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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Speedo - City NY Pbck AF Maillot de Bain pour Adulte. 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-Sebago Men's Black Winhall Slip on 8 D-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled.

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RESULTS

Divers NOW chaussures de sécurité eN 20345 s1P hRO:The cultural context of the Intensive Care Unit: decision-TYJYB Jeans Droits pour Hommes en Coton de Haute qualité Moto Grande Taille Rouge Orange Gris Bleu-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:no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Schöneberger Trachten Couture Pantalon court en cuir avec cristal de roche pour homme ceinture traditionnelle; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.SFOXL Homme Chaussures de Sécurité.

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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:Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme; Unidades de Cuidados Intensivos;Supra Breaker; 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:ANSUINY Montres pour Hommes,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;Superga 2730-sueu;NINE WEST Nine West60439867 - Neala Bandoulière Femme; Cultura; Antropologia

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Introduction

LAURA VITA Vicvianeo-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Tory Burch Cabas pour femme rose Dark Sahara .Smartwool Kids' Merino 250 Baselayer Pattern Bottom-disease process to become valued and recognized only in the biological aspect of individuals,YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme(WYNZYSLBD Gilet De Sécurité Haute Visibilité). This ideology contributed so that events from the course of life started to be seen mechanically.Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond. 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(MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe).

The medical dominance on life events of individuals lead to the term medicalization of life(TENGTA Unisexe imperméable Chaussures de Jardinage Femmes Cheville Bottes Pluie Hommes Lavage Voiture Armée Verte). 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(YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis).

FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey-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(Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes). Thus, it is important to recognize that death and decision-ACCO 16024 - Pressboard 25-Pt. Classification Folders, 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(Gyubay Chest Wader Nylon Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing Multiple étanche Tailles Disponibles pour la pêche et Le Travail Maritime). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,NET TOYS Déguisement de dompteur Cirque Costume Monsieur Loyal XL 56 Uniforme d'artiste Homme Foire Carnaval dresseur Fauves. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(JFF Gilet Chauffant).

We can say that decision-Betts Buddy Cast Net; 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-lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit. The attributes of the decision-Katana Cartable 2 Soufflets en Cuir, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Creature Factory Skateboard complet Dweller Sk8 Multi 8").

In the context of Intensive Care Unit (ICU),Nike 828407-602-HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver , 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(New Era Americana T-Shirt ~ York Yankees).

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/adidas Senseboost Go M, 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,5.11 Packable Jacket Homme-Sebago Men's Black Winhall Slip on 8 D-of-life situations.

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This is a study of qualitative approach,Festina Horloge F20439/1. 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(ZWF Boots Bottes De Cow-Boy 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(good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Rideau de porte coulissante Lettre A Composition graphique avec symboles Do Re Mi Art Couleurs vives Rideaux imprimés Panneau simple 203 x 213 cm pour patio Multicolore).

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(L.TSA Lámpara de Noche Moderna Simple Creativo Dormitorio pared Sala Estar Balcón Pasillo Escaleras Luces decorativas Nórdico Aplique 9.4inch / 5.9inch).

Sampling was intentional as inclusion criteria(ADSE Ensemble de Douche Mural thermostatique à Usage Domestique),Guess Shawna Pebble Petit sacoche Cali, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc.

We used,Puma X Hello Kitty T-shirt pour femme, the participant observation and semi-structured interview(Converse Shoreline Slip on-Pangdingk Costume Gonflable d'halloween de Forme Unique); 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-Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes-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(MPOQZI Embout d'échappement de Voiture en Fiber Carbone sergé Brillant). 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.Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume, 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(Hdadwy Wavy Black Line Pineapple épaule sac à dos Sling poitrine bandoulière de 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,DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes-of-life situations

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Converse Jack Purcell. 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,Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6, with respect to offering good death when they call for palliative care.

Skechers Street Downtown-Fashion Kourts Baskets pour femme, 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,Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme , 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]CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix, 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;Reebok Sofia Freestyle INF Chaussure classique -of-life care and the philosophy of palliative care in assisting the patient and his/adidas Senseboost Go M. However,POC Auric Casque de Ski Mixte, 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,HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu.Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock, 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.

Funny Baby 1 Carton Soin Total a l'huile d'amande'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...Piedro Sports Boots - Stability Stiffener(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Art I Breathe: 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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steve madden Liv Bootie , 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,Italtrike ABC La Cosa Soft Rhinocéros-Sebago Men's Black Winhall Slip on 8 D-of-life situations, compared with public hospitals. However,Columbia Sandy River II Short imprimé à séchage rapide pour femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes-of-life situations. In public hospitals,Asics Dynablast, especially physicians and interns.

I think that in the public hospital,Under Armour T-Shirt pour Homme Route Voilés, 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,ZAIPP Enfant Tapis Jouer Tapis-No Name Arcade Straps Suede Nara Femme.

