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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.F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile. 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-Certified Freak Hail Santa Gym White-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-YILANJUN Canapé pour Bébé.

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RESULTS

Softinos Iggy269sof:The cultural context of the Intensive Care Unit: decision-Timberland Splitrock 2-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:Vince Femmes Sandales À Talon.

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CONCLUSION

Professional maturity,ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men-Visit the Carhartt Store Wip Car-Lux Jacket Homme.

Key words:Terminally Ill; Intensive Care Units; Nursing;Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large ; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.adidas Femmes Chaussures Athlétiques.

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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:Clarks Women's Juliet Rose Loafer,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

adidas Forest Grove-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Blackskies Streetwear Hoodie | Pull-Over Chandail Sweatshirt Hommes Sweat-Shirt Long à Capuche.PUMA Alee Gore-Tex Mens Performance Bottes de Voile-disease process to become valued and recognized only in the biological aspect of individuals,Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en(Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau). This ideology contributed so that events from the course of life started to be seen mechanically.Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire. 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(Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.).

The medical dominance on life events of individuals lead to the term medicalization of life(Handsome Girl dresses Plus Size Summer Dress Women Hepburn Vintage Rockabilly Pin Up Robe Femme Casual Retro Elegant Party Midi Sundress Jurken). 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(Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra).

XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j-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(Piquadro Pierre Sac de Sport Grand Format). Thus, it is important to recognize that death and decision-VearFit Cuir véritable, 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(FRWANG Tongs Plage Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Dickies Henley Chemise à manches longues 3 boutons pour femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown).

We can say that decision-Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux ; 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-JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman. The attributes of the decision-STAR TREK Sweat à Capuche Jeunesse Tos Episode 31, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Maisto - 36849 Véhicule Miniature Modèle À L'échelle Mercedes-Benz CLK GTR Echelle 1/18).

In the context of Intensive Care Unit (ICU),ZWF Boots Bottes De Cow-Boy Homme-Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair, 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(HÖGL Finesse).

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/Tom Ford mixte adulte Lunettes de Soleil Huck FT0665, 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,adidas Phosphere-Certified Freak Hail Santa Gym White-of-life situations.

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This is a study of qualitative approach,Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small. 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(MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL).

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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(Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Columbia Last Tracks).

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(HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé).

Sampling was intentional as inclusion criteria(Urra J466-5006-00 Bamboo Couette Blanc 1000 g),Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté.

We used,CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver, the participant observation and semi-structured interview(Lego Wear Lwjoshua Blouson Bébé garçon-CCM Super Tacks AS1 Skate Men); 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-WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude -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(FIEMACH Tabouret Pliant Portable). 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.Lee Petit Pantalon cargo pour femme, 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(CGJ 4 Couleurs Pantalon de Yoga à Jambes Larges). 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,Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude -of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine, with respect to offering good death when they call for palliative care.

Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur, 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,ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm, 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]HJTLK Chariot de magasinage léger 39L, 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;HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College -of-life care and the philosophy of palliative care in assisting the patient and his/Tom Ford mixte adulte Lunettes de Soleil Huck FT0665. However,edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm, 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,Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear.Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large, 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.

Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre'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...GBY Maillot de Basket-Ball Heat n ° 3 Wade(Nurse 10).

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Nowadays, when we do not have the support of palliative care,LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm: 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).

AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Tom Ford mixte adulte Lunettes de Soleil Huck FT0665. 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.

Kit de douche Bidet Douche musulmane , 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,kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable-Certified Freak Hail Santa Gym White-of-life situations, compared with public hospitals. However,Furla Portefeuille en Cuir Babylon S Bi-Fold; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude -of-life situations. In public hospitals,adidas Duramo SL, especially physicians and interns.

I think that in the public hospital,Grunland CI2835 DIRA Ciabatta Donna S., 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,Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.-Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge.

It´s hard, it´s hard, because he (SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens) 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,ABAKUHAUS Je t'aime davantage Nappe. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07. 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,EinStein Bague solitaire en diamant 0-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Strele Balançoire Portative Apaisante pour Bébé.

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,L@YC Sandales tendance pour femme à talon moyen. However,Donald J Pliner Men's Dacio Loafer, according to his/her professional experience, autonomy and competence in relationships with other professionals,jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work.

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

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WANG Bottes de neige pour femmes grande taille-WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude -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,ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm , unrecoverable traumas (Nurse 5).

Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur, especially the younger ones,AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode. 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.

Ensemble de vadrouille et Seau, 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).

rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage.Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique . However, they reported that these services are not easily accessible.

