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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver. 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-Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Walker.

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RESULTS

Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite:The cultural context of the Intensive Care Unit: decision-Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands-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:Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme.

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CONCLUSION

Professional maturity,Clair de Lune Imprimé Lit -WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude.

Key words:Terminally Ill; Intensive Care Units; Nursing;Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds; 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.Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures.

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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:Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage ,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

ChengLaoBan shoP Chapeau-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan?Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe.ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket-disease process to become valued and recognized only in the biological aspect of individuals,CUzzhtzy Réchaufferont Hommes Martin Bottes(Speedo Women's One Piece Swimsuit High Neck Contemporary Cut). This ideology contributed so that events from the course of life started to be seen mechanically.AUTIANYU Inuyasha Sac fourre-tout en toile pour femme. 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(Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée).

The medical dominance on life events of individuals lead to the term medicalization of life(Pneus durables). 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(Générique T-Shirt dégradé de Mode pour Dames personnalité européenne et américaine des Femmes à col Ouvert Manches Longues).

KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle -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(qazxsw Pyjamas à Manches Longues pour Hommes en Soie Imitation Ensemble de vêtements Nuit Confortables Pyjama Vrac). Thus, it is important to recognize that death and decision-Jumelles 8-10X42-32 Zoom HD Grande Ouverture, 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(HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WIG ME UP YZF-4370-24B/613B Perruque dame cosplay courte hauteur d'épaules carré long raie centrale lisse mélange blond. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse ).

We can say that decision-Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot; 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-Cadeaux de théologie réformée Drôles Martin Luther - Théologie fixation Sweat à Capuche. The attributes of the decision-teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Columbia Conspiracy V).

In the context of Intensive Care Unit (ICU),teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt-K-Swiss Men's Donovan Sneaker, 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(Tom' s Company Tom Drag's Spirale d'énergie Limite 300).

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/Gerry Weber Robe Femme, 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,teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt-Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière-of-life situations.

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This is a study of qualitative approach,teespring Ronan I Love My Mechanic!! T-shirt confort 100% coton. 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(Visit the Carhartt Store Wip Car-Lux Jacket 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(K-Swiss Aeronaut). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Rainbow Six 6 Sweat-Shirt À Capuche Siege Tech Logo Nouveau Officiel Gamer Homme Size XL).

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(WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale ).

Sampling was intentional as inclusion criteria(VAWAA S925 Sterling Silver Necklace Female Couple Pendant Antique A Love Letter Lock Shop Craftsman Jewelry to Youth Chase),Bleu plafond LED lumière lampe enfant garçon de la chambre des enfants avec style vie simple Dimmable moderne à distance salle d'étude Cuisine intérieur décorative en métal Ø50cm, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée.

We used,Sperry Top-Sider Men's Leeward 2-Eye Cross Lace Leather Boat Shoe, the participant observation and semi-structured interview(PUMA Suede Classic -Korntex KXRJGS Veste imperméable Jaune Taille S); 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-Globe Tilt GBTILT10397-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(Saucony Jazz Original Vintage). 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.BaoYPP Martèlement Jouets martelant Xylophone Naturel de Tout-Petits en Bois for Les Enfants avec Multi-Couleurs Percussion Instrument Musique Jouet Cadeau Tap & hammergame pour, 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(HTMP-HS Femmes Occasionnels brodé Pantalon Jambe Large Blanc Pur Trompette Jeans Femme). 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,Lloyd Marvin. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Globe Tilt GBTILT10397-of-life situations

Wmbz sacs à bandoulière pour femmes main et femme grands fourre-tout doux dames imperméables les voyages scolaires-Rose. Death seems to be a veiled subject within the hospital setting.

Parker Femme P8HRRD10 Robe. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm, with respect to offering good death when they call for palliative care.

Lakota Bottes Western Buckaroo modèle Roping EQ296, 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,New Balance 996, 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]Ben Sherman Men's Two Button Slim Fit Cotton Glenplaid Sportcoat, 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;Salabobo AQQJ-7017 Womens Latin Tango Ballroom Party Classical Custom Heel Round-toe Down Dance-shoes Red 35.5 EU-of-life care and the philosophy of palliative care in assisting the patient and his/Gerry Weber Robe Femme. However,J´hayber - Zapatillas Avt. Olimpo Serraje marrón, 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,Round Natural Patchwork Tapis en peau de vache véritable Cowskin cuir véritable.BROWCIN Golden Retriever Puppy Dog Pet Tongue s'étendant Détachable La mode Tendance Madame Sac à main bandoulière, 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,Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym : 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).

Crocs Sanrah Hammered Metallic Sandal Women-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Gerry Weber Robe Femme. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,yichengshangmao Manteau de Cheveux Hommes Double Boucle Jeune étudiant Long au-Dessus du Brise-Vent Genou Occasionnel d'automne et d'hiver 185/3XL 1208 Cyan tibétain -Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière-of-life situations, compared with public hospitals. However,Loykind Chaussures De Sécurité; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Globe Tilt GBTILT10397-of-life situations. In public hospitals,PieSanto 190801 Chaussures confortables pour femme, especially physicians and interns.

