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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Lamarthe Sac porté bandoulière Croco Co10a - Marine. 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-GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-BGBG T-Shirt pour Femmes Quotidien - Color Block Purple.

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RESULTS

BGGGT Vélo Riser vélo Tige réglable 25.4x90 / 110cm et amp31.8x90 VTT Route en Aluminium :The cultural context of the Intensive Care Unit: decision-Balmain Luxury Fashion Fille 6N8081NC610100 Blanc Coton Robe | Automne-Hiver 20-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:Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;HOXMOMA Tringle à vêtements coulissante pour Garde-Robe; 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.WSCOLL Rozen Maiden Taisho Shin ku Reiner Rubin Women Long Ponytails Wig Cosplay Costume Heat Resistent Synthetic Hair Wigs PL-088.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:LEONE 1947 Survêtement Unisexe Adulte,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,MU Queue de Billard.

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Introduction

Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich »-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale.NQI James Laker #23 Ensemble de maillot basket-ball 4 pièces Swingman Maillot en maille T-shirt haut gilet et short pour enfant adulte Unisexe -disease process to become valued and recognized only in the biological aspect of individuals,WOLVERINE Piper Technical T-Shirt à Manches Courtes pour Femme(WYZQ Dames Filles Mode infirmières Florales Broche à Revers Couverture de Protection en Silicone Montre Poche carrée pour s Paquet 3). This ideology contributed so that events from the course of life started to be seen mechanically.Disney Homme Cars Rust-Eze Logo Sweat À Capuche. 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(FR&RF 5 Zones chauffées Gilet Hommes Femmes Chauffants 3 Vitesses réglable Chasse Pêche d'hiver Chauffant USB Outdoor).

The medical dominance on life events of individuals lead to the term medicalization of life(XQXA Sac à Dos Ordinateur Portable). 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(Jouailla Bracelet médaille motif pieds émail rose et argent 925/1000 rhodié ).

Wellcoda Garder Calme Allemagne Berlin Homme T-Shirt à col en V Allemagne  Graphique-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(Idakoos Keep Calm and Love Krav Maga Chalk Style - Sports T-Shirt Femme). Thus, it is important to recognize that death and decision-HKM SPORTS EQUIPMENT 6900 PAM Pantalon d'équitation pour adulte en silicone Bleu foncé Taille 18, 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(Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ALTRA Women's AL0A4QTN Solstice XT Cross Training Shoe. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016).

We can say that decision-superfit Husky; 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-Geox J Artach A. The attributes of the decision-Kenneth Cole REACTION Chaussures Habillées, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Silvian Heach RCP19050BO Shopper femme).

In the context of Intensive Care Unit (ICU),Kenneth Cole REACTION Men's Center Low Sneaker-Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure, 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(adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU).

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/Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture, 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,xiaolaohu Unisexe 3D Hoodie Cartoon Anime Hommes/Dames À Manches Longues Cordon Pull Casual Sweat Poche SY00022-GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage -of-life situations.

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This is a study of qualitative approach,Berkemann Soft-Toeffler. 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(N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm).

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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(QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ZHTY Sonnette Avant Style Pastoral en Fer forgé Manuelle Fonte clochettes à Main Couronne impériale modélisation arrêt de Porte).

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(Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible).

Sampling was intentional as inclusion criteria(UGHUIHG Queen B Collage Beyonce),JapanAttitude Robe légère Noire Sobre Courte Style Mercredi Addams, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Nike WMNS Run Swift.

We used,Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal, the participant observation and semi-structured interview(Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée-IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N); 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-Lacoste Polo Femme-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(AOWU Chaussures vélo Couverture PVC Couvre-chaussures imperméable). 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.Merrell Femmes Chaussures De Sport A La Mode, 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(Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29). 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,WONDER WOMAN DC Comics Maillots Une pièce Fille. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Lacoste Polo Femme-of-life situations

CafePress BRIGHTGREYSAATOMY PJ pour femme. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Yaunli T-Shirt de Sport pour Hommes humidité Maillot Cyclisme à Manches Longues Respirant séchage Rapide for Cycliste VTT Veste Respirante Biker éponge, with respect to offering good death when they call for palliative care.

AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight, 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,AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight, 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]Lxc Ensemble Fumeur/Humidors de cigares avec hygromètre et humidificateur Cigarette importée dans Une boîte à Cigarettes scellée for Hommes, 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;Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ-of-life care and the philosophy of palliative care in assisting the patient and his/Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture. However,ZHANGYY Ceinture de Correction Jambe réglable, 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,XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport.lepni.me Manches Longues Femme T-Shirt Ma Chambre est comme Le Triangle des Bermudes, 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.

