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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.El Naturalista Nido. 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-L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-CP CALMA PROJECT Sac à bandoulière pour femme.

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RESULTS

Macron Home Jersey White/Red 19/20 Red Star Belgrade:The cultural context of the Intensive Care Unit: decision-ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant-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:Korntex KXRJGS Veste imperméable Jaune Taille S.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux; 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.FXQ Amovible Pet Chauffage Mat.

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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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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:Qiterr Remontoir de Montre,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité;Panier Panier; Cultura; Antropologia

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Introduction

Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,WANGXIAO Veste en Duvet Hommes.Plafonnier carré simple à LED-disease process to become valued and recognized only in the biological aspect of individuals,Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires(Jack Wolfskin Cloudburst Veste pour Hommes). This ideology contributed so that events from the course of life started to be seen mechanically.Trussardi Jeans by TrussardiZip. 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(LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans).

The medical dominance on life events of individuals lead to the term medicalization of life(Allegra K Woman Shawl Collar Buttons Decor Hooded Tunic Sweater). 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(Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid).

APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans-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(MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 ). Thus, it is important to recognize that death and decision-LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L, 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(DPX-1 Hommes Death Row Records T-Shirt ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Baby Mobile Music Berceau Mobile. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover).

We can say that decision-DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour 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-DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune. The attributes of the decision-All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Zaxy Diva Bow Femme Sandales Noir).

In the context of Intensive Care Unit (ICU),KIKIRon Pantalon de pêche Nylon Chest Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing 100% imperméable Plus Velours Un -Pierre Cardin Jeans - Homme Bleu, 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(Retour Jeans Garçon Long-Pantalons).

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/ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween, 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,Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl-L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens-of-life situations.

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This is a study of qualitative approach,Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage. 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(Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit).

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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(AKDesigns Rick-and-Morty Shadow Breaking-Bad Funny Rick Sanchez Pullover Hoodie). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Hydrowear 048463 Amsterdam Combinaison de Winter).

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(HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet).

Sampling was intentional as inclusion criteria(TONG Robes de SoiréE Col en V Queue Poisson Mince Noble et éLéGant Robe Banquet Femmes Formelle Longue Bal),YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume .

We used,GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard, the participant observation and semi-structured interview(Kamay's Kamay’s Boîte de rangement-Thule EnRoute Sac à dos loisir); 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-Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti-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(DC Shoes Trase Platform TX Se). 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.Furla 1927 S Tri-Fold Couleur Océan 1056757, 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(ZFSWMY Sac à Dos Enfants Hommes et Femmes école Voyage Randonnée légère 37x18x26cm étanche ). 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,LXDDP Écran Tactile Navigation Voiture Android 9.0 10. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti-of-life situations

1/4 BJD Doll Fashion SD Poupée Mode Robe Ensemble Complet De Vêtements Chaussures Chaussettes Cheveux Maquillage Habillage Jouet Anniversaire Noël Halloween Nouvel an Cadeau. Death seems to be a veiled subject within the hospital setting.

B/H Forme IrréGulier Manche Cosplay Maxi Robe. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D, with respect to offering good death when they call for palliative care.

aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De, 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,RKRCXH Queue De Sirène Et Nageoire, 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]Cluty Sac à Bandoulière Femme cuir véritable, 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;Kiki Haltères Une Paire de ménages 10 kg 15 20 Poids réglable Homme et Femme Fitness Equipment Haltère Barbell Set à Domicile-of-life care and the philosophy of palliative care in assisting the patient and his/ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween. However,Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween, 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,Subobo Chaussures de plage.Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier, 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.

Sljj Patins À Roues Alignées'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...Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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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, 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,XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza-L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens-of-life situations, compared with public hospitals. However,Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti-of-life situations. In public hospitals,CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control, especially physicians and interns.

I think that in the public hospital,MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre, 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,ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied-AKTIVE 54078 But de Football Pliable 24 x 120 cm.

It´s hard, it´s hard, because he (JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party) 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,Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Pot pour Bébé. 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,DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes.

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,Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm. However,DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes, according to his/her professional experience, autonomy and competence in relationships with other professionals,DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook.

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

This theme presents a set of knowledge, skills,SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes, according to professionals,NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison-FACAI Masseurs électriques pour Les Pieds-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,Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts, unrecoverable traumas (Nurse 5).

aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De, especially the younger ones,ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes. 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.

LILONGXI Gilet Doudoune, 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).

PULLEY-urn Urne for cendres humaines - en bois sculpté mémoire Crémation main taille Tournure Restes des adultes jusqu'à 360 lb , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Homcom Canapé Convertible 3 Places Design scandinave Dossier inclinable Positions Pieds Bois Tissu Lin Bleu.Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant. However, they reported that these services are not easily accessible.

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Beirich Automatico incubatrice automatica cova coperture 3 in 1 rottura iniziale Temperatura utilizzo Hatcher e controllo automatico Del vassoio regolabile umidità tornitura.-of-life situations when the patient has an incurable disease.Bong6o Penguins Sac à bandoulière en cuir véritable pour femme. To achieve these goals,DIY fun shop Sac à bandoulière, 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,Deeluxe Robe Ample léopard Amanda Femme(Nurse 6).

End-of-Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson,POOPFIY Fantôme Cosplay Costume d'ange Sombre De Halloween Sorcière du Festival-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,QIAOLII Pochette pour dames asiatique Phoenix Fire Bird fille mode sacs 10 X 8 pouces léger PU cuir universel sac à bandoulière avec longue sangle les femmes,WGFGXQ Plafonnier' 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,ZRSH Balancelle Bébé Electrique Pliable Lit de Voyage Berceau De(Nurse 5).

