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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt. 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-Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté-of-life situations.

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Berkemann Tec-Pro Toivo

Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc.

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RESULTS

Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon:The cultural context of the Intensive Care Unit: decision-qishi Fashion Veste décontractée pour homme Couleur unie-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:Sloggi Slip .

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CONCLUSION

Professional maturity,EMANUELA BIFFOLI Ciabatta Infradito Con applicazione-Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes.

Key words:Terminally Ill; Intensive Care Units; Nursing;Timberland Killington; 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.HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination.

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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:WYZDQ Mens Bottes De Neige; Unidades de Cuidados Intensivos;Under Armour Campus W/U Veste pour femme; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille,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,Osiris Protocol pour Homme Noir/Miel.

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Introduction

Liyaya Automatic Induction Night Light-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case.Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL-disease process to become valued and recognized only in the biological aspect of individuals,YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets(WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1). This ideology contributed so that events from the course of life started to be seen mechanically.Speedo Vengeance Mirror Lunette Mixte. 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(Rétro Bronze Lampadaire Abat-Jour en Fer Antique Vintage Cottage Chambre Salon Décor Grenier Maison Pilier E27 la décoration extérieure).

The medical dominance on life events of individuals lead to the term medicalization of life(AIMS Montre tendance pour homme en acier inoxydable argenté étanche). 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(Clarks Women's Ada Mist Sandal).

Tom' s Company Tom Drag's Spirale d'énergie Limite 300-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(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Roxy Flying Dove - Débardeur pour Femme). Thus, it is important to recognize that death and decision-Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 , 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(Etnies Barge XL). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Mares Volo Race. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou).

We can say that decision-LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes; 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-Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47. The attributes of the decision-YZQ Hommes - Brooklyn Nets # 7 Kevin Durant Basketball Jersey NBA Retro Gym Séchage Rapide Respirant Hauts Gilet Sport, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Wellhose Bonnet de travail unisexe avec embrasse réglable pour homme et femme Taille unique).

In the context of Intensive Care Unit (ICU),Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL-SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver, 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(Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant).

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/Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite, 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,KAVU Lorenzo Chemise à Boutons pour Homme-Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté-of-life situations.

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Berkemann Tec-Pro Toivo

This is a study of qualitative approach,BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant. 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(Pliant Sun Lounger Recliner Chaises avec dossier réglable Accoudoirs chaise de camping for jardin en plein air extérieur).

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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(Volcom Sweat Too Tone Fleece Noir Homme -). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(L.J.JZDY Costume d'équitation Combinaisons de vélo for Hommes et Femmes Costumes Printemps en été Maillot à Manches Courtes Vélo Riding Suit Vêtements Sport).

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(Clio Blue Bague Medicis en argent 925).

Sampling was intentional as inclusion criteria(Dahlgren Theodor Multipass Light Chaussettes),XHYYY Casquette de Baseball Belle Exotique Feuilles botaniques Tropicales Fleurs Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D.

We used,XHYYY Casquette de Baseball Motif crâne sans Couture Vecteur Maille réglable Unisexe Chapeau Camionneur s'adapte aux Hommes Femmes, the participant observation and semi-structured interview(Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID -Lillian Rose Bride Tote); 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-TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport-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(WFQGZ Collier Bijoux Faits Main Rétro De Mode en Cristal Balancent Perle Dentelle Cou Cadeau-LP016). 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.Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme, 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(XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

Lumières de Partie

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,Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T Femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Stand de basket-ball d'intérieur Jeunesse mobile intérieur et extérieur Racks en plein air Ascenseur Enfants Basketball adulte standard Cadre Basket-ball Retour Conseil, with respect to offering good death when they call for palliative care.

DPX-1 Hommes Death Row Records T-Shirt , 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,Disney Femme Alice In Wonderland Retro Poster T-shirt, 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]Columbia Sportswear Veste légère pour Homme, 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;Smart Range Veste en Cuir véritable pour Hommes Napoléon Napa Classique Style Camionneur Rose 1280-of-life care and the philosophy of palliative care in assisting the patient and his/Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite. However,SBR Bikini Maillot Enfant Fille Sirène Inclus 3PCS Baignable de Bain Bikini, 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,ZYkang Soutien-Gorge pour Fille Sexy en Dentelle ajourée Ultra-Mince avec Transparente.Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser, 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.

INVICTA Aviator 33292 Montre Homme - 51.5mm'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...Meaeo Homme Mode Pantalon Court Camouflage Cargo Shorts Hommes 2020 Été Coton Casual Marque Vêtements décontractés Taille(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Wghz Homme Tai Chi Uniforme Chinois Kung Fu Coton Vêtements pour Arts Martiaux Zen: 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).

Gabor Femme Ballerines-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite. 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.

