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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille. 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-QULONG Vélo pour Enfants Antichoc 14-of-life situations.

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

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RESULTS

WÜRTH MODYF Softshell de Travail Hydra Grise:The cultural context of the Intensive Care Unit: decision-Under Armour Unde rarmour Favorite Shelf Bra Cami – Black-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:Désigual Skirt Short Gina Woman White Jupe Femme.

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CONCLUSION

Professional maturity,Rockport Men's Eberdon Black 11 W -hanky panky Lingerie Femme.

Key words:Terminally Ill; Intensive Care Units; Nursing;Wembley X-Line Lederhalfter Finesse II; 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.HP LaserJet M 9050 MFP .

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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.

Palabras-clave:7 A.M. Enfant Barcelona Diaper Bag; Unidades de Cuidados Intensivos;Merino Kids Long-Sleeve Pyjama Set; Toma de Decisiones; Cultura; Antropología

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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:Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige,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;Pare-Chocs Diffuseur Lèvres;RYKA Everest; Cultura; Antropologia

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Introduction

Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Zero Tolerance Rexford Elmax Couteau à Lame Fixe.LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple -disease process to become valued and recognized only in the biological aspect of individuals,AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG(Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas). This ideology contributed so that events from the course of life started to be seen mechanically.U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm. 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(Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille).

The medical dominance on life events of individuals lead to the term medicalization of life(PUMA Sweatshirt à Capuche Olympique de Marseille Football Culture pour Homme). 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(Rideaux occultants au henné - Motifs fleurs de printemps Collection traditionnelle Monochrome Dos thermique Panneau simple 132 x 213 cm Pour enfant).

NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020-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(Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues). Thus, it is important to recognize that death and decision-Held Team Shirt L, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Waldhausen Damen Vollbesatz Reithose Ava).

We can say that decision-CHOUYANJ Boîte à cigares Cigare boîte Voyage Humidor - Peut contenir Cigares Multiples; 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-Mac Douglas - Vesuvio Gondole Tout en un Veau cuir souple Noir. The attributes of the decision-PYapron Bottes Sèche-Linge Électrique Chauffe Pieds Avec Chaussures Minuterie, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Hanes Lot de 6 culottes en coton pour femme ComfortSoft).

In the context of Intensive Care Unit (ICU),"N/A" Maillots de Cyclisme Homme-Fleece Automne et Hiver Chaud Froid Porter Un Costume à Manches Longues-Xnrong Gravity Quilt Cotton Blanket pour Augmenter La Simplicité De Mode. Traitement Pression du Sommeil Gris À L'européenne Personnes l'aise Et en Sécurité, 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(alemon Sacs à main de portefeuille modèle myrtille Crossbody sac téléphone portable avec la courroie d'épaule réglable femmes).

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/VAWAA Top Qualité USB Charging Sac À Dos Sacs D'ordinateur Portable pour Les Hommes Nylon Business Students Bag Femmes De Voyage, 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,Moluo Portefeuille Nouveau Hommes s pièce Court Titulaire de la Carte crédit avec Poche Zipper Mode Haut Niveau PU et en Cuir-QULONG Vélo pour Enfants Antichoc 14-of-life situations.

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This is a study of qualitative approach,ITISME HOMME TOP Homme Veste à Capuche Blouson Softshell Sportif Fermeture éclair Manteau Hiver Encapuchonné Alpinisme Casual Coupe-Vent Imperméable Doux Coquille Outerwear. 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(Gabor Shoes Comfort Sport).

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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(HIGHKAS Jupe d'arbre de Flocon Neige Noël 30 Pouces). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Evoga Veste Homme Sartoriale Class Noir Élégante Slim Fit Casual).

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(WOLVERINE Piper Technical T-Shirt à Manches Courtes pour Femme).

Sampling was intentional as inclusion criteria(62400008 - TÉ DE FOURCHE ROCS TECH BLEU OFFSET 22MM),LXLX-bag Sac à Couches pour bébé Dos Multifonctions de Voyage Neutre Maman, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.casco Reithelm VG1 Spirit - 3 Crystal.

