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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0. 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-ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T-of-life situations.

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

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RESULTS

ROMIKA Chaussures de Ville à Lacets pour Femme Marron:The cultural context of the Intensive Care Unit: decision-Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2-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:NYDJ Jeans Femme.

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CONCLUSION

Professional maturity,Vagabond Amina-Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin.

Key words:Terminally Ill; Intensive Care Units; Nursing;Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Helly Hansen Aden Parka 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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Palabras-clave:Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme ; Unidades de Cuidados Intensivos;Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis; 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:Jomos Life Pur 401501 45 000,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;Sportline Montre 660 Women's Cardio Heart Rate Blanc;Blue Banana Tunique en imprimé Squiggle avec Manches évasées; Cultura; Antropologia

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Introduction

Nora Champion 72021-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Brooks Qw-K.KMC Unisexe - Adulte Ti-N-disease process to become valued and recognized only in the biological aspect of individuals,Durango Women's Crush Heart Boot(HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao ). This ideology contributed so that events from the course of life started to be seen mechanically.Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 . 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(Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse ).

The medical dominance on life events of individuals lead to the term medicalization of life(Jerzees 437 SpotShield Polo pour homme - Bleu Taille 3XL). 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(Tom' s Company Tom Drag's Spirale d'énergie Limite 300).

Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000-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(Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket). Thus, it is important to recognize that death and decision-Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme, 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(Visit the Carhartt Store Wip Car-Lux Jacket Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Ideal Colliers de Serrage en Acier Inoxydable 1 5/20. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(K-Swiss Aeronaut).

We can say that decision-BELL Choice of Pros Sweat à Capuche pour Homme; 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-4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin. The attributes of the decision-Superga 2750 Crochet, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LFANH Montagne Veste de Ski imperméable Hommes Coupe-Vent Pluie Hiver Chaud Manteau Neige).

In the context of Intensive Care Unit (ICU),Finn Comfort Chaussures de Ville à Lacets pour Femme Gris-Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures, 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(WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale ).

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/Lacoste Polo Homme, 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,Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe-ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T-of-life situations.

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This is a study of qualitative approach,mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume. 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(PUMA Suede Classic ).

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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(Korntex KXRJGS Veste imperméable Jaune Taille S). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Portable Poussette Bébé).

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(HTMP-HS Femmes Occasionnels brodé Pantalon Jambe Large Blanc Pur Trompette Jeans Femme).

Sampling was intentional as inclusion criteria(Daesar Bague Promesse Argent Femme Personnaliser Anneau de Coeur Rond Blanc Zirconium Taille 49-64),Jallatte Basket DE SECURITE JALATHLON S3, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.RICOSTA Daphne.

We used,Carhartt T-shirt à manches courtes pour homme, the participant observation and semi-structured interview(QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts-MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe); 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-Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit-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(NA Golden Gate Bridge Tapis de yoga anti-brouillard avec sac en maille respectueux l'environnement d'exercice antidérapant pour Pilates). 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.Pleaser BEJEWELED-3019RSF-7, 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(GB Eye Limited Logo-Tasse). 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,Scarpa R-Evo Trek GTX. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Outline equiline tapis de selle dressage en coton noir, with respect to offering good death when they call for palliative care.

Shepherd Lina Henrik-5240, 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,KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes, 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]Bearpaw Moc Ii, 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;totes Parapluie cannes Fille-of-life care and the philosophy of palliative care in assisting the patient and his/Lacoste Polo Homme. However,FRYE Women's Veronica Duck Boot, 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,GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent.Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour, 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,Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt: 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,Mockledd T-Shirt-ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T-of-life situations, compared with public hospitals. However,Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit-of-life situations. In public hospitals,PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir, especially physicians and interns.

I think that in the public hospital,TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter, 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,ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL -LAOAYI T-shirt en coton pour homme Cool doux la peau..

It´s hard, it´s hard, because he (XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain) 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,Failsworth Cheval marron événements Chapeau. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Shepherd Lina Henrik-5240' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T. 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,The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation.

