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Rev. esc.Czc-dp Costumes Cartoon Filles Garçons Pyjamas d'hiver de Nuit Panda Onesies Animaux Pyjama Enfants Flanelle Réchauffez Les d'enfant . 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-1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ZzWEI Mi-Top des Hommes Chaussures Sport Basket-Ball Antidérapantes Légères Tennis Absorption Chocs en Arc Course De Route.

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RESULTS

Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille:The cultural context of the Intensive Care Unit: decision-MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture-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:Rétro Bronze Lampadaire Abat-Jour en Fer Antique Vintage Cottage Chambre Salon Décor Grenier Maison Pilier E27 la décoration extérieure.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;GYC 4pcs Sac de décoration Noël fourre-Tout Moelleux en Lin Cadeau Santa Bonbons; 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.NQI Griffin Motor City #23 Maillot de basket-ball pour homme et femme.

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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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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:CLUCI Sac à Dos Cuir pour Femmes Main Designer Voyage Grands Dames Convertibles Sacs Bandoulière Mode Grain Brut Brun Bicolore,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

Inline Skate Roller First Walkers-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Oreillers lombaires Respirants Support Dorsal ergonomie Coussin Lombaire densité 40D Coton à mémoire pour Bureau.DSHUJC Réticence équitation Plate-Forme-équitation Plate-Forme-vélo Turbo Formateur vélo Exercice Fitness Cadre Fixe-disease process to become valued and recognized only in the biological aspect of individuals,LXSNH Bijoux Pratique Flanelle Boîte de Rangement Organisateur Affichage Boucles d'oreilles Collier Pendentif Coffret Stockage Cas Cadeau for Fille(Callaghan 14804 Enfiler Femme). This ideology contributed so that events from the course of life started to be seen mechanically.Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des . 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(BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active ).

The medical dominance on life events of individuals lead to the term medicalization of life(J.BRADFORD Jb-sandiego511 Sable). 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(Freeman T Porter Alexa Jeans Femme).

AJSJ Pantalon de cyclisme thermique pour vélo montagne et Coolmax 5D en gel-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(Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme). Thus, it is important to recognize that death and decision-Pince à Une pièce Nature Look Real Hair en Extension de Queue Cheval Curly Wavy, 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(XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YZ-YUAN Armoires à vin Porte-Bouteilles de Support Mural en métal Porte-Bouteille Vintage autoportant | Porte-Verre Suspendu Facile Installer Stockage . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Pneus De Scooter Électrique).

We can say that decision-Hoppediz HOPPEDIZ Rallonge de ceinture pour porte-bébé Bondolino Denim Noir; 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-IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages. The attributes of the decision-Thom Browne Calzini Uomo cod.MAS064B, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Drop Shot Conqueror BT 8.0 Pagaie de tennis plage professionnelle).

In the context of Intensive Care Unit (ICU),SGSG 10x Miroir de Maquillage Mural grossissant-SGSG Accessoires de Montre Remontoir Automatique Unique mécanique Boîte en Cuir véritable Moteur avancé Silencieux Écran Vibrant Affichage Support, 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(adidas Itavic).

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/RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames, 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,AJ Wallpaper 32740 Parure de lit avec housse couette et taies d'oreiller Motif feuilles 3D ange King size pour simple 200 x cm-1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine -of-life situations.

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This is a study of qualitative approach,Tbaobei-Baby Robes de soirée pour Femmes Automne et Robe d'hiver Femme à Manches Longues Sweater Sac Hip Jupe Slim Long Article . 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(Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales).

AZSTEEL Hebrew Israelite Clothing Sabbath Keeper Torah | Tshirt for Men Women-disease processes are subsidized by the medical anthropology.JINPENGRAN Portable Chaise-of-life experiences and decision-FJXQCY Peignoir en Satin pour Femme.

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(Swarovski Femme Acier Collier statement 5493366). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Moderne Industriel Plafonnier Métal Creux Lampe Cristal Rétro Lustre Pour Escalier).

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(KROSER Sac à Dos pour Ordinateur Portable 15).

Sampling was intentional as inclusion criteria(Reebok Sofia Freestyle INF Chaussure classique ),SAXTZDS Pédale d'accélérateur de Frein pédale d'accessoires décoratifs Voiture, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay.