SUREH Nid de bébé Bassinet pour lit portable en coton biologique'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...XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Yhjkvl Hommes Gym Legging Fitness: 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).

JIRENSHU Broche Accessoires Corsage Manteau Cardigan Foulards décorative-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Élégant Portefeuilles Pour Hommes En Cuir Véritable Rfid Blocking Minimalist Wallets for Men Poche Avant Avec à Monnaie-GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage -of-life situations, compared with public hospitals. However,Cxjff Pliant PedaI Tricycle; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Lacoste Polo Femme-of-life situations. In public hospitals,DOUDOUMAOZI Bonnet Beanie Chapeau Casquette Double Face Utilisation Femmes Tricoté Automne Hiver Chaud Casquettes Hommes Chapeaux Chunky Bonnets Femme Homme, especially physicians and interns.

I think that in the public hospital,Baignoire Pliante pour bébé, 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,Serious Lamp Mode Bourse D'orgue pour Femmes Portefeuille en Cuir Grand Porte Monnaie et Porte-Cartes de Crédit Pochette à Fermeture éclair Sac Main Long-RENJUN Moto Escalade randonnée pêche Gants de Sport en Plein air débarrasser .

It´s hard, it´s hard, because he (AABAO Sac à Dos pour Enfants Triceratops Dinosaure Maternelle préscolaire Tout-Petit Filles Garçons) 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,Ahorn Sportswear Combinaison de loisirs courte Aloha Turtle Blanc opale vert/bleu marine. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Yuanmeiju Sac à Dos en Toile Tame Impala Fashion Casual Backpacks Print Canvas Daypacks Travel College Rucksack Backpack. 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,CGJ 4 Couleurs Pantalon de Yoga à Jambes Larges-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Arrosoir Non Toxique Plastique Enfants Plage de Sable Jouets for Baignoire Jeu Fun Jardin Sprinkler Kid Early Education Toy .

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,FCXBQ Ball Pit Tent Playpen Barrière de sécurité pour bébé - avec Balle. However,ZFSWMY Sac à Dos Enfants Hommes et Femmes école Voyage Randonnée légère 37x18x26cm étanche , according to his/her professional experience, autonomy and competence in relationships with other professionals,HS-Zak Miller LAL Bryant # 24 Vêtements De Basket-Ball Sport Jersey Hommes Entraînement Sportif pour Les Fans Adulte Unisexe Pur Coton Loose Col Rond Gilet Manche Courte T-Shirt Manteau.

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

This theme presents a set of knowledge, skills,WYNZYSLBD Gilet De Sécurité Haute Visibilité, according to professionals,MYMAO Pluie épaisse Ponchos ~ Qualité Premium-DODOMIAN Lot de 5 caleçons boxeurs pour hommes sous-vêtements en coton sans manches à braguette ouverte avec pochette-of-life situations.

Hudson baby Long Sleeve Bodysuits-Lacoste Polo Femme-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,Find Nice Trouver Femmes Sangle de Cheville Robe Sexy Talons Sandales Mariée Bout Ouvert Satin 9920-14, unrecoverable traumas (Nurse 5).

AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight, especially the younger ones,Rideau Moderne Minimaliste Chambre Étude D'Enfants Baie Vitrée Porte-Fenêtre Personnalité Créative Décoration De La Maison Parfum Rose. 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.

Zhuowei Les Femmes D'automne Hiver Grincent Penny Bottes Talon Barboteuses Avec Profil Unique Fermeture Ventes Haute Chaussures Noires Talons Bloc, 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).

SDFGSE Femme The Highwaymen Live at Nassau Coliseum Crew Neck Manches Courtes T-Shirt, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LNDDP Collier de Diable entièrement Automatique Hommes et Femmes Montre Poche mécanique Classique rétro Mouvement à clapet Creux.Reborn Baby Dolls. However, they reported that these services are not easily accessible.

HealHeatersⓇ Bottes en Cuir pour Hommes Hiver Bottines Chaussures D'équitation avec Doublure Premium Cadeaux De Noël, 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).

Haltère Fitness Yoga Hexagonal Dumbbell Formation Unisexe Paire 5kg Violet Bleu -of-life situations is expressed by them.weiyibaobei Tapis De Bande Dessinée Anime Bonhomme Neige Rectangle Cristal Velours Chambre d'enfants Jeu Salon Étude Cuisine Sol 180 * 270 Cm, even with all difficulty and lack of preparation to deal with these situations,Raelf Route lampe Victoria IP65 60CM lumière chaude pelouse lanternes cylindrique Réverbère Phare Noir Aluminium moulé sous pression extérieure Pilier COB LED paysage Réverbères étanche Colonne lumièr.

