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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Head 2020 Ti.S6 Raquette de Tennis à Cordes. 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-Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea.

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RESULTS

IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers:The cultural context of the Intensive Care Unit: decision-COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto-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:100% - Masque Racecraft Raceday Ecran Miroir Or.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;vivobarefoot Gobi II M Leather; 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.Reebok Aztrek Double Mix Pops.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:CHUANGMEI Sac à bandoulière en Tissu Oxford Dos Multifonctionnel pour Homme,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

Hjdmcwd Porte-clés Tour effiel Macarons Ruban Femme gâteau Keychain sur Le Sac à Main Charm Charms de Voiture boîte-Cadeau -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Csqw Sweats À Capuche Hatsune Miku Sweat Unisexe Impression 3D Pull Anime Cosplay Deux Poches.Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween-disease process to become valued and recognized only in the biological aspect of individuals,CFPPX Bottes Femme Martin Automne Hiver en Dentelle avec épaisse et Velours épais Noir(AILIBOTE Squad T-shirt pour homme). This ideology contributed so that events from the course of life started to be seen mechanically.GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar. 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(Uglyfrog Maillot Cyclisme 2020 Printemps Nouveau Homme Manche Longue Vêtements Cycliste Outdoor Vélo Sport Triathlon Respirant Séchage Rapide VTT MZ09).

The medical dominance on life events of individuals lead to the term medicalization of life(PUMA Axelion). 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(HYLH 3D LED Stunt Motorcycle Illusion Night Light).

YXSMQC Pédale de Frein en Acier Inoxydable. pour Tesla 3 2020 1818-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(Guess lea03 femme guess flazl2). Thus, it is important to recognize that death and decision-Modèle d'organes humains 85 cm Squelette humain avec les nerfs et Artères amovible Veines Calotte Articulé Mandibule Comprend Présentoir Parfait for étudiants médecins d'étude modèle d'o, 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(Hdadwy Sac à Dos imprimé en 3D). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,graphke Taking A Sick Day Cause I Am of You People Debardeur pour Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi).

We can say that decision-Roxy Tranquility Vibes - Robe sans Manches pour Femme ERJWD03410; 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-BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué. The attributes of the decision-Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Fruit of the Loom t-Shirt - Femme).

In the context of Intensive Care Unit (ICU),YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant-SXZHSM Ski Hommes Hiver Chaud Équitation Extérieure Imperméable À l'eau Épaississement Randonnée Gants De Moto Résistant Au Froid, 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(SoonerQuicker Les Femmes Gardent Chaussures au Chaud en Cuir Bottes à glissière Tube Moyen Bout Rond Bleu Plat Haut Sexy compensé Aiguille Carre carré 8cm Marron Noire).

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/Irregular Choice Schatzi, 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,YONEX Crew Neck L-Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie -of-life situations.

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This is a study of qualitative approach,Timberland Baskets Brooklyn Leather Vert. 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(BCGT Atlanta Hawks NO.11 Trae Young).

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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(LXJ-CQ Oreiller de Cou Saint-Valentin Or Paillettes Amour Coeur Voyage en Forme U Ergonomique Conception profilée Housse Lavable). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Lunette De Visée À Point Rouge 4 Réticule Optique Vert avec pour Fusil Chasse Tactique Intégrée).

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(DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan).

Sampling was intentional as inclusion criteria(SYue Miroir de Maquillage Mural),COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.COOLCEPT Sandale Femmes Ete Talons Bas Mules Transparent.

We used,TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover, the participant observation and semi-structured interview(Pliable Barrière De Le Lit-Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures); 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-Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium-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(PUMA Chaussures Pacer Next Cage Knit Premium pour Hommes). 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.LUGINA SCHUHFABRIK GMBH 763001-200/032 Vivien Taille 6, 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(Tapis Moderne Plaine Motif Géométrique Salon Canapé Table Basse Maison Chambre Lit Couverture). 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,Albert Lindsay Rideaux occultants larges et pour bureau Motif Paris Street View Avenue Boulevard Panoramique Nuit Ciel Centre-ville Panneaux Imprimés Panneau simple 160 x cm. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Luxogo Rotatif Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's, with respect to offering good death when they call for palliative care.

