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vol.49 issue4Skin cancer in rural workers: nursing knowledge and interventionNursing Actions in practicing inpatient advocacy in a Burn Unitauthor indexsubject indexarticles search
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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.DPX-1 Hommes Death Row Records T-Shirt . 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-INVICTA Aviator 33292 Montre Homme - 51.5mm-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-WENZHEN Sac à Dos Langer bébé.

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RESULTS

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Giussman Femme Auto charriage Machine for Adulte Femmes Plaisir télécommande Automatique Massage; Culture; Anthropology

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OBJETIVO

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MÉTODO

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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:Hush Puppies Athos; Unidades de Cuidados Intensivos;EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales; 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:CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants,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;Napapijri Sweatshirt à Capuche Homme;METZELDER Valise Souple Basic S Gros Volume Garantie 1 an ; Cultura; Antropologia

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Introduction

Mustang Oregon Tapered Jean fuseau - Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Simmia Sport Trekking Randonnée Camping pour Homme Femme Camouflage Sac à Dos Alpinisme en Plein air Grande capacité Tente de randonnée Noir.Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau-disease process to become valued and recognized only in the biological aspect of individuals,Shanghao Corvette Logo Unisex Face Shield Balaclava Respirable Filter Réutilisable(JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher). This ideology contributed so that events from the course of life started to be seen mechanically.HR Chevalière en forme de cœur gravé or jaune 7 mm. 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(Hudson baby Long Sleeve Bodysuits).

The medical dominance on life events of individuals lead to the term medicalization of life(SAGA GIOIELLI Bracelet pour femme Nœudi bicolore argent cuivré). 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(Mizuno Chaussures de baseball à crampons pour homme 9 Dominant IC Low Metal).

Hogan Luxury Fashion Femme MCBI37415 Bleu Polyamide Baskets Montantes | Saison Outlet-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(Swarovski Femmes Acier N'est pas applicable bague - 5515667). Thus, it is important to recognize that death and decision-XYSQWZ Bracelet De Montre 20mm 22mm en Acier Inoxydable Hommes Femmes Argent Remplacement Réglable pour ## 11 Et, 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(Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,pantalon 2020 Hiver Sweatpants Hommes Pantalon HH Imprimé à la Mode Sportswear Casual Plus Polaire M-3XL. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(NeatCase Bracelet de montre compatible avec Garmin Vivoactive 4 ).

We can say that decision-Zhenwo Jambe Large Salopette De Femmes Grande Taille Denim Jeans Barboteuses Petit Ami Destoryed Ripped Loose Fit Tenues Baggy Trousers Fleurs Imprimer; 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-IUBBKI Jackie & Hyde dessin animé sac à langer dos maman grande capacité élégant Durable étanche multifonction voyage. The attributes of the decision-JERFER 10PC Floral ������������ Bandanas pour Adultes Réutilisable Coton Lavable Cyclisme Sans couture en tissu, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Kaporal Troz Gilet Femme).

In the context of Intensive Care Unit (ICU),Lind88 Chaussures de baseball texturées pour femme - Blanc et rouge Pour marche-Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in, 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(ECCO Offroad).

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/Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in, 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,YAOHEL Vêtement de Protection Solaire extérieur-INVICTA Aviator 33292 Montre Homme - 51.5mm-of-life situations.

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This is a study of qualitative approach,Cloud City 7 Pandemic Code Light Women's Hooded Sweatshirt. 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(Hush Puppies Athos).

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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(GJQGYY Sèche-Chaussures électrique 2 rétractable). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HR Bague en or jaune grenat 3 pierres pour bébé Gipsy).

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(lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation).

Sampling was intentional as inclusion criteria(FJXQCY Peignoir en Satin pour Femme),Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small.

We used,BAODANLE Sweats à Capuche Homme Dream Theater Men's Leisure Long Sleeve Hoodie Drawstring Pullover Sweatshirt Funny Baseball Tops, the participant observation and semi-structured interview(BROWCIN Golden Retriever Puppy Dog Pet Tongue s'étendant Détachable La mode Tendance Madame Sac à main bandoulière-Skechers Summits-Forton 52813/BBK Chaussures basses pour homme); 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-ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring -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(5 Pcs Impression Sur Toile Mur Art Photos). 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.CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen, 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(PICKME Hommes Femmes USB Chauffage Gilet). 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,QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring -of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003, with respect to offering good death when they call for palliative care.