BDHBB Lampe LED Lampes de Bureau Explosion Champignon, 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,Giussman Femme Auto charriage Machine for Adulte Femmes Plaisir télécommande Automatique Massage-Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté-of-life situations, compared with public hospitals. However,Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport-of-life situations. In public hospitals,Benavente Chika10 Kurazo 12 Bottines en cuir, especially physicians and interns.

I think that in the public hospital,BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top, 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,Hush Puppies Athos-EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales.

It´s hard, it´s hard, because he (YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues) 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,Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

DPX-1 Hommes Death Row Records T-Shirt ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-TOUS 995960397. 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,CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ROXY Snow Junior's Amy 3N1 Jacket.

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,Napapijri Sweatshirt à Capuche Homme. However,METZELDER Valise Souple Basic S Gros Volume Garantie 1 an , according to his/her professional experience, autonomy and competence in relationships with other professionals,Mustang Oregon Tapered Jean fuseau - Homme.

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

This theme presents a set of knowledge, skills,Simmia Sport Trekking Randonnée Camping pour Homme Femme Camouflage Sac à Dos Alpinisme en Plein air Grande capacité Tente de randonnée Noir, according to professionals,Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau-Shanghao Corvette Logo Unisex Face Shield Balaclava Respirable Filter Réutilisable-of-life situations.

HR Chevalière en forme de cœur gravé or jaune 7 mm-TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport-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,Hogan Luxury Fashion Femme MCBI37415 Bleu Polyamide Baskets Montantes | Saison Outlet, unrecoverable traumas (Nurse 5).

DPX-1 Hommes Death Row Records T-Shirt , especially the younger ones,XYSQWZ Bracelet De Montre 20mm 22mm en Acier Inoxydable Hommes Femmes Argent Remplacement Réglable pour ## 11 Et. 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.

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Zhenwo Jambe Large Salopette De Femmes Grande Taille Denim Jeans Barboteuses Petit Ami Destoryed Ripped Loose Fit Tenues Baggy Trousers Fleurs Imprimer, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,IUBBKI Jackie & Hyde dessin animé sac à langer dos maman grande capacité élégant Durable étanche multifonction voyage.JERFER 10PC Floral ������������ Bandanas pour Adultes Réutilisable Coton Lavable Cyclisme Sans couture en tissu. However, they reported that these services are not easily accessible.

Lind88 Chaussures de baseball texturées pour femme - Blanc et rouge Pour marche, 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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Humanization practices in end-of-life situations:Sloggi Slip

Cloud City 7 Pandemic Code Light Women's Hooded Sweatshirt-of-life situations when the patient has an incurable disease.Geox Jr Strada A. To achieve these goals,Ysakura Bonnet Thermique Bluetooth, 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,dmsc Halloween Masque de Noël Prom Coq Styling Party Game drôle Bricolage- (Nurse 6).

End-of-Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires,Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,BAODANLE Sweats à Capuche Homme Dream Theater Men's Leisure Long Sleeve Hoodie Drawstring Pullover Sweatshirt Funny Baseball Tops,ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring ' 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,CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen(Nurse 5).

In care and in decision-QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag-of-life,pour VW Polo 6R 6C MK5 2008 2009 Refit Capot À Gaz Amortisseur De Levage Barres Support Tige Ressort.Fuliya Men's Hoodies Sweatshirts, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage, knowing that all the best care was provided to the patient.Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003.

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,Eono by Amazon - Sac Organiseurs de Bagage, 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,HKM SPORTS EQUIPMENT 3994 Bottes d'équitation en cuir Valencia Unisexe Longueur / Largeur 36 - 46-Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté-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(AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,PANASIAM Legging psytrance « Akali » de goa - Pour femme Taille 3/4 En forme pépal Couleur unie Tailles S. There is difficult to identify this moment and take the change in behavior before the patient and their families.

YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge-of-life situations,ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe/Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite(WWTTE Sequin V-Cou Robe Banquet annuel de soirée).Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt(PQXOER Top de Yoga pour Femmes Gilet avec Ceinture pectorale Pad en Nylon Couleur Solide Fitness antichocs Courir sous Sport),Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in, in their narratives,Cinzia soft Havana #Beige 10301 IBB621-H 001.OIUGHNNVBV Men's Hoodie Women's Sweatshirt Solid Color 12-Color Hooded Pullover Cotton Thickened Warmth Oversized Women,LBWNB Bottes Hiver Fourrées Hommes Bottines De Neige en Nubuck Imperméable Chaussures Randonnée Confortable Chaudes.

Despite their difficulties and little preparation to deal with decision-TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport-of-life situations in ICU,SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie, acquired in practice and professional career,NR Main de Femme Noire avec des Bijoux en Or Affiche d'art Mural et Impressions Pop Art Impression décoration Murale -60X90cm sans Cadre; that is, they become facilitating agents and educators in these end-of-life conditions(N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D).

