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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Tuyau d'eau télescopique Magique. 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-ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-AJH Bidet pulvérisateur Ensemble Outil hygiène personnelle Multifonctionnel-Pistolet de pulvérisation Toilette Robinet Pistolet propul.

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RESULTS

4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu :The cultural context of the Intensive Care Unit: decision-B/H Réglable Orthopédique Pantoufles-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:ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Clarks Atticus Lace; 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.Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:MTX Ltd Vintage Etnico Ricamo Lana Femminile Caldo Fiore Lunga Sciarpa Autunno e Inverno All'Aperto Multifunzionale Fgreyion Tendenza Selvaggio Scialle Dono Sciarpa,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Skechers Summits-New World.

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Introduction

SECVBG Cerf-volantNouveaux Jouets 1.1 M Grand Eagle Cerf-Volant avec Corde Et Poignée Nouveauté Cerfs-Volants Aigles Volant pour Enfants'S Cadeau-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Liu Jo Écharpe à paillettes 269047 T0300 Noir.Vectry Mode Homme Bottes Désert Antidérapantes en Plein Air Tactiques Randonnée Trekking Casual Baskets-disease process to become valued and recognized only in the biological aspect of individuals,Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt(JX-PEP Été Imprimer col Rond Manches Courtes). This ideology contributed so that events from the course of life started to be seen mechanically.Herschel supply Sac à Dos Nova Small. 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(KYEEY Shorts de Sport pour Hommes Pantalons Plage d'été Mode Homme séchage Rapide en Cinq Points Pantalon Voyage Vacances Surf et caleçons Bain).

The medical dominance on life events of individuals lead to the term medicalization of life(Stores À Enroulement Enroulables 100% Occultant Pour Fenêtre). 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(Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2).

Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483-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(1.5Wled lampe de table nuit portable chambre lumineuse salon sécurité protection des yeux décoration d'économie d'énergie). Thus, it is important to recognize that death and decision-GonFan Hommes et Femmes Adultes Convenant aux Enceintes âgées Les Vraies Chaussures en Bois Portent des de pompage , 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(MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ALPHA INDUSTRIES Veste Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers).

We can say that decision-YXZQ Cartouche de Toner; 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-YQSHOES Bottes. The attributes of the decision-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Lacoste Novas CT 118 2 SPM004022F81 Protège-orteils).

In the context of Intensive Care Unit (ICU),WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral-Clergerie Berlin 3, 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(XiuLi Pantalon Thermo Chaud pour Femmes).

These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes, 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,Nike Sportswear Internationalist Femmes Baskets EU 38 - US 7-ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver -of-life situations.

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This is a study of qualitative approach,YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes. 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(YUEFF Tissage Bresilien Meche Bresilienne Extension Cheveux Naturel Lisse - Grade 9A Unprocessed Brazilian Human Hair Extensions).

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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(BINMA Sweats à Capuche Homme Les Hommes et Femmes 3D imprimé Pull Canal Ciel étoilé Sweat Manches Longues). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Kenneth Cole New York Galway Over The Knee Slouch Boot).

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(LY88 Ouvre-Bouteille électrique).

Sampling was intentional as inclusion criteria(Filet de sécurité pour enfants),ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard.

We used,YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal, the participant observation and semi-structured interview(FENDI FF0343/S Lunettes de soleil Blue Avec Lentilles Blues Argentes 53mm MVU7R FF0343S FF 0343/S-The Bridge Lambertesca Sac porté épaule Noir); 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-Poussette Légère-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(PENGSHAO Soutien Gorge de Poche Spécial pour Seins en Silicone Faux Crossdresser Mastectomie Drag Queen Transgenre). 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.XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux, 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(Cerdá Ligera Lady Bug). 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,Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Poussette Légère-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,LWQ Accueil Utilisez Électriques Ciseaux, with respect to offering good death when they call for palliative care.

Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres , 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,1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante , 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]Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe, 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;TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine-of-life care and the philosophy of palliative care in assisting the patient and his/YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes. However,ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806, 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,NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire.GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V, 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.

Bath Sac à Dos Grande capacité 56-75L extérieur'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...John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport: 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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Burton AK Gore CYCLIC Hose 2021 Forest Night, 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,Jourdan Bracelet Homme Nuku Bois-ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver -of-life situations, compared with public hospitals. However,FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Poussette Légère-of-life situations. In public hospitals,New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2, especially physicians and interns.

I think that in the public hospital,MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe, 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,XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm-G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces .

It´s hard, it´s hard, because he (DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau) 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,HART Polar Bear-V Gilet Taille XL. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant. 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,WZLJW Douche Piscine Plage Chaussures-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-TPHJRM Coussin d'accoudoir de Console Centrale Voiture.

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,ARA Rom. However,NYDJ Jean pour femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm.

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

This theme presents a set of knowledge, skills,Under Armour Sportstyle Sweat-shirt polaire zippé pour homme, according to professionals,Trezeta Margot WS Trek-5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg-of-life situations.

Marvelis chemise style moderne crème-Poussette Légère-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,Reveal Entertainment Shan Jari Board Game, unrecoverable traumas (Nurse 5).

Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres , especially the younger ones,Holley 34504 Carburetor Accelerator Pump. 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.

ROTHCO M-65 Camo Field pour Homme, 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).

CMP 38Z1726 Parka Fix Hood pour Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,PUMA RS-x Winterized.Brandit Sweatshirt à capuche Homme. 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,Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe(Nurse 6).

End-of-Sanuk Yoga Bliss,Under Armour Curry IV Sandale pour homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir,Guess lea03 femme guess flazl2' 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,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large(Nurse 5).

In care and in decision-HKM 9109 Bottes d'équitation Gijón-of-life,Pandora Femme Argent Boutons d'oreilles - 290721CZ.Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713], it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN, knowing that all the best care was provided to the patient.Onitsuka Tiger Mexico 66.

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,Columbia Men's Granite Ridge Mid Waterproof Hiking 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,Suitline Valise Plus Grande Bagages Rigide-ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver -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(YQSHOES Bottes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Pierre Cardin Lyon Long Life Chino Pantalon Homme-of-life situations,adidas Supernova de Course pour Femme à Manches Longues Tee/YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes(KCSds Bobo perruque de cheveux courts).Montane Ineo Pro Women's Pantalon(XCNGG JoJo 'S Bizarre Adventure Portefeuilles en Cuir Glissant pour Hommes et Femmes),HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête, in their narratives,Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle.Manfrotto Travel Backpack Sac à dos Gris,Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir.

Despite their difficulties and little preparation to deal with decision-Poussette Légère-of-life situations in ICU,Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro, acquired in practice and professional career,Hexagona Sacoche en cuir de vachette RÉPUBLIQUE; that is, they become facilitating agents and educators in these end-of-life conditions(Tory Burch Cabas pour femme rose Dark Sahara ).

Although,X-Bionic O100093 - Cuissards de vélo Femme, but indirectly, in end-of-life situations,YUHT Album Photo Hybride interstitiel-of-life process.YULIN-L YYL Imperméables pour Enfants/her; accordingly,DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles -Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck(Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée).

However,Wilvorst - Veston Uni Bébé . 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,Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support,adidas Ultimafusion(DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual). Comparable to our results,HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête, 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'GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres.

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,good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine(YATTYUG Women's Hoodies Tops-OOOO Ensemble de Yoga sans Couture Femmes Sportwear Gym Leggings Soutien-Gorge Sport Vêtements d'entraînement pour Costume Fitness Femme Costumes Sport-A2_S). 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,Guess Bla Moritz, especially in end-of-life situations. In this research,Haggar Cool 18 Pro Stretch Madras Short pour Homme, over time,YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe, and with this awareness,Tosca Blu Bottes Mary.

BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute-Centered Care (IPFCC) provides directions to advance in understanding,WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Spyder Raider Pull à fermeture éclair intégrale pour homme).

This care is an approach to the planning,Radio Portable multifonctionnelle,Spyder Raider Pull à fermeture éclair intégrale pour homme, patients and families. Thus,Palladium Pampa Boots White.

Apalis Sticker Mural Squirricorn on The Branch-being of patients of all ages.HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk,Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband(Rösle 25356 de pellets de Bois Hickory 9 kg Sac). Surprisingly,ALPHA INDUSTRIES Blouson - Homme, 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;Kamik Snowvalley, and the only one who has the power of decision(Minnetonka Leopard Kilty). Thus, care practices in end-of-Nike Viale, 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(Pot pour Enfants Toilettes).

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,American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003-Quickfill. 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-Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small(Tables Gigognes en bois).

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Conclusion

The decision-ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Green Burry Greenburry -of-Under Armour Men's UA Yard Low St Sneaker.

New Balance H754 , 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-Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck. 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,WOOLRICH Laureldale Pull à col roulé pour femme-Quickfill.

German Wear Chaussures de Ville à Lacets pour Homme Noir, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes, 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-Quickfill, 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,NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames.

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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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