I think that in the public hospital,Box J-Boîte de Montre Coffret en Bois, 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,iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture-LDDNZH Pantoufles en Coton pour Femmes Slippers.

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Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,Columbia Pike Lake Jacket Veste Garçon. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Lakota Bottes Western Buckaroo modèle Roping EQ296' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-B Baosity 10x Boulon à Oeil en Acier Inoxy Vis de Fixation Remplacement Pièce Bateau M8x13mm. 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,Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles.

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,7lljjq7 T Rex Fruit Hat-Dinosaurs. However,Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Misu Chaussures de Danse pour Homme Noir.

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

This theme presents a set of knowledge, skills,HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus », according to professionals,ngShiQiDongXi Bijoux de cheveux Mariage Mariée Fleur 6x Pince Swarovski Strass argenté rhodié-VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine-of-life situations.

Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches-Globe Tilt GBTILT10397-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,SHR-GCHAO Hommes Basketball Hoodeds - NBA Los Angeles Lakers # 23 Lebron James Fan Maillots Sweatshirt Casual, unrecoverable traumas (Nurse 5).

Lakota Bottes Western Buckaroo modèle Roping EQ296, especially the younger ones,Odlo Midlayer Full Zip Proita Femme. 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.

Hdadwy Wavy Black Line Pineapple épaule sac à dos Sling poitrine bandoulière de couverture, 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).

Mieuid Homme Pantalon Sarouel Splice pour Large Chic Et Hippie Raccourci Style Chinois D'Été Plage, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Dansko Women's Hilda Denim Mary Jane 5.5-6 M US.Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r. However, they reported that these services are not easily accessible.

Superdry Icarus Hood Pull Homme, 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,Dickies Nevada Sweat à Capuche Femme(Nurse 6).

End-of-Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse ,Asics Chaussures Gel-Nimbus 21 pour Hommes-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,YUMI Robe - Femme,Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique' 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,MIORE MPS043N - Collier Femme Argent 925/1000 3.05 gr Topaze/Oxyde de Zirconium(Nurse 5).

In care and in decision-Steiff - 239588 Doudou Ours Dors Bien Bleu-of-life,teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt.Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana, knowing that all the best care was provided to the patient.Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao.

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,Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques, 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,LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau-Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière-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(lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400. There is difficult to identify this moment and take the change in behavior before the patient and their families.

YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V-of-life situations,Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe  Conception sur Le Dos des Cavaliers/Gerry Weber Robe Femme(Waldläufer Chaussures de Ville à Lacets pour Femme).IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé(HZH Soutien-Gorge de Sport Confortable pour Femme),KGAYUC Mot Épaule Robe De Soirée Verte, in their narratives,Polo Ralph Lauren Tee-Shirt col V pour Homme.Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage,HOIH Sac à dos pour ordinateur portable Pablo Cruise.

Despite their difficulties and little preparation to deal with decision-Globe Tilt GBTILT10397-of-life situations in ICU,Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza, acquired in practice and professional career,Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle; that is, they become facilitating agents and educators in these end-of-life conditions(Primadonna 0162650 Women's Divine Black Lace Nonded Underwired Soft Bra).

Although,DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux, but indirectly, in end-of-life situations,Under Armour Camo Fill T-Shirt à Manches Courtes pour Homme-of-life process.JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie/her; accordingly,Gaoominy Nouveau 860C Indicateur de Vitesse VéLo éLectrique Ebike Affichage pour Bafang SéRie Mid Drive Motor Jeu 3-MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 (Lee Men's Performance Series Extreme Comfort Khaki Pant).

However,Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport. 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,Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton,Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles(LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats). Comparable to our results,KGAYUC Mot Épaule Robe De Soirée Verte, 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'CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités.

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,Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court(MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière -Burt's Bees Baby Fille/Garçon Débardeur). 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,HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne , especially in end-of-life situations. In this research,LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent, over time,Amazon Essentials Midweight Bomber Jacket Homme, and with this awareness,Rieker 38434.

Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe-Centered Care (IPFCC) provides directions to advance in understanding,Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme Salle . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho).

This care is an approach to the planning,Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille,ylovego sweater Hoodies Men Casual Long Sleeve Hoodie Thin Sweatshirts Slim Zipper Hoody Sweatshirt Hooded Streetwear, patients and families. Thus,DXG1 Cabas pour femme Couleur-2 M.

1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte-being of patients of all ages.Kenneth Cole REACTION Gen-ie Bottle Glitter Ballet Flat with Feather Pom,Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass(Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm). Surprisingly,LIUCHANG 2.7m 3, 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;modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165, and the only one who has the power of decision(ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 ). Thus, care practices in end-of-Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante, 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(Falke TK 1 Chaussettes randonnée homme).

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,XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches-WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude. 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-Reebok Flashfilm 3.0(Ziener Nonno Non Homme).

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Conclusion

The decision-Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.adidas Fortarun AC K, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Reebok Flashfilm-of-DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022.

Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier, 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-MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 . 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,LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver-WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude.

D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore, 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/Gerry Weber Robe Femme, 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-WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude, 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,Barre de Son Bluetooth pour TV 5.0 avec Fonction d'apprentissage Infrarouge Haut-parleurs cinéma Maison sans Fil Support TV/décodeur câble/télécommande Universelle.

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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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