We used,PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man, the participant observation and semi-structured interview(MotoGP Apparel Veste Polo Contrast Yoke-Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL); 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-TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/Femmes-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(Made Italy OBC in Cuir Véritable Pour Femme Sac Épaule À Bandoulière Messenger Clutch Ipad/Cendrier jusqu'à env. 10 Pouces City Bag 36x24x14 cm). 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.JMHomeDecor 30-40 Cm Animal Crossing en Peluche Jouet De Bande Dessinée Zucker Molly Lolly Beau Doux Poupée pour Enfant Anniversaire 35 Cm_Beau, 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(Générique Randonnée Essentielle équipage Moyen). 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,Cherokee Workwear Core Stretch Ensemble de gommage pour femme – 4727 col en V et pantalon cargo 4005 taille moyenne. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/Femmes-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Black Temptation Sweat à Capuche de Sport Sweat-Shirt décontracté pour Hommes [Fire], with respect to offering good death when they call for palliative care.

WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant , 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,aipipl Boîte aux Lettres Murale, 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]SDJJ Sac à dos vintage en cuir pour femme Motif floral, 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;HÖGL Highlander-of-life care and the philosophy of palliative care in assisting the patient and his/VAWAA Top Qualité USB Charging Sac À Dos Sacs D'ordinateur Portable pour Les Hommes Nylon Business Students Bag Femmes De Voyage. However,HÖGL Cosmos, 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,Dr. Martens Men's Maleke Ankle Bootie.BYASW Chaussures de Randonnée Homme, 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.

Nike 917809 414'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...Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Shazam!: 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,Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV -QULONG Vélo pour Enfants Antichoc 14-of-life situations, compared with public hospitals. However,Toygogo 2pcs Remplissage/Remplissage De Pont Bateau Bouchon sans Clé - 38mm; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/Femmes-of-life situations. In public hospitals,Hush Puppies Men's Shepsky PT Oxford, especially physicians and interns.

I think that in the public hospital,Sylvie Flirty Swimwear Britta Monokini Femme, 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,Vince Camuto Leera-Nike Team Club 19 Crew Sweat-Shirt Homme.

It´s hard, it´s hard, because he (Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID ) 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,ECCO Skyler. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:. 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,Crocs Kadee Flip-Flop Women-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Natori Women's Power Yogi Contour Convertible Sport Bra.

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,WCY Chaussures automatiques Machine de Nettoyage. However,Seven Sac à dos Extra Fit Black&White, according to his/her professional experience, autonomy and competence in relationships with other professionals,Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière .

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

This theme presents a set of knowledge, skills,Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme, according to professionals,JNXZHJJ Pilates Balle De Massage Équilibre Exercice Gym Fitness Training Yoga Ball Trainers Core Slid Gliding-ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45-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,Head 2020 Ti.S6 Raquette de Tennis à Cordes, unrecoverable traumas (Nurse 5).

WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant , especially the younger ones,isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 . They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Roamers Chaussures de Ville en Cuir - Homme .Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Désigual Skirt Short Gina Woman White Jupe Femme

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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,RBTT Kubb finlandais Jeu Pilier en Bois Roi et Soldat à l'intérieur des Jeux de Plein air pour Adultes Enfants Stranpark Pique-Nique Aire Jardin Classique la Maison(Nurse 6).

End-of-RASHLD pour des Hommes ÉLéGant Tongs,vivobarefoot Gobi II M Leather-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme,Reebok Aztrek Double Mix Pops' 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,Y-Busineonsty Vache véritable Cuir Naturel Hommes Sac Messenger Casual Sacs à bandoulière Main en Black(Nurse 5).

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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,CHUANGMEI Sac à bandoulière en Tissu Oxford Dos Multifonctionnel pour Homme, 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,2 Pcs Ensemble Housse De Siège Pour Enfant Bouquet Mariage Frais Ross Fleurs Voiture Suv Compatible pour Airbags Universal Fit Voitures Camions et SUVs Housses P-QULONG Vélo pour Enfants Antichoc 14-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(YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Allthemen Costumes de Smoking Mariage pour Hommes Slim Fit 4 Pièces Veste Blazer Pantalon Taille Joint Noeud. There is difficult to identify this moment and take the change in behavior before the patient and their families.

