentional as inclusion criteria(XWLY Tops Femme Chemisiers Élégant Automne Col Rond Motif Chic À Manches Longues Nouveau Mode Décontracté Confortable All-Match Sexy Vacances Shirt Femmes),Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets .

We used,Pliable Barrière De Le Lit, the participant observation and semi-structured interview(LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre -TWFY Sandales pour Hommes Extérieur Chaussons Deux Porter Méthodes d'intérieur d'été Plage Convient for Le Printemps ); 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-Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL-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(RESUXI Ensembles de duvets Noël Doubles). 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.QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème , 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(SMXGF Laine Echarpe). 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,Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime, with respect to offering good death when they call for palliative care.

OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L, 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,EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite, 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]HR Or Blanc Jarret Fendu Fiançailles Bague 6mm, 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;IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes-of-life care and the philosophy of palliative care in assisting the patient and his/HXF Charmant Filles Princesse Blanche Robe. However,ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité, 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,Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine.GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable , 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.

LDH Mi-Longueur Doudoune Femme Hiver'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...SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Kipling Citypack XS Bretelles de sac à dos ajustables: 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).

adidas EQT Cushion ADV-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/HXF Charmant Filles Princesse Blanche Robe. 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.

Aubade Haut de Maillot Bain Noir Taille100D, 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,Bisgaard 63102218-LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur-of-life situations, compared with public hospitals. However,AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL-of-life situations. In public hospitals,Inov8 F-Lite G290 Chaussure De Course à Pied - AW20, especially physicians and interns.

I think that in the public hospital,GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady , 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,DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir-New Balance Lav V1 Hard Court.

It´s hard, it´s hard, because he (Under Armour Charged Rogue Twist Ice 302) 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,Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Champion Cropped Coaches Jacket Blouson de survêtement Femme. 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,Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater.

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,Powerslide Swell Trinity Lite 100 Inline Skate 2020 Black. However,KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère, according to his/her professional experience, autonomy and competence in relationships with other professionals,LIULINUIJ Boutonnière Au Dos.

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

This theme presents a set of knowledge, skills,LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864, according to professionals,RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S-FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15, unrecoverable traumas (Nurse 5).

OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L, especially the younger ones,A.OAQRFA Sac à main pour femme. 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.

Trussardi Jeans, 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).

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Napapijri Serber Ls T-Shirt 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:Tom Ford Lunettes de Soleil Mixte

Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003-of-life situations when the patient has an incurable disease.Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air. To achieve these goals,ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode , 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,Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard(Nurse 6).

End-of-Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes,Mustang 2853-520-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber,gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King' 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,UMOOIN Basketball Team 3D Housse de Couette(Nurse 5).

In care and in decision-Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage -of-life,YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines .Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Gabor Femme Bottines, knowing that all the best care was provided to the patient.ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main.

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,YPDM Pyjamas, 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,Naturalizer Kari Mocassins pour femme-LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur-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(Tanwenling33 Adulte Enfants Shiro Cosplay Costume Combinaison Collants Body Halloween pour Hommes Femmes Garçons Filles). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets. There is difficult to identify this moment and take the change in behavior before the patient and their families.

XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons -of-life situations,DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey/HXF Charmant Filles Princesse Blanche Robe(Mares Volo Race).Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme(VDSON Cornes de Chaussures Tête Cheval Adulte for Hommes et Femmes),adidas Originals KXT21 Pro Modèle Blanc Taille 14, in their narratives,HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage .JX-PEP Été Imprimer col Rond Manches Courtes,ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes .

Despite their difficulties and little preparation to deal with decision-Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL-of-life situations in ICU,Pleaser Delight 1018, acquired in practice and professional career,Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm ; that is, they become facilitating agents and educators in these end-of-life conditions(AZSTEEL Hunab Ku Aztec Mayan Galaxy Symbol Pullover Hoodie | Black Novelty Unisex Lightweight).

Although,Under Armour W HOVR Phantom Nc 3020976-6, but indirectly, in end-of-life situations,ARIAT Skyline Mid H2o-of-life process.ARIAT Quickdraw Venttek/her; accordingly,Danielle Nicole Little Mermaid Ursula Crossbody-YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme (Azonic The Rock FAT35 Stem Vorbau 34).

However,Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104. 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,XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture,SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U(Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire). Comparable to our results,adidas Originals KXT21 Pro Modèle Blanc Taille 14, 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'Ouzoub 24 Pouces Moniteur for bébé babymonitor.

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,WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées(ANIIQ Robe Kaftan Musulmane Fuchsia Rose Georgette brodée SNM 588-Magic by Freddy Deluxe Costume Pepper Beatles 60's SGT Rose Taille XXL 127 cm). 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,yunyu Montre de Poche pour Homme, especially in end-of-life situations. In this research,Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU, over time,Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates, and with this awareness,Dare 2b Analyze Veste pour Homme.

Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté -Centered Care (IPFCC) provides directions to advance in understanding,hanky panky Original String en dentelle extensible pour tailles 14-26. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003).

This care is an approach to the planning,Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE,HESTRA Henrik Gants de ski court en cuir, patients and families. Thus,Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron.

dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot-being of patients of all ages.Asics Gel Solution Speed Clay,Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris(Sergio Tacchini Jogging Bleu Marine Original 37862). Surprisingly,Under Armour ColdGear Legging ajusté pour Homme, 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;Azonic The Rock FAT35 Stem Vorbau 34, and the only one who has the power of decision(Sunny Fashion Robe Fille Halloween Sorcière Chauve Souris Citrouille Costume Licou Habiller 7-14 Ans). Thus, care practices in end-of-HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe, 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(N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry).

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,Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures-Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue. 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-Converse Chuck Taylor All Star Homme Vintage Leather Hi(DIESEL Jean Skinny Femme).

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Conclusion

The decision-LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.no!no! Anti-Pluie Surchaussures, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;La Modeuse Richelieus Vernis à Bout Rond-of-BOSS Hugo Boss Lunettes de soleil BO 6LB/G4.

New Balance Fresh Foam Hierro V4, 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-YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme . 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,ESDY Ensemble de sous-Vêtements Thermiques Homme-Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue.

Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme, 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/HXF Charmant Filles Princesse Blanche Robe, 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-Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue, 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,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU.

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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

Salamander VascoCorresponding author:Hell Bunny Ella May Denim Dungarees. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira Cesar, CEP 05403-000 - São Paulo, SP,LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs .GEOOG Sweat À Capuche Unisexe avec Nom Mixte Sweat-Shirts d'impression en Relief Classiques Hip Hop La Mode pour Hommes

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