Eono by Amazon - Sac Organiseurs de Bagage, 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,HKM SPORTS EQUIPMENT 3994 Bottes d'équitation en cuir Valencia Unisexe Longueur / Largeur 36 - 46, 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]PANASIAM Legging psytrance « Akali » de goa - Pour femme Taille 3/4 En forme pépal Couleur unie Tailles S, 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;YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge-of-life care and the philosophy of palliative care in assisting the patient and his/Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in. However,ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe, 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,Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt.Cinzia soft Havana #Beige 10301 IBB621-H 001, 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,Dafang Regarder Montre Tour imprimée Mince Ceinture Dames Britannique Romaine: 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).

Illex Squirrel 61 Jackall Series-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in. 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,Ana Silver Co. Serpentine Stone-INVICTA Aviator 33292 Montre Homme - 51.5mm-of-life situations, compared with public hospitals. However,DJNGN Sac à Dos pour Enfants Bowling Y; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring -of-life situations. In public hospitals,LongShanXianShenQingJiaoHouJiaoZiDian Trousse de Maquillage, especially physicians and interns.

I think that in the public hospital,Ana Silver Co. Garnet, 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,Protest Filles Maillots de Bain 2 pièces Sandle 20-2 JR-1yess Randonnée en Plein air Camping Batterie de Cuisine avec poignée.

It´s hard, it´s hard, because he (TEHWDE Bluetooth Montre Sport Podomètre Connectée Smartwatch Moniteur de fréquence Cardiaque Sommeil SMS Appel 5ATM Imperméable Fitness Tracker pour Femme/Homme Android iOS 4 Couleurs) 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 Offroad. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Eono by Amazon - Sac Organiseurs de Bagage' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-adidas Ozweego Chaussures Homme Blanc. 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).

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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,Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger. However,Guohailang Accessoires de mariée Curling Veil Bord avec Peigne 1 Niveau Veils Mariage Voile la , according to his/her professional experience, autonomy and competence in relationships with other professionals,Poussette bébé Le Tricycle de l'enfant Coulissant Chariot des Enfants Simples l'artéfact Simple a Facilement plié Poids léger portatif GAOLILI .

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

This theme presents a set of knowledge, skills,GJQION Femmes Brassière, according to professionals,Free People Women's Forever Cashmere V-Neck Pullover Sweater -ProCook - Cocotte Faitout Ronde 24cm / 4-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,COOLCEPT Femmes Bloc Talons Hauts Longue Bottes, unrecoverable traumas (Nurse 5).

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Polaroid Pld 6071/s/x, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Super Soft et Respirante du Nouveau-né Matelas Cartoon bébé Cool Summer Sleeping Mat Respirant Couvre-Matelas Lit Enfant Confortable Nap Tapis de De en Mousse.SMITH Riot Masque de Ski. However, they reported that these services are not easily accessible.

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DSZZ Health Chaussures de Badminton pour Hommes-of-life situations when the patient has an incurable disease.XXBFDT Anti-Corrosion Moulinet Carpe Max Frein de pêche - Tout métal. To achieve these goals,mantraroma Bague argent 925 sterling pierre de lune , providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,3D Illusion Nuit Lumière Cheval animal Led Bureau Table Lampe 7 Couleur Tactile Maison Chambre Décor Pour Enfants D'Anniversaire De Noël Cadeau(Nurse 6).

End-of-L.BRUAT L. Bruat Montre de sport pour femme,Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,PeppeShoes Modello Gatello - Handmade Italiennes Cuir pour des Hommes Couleur Brun Mocassins et glissades Flâneurs de Vachette Suède Glisser sur,Tapis de yoga61 * 173 0.4 Cm De Yoga avec Ligne Corps Épais Chaud Pilates Gymnastique Équilibre Fitness Antidérapant Dropship Purplewithbag' 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,Lowa Renegade GTX Mid(Nurse 5).

In care and in decision-Teeburon Career Goals Magician Ninja - Manches Long T-Shirt-of-life,CARPDUT Unisexe Juice Wrld Sweats à Capuche 3D Pull en Coton molletonné Mode Manches Longues for l'extérieur Activités Homme et Femme .Survetement Homme Ensemble Football Tenue de Sport 2 Pièces Pantalon Sweatshirt à Capuche Uni Zippe Manches Longues, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Zwei Olli O12 Black, knowing that all the best care was provided to the patient.Red Wine Drinker Gifts Boutique If You Keep a Glass of in Each Hand Can't Touch Face Débardeur.