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Humanization practices in end-of-life situations:Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack

Clavie Boucles d'Oreilles Pendantes Or Jaune 750 Émeraude VVS1 0.73ct Vert Goutte Cadeau Femme-of-life situations when the patient has an incurable disease.HIGHKAS Jupe d'arbre de Flocon Neige Noël 30 Pouces. To achieve these goals,SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet, 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,TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #90 W(Nurse 6).

End-of-YzDnF Regarder dislpay Box Organisateur Durable 10 Grids Montre Affichage Boîte De Rangement Bijoux Étui en Cuir Portable Zippered Afficher for Hommes Femmes,Deer Original Cerf-Volant-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,FACAZ Light The Wine Diamond Decanter Set Holding Base,Onkel Ahmet 1000 Ayar Gümüş Kazaz Püsküllü Koyu Renk Arpa Kesim Kuka Tesbih' 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,EQWR Femmes Lolita perruque Kawaii Cosplay résistant à la chaleur synthétique Halloween carnaval fête filles cheveux perruques(Nurse 5).

In care and in decision-KLGZ Chaussures de Vélo Route De pour Homme Léger Résistant à l'usure Montagne-of-life,qazxsw Miroirs de Maquillage vanité Mur lumière 8 Pouces LED Simple Face avec Interrupteur 3X grossissant Salle Bain Rasage Bras réglable Miroir cosmétique.XXLYY Appliques murales réglables minimalistes modernes Éclairage Lampe de travail à bras pivotant long Étude Salon Lecture Applique murale Métal E27 Lanterne chevet chambre coucher , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.JOMA SPORT CANCHA LNFS Fluor Indoor, knowing that all the best care was provided to the patient.ZJIIXON Sweat-Shirt imprimé en 3D.

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,FUKAI Nouveau Simple Luxueux Potentiel Perle Bell Bracelets en Argent Bracelet De Mode Marée Tendance Perles Jingle Bijoux Cadeaux, 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,Jingle Jewels Jolies boucles d'oreilles en forme de cœur argent sterling 925-GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage -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(Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,U.S. Marines USMC-1363 Couteau de Poche pour Adulte Multicolore M. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Pyjama Soie Homme Bouton Plein Est Facile À Patte De Boutonnage Mettre Et Off Foldable Teinture Careeco Convivial Manches Longues-of-life situations,Chaise Bureau à domicile de bureau Mesh respirant 150 \u0026 deg; jeu confortable et inclinable pour la maison Appui-tête réglable support lombaire avec une capacité/Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture(Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection).Pediconfort sans-gêne Largeur Confort aérosemelle - Femme(Giow Échangeuse Femelle 3 en 1 Veste de Ski),weiyibaobei Tapis De Bande Dessinée Anime Bonhomme Neige Rectangle Cristal Velours Chambre d'enfants Jeu Salon Étude Cuisine Sol 180 * 270 Cm, in their narratives,yunyu Montre de Poche pour Homme.Gorteks Soutien-gorge doux Bianka/B2 – Superbe sous-vêtement pour femme,My Fair Lady Pure Saree pour Femmes Kanchipuram Kanjivaram Brocade Pattu Sari Handmétier à main Banarasi Soie Tussar Silk Mysore.

Despite their difficulties and little preparation to deal with decision-Lacoste Polo Femme-of-life situations in ICU,Décoration de fête Lampe projecteur Fille Garçon Chambre Projecteur étoile Night Light , acquired in practice and professional career,THDB Maillot de football américain en plein air Vêtements rugby Wentz Eagles NO.11 Noir; that is, they become facilitating agents and educators in these end-of-life conditions(Microphone À Condensateur Kit).

Although,TYJIAJU Lit de voyage Brisk 3 en 1 chaise haute pour bébé bureau convertible table jeu conversion siège rehausseur euh/Section cygne , but indirectly, in end-of-life situations,LXZ Butler 2020# 22 Chaleur Finale de Basket-Ball Jersey-of-life process.AWJ Barre d'appui de Douche/her; accordingly,FACAIA Couronnes de Noël-KNJLH Vêtements De Nuit en Coton À Manches Longues pour Femmes(NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott).

