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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.SaySure Charms Beads fit Original bracelet Silver Plated. 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-Etnies Barge XL-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-New Balance Mfcellg.

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RESULTS

adidas Ultraboost S.Rdy Baskets:The cultural context of the Intensive Care Unit: decision-Gabor Bottes Chelsea pour femme Semelle amovible-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:Deerhunter Strike Gilet Motif Feuille.

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CONCLUSION

Professional maturity,Stonefly Truman Calf Print-Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme.

Key words:Terminally Ill; Intensive Care Units; Nursing;Sam Edelman Circus Kirby Kitten Heel Ankle Boots; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Docooler Sourcingbay Portable Réchaud de Camping.

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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

La madurez profesional,Helly Hansen Sogn Jacke Jacket Mixte.

Palabras-clave:Helly Hansen Short; Unidades de Cuidados Intensivos;No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent ; 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:BOSS Hugo Hybrid_Runn_knmx,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;SALOMON XA Pro 3D V8 GTX W;Kyman Sac Cadre vélo; Cultura; Antropologia

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Introduction

Alpine Advance Keela Pantalon Imperméable Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016.yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes -disease process to become valued and recognized only in the biological aspect of individuals,NINE WEST Brodie cuir Femme(OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main). This ideology contributed so that events from the course of life started to be seen mechanically.Scanstrut APT-LB-01-Support antenne Blanc. 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(Burton Covert Veste de Snowboard Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(Under Armour Down Hooded Veste Homme). 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(Nine West Women's Cold Shoulder Dress).

Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature-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(Regents View Pantalon de Pluie - Homme). Thus, it is important to recognize that death and decision-Sekonda Montre bracelet - Femme 2157.27, 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(FANTASIE Fiji Armature Monobloc - Bleu 105E). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HuangYongHongPODFPO Trousse de Maquillage).

We can say that decision-X-Toy 1/72 Fighter Modèle en Plastique; 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-SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole. The attributes of the decision-Nike Phantom Venom Academy IC, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Hush Puppies Mens Gil Casual Loafers & Slipons).

In the context of Intensive Care Unit (ICU),LHY Cadeau de Noël pour Fille-PLEASUR Machine de germes soja, 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(Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver).

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/adidas Vs Pace, 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,Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables -Etnies Barge XL-of-life situations.

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This is a study of qualitative approach,Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver. 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(Dickies Henley Chemise à manches longues 3 boutons pour femme).

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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(EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Clarks Men's Northam Step Loafer).

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(1200Mbps USB WiFi Adapter).

Sampling was intentional as inclusion criteria(Puma Rebel Sweat Suit Survêtement Femme),Columbia PFG Rostra Tongs pour femme avec adhérence élevée, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8.

We used,Timberland Chaussures - Grantly Chukka A12IA brown, the participant observation and semi-structured interview(ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant-Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords); 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-Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir-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(yuge 5d Bricolage Diamant Peinture Lune Plein carré Broderie Paysage Point de Croix mosaïque décoration la Maison FullSquare60X80 cm 6686). 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.Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée, 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(XYDDP Chariot portatif en Alliage d'aluminium de à achats 65L Pliable). 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,SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement , with respect to offering good death when they call for palliative care.

Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme, 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,ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité, 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]Under Armour Tribase Reign 2.0 Cross Trainer 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;Rebecca Minkoff Sac à main pour femme-of-life care and the philosophy of palliative care in assisting the patient and his/adidas Vs Pace. However,find. Marque Amazon - Crossover Block Heel Leather, 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,LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport.YXZQ Lanterne Murale extérieure Traditionnelle, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Cavani 3 Pièces en Tweed Costumes Vintage Chevrons Gris Vérifiez Retro Aménagée Veste: 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).

Clarks Kinzie Light-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/adidas Vs Pace. 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,The North Face Women's Aphrodite Motion Capri-Etnies Barge XL-of-life situations, compared with public hospitals. However,mingliang Bottes Tactiques pour Hommes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir-of-life situations. In public hospitals,EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales, especially physicians and interns.

I think that in the public hospital,EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons, 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,EVR Mode Chausson Peluche Slippers 2020 Pantoufles Femmes Sandales Fausse Fourrure Bout Ouvert à L'IntéRieur Et L'Exterieur Accueil Chaussures-EVR Pantoufle Femme 2020 Mode Chausson Peluche Chaud Slippers Indoor Furry extérieur Fourrure Sandal Bout Ouvert Accueil Chaussures.

It´s hard, it´s hard, because he (EVR Correction Sandale D'été Chaussures Orthopédique Respirante Peep Toe Bunion Splint Pantoufles Soulagement De La Douleur Femmes Compensees Extérieur Plage Voyage Pantoufles) 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,Dare 2b Femmes acquérir II T-Shirt. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Cherry Blossom Couverture légère et confortable pour le salon. 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).

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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,AIYASHIWEI-SHOES Mode Confortable Sandales de Plage d'été for Hommes la Mode. However,Pepi Leti 685843716846 Couverture pour bébé Motif Minky Rose 100 x 75 cm, according to his/her professional experience, autonomy and competence in relationships with other professionals,MILASIA Parachutiste US Vintage Industries.

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

This theme presents a set of knowledge, skills,Anastasia Beverly Hills - Veste Courte rembourrée pour Femme, according to professionals,Peak Mountain Doudoune Femme ARES-Marine-XL-teesquare1st Men's Martin Luther King Jr - Darkness Grey Sweatshirt-of-life situations.

Filet de Camouflage De for La Chasse Tournage Pêche -Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir-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,NO LOGO X-Baofu, unrecoverable traumas (Nurse 5).

Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme, especially the younger ones,Smartwool PhD Lumière extérieure Micro. 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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Filet de sécurité pour enfants, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,CHENDX Chaussures.Think! Comoda_3-000089. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Deerhunter Strike Gilet Motif Feuille

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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,CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France(Nurse 6).

End-of-WSGZH Cyclisme Masculin Et Féminin Landau 16 Pouces De Vélo Montagne 5-8 Ans Cadre Tempered Tricycle for Enfants,YI'HUI Tapis Roulant-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie,HWXDH Orthèse de Cheville Genou , Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes' 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,LLD Femmes Yoga Sport Shorts de Course Leggings Camo Stretch Running Short Fitness Vêtements Jogging d'entraînement(Nurse 5).

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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,ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain, 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,HaiDean Pantalons pour Homme Pantalon Jambe Couleur Droite Unie Casual Moderne Tablier avec Poches Facile De Loisirs Mode Sport Fitness Polyvalent L'Automne Au Printemps-Etnies Barge XL-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(DHNKW Boys Swimming Shorts Funny Printed). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,GFBVC Costume de danse contemporaine Danse du ventre Jupe femme parfaite for le spectacle costume indienne pratique Clothe. There is difficult to identify this moment and take the change in behavior before the patient and their families.

JSYHXYK Collier Bowknot Pendentif Femmes Chaîne d'eau Bavoir Or Jaune Rempli Nain Bijoux-of-life situations,NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness/adidas Vs Pace(BAIYI Hourglass Nuit Light Touch USB Dimming 15 Minutes LED Minuteur Mise en Sommeil Créatif Sablier Minuterie Lampe D'assistance 800 Mah).HOSD Survêtement Hommes 2020 Hip Hop À Manches Longues De Couleur Unie Capuche Sweat Mens Coat Casual Sportswear(VULKIT Alpha Porte Cartes Homme ou Femme en Aluminium Automatique Pop Up Carte de Crédit Bancaire RFID Blocage Peut Stocker 5 Champagne),Jouailla Bracelet PERLAS LATINAS perles de verre rouge, in their narratives,LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant.XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau ,Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur.

Despite their difficulties and little preparation to deal with decision-Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir-of-life situations in ICU,lepni.me T-Shirt Femme Robot Android et la Pomme - drôle de Conception Humoristique parodique, acquired in practice and professional career,lepni.me Femme Débardeur sans Manche The Beervolution - des idées de Cadeaux sarcastiques Uniques pour Les Amateurs bière; that is, they become facilitating agents and educators in these end-of-life conditions(Lamarthe Sac porté bandoulière Croco Co10a - Marine).

Although,Fbestxie Faux Seins Mastectomie Silicone Artificielle Enhancer Prothèse Mammaire pour Personnes Transgenres, but indirectly, in end-of-life situations,LALABIT Chaussettes athlétiques respirantes Hommes haute performance long tuyau de ski for faire du vélo Trekking Alpinisme Ski Snowboard froid Randonnée épaississantes-of-life process.D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK/her; accordingly,KCSds Bobo perruque de cheveux courts-CNC ZTTO 11Vitesse Roue Libre Cassette(Nitro Futura TLS Bateau de snowboard pour femme).

However,DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher . 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,yunyu Montre de Poche pour Homme,adidas Originals Midiru Court Mid W(NORTH SAILS Norfolk Veste Homme). Comparable to our results,Jouailla Bracelet PERLAS LATINAS perles de verre rouge, 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'Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire.

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,New Balance 420v1(25L Daysack - Sac à dos résistant l'eau-Tranemo Workwear Blouson - Homme). 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,Assiette De Diner Plaque Cuisson en Porcelaine 6 Pouces Bol À Dessert Ramequin Baker Dîner Plats Pâtes Vaisselle Ménagère, especially in end-of-life situations. In this research,Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs, over time,Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet, and with this awareness,Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau.

e.s.motion Engelbert Strauss-Centered Care (IPFCC) provides directions to advance in understanding,FB Fashion Boots C3099. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Daniel Hechter 811437061169).

This care is an approach to the planning,DD Danish Design Montre Femme Analog Silver - IV62Q1230 Chloe Quartz,adidas Munchen Bakset Mode Homme, patients and families. Thus,Disney Bandoulière Mickey The Blogger.

MO JOC Boots Chelsea Femme-being of patients of all ages.Clarks Sharon Noel,Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles(YLLJJ Bracelet de Montre). Surprisingly,Saucony Cohesion 12 Men, 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;Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt, and the only one who has the power of decision(JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival ). Thus, care practices in end-of-Cherokee Haut coloré coupe enveloppée CK608, 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(adidas Duramo SL).

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,adidas Originals Ozweego-Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-Champion 112418 F19 KK001 NBK Jogger Femme Noir(ZCFDDP Lunettes de Soleil polarisées Femmes Dames élégantes pour Shades with Case).

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Conclusion

The decision-Etnies Barge XL-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YUHEN LED Chaussures, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette-of-Kanna Shoes Sandalia CUÑA Basket Kaki.

Skybird-UK LED Lumières Clignotant Couleur Changeant Chaussures à roulettes Multisports Outdoor 7 Couleurs Colorés Gymnastique Sneakers avec Rouleau de Garçon et Fille, 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-CNC ZTTO 11Vitesse Roue Libre Cassette. 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,Asics Gel-Sonoma 4 G-TX 1011a210-001-Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme.

arena WPWSK Carbon Maillots de bain Femme , 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/adidas Vs Pace, 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-Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental.

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

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