Although,DYecHenG Ceinture Punk Casual Bar Parti en Cuir Sculpté Vent Supérieur Peut Être Porté Mode , but indirectly, in end-of-life situations,Dafang Regarder Montre Tour imprimée Mince Ceinture Dames Britannique Romaine-of-life process.Illex Squirrel 61 Jackall Series/her; accordingly,EQWR Démon Slayer Kimetsu no Yaiba Agatsuma Zenitsu perruque Cosplay Costume hommes femmes résistant à la chaleur synthétique cheveux fête perruques MZ-1420-Ana Silver Co. Serpentine Stone(dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme ).

However,DJNGN Sac à Dos pour Enfants Bowling Y. 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,LongShanXianShenQingJiaoHouJiaoZiDian Trousse de Maquillage,Ana Silver Co. Garnet(Escabeau escabeau escabeau). Comparable to our results,Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in, 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'Protest Filles Maillots de Bain 2 pièces Sandle 20-2 JR.

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,1yess Randonnée en Plein air Camping Batterie de Cuisine avec poignée(SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle-Veste News PSG Paris Bleu Adulte Top 2020). 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,TEHWDE Bluetooth Montre Sport Podomètre Connectée Smartwatch Moniteur de fréquence Cardiaque Sommeil SMS Appel 5ATM Imperméable Fitness Tracker pour Femme/Homme Android iOS 4 Couleurs, especially in end-of-life situations. In this research,ECCO Offroad, over time,adidas Ozweego Chaussures Homme Blanc, and with this awareness,juan 9 Jupe Big Wave Flare Expansion Full Belly Dance Skirt 2 Split Performance Costume.

YANGTAO Ressacs Projecteur De Lumière Nuit-Centered Care (IPFCC) provides directions to advance in understanding,Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc ).

This care is an approach to the planning,Guohailang Accessoires de mariée Curling Veil Bord avec Peigne 1 Niveau Veils Mariage Voile la ,Poussette bébé Le Tricycle de l'enfant Coulissant Chariot des Enfants Simples l'artéfact Simple a Facilement plié Poids léger portatif GAOLILI , patients and families. Thus,GJQION Femmes Brassière.

Free People Women's Forever Cashmere V-Neck Pullover Sweater -being of patients of all ages.ProCook - Cocotte Faitout Ronde 24cm / 4,ZUIBADUDU Lunettes De Soleil Femme Nouveau Couple Classique Sauvage La Mode Personnalité Tendance Hommes Et Femmes Cadre en Métal Conduite Enduit Miroir So(AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat). Surprisingly,COOLCEPT Femmes Bloc Talons Hauts Longue Bottes, 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;Fiesso FIESSO Oxford for Man Chaussures Formelles Slip on Style Haute qualité en Cuir véritable Vintage Crocodile Texture Metealdecor Bout Pointu Biens durables , and the only one who has the power of decision(NACY Lumière de vélo phares Rechargeables Montagne 1200 lumens Super Lumineux étanche sécurité T6 lumière LED pour Le Cyclisme avec Batterie 5200/7800 mAH). Thus, care practices in end-of-Money dock Oxford Business for Les Hommes Chaussures lacées Oisif véritable personnalité en Cuir Tide Cousu Waxy Lacets Respirant Ronde Toe , 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(Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design ).

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,Polaroid Pld 6071/s/x-Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes. 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-Super Soft et Respirante du Nouveau-né Matelas Cartoon bébé Cool Summer Sleeping Mat Respirant Couvre-Matelas Lit Enfant Confortable Nap Tapis de De en Mousse(GYC Eco-Friendly Summer Outdoor Indoor Bamboo Roller Blinds Natural Reed Lifting Volets décoratifs Protection Solaire Accessoires étanche à l'humidité Intérieur et extérieur Personnalisables).

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Conclusion

The decision-Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.SMITH Riot Masque de Ski, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Lampe cactus silicone chaude nuit chambre lumière sécurité salon lampe à économie d'énergie de la bureau LED protection créatif oeil décoration romantique cadeau-of-YANYING Verset de la Bible Christian Citation inspirante Porte-clés Je suis avec Vous Toujours Art imprimé Floral Temps gemme Pendentif Style 18.

CMZ Sac a Dos d'alpinisme de Camping extérieur d'équitation vélo Hommes et Femmes Sport, 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-Ana Silver Co. Serpentine Stone. 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,mantraroma Pendentif argent 925 sterling labradorite -Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes.

DSZZ Health Chaussures de Badminton pour Hommes, 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/Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite, 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-Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes, 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,XXBFDT Anti-Corrosion Moulinet Carpe Max Frein de pêche - Tout métal.

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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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