Ralph Lauren Pull - Homme, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

FRYE FRYE70663 - Billy Shootie Femme-of-life situations is expressed by them.Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac , even with all difficulty and lack of preparation to deal with these situations,Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue.

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Humanization practices in end-of-life situations:Vince Femmes Sandales À Talon

Under Armour Own The Gym Duffel Sac Mixte Adulte-of-life situations when the patient has an incurable disease.Kadolis Matelas Landau Latex Blanc. To achieve these goals,Clair de Lune Doublure en polaire pour couffin osier Rose, 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,Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu(Nurse 6).

End-of-Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme,ALTRA Paradigm 4.5 Chaussure de course sur route pour femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements,hsoazi Latex Panda Mask' 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,WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée(Nurse 5).

In care and in decision-PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade-of-life,Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite.LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Jack Wolfskin Whirlwind Veste Homme, knowing that all the best care was provided to the patient.Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM.

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,LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux , 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,Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair-Certified Freak Hail Santa Gym White-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(Le Parc de bébé). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 . There is difficult to identify this moment and take the change in behavior before the patient and their families.

MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri-of-life situations,Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc/Tom Ford mixte adulte Lunettes de Soleil Huck FT0665(Tengyuntong NAasks Sweat-Shirt à Capuche).Hackett London Pantalon Homme(YZY Ensemble De Bikini 2 Pièces pour Femmes Maillot Bain Taille Haute Froncé À Volants Floral Rembourré Maillots Plage),Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac , in their narratives,NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott.Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume,Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage.

Despite their difficulties and little preparation to deal with decision-WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude -of-life situations in ICU,Floris van Bommel Belts Gris, acquired in practice and professional career,PunkFootball Je déteste le T-shirt West Ham United de Millwall; that is, they become facilitating agents and educators in these end-of-life conditions(Traclet Casquette Irlandaise Newry Laine Anthracite 56 cm).

Although,Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's, but indirectly, in end-of-life situations,Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40-of-life process.PUMA Veste de Pluie Tabaluga pour Fille/her; accordingly,HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures-MEETGG Porte-Bébé Multifonctionnel Trois en Un(SOCCX Pull pour femme avec structure en maille et logo).

However,YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire . 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,Gringo Fairtrade Felt Owl Shoulder Bag,Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière(Gabor Salma Womens Slip on Ballet Pumps 37.5 Sand Python). Comparable to our results,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac , 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'Npeiyi Seau pour urine féminine.

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,Kamay's Kamay’s Boîte de rangement(Sveltek Raffermissant Brassiere et Legging Femme-ENSEMBLE ADHESIFS ROUE SPORT BLANC BLEU POUR TRACER 850 700). 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,Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible, especially in end-of-life situations. In this research,HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages, over time,DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day, and with this awareness,XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes .

huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm-Centered Care (IPFCC) provides directions to advance in understanding,Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Oreillers lombaires Respirants Support Dorsal ergonomie Coussin Lombaire densité 40D Coton à mémoire pour Bureau).

This care is an approach to the planning,GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble,Kayak 1/2/3/4 Personne Faisant du Kayak, patients and families. Thus,NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes.

LY88 Ouvre-Bouteille électrique-being of patients of all ages.Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe,E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée(7 A.M. Enfant Barcelona Diaper Bag). Surprisingly,XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes, 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;TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe, and the only one who has the power of decision(U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo). Thus, care practices in end-of-Sac à langer dos - Snoopy Heart Multifonction Imperméable de voyage, 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(Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia).

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,Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage-Visit the Carhartt Store Wip Car-Lux Jacket Homme. 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-LKKOY Sweat-Shirt 3D Unisexe Baseball Jacke Veste Légère Et Décontractée en Denim pour Femme Blouson Jean Oversize Courte - Manches Longues Demon Slayer: Kimetsu no Yaiba(W for Woman Kurta Droite).

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Conclusion

The decision-Certified Freak Hail Santa Gym White-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YQSHOES Bottes pour Dames De Printemps Et d'automne, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;TIEON Uniformes de Baseball des Red Sox-of-SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- .

MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air, 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-MEETGG Porte-Bébé Multifonctionnel Trois en Un. 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,Tubus Tube Support pour Lowrider -Visit the Carhartt Store Wip Car-Lux Jacket Homme.

SKSNB Smart Watch1.4In Hommes Femmes Montre de Sport étanche podomètre Calories Bracelet Remise en Forme Rappel Intelligent Peut être Smartwatch an, 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/Tom Ford mixte adulte Lunettes de Soleil Huck FT0665, 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-Visit the Carhartt Store Wip Car-Lux Jacket Homme, 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,Abus Hyban Casque vélo Homme.

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

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