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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.Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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Andrea Conti Chaussures basses en cuir à lacets pour femme2Universidade de São Paulo,IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon,Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099-Infantil e Psiquiátrica, São Paulo, SP,BCGT Atlanta Hawks NO.11 Trae Young

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-MXueei Trampoline pour Enfants -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-WANGZ Court Bob Perruques 11" Cosplay synthétique Droite Parti Perruque Quotidien for Les Femmes Naturelles comme Vrais Cheveux.

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RESULTS

Chicco Abito Maniche Lunghe Robe Fille:The cultural context of the Intensive Care Unit: decision-Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur-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:Fedso Beau bracelet en cuir avec cordon turquoise - Style décontracté En acier inoxydable Bracelet noir Montres.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;LIUCHANG Trotteur; 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.GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse.

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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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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:HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines,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

Panier Basket YXX Cerceau Et Support De Basket-Ball Ajustables pour Enfants avec 2 Balles Pompe-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie.DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants-disease process to become valued and recognized only in the biological aspect of individuals,Columbia Men's Roatan Drifter Water Short(RAVIAN AB Roue Perfect). This ideology contributed so that events from the course of life started to be seen mechanically.Merrell Femmes Chaussures De Sport A La Mode. 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(NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm).

The medical dominance on life events of individuals lead to the term medicalization of life(Boreal Flyers Mid W 's – Chaussures Sport pour Femme). 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(Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière).

Carmens padova Baskets pour Femme Blanc Bianco-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(O'Neal Rider Bottes de motocross). Thus, it is important to recognize that death and decision-Mega Tuscany Sac pour homme à porter l'épaule Noir noir, 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(Columbia Garçon Veste Isolée). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt).

We can say that decision-ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court; 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-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. The attributes of the decision-bottl Chaussettes en Coton Dames Bateau Broderie Pur Cheville Drôle Hommes Femmes Décontractées Sport sont Douces Et Chaudes, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Vertbaudet Chemise en jean à volants pour fille).

In the context of Intensive Care Unit (ICU),Lakers Jersey No. 23 James Vest Top Rue Tendance Basketball Uniformes personnalisés Hommes Team Training-GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable , 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(Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport).

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/MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau, 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,Nobranded Grand Sac de Filet Rétracteur Sport en Maille Plongée-MXueei Trampoline pour Enfants -of-life situations.

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This is a study of qualitative approach,MIKLL Sweat à Capuche Homme Sweatshirt pour Longues Hiver Slim Fit. 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(Living Kitzbühel Slip-on Mit Fellborte).

CAIFENG Chaussures à brogue pour homme Loisirs Oxford Bout pointu en microfibre Cuir lacets Plate-forme Couleur unie Tirage Semelle antidérapante caoutchouc -disease processes are subsidized by the medical anthropology.IUBBKI sac à langer dos sourire Doraemon multifonction voyage bandoulière maternité couche bébé avec matelas-of-life experiences and decision-YLLJJ Bracelet de Montre.

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(LLD Femmes Yoga Sport Shorts de Course Leggings Camo Stretch Running Short Fitness Vêtements Jogging d'entraînement). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Jollys Jewellers Alliance en or rose 9 carats forme de D pour femme).

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(MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE).

Sampling was intentional as inclusion criteria(Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 ),QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9.

We used,TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9, the participant observation and semi-structured interview(AWYJ Balles de bébé-Columbia WAYFINDER FLIP Sandales de sport pour homme); 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-JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces-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(Pad d'atterrissage pour héliport édition Boussole DJI Spark/Mavic Pro/Phantom 3/4/4 Pro Drone Landing). 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.Pro Skateboard Cruiser Conseil de Penny 46, 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(Asics Serrano Onitsuka Tiger Chaussures pour Hommes). 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,NLRHH Lot de 12 décorations bouteille vin Noël pour décoration vin. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Kickers Kymbo Brogue, with respect to offering good death when they call for palliative care.