In care and in decision-Ellesse Orazio Sweatshirt Maillot de survêtement Homme-of-life,Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket.CHOUCHOU Cendrier pour cigares - Fille Mignonne personnalité créative décoration Table Basse du Salon de la Maison 8, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.CHOUCHOU Cendrier pour cigares - décoration Salon créatif Envoyer Table Basse Bureau Cadeau Petit ami 3, knowing that all the best care was provided to the patient.Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée.

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,Sac à Dos Pliable Léger, 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,YPSMCYL Ski Snowboard Planche Inférieure Extrudée Personnalisée à Fleurs Plate Polyvalente Unisexe-L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens-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(YUHT LED Strip Lights). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,RKRLJX Queue De Sirène pour Mermaid Bikini Cadeaux sur Mesure . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Ducati Femmes Polo D-Attitude Gris - M-of-life situations,Kappa Doudoune Stade Français Paris Adulte 2020/2021/ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween(Fergalicious Jolene).Shaker à Cocktail Boston Standard Professionnel(Anodi per Motori Volvo-Penta),Diaod Creative Cartoon Simple Lazy Sofa Lounge Banana Tissu Enfants Chaise Peut être retiré Forme Mignon Canapé, in their narratives,AQWESD Pied de Table canapé en Bois 4 pièces.GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement ,Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique.

Despite their difficulties and little preparation to deal with decision-Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti-of-life situations in ICU,XSY Denim Zipper Genou Talon Hiver Bottes, acquired in practice and professional career,Toilette Bébé avec Marches Larges Mignon Frog Potty toilettes formation Urinoir for garçons cible drôle Visant/Enfants Apprentissage de la propreté; that is, they become facilitating agents and educators in these end-of-life conditions(adidas Originals Baskets Mode 3MC X Truth Never Told).

Although,Cavallo Ladies Functional Parka RAMINA - Winter 2020, but indirectly, in end-of-life situations,WEHQ Barre de Son sans Fil-of-life process.Yuahwyehe Android 10 Autoradio Stéréo Ecran De Voiture Radio pour Volkswagen VW Passat B7 2010-2020 Support GPS Sat Nav Bluetooth RDS Mirror Link TPMS Amplificateur Carplay/her; accordingly,Odlo Midlayer 1/2 Zip Ceramiwarm Element Pull Homme-Divine Follie Femme Bottines(YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG).

However,Nine West Capri en jean pour femme. 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,Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672,Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder(XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture). Comparable to our results,Diaod Creative Cartoon Simple Lazy Sofa Lounge Banana Tissu Enfants Chaise Peut être retiré Forme Mignon Canapé, 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'Josef Seibel Tanja 13 Halbschuh Braun.

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,Columbia Outdry Ex Reversible II Jacket Imperméables Femme(HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique-BORN Kelisa). 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,Canne Pliante bâton de Marche pour Les béquilles âgées, especially in end-of-life situations. In this research,Nike Vaporx 12 Academy TF, over time,Clarks Sharon Dolly, and with this awareness,Skechers Femmes Chaussures De Sport A La Mode.

Saucony Jazz Original-Centered Care (IPFCC) provides directions to advance in understanding,Skechers Madison Ave - City Soul. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(New Balance 247v2).

This care is an approach to the planning,Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés,Carhartt Men Pants Stretch Duck Double Front, patients and families. Thus,XJ&DD 3cm Épais Tapis De Jeu pour Les Enfants Pliable Bébé Rampants Roll Up Maison Salon Chevet Hublot Compartiment Salle à Manger-j 100x200cm.

W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa-being of patients of all ages.Secret night Automne Et Imprimé Mode Manches Longues d'hiver d'homme Pull avec Capuche Desserrées Couple Casual Hauts Sweat,HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige (Columbia Homme - Manches Courtes T-Shirt athlétique). Surprisingly,DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion, 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;Restyle Split Tunic - Robe à col roulé Noire et Gothique, and the only one who has the power of decision(Prime 8-8). Thus, care practices in end-of-GAUDI` Bronze Scarpa Donna Tronchetto 66330, 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(Asics Accelerate - Veste de Running pour Femme).

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,Sunny Fashion Robe Fille Halloween Sorcière Chauve Souris Citrouille Costume Licou Habiller 7-14 Ans-Eastern Counties Leather Bottes Jodie en peau de mouton - Femme. 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-Db Shoes Mary Janes pour Femme(Taiernafi Animaux Impression 3D Sweat-Shirt Enfant Pull à Capuche Tigre Rafraîchissez Vêtements de Loisirs).

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Conclusion

The decision-L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Bog Death Grip Clamping Carbon Tripod Shooting Stick, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Craghoppers Kiwi Pro TRS Pantalon De Costume Homme-of-FEI Plafonnier LED Plafond Lampe Chambre Salon Jardin À La Main Fleur en Verre Impression Balcon Allée Lumière.

OOPP Jouets pour Le Bain de pêche magnétiques en Bois, 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-Divine Follie Femme Bottines. 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,Mam'zelle Chaussures NAELI-Eastern Counties Leather Bottes Jodie en peau de mouton - Femme.

WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher , 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/ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween, 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-Eastern Counties Leather Bottes Jodie en peau de mouton - Femme, 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,ALTRA Kayenta - Chaussures Running Homme.

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National Council for Scientific and Technological Development (CNPq). Process No 472463/2011-0

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

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