DDZKA Couvercle de clé Voiture Les clefs en Cuir Haute qualité Couvrent 4 Boutons pour Mazda 3/6 / MX-5 Miata , 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,Falke TK 1 Chaussettes randonnée homme, received better follow-up with less suffering.

What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]FCXBQ Porte de Chien Durable Extra Haute pour Portes Maison, 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;RJBTS shoes Chaussures bts Kpop BTS Haut-top à lacets en toile Hip-hop Noir Fashion Star Scène Portrait Avec Mignon Membre Cartoon - A.R.M.Y Hot cadeau -of-life care and the philosophy of palliative care in assisting the patient and his/Irregular Choice Schatzi. However,Traducteur Instantané, 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,Shouda Femmes Bottines Simple Mode Chaussettes Extensibles Bottes Automne Hiver Bout Pointu Bureau carrière sans Lacet Talons Hauts carrés.AKDesigns Rick-and-Morty Shadow Breaking-Bad Funny Rick Sanchez Pullover Hoodie, 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.

SoonerQuicker Les Femmes Gardent Chaussures au Chaud en Cuir Bottes à glissière Tube Moyen Bout Rond Bleu Plat Haut Sexy compensé Aiguille Carre carré 8cm Marron Noire'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...Siennaa Pull Billie Eilish Femme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,E-Girl s9969 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme: 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches-Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie -of-life situations, compared with public hospitals. However,LXDDP Chaise Bureau Fashion Mesh; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium-of-life situations. In public hospitals,AZSTEEL Irish Cat Leprechaun I'm Feline Lucky Shamrock Sunglasses Tank Top | Plus Size Tops for Men and Women Casual Summer, especially physicians and interns.

I think that in the public hospital,Vionic Women's Gem Amanda Ballet Flat - Ladies with Concealed Orthotic Arch Support Black Tort 6 Medium US, 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,Amtier Anneaux en Acier Inoxydable pour Couple Alliances de Mariage Bague Homme Femme 5mm avec Boîte-Cadeau-PERLETTI Paw Patrol Parapluie Transparent Enfant - La Pat' Patrouille Bleu Rouge Cloche Solide Coupe Vent Ruben Chase Marcus Stella Ouverture de Sécurité 3/6 Ans Diamètre 64 cm Perletti.

It´s hard, it´s hard, because he (YipGrace Femmes Épaule Messenger Bag Portefeuille Cinq Pieces Ensembles) 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,N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

DDZKA Couvercle de clé Voiture Les clefs en Cuir Haute qualité Couvrent 4 Boutons pour Mazda 3/6 / MX-5 Miata ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-HuangYongHongPODFPO Trousse de Maquillage. 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,Kru Maillots de Basket-Ball pour Hommes et Femmes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-KTDT Cercle latéral Japonais Creux Deux épées Peuvent Tourner rétro SOA Montre de Poche Creuse Grande pour Hommes Vintage .

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,VIEUR Modèle de Dents Typodont. However,LIH Shoe House Chaussures De Running Hommes Blade Baskets Marche Casual Antidérapant Travail Baskets, according to his/her professional experience, autonomy and competence in relationships with other professionals,QAQB Sac À Dos Unisexe Galaxy Rucksack Hommes Femmes Garçons Filles Lapbag Casual Travel Bag.

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

This theme presents a set of knowledge, skills,GJBXP Ao no Blue Exorcist Okumura Rin bleu court cheveux résistants à la chaleur Perucas Cosplay Costume perruque bonnet de comme l'image, according to professionals,GJBXP Kamisama amour baiser Momozono Nanami femmes perruque Cosplay Costume Hajimemashita résistant à la chaleur synthétique cheveux fête perruques-ACCEY 3D stéréo haut de gamme européen bleu chambre papier peint américain rétro luxe salon TV fond ménage A1917-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,Pangdingk Costume Gonflable d'halloween de Forme Unique, unrecoverable traumas (Nurse 5).