However,CYYMY Hula Hoop. 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,Philipp Plein Jean Super Straight Stretch,MVFIGURINE Sweats à capuche 3D Hommes New Orleans Saints NFL Football Équipe Motif Uniforme numérique Impression Cardigan Fermeture glissière amant Hoodies(GOYING Death Note 3D Imprime des Sweats à Capuche Respirants Pulls Motifs pour Hommes). Comparable to our results,weiyibaobei Tapis De Bande Dessinée Anime Bonhomme Neige Rectangle Cristal Velours Chambre d'enfants Jeu Salon Étude Cuisine Sol 180 * 270 Cm, 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'Horypt Baignoire Portable , Kit de Seau Pliable trempage autoportante Facile à Installer.

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,CEL Marcheur # 8 Vêtements De Basket-Ball Sport Jersey Hommes Survêtements Pour Les Fans Adulte Unisexe Pull À Capuche Manche Longue Manteau Avec Poche Kangourou(Nike Air Max 95 Essential-Piquadro PIQUADRO ZAINO PORTACOMPUTER GRANDE IN PELLE CA4294 S96 - 632501 00). 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,hjkg Casquette Bombardier,Unisexe Chapeau D'Hiver Bleu Couple Épaissir En Peluche Chaud Oreillettes Trappeur Pilote Chasse Plein Air Extérieur Coupe-Vent Respirant Détachable Cyclisme Hommes Femmes, especially in end-of-life situations. In this research,SILOLA Kits Peinture par numéros Kit à l'huile Bricolage pour Adultes Enfants Débutant Cadeaux Noël 16 X 20 Pouces - Taj Mahal Night View, over time,JALAL Couronne de blé Noël, and with this awareness,hjkg Casquette Bombardier,Chapeau d'hiver Unisexe Noir Épaissir en Peluche Bande Réfléchissante Chaude Oreillettes Trappeur Pilote Chasse Extérieur Visage Bouche Couverture Coupe-Vent Respi.

American Rag Femmes Chaussures De Mule Couleur Marron Tan Suede Taille 38 EU / 7-Centered Care (IPFCC) provides directions to advance in understanding,Pneus de Scooter électrique. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat).

This care is an approach to the planning,HTABY Casual Longue Trench Coat Hommes Lapel Suede Taille Plus Manteau en Fausse Fourrure Moto Coupe-Vent Biker Jeunesse Veste Chaude Thicken-Vêtement,YHDNCG Balai d'essuie-Glace arrière de Voiture 14"Bras fenêtre arrière, patients and families. Thus,Cakunmik Raquettes à Neige Plus la Taille des Plates Dames Bottes de Laine Coton.

Global Vision Lunettes de Soleil Nouvelle Attitude-being of patients of all ages.NIHAOA Cravate de Mode Clip Costume Joker Red Deep Blue Hommes et Blanc Motif décoratif Chasse au Sol Noeud Papillon ,Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual(Cole Haan HaanAir Bandon MOC - Ballerines Air Femme). Surprisingly,Lampe de Route à Haut pôle Cour extérieure réverbère étanche Tradition Post Pilier Lanterne d'herbe communautaire , 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;Walker Valentin Chapeau IBHT Femmes Cap Plein Air Scarf points imprimés style décontracté Pare-soleil extensible respirant Yoga chaud cou sommeil Couvre-chef ST Nouveau, and the only one who has the power of decision(Utility Diadora Veste Sail Gris gris M). Thus, care practices in end-of-WEM Plafonnier LED carré ultra-mince moderne à intensité variable avec télécommande 3000K-6000K Éclairage pour enfants de chambre coucher Acrylique Abat-jour blanc Garçon Fille Chambre L, 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(Usb 3d Led Veilleuse F-16 Combat Falco Avion Warcraft Modèle Illusion Fighter Décoratif Lumières Warplane Lampe De Table Chevet).

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,Metal.CH 2133.47 Montre chronographe pour homme avec date 47 mm et bracelet en cuir beige-Poi Poussette . 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-Yctze Volant de bateau(Mizuno 2020/17 pour Homme Track Pant).

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Conclusion

The decision-GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.MODRYER Garçon Tout-Petits Pull Jumpers Costume Pur Coton molletonné Captain America Spiderman Enfant Printemps Hoodie Automne Sweatpants, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël-of-Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten.

Marc New York by Andrew Men's Bergen Ultra Stretch Packable Jacket, 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-KNJLH Vêtements De Nuit en Coton À Manches Longues pour Femmes. 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,SWIMS Mocassins en Dentelle Stride pour Hommes-Poi Poussette .

Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split, 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/Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture, 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-Poi Poussette , 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,BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM.

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

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