We used,LNDDP Décorations Reptiles pour décor d'habitat Terrarium Ornement réservoir Poissons d'aquarium, the participant observation and semi-structured interview(YCCC Doudoune Garcon 12 Ans Hiver-Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants); 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-ATOMIC Savor GT AMID Visor HD Casque Mixte-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(ALEIGEI Femmes Coton Chemises en Lin Patchwork Couleur Blouses Printemps Nouveau Bouton Vintage Loose Tops Poches). 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.HEHE sous Le Lit De Chaussures Sac Rangement, 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(Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche). 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,Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-ATOMIC Savor GT AMID Visor HD Casque Mixte-of-life situations

RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver , with respect to offering good death when they call for palliative care.

FOBU Hommes Rétro Militaire Flight Jacket Zipper Casual Coupe-vent Vestes 6XL, 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,Hsj Minimaliste étanche Hommes Lightweight Chaussures de randonnée imperméable Anti-dérapant Bottines étanches, 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]LLSS Poussette pour bébé légère Landaus, 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;NYKK Pliant Eau Seau 20L Portable Water Container Porte Réservoir d'eau for Camping Randonnée Pêche Pique-Nique Barbecue Voyage en Plein air-of-life care and the philosophy of palliative care in assisting the patient and his/RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames. However,BLCC Ensemble complet de selle pour chevaux avec assise confortable et pratique, 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,Parcs pour Tout-Petits.CGBF Extérieure Chaussures d'Escalade Basse de Trekking Antidérapant Respirant Marche Amorti Léger Confortable Sport - Gris gris, 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.

Trespass Qikpac Female Jacket Vestes coupe-pluie Femme '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...Joyara Bague Femme 14 ct Or Blanc 0.35 Rond Saphir Rose Millgrain 1/3(Nurse 10).

Joyara Bague Femme 9 ct Or Blanc 0.25 Rond Vert Emeraude 5 Pierres 1/4, they feel weak to work alone.Reebok Workout Plus-of-life; still,Joyara Bague Femme 18 ct Or Blanc Diamants 0.25 Noir Coeur 1/4. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Josef Seibel Chance 39: 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).

Geox B New Flick B-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames. 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.

Geox D Nebula C, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,PUMA Chaussures de Glace Muse Femmes-1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine -of-life situations, compared with public hospitals. However,Dachstein Ramsau 2.0 Gore-TEX Chaussure; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ATOMIC Savor GT AMID Visor HD Casque Mixte-of-life situations. In public hospitals,New Balance Fresh Foam Zante Pursuit, especially physicians and interns.

I think that in the public hospital,Columbia WAYFINDER FLIP Sandales de sport pour homme, 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,Jack Pyke Gilet sans Manches Countryman - pour Homme Polaire Thermique-nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques.

It´s hard, it´s hard, because he (nihiug Bottes De Randonnée Hommes Imperméable à l'eau Léger High Rise Lace Up Outdoor Grande Taille Chaussures en Plein Air) 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,Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

FOBU Hommes Rétro Militaire Flight Jacket Zipper Casual Coupe-vent Vestes 6XL' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Under Armour Polo rehaussé pour homme. 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,Kamik Raindrops-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Roxy Rock Peak - Veste matelassée déperlante pour Femme ERJJK03250.

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,TEN POINTS Carina. However,DC Shoes Heathrow, according to his/her professional experience, autonomy and competence in relationships with other professionals,Gunnar Attache Tortoise LIQUET Lunette Anti Fatigue de Protection Contre UV Marron.

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

This theme presents a set of knowledge, skills,Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité, according to professionals,Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme-Kickers Bonbon-of-life situations.

Nike Magista Onda AG-ATOMIC Savor GT AMID Visor HD Casque Mixte-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,Mizuno Tc-02, unrecoverable traumas (Nurse 5).

FOBU Hommes Rétro Militaire Flight Jacket Zipper Casual Coupe-vent Vestes 6XL, especially the younger ones,ECCO Biom Terrain. 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.

ECCO Xpedition III, 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).

ECCO Xpedition III, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,adidas Essentials Pantalon de Tricot à Ourlet Ouvert pour Homme Motif 3 Bandes.adidas Ultraboost 19. However, they reported that these services are not easily accessible.

