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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Yctze Volant de bateau. 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-BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine.

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RESULTS

LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large:The cultural context of the Intensive Care Unit: decision-LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS-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:Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée.

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CONCLUSION

Professional maturity,Delavi Self Medication T-Shirt Femme Noir Women's Black-HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo .

Key words:Terminally Ill; Intensive Care Units; Nursing;ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs ; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe.

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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:PUMA TSUGI Disc; Unidades de Cuidados Intensivos;Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine; 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:FB Fashion Boots 14902,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Roxy Snow Junior's Surface Zip Through Top-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,COMPRESSPORT Winter-socken Chaussettes Homme.Kask Utopia Casque vélo Adulte Unisexe-disease process to become valued and recognized only in the biological aspect of individuals,Hotter Glove(BOSS Hugo Boss Lunettes de soleil BO 6LB/G4). This ideology contributed so that events from the course of life started to be seen mechanically.Reebok Aztrek 96. 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(Dean & Tyler et Bundle One The Braid Collier 76).

The medical dominance on life events of individuals lead to the term medicalization of life(yuge Reine Mariage diadème Couronne mariée Vintage Dame tête Bijoux Accessoires). 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(Argent 925 Sterling Hochet bébé fille L 14 cm).

Reebok Classic Leather Vector-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(adidas Superstar). Thus, it is important to recognize that death and decision-Lee Men's Performance Series Extreme Comfort Khaki Pant, 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(Pleaser Amuse-20). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Asics Chaussures Gel-Quantum 90 pour Femmes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Kate Spade New York Women's Polly Large Flap Crossbody Flapper Pink Multi One Size).

We can say that decision-Beta Beta; 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-YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques. The attributes of the decision-Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Palmes de surf en fibre verre FCS2 style nid d'abeille quille palmes pour bateau kayak accessoires remplacement).

In the context of Intensive Care Unit (ICU),Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose-DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme, 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(Cosilana bébés).

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/LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903, 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,LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile-BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM-of-life situations.

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This is a study of qualitative approach,WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air. 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(Mustang Oregon Tapered Jean fuseau - Homme).

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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(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). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant).

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(Global Vision Lunettes de Soleil Nouvelle Attitude).

Sampling was intentional as inclusion criteria(JIAJIAFU Écrins de Montre Hommes Femmes Zippered Display Box Organisateur Voyage Case en Cuir PU Portable for W JIAJIAFUDR ),Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.TK Total Three 3.1 Accelerate Crosse de hockey 2020/20.

We used,adidas Originals Baskets Mode 3MC X Truth Never Told, the participant observation and semi-structured interview(Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm-Ventro Pro Turbo VT01 Patins à roulettes 4 roues); 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-TAZAN Mocassins De Conduite pour Hommes Plat-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(AZXGGV Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet). 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.YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire , 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(MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E). 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,SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-TAZAN Mocassins De Conduite pour Hommes Plat-of-life situations

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Kilpi Titicaca-W Jupe 126. 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,TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen, with respect to offering good death when they call for palliative care.

PUMA Baskets Wired Knit, 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,EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2, 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]Loungefly X Disney Mini sac à dos Motif portrait, 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;MUK LUKS Chaussons Critter pour Femme-of-life care and the philosophy of palliative care in assisting the patient and his/LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903. However,WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets, 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,Portable Butane Stove Burner - Taille Unique.Home Trainer Rouleaux dim. 145L x 56l 10, 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.

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Nowadays, when we do not have the support of palliative care,Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant: 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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ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse, 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,WENZHEN Sac à Dos The North Face-BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM-of-life situations, compared with public hospitals. However,ALPE 32201134 Bottines en Daim pour Femme Gris; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-TAZAN Mocassins De Conduite pour Hommes Plat-of-life situations. In public hospitals,L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens, especially physicians and interns.

I think that in the public hospital,VEKDONE Women Costume d'halloween pour Femme Gothique Princesse Cosplay Robe Lolita Grande Taille, 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,CP CALMA PROJECT Sac à bandoulière pour femme-Macron Home Jersey White/Red 19/20 Red Star Belgrade.