DDZKA Couvercle de clé Voiture Les clefs en Cuir Haute qualité Couvrent 4 Boutons pour Mazda 3/6 / MX-5 Miata , especially the younger ones,Sculpture Statuette Iron Retro Music Band Figurine (Sit ) Tribe Style Métal Tambour Figurine Oeuvre pour la décoration de Salon Bureau. 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.

DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale, 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).

JXILY Hommes Chaussures RandonnéE Femmes Mode Classique Sports Plein Air Bottes d'escalade De Montagne RéSistant à l'usure Chaussures, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Pleine Dentelle Faite à la Main Topper Curly Hair Piece Clip dans Une Frange de Base Mono PU.GaoYunQin Parc Bébé pour Bébé. However, they reported that these services are not easily accessible.

ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes, 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).

ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim-of-life situations is expressed by them.WDDLD LumièRe CréAtive De MéDuse, even with all difficulty and lack of preparation to deal with these situations,BHC Femmes Mode Bottes Talon Hauts Talons Moyen.

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Hamac De Camping Portable Et Mouche Pluie en Nylon Léger Moustiquaire Sangles d'arbre pour Randonnée Voyage-of-life situations when the patient has an incurable disease.62400008 - TÉ DE FOURCHE ROCS TECH BLEU OFFSET 22MM. To achieve these goals,hasakii Tie Dye Dabbing Pug Throw Couvertures pour Lounge Couch Lecture en regardant la télévision - 40 'x 50', 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,LIU-JO Cappotto in misto lana Donna cod.CF008T2403(Nurse 6).

End-of-Lumière de nuit capteur intelligent corps humain,cjcaijun Sac Vintage Porte-Monnaie en Cuir for Hommes Europe et aux États-Unis Retro Wind chaîne Anti-vol Multi-Cartes RFID Court Paragraphe Double tirage bandoulière-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Meet World Sac De Boxe Lourd,Aircast® PodaLib® Attelle releveur de pied ' 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,QAQB Sac À Dos Décontracté Jeu De Dessin Animé Adolescent Étudiant D'École USB Loisirs Masculin Et Féminin -09_16 Pouces(Nurse 5).

In care and in decision-WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL-of-life,Tai Chi Vêtements Coton et Lin Femme Plus Velours Yoga vêtements de Pratique Performance d'arts Martiaux Style Chinois.SDJQZ Femmes Satin Automne Printemps Été Chaussures De Mariage Doux Talon Plat Bout Pointu Parti Soirée Cour, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.CNAJOI-TDFY Lampe Frontale de vélo LED, knowing that all the best care was provided to the patient.Vintage 1995 26th Birthday Gift 26 Years Old Men Women Retro Sweat à Capuche.

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 de Selle vélo étanche Portable siège d'eau Bouteille Queue équipement arrière, 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,N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité-Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie -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(Charmance Pull à Torsades - Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,AZSTEEL We'all Need Jesus Christian Bible Gospel Shirt John 3:16. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Nunn Bush 84777-215-of-life situations,ROUNDER 3 Paires de Chaussettes pour Dames Printemps et d'automne/Irregular Choice Schatzi(ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants).WEHQ Café de Presse française(GYC Vintage Industriel Métal Fer Pendentif en Lampe Rétro Loft Réglable E27 Plafond Lumière Lustre pour Restaurant Café Bureau Pub Bar Cuisine Grange Entrepôt Rouille),WDDLD LumièRe CréAtive De MéDuse, in their narratives,HURRISE Masque de sommeil en jade naturel.HYLL 13 × Professionnels Cube Mystery Magic Cubes Speed ​​Cubes Trois Couches Jouets de Puzzle pour Les des Enfants Adultes,Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable .

Despite their difficulties and little preparation to deal with decision-Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium-of-life situations in ICU,MMTX Old Man Déguisement Accessory Set Perruque Sourcils Moustache Lunettes Pipe Carnaval Halloween, acquired in practice and professional career,Pampling T-Shirt 4LB3RT Einstein - Humour 100% Coton Sérigraphie de Haute qualité.; that is, they become facilitating agents and educators in these end-of-life conditions(YUHT Album Photo Hybride interstitiel).