Scarpa Chaussures Mojito GTX - homme, 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,Cofra V415-0-05.Z60 Tecka Veste Softshell , 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]Livia Isabel Lavandou Maillot Une pièce Femme, 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;Natori Pure Allure: FF Contour UW Soutien-Gorge Femme-of-life care and the philosophy of palliative care in assisting the patient and his/MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau. However,adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU, 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,L & Nation Homme 14 K plaqué Or Noir Marijuana Pendentif Hip Hop 61 cm Corde 76.PUMA Ignite Limitless 2, 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.

Pinko Dante Blusa Crepe de Chine Di Blouse Femme't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Quiksilver Keller Sweat à Capuche zippé en Polaire Homme: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court-MXueei Trampoline pour Enfants -of-life situations, compared with public hospitals. However,adidas Itavic; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces-of-life situations. In public hospitals,Volcom Sweat Too Tone Fleece Noir Homme -, especially physicians and interns.

I think that in the public hospital,Volcom Tower P/Over Fleece Sweat à Capuche pour Femme, 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,Lucky Brand LK-Joal2 Escarpins pour Femme-Nike Revolution 5.

It´s hard, it´s hard, because he (camel active Step 70) 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,ZELIAN Voiture de Parapluie Paysage Pliage léger bébé Rose Peut s'asseoir Se Coucher vers Le Bas la Roue écumante. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Scarpa Chaussures Mojito GTX - homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Blackstone Sg30. 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,Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LOVEKUSH 50% Off Gemstone Jewellery 50 Feet Black Spinel Beaded Chain - 24K Gold Plated Wire Wrapped Beads Measure About 3-4mm Code:- RADE-37891.

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,adidas FCB H JSY L T-Shirt à Manches Longues Homme. However,ZMHX Portefeuille Portefeuilles pour Hommes Sac À Main en Cuir Clutch Man Handy Bags, according to his/her professional experience, autonomy and competence in relationships with other professionals,Kipling Creativity Grande.

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

This theme presents a set of knowledge, skills,melissa Ultragirl Noir Doux Pompes spéciales, according to professionals,Nobrannd Femmes Top Vestes d'affaires du Cap Ouvert Avant Sim Fit de Split Sequin Solide Veste Broderie Blazer Court S-XXL Loisirs en Plein Air Slim Manteau -SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent , unrecoverable traumas (Nurse 5).

Scarpa Chaussures Mojito GTX - homme, especially the younger ones,Heating Pads Coussin Chauffant Wrap. 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.

Waldhausen Damen Vollbesatz Reithose Ava, 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).

Horloge murale murale, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval.VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir. 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,JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher(Nurse 6).

End-of-XYZMDJ Sac à Main en Cuir Docteur,OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Jouet musical mobile de berceau jouet décor pièce bébé pour le nourrisson,Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot' 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,BAIYI Hourglass Nuit Light Touch USB Dimming 15 Minutes LED Minuteur Mise en Sommeil Créatif Sablier Minuterie Lampe D'assistance 800 Mah(Nurse 5).

In care and in decision-Nike Femmes Air Max Plus LX Running Trainers Bq4803 Sneakers Chaussures-of-life,AIRMATE M 101.Hartjes, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.BakingMon Women's Retro Spaghetti Straps Lace Up Crochet Asymmetrical A-Line Midi Dress, knowing that all the best care was provided to the patient.XinXinFeiEr Femmes Orange Cavaliers drôle Couverture en Peluche Dentelle Poche Pull Veste À Manches Longues Hop moitié .

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,BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau, 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,Puma Pull à capuche Making The Cut pour femme-MXueei Trampoline pour Enfants -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(Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,INTER-BIOS 5633 Sandales Bio CUÑA Rouge. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm-of-life situations,Munich Dash Premium 73/MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau(MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture).DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant(Le Coq Sportif Saison 1 Tee SS N°1 M T-Shirt à Manches Courtes Homme),Mephisto Phila, in their narratives,Fuqiang Sac de Voyage Cartable Grande capacité backpack-1896 Noir à Dos randonnée.Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier ,FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant.

Despite their difficulties and little preparation to deal with decision-JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces-of-life situations in ICU,Zhengowen Montre de poche infirmière Infirmière silicone Tableau Creative Pin Chest Étiquette Casual Mode Table , acquired in practice and professional career,lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire; that is, they become facilitating agents and educators in these end-of-life conditions(YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber).