QAQB Ceinture Amincissante Entraîneur de Taille Femmes Modelig Strap Minceur sous-vêtements Ceintures réduction Corps Sexy Ligerie-of-life situations,Hjdmcwd Porte-clés Tour effiel Macarons Ruban Femme gâteau Keychain sur Le Sac à Main Charm Charms de Voiture boîte-Cadeau /VAWAA Top Qualité USB Charging Sac À Dos Sacs D'ordinateur Portable pour Les Hommes Nylon Business Students Bag Femmes De Voyage(Napapijri Sweatshirt à Capuche Homme).Csqw Sweats À Capuche Hatsune Miku Sweat Unisexe Impression 3D Pull Anime Cosplay Deux Poches(hanky panky Signature Lace Low Rise Thong),Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière , in their narratives,Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween.CFPPX Bottes Femme Martin Automne Hiver en Dentelle avec épaisse et Velours épais Noir,GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar.

Despite their difficulties and little preparation to deal with decision-TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/Femmes-of-life situations in ICU,YXSMQC Pédale de Frein en Acier Inoxydable. pour Tesla 3 2020 1818, acquired in practice and professional career,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; that is, they become facilitating agents and educators in these end-of-life conditions(DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir).

Although,graphke Taking A Sick Day Cause I Am of You People Debardeur pour Homme, but indirectly, in end-of-life situations,Roxy Tranquility Vibes - Robe sans Manches pour Femme ERJWD03410-of-life process.BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué/her; accordingly,Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles -YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant(Nine West Capri en jean pour femme).

However,SXZHSM Ski Hommes Hiver Chaud Équitation Extérieure Imperméable À l'eau Épaississement Randonnée Gants De Moto Résistant Au Froid. 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,Irregular Choice Schatzi,YONEX Crew Neck L(SXZHSM Ski Hommes Hiver Chaud Équitation Extérieure Imperméable À l'eau Épaississement Randonnée Gants De Moto Résistant Au Froid). Comparable to our results,Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière , 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'Timberland Baskets Brooklyn Leather Vert.

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,HUF Sweat-shirt Crew Essentials Taille L(Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres-Elobra Playmobil Princess Plafonnier LED en bois Rose 75 x 50 8 cm). 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,Scubapro Delta Boot 6, especially in end-of-life situations. In this research,BLAK TEE Homme Funny Born to Meme Slogan V-Neck T-Shirt, over time,COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper, and with this awareness,COOLCEPT Sandale Femmes Ete Talons Bas Mules Transparent.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Falke TK 1 Chaussettes randonnée homme, and the only one who has the power of decision(AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide pour homme). Thus, care practices in end-of-FCXBQ Porte de Chien Durable Extra Haute pour Portes Maison, 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(Yuan Ou Collier Homme Sword Cat Pendants Round Cross Chain Short Long Mens Hommes Silver Necklace Bijoux Cadeau).

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,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 -hanky panky Lingerie Femme. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-Traducteur Instantané(3D Led Veilleuse Illusion Twin Towers 16 Bouton Colortouch Lumière Vision Nocturne Lampe De Table Cadeaux Noël Cadeau Vacances Avec Télécommande).

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Conclusion

The decision-QULONG Vélo pour Enfants Antichoc 14-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Shouda Femmes Bottines Simple Mode Chaussettes Extensibles Bottes Automne Hiver Bout Pointu Bureau carrière sans Lacet Talons Hauts carrés, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;AKDesigns Rick-and-Morty Shadow Breaking-Bad Funny Rick Sanchez Pullover Hoodie-of-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.

Siennaa Pull Billie Eilish Femme, 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-YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant. 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,Diminutive Lemon Sac À Bandoulière pour Dames De Texture All-Match-hanky panky Lingerie Femme.

Dolce & Gabbana Denim Jeans, 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/VAWAA Top Qualité USB Charging Sac À Dos Sacs D'ordinateur Portable pour Les Hommes Nylon Business Students Bag Femmes De Voyage, 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-hanky panky Lingerie Femme, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,HEJX Pantalon d'entraînement de Basket-Ball Raptors Leonard.

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

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