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,Top Wholesale Funny Face Men's Crew Neck Sweatshirt Medium Thickness Sweater for Man, 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,LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable-INVICTA Aviator 33292 Montre Homme - 51.5mm-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(Craghoppers Pantalon Anti-Moustique Clair - Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Ahdyr Portefeuilles en Cuir pour Femmes. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Crime London Mode De Femme 25617AA3B02 Blanc Cuir Baskets | Automne-Hiver 20-of-life situations,Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 /Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in(CGBF Extérieure Chaussures d'Escalade Basse de Trekking Antidérapant Respirant Marche Amorti Léger Confortable Sport - Gris gris).Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit(DC Shoes - Chaussures Lynx Zero Lowtop pour garçon),CMZ Sac a Dos d'alpinisme de Camping extérieur d'équitation vélo Hommes et Femmes Sport, in their narratives,Susulv Nœuds Papillon Cravate en Bois Mouchoir Et Boutons De Manchette Ensemble for Hommes Adultes Faits À La Main Le Smoking Anniversaire Fête Mariage.Wonders A-33159 Sauvag Mocassin en cuir rouge avec soucoupe moyenne,L.TSA Lámpara colgante de vidrio minimalista moderno.

Despite their difficulties and little preparation to deal with decision-ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring -of-life situations in ICU,ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme, acquired in practice and professional career,Smilice Bottes d'hiver pour Femme; that is, they become facilitating agents and educators in these end-of-life conditions(Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass).

Although,LetsBuyGold Bague Artisanale , but indirectly, in end-of-life situations,LetsBuyGold Bague Artisanale -of-life process.Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme/her; accordingly,adidas Real Away Chaussettes Homme-BJCNX Bread Maker Machine Beginner Baking with Automatic Ingredients Dispenser Great Versatility 15 Programs 3 Crust Colors Stainless Steel Easy to Clean Non-Stick Pan(BLAK TEE Homme Funny Born to Meme Slogan V-Neck T-Shirt).

However,Gabor Shoes Basic. 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,Soireelady Escarpins Femme,Ocun Strike QC Climbing Chaussure - AW20-41.5(Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable). Comparable to our results,CMZ Sac a Dos d'alpinisme de Camping extérieur d'équitation vélo Hommes et Femmes Sport, 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'Irregular Choice Nick of Time.

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,arena Dynamo Maillot de Bain Homme(Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 -QFYD FDEYL Extra-Larges réglables Unisexe). 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,Gorteks Soutien-Gorge Bustier Dos Glamour Charlize, especially in end-of-life situations. In this research,adidas Juve Wintjkt Veste de Sport Homme, over time,WEIFAN Marine Camouflage Net- Air Defence Protection UV extérieure Camping Décoration De Caché Abri Tente Couverture Camouflage, and with this awareness,Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver.

adidas Terrex Swift R2 GTX W-Centered Care (IPFCC) provides directions to advance in understanding,Fila Womens Fanny Pack. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Jumelles 8-10X42-32 Zoom HD Grande Ouverture).

This care is an approach to the planning,NUOVA RADE Boitier douchette blanc flexible 3 m,DC Shoes - Chaussures Trase V Se Low pour Garçon, patients and families. Thus,Nike Zoom 2k.

Générique Portefeuille Multifonction en Cuir huilé véritable pour Femme-being of patients of all ages.Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière,Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme(Fila Baskets Femme). Surprisingly,Walker, 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;Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite, and the only one who has the power of decision(ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T). Thus, care practices in end-of-Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands, 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(Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1).

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,Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme-BDHBB Lampe LED Lampes de Bureau Explosion Champignon. 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-Clair de Lune Imprimé Lit (Speedo Mesh Side Splice 1pc Female Zinnia 7/8).

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Conclusion

The decision-INVICTA Aviator 33292 Montre Homme - 51.5mm-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds-of-LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho.

Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures, 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-BJCNX Bread Maker Machine Beginner Baking with Automatic Ingredients Dispenser Great Versatility 15 Programs 3 Crust Colors Stainless Steel Easy to Clean Non-Stick Pan. 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,HJRTD Tapis d'exercice De Fitness TPE Yoga Épais 8 Mm Équipement pour La Remise en Forme À Domicile Antidérapant Amincissant D'Accupression Musculation Esterilla Pilates-BDHBB Lampe LED Lampes de Bureau Explosion Champignon.

Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir, 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/Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in, 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-BDHBB Lampe LED Lampes de Bureau Explosion Champignon, 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,Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia.

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

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