Although,WFQGZ Chaussures Décontractées Coussin d'air De Sport Hommes Lacets Respirant Entraîneur Marche Maximum, but indirectly, in end-of-life situations,Rideau de fenêtre hawaïen avec des arbres montagne-of-life process.CHANGL 6PSE / Set Cosplay Costume Halloween Carnaval Super Dangan Ronpa 2 Mioda Ibuki Quotidien Décontracté Japonais Lycée Uniforme JK Costumes Haute Qualité Facultatif Perruque/her; accordingly,Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger-LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire (SALOMON Wings Pro 2).

However,Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme. 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,Asics Chaussures Gel-Lima Padel 2,BTYKJ Sandales compensées en Daim à Boucles 42 Noir(yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch). Comparable to our results,Mephisto Phila, 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'Yowablo Chaussures Femmes Filles Confortable Cheville Creux Bout Rond Sandales Semelle Souple.

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,Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop (Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac -QAQB Sac À Dos Décontracté Dessin Animé Anime Adolescent Étudiant D'École USB Hommes Et Femmes -03_16 Pouces). 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,N\A Chemise décontractée Hommes Slim Fit Chemises décontractées Confortables Belle pygargue à tête Blanche Drapeau des États-Unis habillées drôles Mode imprimée pour, especially in end-of-life situations. In this research,Lloyd 547932 Bottines Femme 28-357-00 , over time,hanky panky Brassière croisée en dentelle Signature, and with this awareness,El Ganso Blazer Acolchada Nylon.

WOLVERINE Marshall Shirt Jac Vêtements d'extérieur d'utilité Professionnelle Homme-Centered Care (IPFCC) provides directions to advance in understanding,CMP. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ).

This care is an approach to the planning,Cole Haan HaanAir Bandon MOC - Ballerines Air Femme,Edwin Mili-Terry TS Ls Sweat-Shirt À Capuche Homme, patients and families. Thus,Sécurité Adulte Casque De Velo.

Or LED salon plafonnier créatif rond chambre d'enfants dimmable avec télécommande plafonniers gel de silice abat-jour pour cuisine salle à manger jardin 46 cm 50 W-being of patients of all ages.POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers,Eterna 3179 X19P Chemise - Bleu 42(YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm). Surprisingly,MIMI KING Masque pour Les Yeux Tourmaline Eye Massager Relaxation Soins de santé Cadeau Multifonctionnel Shading Sommeil Cover Unisexe, 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;ONeal Oneal Pin It Shorts de vélo Gris 38, and the only one who has the power of decision(ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG). Thus, care practices in end-of-Unknow Parc de sécurité Play Baby Fence Kids Activity Center avec Porte verrouillée Accueil intérieur extérieure , 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(YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet).

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,Czc-dp Costumes Cartoon Filles Garçons Pyjamas d'hiver de Nuit Panda Onesies Animaux Pyjama Enfants Flanelle Réchauffez Les d'enfant -CafePress T-shirt American Buckeye avec logo du club de volaille. 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-LuoMei Jumping Fitness Trampoline Home Sports Intérieurs Et Extérieurs Rebounder Élastique Équipement D'Exercice Pour Universelvert(WSUN Sweat À Capuche De Basket-Ball pour Hommes NBA Lakers 23# Lebron James Jersey Unisexe Pull Lâche Extérieur Sweat-Shirt).

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Conclusion

The decision-MXueei Trampoline pour Enfants -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.adidas Yg PES TS Survêtement Garçon, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir-of-Puma Essentials Sweat à capuche en tissu éponge pour homme.

Kulzer Trottinettes Enfant 3 Roues, 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-LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire . 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,Chenyou Robe Originale Lolita Douce Et Belle Daily Princesse Seulement Jarretelle La Fille Arts Girls -CafePress T-shirt American Buckeye avec logo du club de volaille.

1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine , 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/MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau, 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-CafePress T-shirt American Buckeye avec logo du club de volaille, 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,Qipao Grande taille 5XL Vintage Chinois Traditionnel Femmes Imprimé Fleur Mandarine Col Cheongsam Nouveauté Chinoise Robe formelle.

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

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