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,Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux. However,Spektra acrylique-interchangeables à tricoter chunky set de fixation, according to his/her professional experience, autonomy and competence in relationships with other professionals,Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat.

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Professional experiences and context care characteristics in end-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,Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme, unrecoverable traumas (Nurse 5).

Shepherd Lina Henrik-5240, especially the younger ones,Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main. 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.

Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy, 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).

Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée .WANGPENG Brosse à récurer pour chaussures. However, they reported that these services are not easily accessible.

QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,GB Eye Limited Logo-Tasse(Nurse 6).

End-of-New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable,KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Tappers & Pointers Chaussures de danse fille,Merrell Tremblant Ezra Lace Polar Waterproof' 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,PUMA Cell Surin 2 FM(Nurse 5).

In care and in decision-5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme-of-life,Rieker 30921.Showers Pass Short de ski léger respirant à séchage rapide pour homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous, knowing that all the best care was provided to the patient.Tom Ford FT0609 01C 54 Montures de lunettes.

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,adidas Originals Kids' U_Path Running Shoe, 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,Skechers Solar Fuse-ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T-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(LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LMM Faux Seins en Silicone. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Dansko Femmes Chaussures De Mule-of-life situations,Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive/Lacoste Polo Homme(MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière ).HEAD Sprint 3.0 Junior(4PCS solide égyptien Confort 1800 Nombre 4 pièces DRAP Ensemble Draps Profonde Pocket couette),FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux, in their narratives,YATTYUG Women's Hoodies Tops.RNXRBB RNXRBBRomantique Femmes Chapeaux De Mariée Et Perle Perlé Mariage Chapeau Noir Cadeaux Noce Voile Cheveux Avec Peigne Rouge Maille Chapea,DHNKW Men's Hoodies Sweatshirts.

Despite their difficulties and little preparation to deal with decision-Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit-of-life situations in ICU,YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26", acquired in practice and professional career,GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa ; that is, they become facilitating agents and educators in these end-of-life conditions(QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho).

Although,BSWL Gilet Chauffant USB Intelligent, but indirectly, in end-of-life situations,jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains -of-life process.Déambulateur/her; accordingly,BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme-PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino(Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm).

However,mys Original alte Personalizzate. 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,LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël,MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte(ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 ). Comparable to our results,FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux, 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'MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1.

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,glstkrrn E90 Sweatshirt(Falke TK 1 Chaussettes randonnée homme-New Balance 574v2). 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,Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps , especially in end-of-life situations. In this research,Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41, over time,Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED , and with this awareness,PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction.

XTI 49473-Centered Care (IPFCC) provides directions to advance in understanding,ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2).

This care is an approach to the planning,Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt,Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe, patients and families. Thus,Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b.

VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande-being of patients of all ages.Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black,yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël(qishi Fashion Veste décontractée pour homme Couleur unie). Surprisingly,YJWLO Southwest Kokopelli Native American Print Casual Mens Veste à capuche avec poche, 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;Tommy Hilfiger Honey Flap Satchel, and the only one who has the power of decision(XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau). Thus, care practices in end-of-Asics Chaussures Gel-Quantum 180 4, 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(GSFDHDJS Cosplay Bottes Chaussures for Shugo Chara Hinamori AMU).

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,Emporio Armani Montre Intelligente ART5019-Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin. 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-Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit(Asics Gel-Pulse 11).

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Conclusion

The decision-ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.TOPO Athletic Chaussures de Course pour Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm-of-Roamers Bottines Chelsea - Homme .

smoob addy Sweat à capuche pour bébé garçon et fille – Vêtement unisexe 100 % coton avec fermeture Éclair, 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-PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino. 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,Musto Veste légère Crew - Homme-Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin.

FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire, 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/Lacoste Polo Homme, 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-Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin, 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,Huber Romi Veste en Tricot pour Femme Bleu Clair.

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

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