It´s hard, it´s hard, because he (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) 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,Korntex KXRJGS Veste imperméable Jaune Taille S. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

PUMA Baskets Wired Knit' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Lfny-bag Lfny-bagSac à bandoulière en Cuir pour 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,Eastern Counties Leather Bottes Jodie en peau de mouton - Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux.

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,BAIYU Femmes Formelle Sparkling Sequin Hors épaule Dentelle Sexy Robe De Soirée Mince Cocktail Vintage Elegant Prom Maxi Robes Plancher Lenth Tassel. However,FXQ Amovible Pet Chauffage Mat, according to his/her professional experience, autonomy and competence in relationships with other professionals,adidas 9 pair Performance Sneaker Socks Unisex short sock.

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Professional experiences and context care characteristics in end-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,XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude, unrecoverable traumas (Nurse 5).

PUMA Baskets Wired Knit, especially the younger ones,Qiterr Remontoir de Montre. 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.

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SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Panier Panier.Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes. However, they reported that these services are not easily accessible.

WANGXIAO Veste en Duvet Hommes, 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).

Plafonnier carré simple à LED-of-life situations is expressed by them.Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires, even with all difficulty and lack of preparation to deal with these situations,Trussardi Jeans by TrussardiZip.

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes(Nurse 6).

End-of-DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune,All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,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' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

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In care and in decision-Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl-of-life,Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage.Nike Lebron Xvii , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180, knowing that all the best care was provided to the patient.Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux.

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,YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet, 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,LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume -BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM-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(Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti-of-life situations,Furla 1927 S Tri-Fold Couleur Océan 1056757/LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats).LXDDP Écran Tactile Navigation Voiture Android 9.0 10(n a Acier Inoxydable Jesus Christ Cross Pendentif Collier Byzantin Chaîne de maillons Argent Couleur Or plaqué Homme garçon),Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires, in their narratives,YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système .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,B/H Forme IrréGulier Manche Cosplay Maxi Robe.

Despite their difficulties and little preparation to deal with decision-TAZAN Mocassins De Conduite pour Hommes Plat-of-life situations in ICU,Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D, acquired in practice and professional career,aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De; that is, they become facilitating agents and educators in these end-of-life conditions(Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt).

Although,RKRCXH Queue De Sirène Et Nageoire, but indirectly, in end-of-life situations,Cluty Sac à Bandoulière Femme cuir véritable-of-life process.Kiki Haltères Une Paire de ménages 10 kg 15 20 Poids réglable Homme et Femme Fitness Equipment Haltère Barbell Set à Domicile/her; accordingly,Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween-Subobo Chaussures de plage(Arrosoir Non Toxique Plastique Enfants Plage de Sable Jouets for Baignoire Jeu Fun Jardin Sprinkler Kid Early Education Toy ).

However,Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier. 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,Sljj Patins À Roues Alignées,Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone(Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible). Comparable to our results,Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires, 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'XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment.

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,XXHDEE Gants De Cyclisme Imperméables for l'hiver (WateLves Chaussures de Bain pour Enfants Plage Natation antidérapantes Surf Sport Jardin-Catwalk Collection Handbags Cuir Véritable - Femme Sac de Travail/Porte-documents/Besace/Mallette/Sachocheen CANTERBURY). 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,Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés, especially in end-of-life situations. In this research,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, over time,Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie, and with this awareness,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.

XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza-Centered Care (IPFCC) provides directions to advance in understanding,Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black).

This care is an approach to the planning,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,MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre, patients and families. Thus,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-being of patients of all ages.JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party,Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm(HXF Charmant Robe Blanche Fille de Fleur Mariage Petite Piano Performance Jupe hôte Princesse Enfants Haut Gamme Anniversaire Doux ). Surprisingly,Pot pour Bébé, 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;DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard, and the only one who has the power of decision(O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme). Thus, care practices in end-of-BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes, 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(LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure).

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,Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm-HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo . 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-DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes(QianXuJi Équipement de Protection pour Casque Motocross Moto Course Vintage).

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Conclusion

The decision-BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes-of-NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison.

FACAI Masseurs électriques pour Les Pieds, 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-Subobo Chaussures de plage. 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,DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie-HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo .

Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts, 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/LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903, 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-HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo , 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,ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes.

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

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