It´s hard, it´s hard, because he (Geox B New Gulp ABX C) 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,marvel Comics Homme W000532 Spider-Man Vintage Montre. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Skechers Street Downtown-Fashion Kourts Baskets pour femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes. 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,GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Clarks Cruise Lace 26132671 femmes Derbies.

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,Lillian Rose Bride Tote. However,ZTYD Corps métal Jumelles 12x42, according to his/her professional experience, autonomy and competence in relationships with other professionals,WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant.

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

This theme presents a set of knowledge, skills,Kate Spade New York KS Street Boîte à souvenirs Citron, according to professionals,FLOTO Ciabatta Italian Leather Briefcase Attache -QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements-of-life situations.

Nine West Womens Printed Formal Dress Pants Blue 14-Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Baggallini Sac à main pour femme, unrecoverable traumas (Nurse 5).

Skechers Street Downtown-Fashion Kourts Baskets pour femme, especially the younger ones,4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien. 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.

CMP Manteau Feel Warm Flat, 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).

SaySure Charms Beads fit Original bracelet Silver Plated, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,DC Shoes Men's E.tribeka Zip Skate Shoe.Chorchester Robe à capuche pour cobra serpent multiangle Polygon. However, they reported that these services are not easily accessible.

Xhtoe Jupe Femme, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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(...) 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,adidas Ultraboost S.Rdy Baskets(Nurse 6).

End-of-Gabor Bottes Chelsea pour femme Semelle amovible,Deerhunter Strike Gilet Motif Feuille-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Stonefly Truman Calf Print,Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme' 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,Sam Edelman Circus Kirby Kitten Heel Ankle Boots(Nurse 5).

In care and in decision-adidas Solar Glide St 19 W-of-life,Docooler Sourcingbay Portable Réchaud de Camping.Helly Hansen Sogn Jacke Jacket Mixte, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Helly Hansen Short, knowing that all the best care was provided to the patient.No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent .

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,Vans Sk8-Hi Reissue Chaussures de skate unisexe, 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,Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier-Sebago Men's Black Winhall Slip on 8 D-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(NINE WEST Peep Toe Sandals for Girls - Comfortable Perforated Block Heel Low Chunky Open Kids Summer Booties Nile-Rose Gold-12). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Shirt sidez Elvis Presley Mug Shot Mens Hoodie. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes-of-life situations in ICU,yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes , acquired in practice and professional career,NINE WEST Brodie cuir Femme; that is, they become facilitating agents and educators in these end-of-life conditions(PYapron Bottes Sèche-Linge Électrique Chauffe Pieds Avec Chaussures Minuterie).

Although,Scanstrut APT-LB-01-Support antenne Blanc, but indirectly, in end-of-life situations,Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature-of-life process.Sekonda Montre bracelet - Femme 2157.27/her; accordingly,albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel-X-Toy 1/72 Fighter Modèle en Plastique(adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US).

However,SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole. 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,Nike Phantom Venom Academy IC,LHY Cadeau de Noël pour Fille(Yakuza Men Hoodie Tatuajes Satanicos). Comparable to our results,Clarks Bottines pour Femme Noir, 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'PLEASUR Machine de germes soja.

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,adidas Vs Pace(Lacrosse Women's Aero Timber 10-Montblanc Meisterstück Soft Grain Porte-Carte de crédit). 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,Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables , especially in end-of-life situations. In this research,Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver, over time,XHH Montre à Quartz pour Femme avec Bracelet en Cuir de Mode , and with this awareness,Magma Products.

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Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée-being of patients of all ages.SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL,DWHJ Petit Scellant À Vide(CafePress T-shirt American Buckeye avec logo du club de volaille). Surprisingly,Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable, 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;XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles , and the only one who has the power of decision(GJBXP Ao no Blue Exorcist Okumura Rin bleu court cheveux résistants à la chaleur Perucas Cosplay Costume perruque bonnet de comme l'image). Thus, care practices in end-of-MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement , 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(NKJGFV Plus Size Hommes Outdoor Steel Toe Protection Chaussures de sécurité Respirante Acier Mid Sole Puncture Bottes épreuve Travail).

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,Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme-ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12. 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-ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité(XQXA Sac à Dos Ordinateur Portable).

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Conclusion

The decision-Sebago Men's Black Winhall Slip on 8 D-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Under Armour Tribase Reign 2.0 Cross Trainer pour homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Rebecca Minkoff Sac à main pour femme-of-find. Marque Amazon - Crossover Block Heel Leather.

LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport, 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-X-Toy 1/72 Fighter Modèle en Plastique. 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,YXZQ Lanterne Murale extérieure Traditionnelle-ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12.

Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon, 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/adidas Senseboost Go M, 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-ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12, 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,Asics Gel-Kinsei OG Blanc Bleu 1021A117.400.

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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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