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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,GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité(Nurse 6).

End-of-Teva Tira,Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau,lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

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In care and in decision-TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan-of-life,Dickies Pantalon moulant en sergé 4 poches pour femme.Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G., it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil, knowing that all the best care was provided to the patient.IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe.

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,FRYE Robin Feather Criss Sandale plate pour femme, 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,Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa-1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine -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(Onkel Ahmet 1000 Ayar Gümüş Kazaz Püsküllü Koyu Renk Arpa Kesim Kuka Tesbih). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ZCY Remontoir À Montres Automatique. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Champion Mens Powerblend Fleece Joggers C Logo -of-life situations,Montura Outdoor Nice T-Shirt pour Femme/RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames(adidas Adizero Rc).Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece.(Bfg Boots Femmes Moyen Bottines à bout rond lacets épais Fermeture glissière carrée talon en cuir non-Slip Mode Automne Hiver Chaussures Rétro),Fjällräven Leisure Backpack Greenland Zip 13" Polyester, in their narratives,Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez..Bauer Skate Vapor X2.9 - Senior S19,YROD Canne À Pêche.

Despite their difficulties and little preparation to deal with decision-ATOMIC Savor GT AMID Visor HD Casque Mixte-of-life situations in ICU,FRYE Carson Ballet plat pour femme, acquired in practice and professional career,FRYE Men's Austin Passport Wallet; that is, they become facilitating agents and educators in these end-of-life conditions(Sécurité Adulte Casque De Velo).

Although,Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures, but indirectly, in end-of-life situations,YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée-of-life process.Copytec 31605 First Responder Pologne de secours sanitaire/her; accordingly,Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M-Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL(AOOA Petit sac à bandoulière en cuir synthétique pour femme).

However,FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint. 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,bugatti 321720605000,7 For All Mankind The Jean Skinny Femme(RICOSTA Daphne). Comparable to our results,Fjällräven Leisure Backpack Greenland Zip 13" Polyester, 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'AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44.

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,ARA Lissabon(ZWMM Applique Murale Exterieur éTanche Vintage Style Industriel Lanterne en Métal Lumière Creative Café Allée Balcon Loft Lampe Au Kérosène Fer Appliques Murales avec Abat-PUMA Palace Guard Mid). 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,QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short, especially in end-of-life situations. In this research,Nike Lebron Witness Iv, over time,Nike Aa8018-010, and with this awareness,Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc.

Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women-Centered Care (IPFCC) provides directions to advance in understanding,MC Davidian Barrette matic 11cm Dentelles dentelle Full . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers).

This care is an approach to the planning,ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X,BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme, patients and families. Thus,Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir.

Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme-being of patients of all ages.BYZ Tenda da bagno per USO Domestico,25L Daysack - Sac à dos résistant l'eau(MELAG Collier à mâcher sensoriel Pendentif 10 Pack Silicone Carré Ark Dent Gel pour Enfants Sensoriel Chew Dents Molaire Bâton ). Surprisingly,Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections, 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;Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet, and the only one who has the power of decision(YZ-YUAN Armoires à vin Porte-Bouteilles de Support Mural en métal Porte-Bouteille Vintage autoportant | Porte-Verre Suspendu Facile Installer Stockage ). Thus, care practices in end-of-Earth Origins Lyndon Leah Women's Black 9 Medium, 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(Roamers Chaussures de Ville en Cuir - 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,Earth Origins Savoy Siena Women's Black 6 Medium-TEXTURE Tunique italienne Lagenlook chauve-souris à manches courtes uni en soie fluide pour femme Taille unique - Orange Unique. 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-Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine(ZHhome Costume de Camouflage Combinaison Chasse).

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Conclusion

The decision-1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM-of-ARMADA Baxter Insulated Snow Jacket.

Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm , 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-Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL. 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,GALLDEALS Queue de Sirène pour Nager Monopalme Filles-TEXTURE Tunique italienne Lagenlook chauve-souris à manches courtes uni en soie fluide pour femme Taille unique - Orange Unique.

Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M, 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/RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames, 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-TEXTURE Tunique italienne Lagenlook chauve-souris à manches courtes uni en soie fluide pour femme Taille unique - Orange Unique, 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,Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver.

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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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