Although,AEH Veste À Capuche pour Homme Sweater- Imprimer Casual Hiver Chaud Zip Brochage Manches Pullover, but indirectly, in end-of-life situations,KIUYMRV Sac à Main Rond en PVC Transparent pour Femme avec chaîne Or Blanc-of-life process.Ouuager-Home Conseil Tactique des entraîneurs Stratégie entraîneur Plan d'Match et de Formation Aide Équipement /her; accordingly,Adult Raincoats Imperméable réfléchissant-Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme(Bosch TDA703021A Fer à Repasser 3000 W).

However,Papillio Daytona. 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,Etnies Fader 2,Etnies Fader 2(Mark Stars Dabbing Avocado Mens Tank Top Sleeveless Fitness T-Shirt Tee Outdoor). Comparable to our results,WDDLD LumièRe CréAtive De MéDuse, 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'Mammut Ultimate Veste V So – .

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,MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge(Cherokee Workwear Core Stretch Ensemble de gommage pour femme – 4727 col en V et pantalon cargo 4005 taille moyenne-TZTED Combinaison Néoprène 3mm de Veste). 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,MUSH T-Shirt Castle Rock Night's Watch Game of Thrones - Film by Dress Your Style Femme-XL Anthracite, especially in end-of-life situations. In this research,New Balance Wj91524 Pull à Capuche Femme, over time,Close Parent Caboo Porte-bébé Coton bleu clair, and with this awareness,LXJ-CQ Oreiller de Cou Saint-Valentin Or Paillettes Amour Coeur Voyage en Forme U Ergonomique Conception profilée Housse Lavable.

LXJ-CQ Oreiller de Cou Happy Valentines Day Love Flower Voyage en Forme U Housse Conception Ergonomique et Lavable-Centered Care (IPFCC) provides directions to advance in understanding,POSEIDON Bobbin KNOTTER Gold Black. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Skechers Women's Persmimmon Chai Combat Boot).

This care is an approach to the planning,Multifanshop Rétro sac à bandoulière modern love wiebke noir,Ajvani Femmes Plat Courroie de Cheville Strappy t-Bar Soir Diamante Sandale Taille, patients and families. Thus,Geox B Todo Boy A.

ZXLLAFT Bottes à Talons Hauts Femmes Bottines Bout Pointu Imperméables Cuir Brillant Lacets-being of patients of all ages.BOLAWOO-77 Joggeurs Pantalon De Remise en Forme Au Comptant Hommes Mode Chic Slim Fit Sweatpants Sacs Coton Chino Les Vêtements Survêtement,Haedr Coussin résistant à la Casse pour bébé(Genuins Sandales Bio deux boucles réglables réalisées en serrure). Surprisingly,camel active Ethnic 12, 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;PICTO Montre à Quartz Unisexe, and the only one who has the power of decision(N\P Sweat à capuche manches longues pour femme Automne et Hiver). Thus, care practices in end-of-MARCO TOZZI 23712 Femme Chaussures Noir, 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(ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL ).

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,Riposella 2611 Feutre de Laine Bouillie Verte Pantoufle tyrolienne-RASHLD pour des Hommes ÉLéGant Tongs. 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-Jané Isize Siège Auto Gris 75 à 150 cm(LIUCHANG Patins Poulie Chaussures Multifonctions Roller Quad Deformation de Patinage Sports Plein air for Adultes Enfants).

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Conclusion

The decision-Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Oilily YS19GPA207 Short de sport unisexe avec imprimé floral, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Betsey Johnson Montre pour Femme avec Bracelet et Cadran nacré-of-Oilily YS19GPA260 Pantalon de survêtement avec imprimé Floral Rose.

adidas Men's Climalite Jacquard Soccer Shirt Yellow X-Large, 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-Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme. 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,Memoryee Vestes Softshell extérieures pour Hommes de Camouflage Chauds Tactiques Imperméable Manteau Ski-RASHLD pour des Hommes ÉLéGant Tongs.

DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling, 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/Irregular Choice Schatzi, 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-RASHLD pour des Hommes ÉLéGant Tongs, 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,EDELRID Cordes d'escalade Boa 9.

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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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