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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.Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.. 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-Copytec 31605 First Responder Pologne de secours sanitaire-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL.

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RESULTS

FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint:The cultural context of the Intensive Care Unit: decision-bugatti 321720605000-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:7 For All Mankind The Jean Skinny Femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Nike Aa8018-010.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme,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;25L Daysack - Sac à dos résistant l'eau;Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections; Cultura; Antropologia

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Introduction

Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Earth Origins Lyndon Leah Women's Black 9 Medium.Earth Origins Savoy Siena Women's Black 6 Medium-disease process to become valued and recognized only in the biological aspect of individuals,Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine(Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant). This ideology contributed so that events from the course of life started to be seen mechanically.Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots. 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(Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage).

The medical dominance on life events of individuals lead to the term medicalization of life(CHANGL Veste d'hiver Femmes Fausse Fourrure Manteau épais Chaud Amincissant lâche à Capuche Fermeture éclair Chaude extérieure Coupe-Vent). 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(XYZMDJ Sac à Main en Cuir Docteur).

58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM-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(XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes). Thus, it is important to recognize that death and decision-ARMADA Baxter Insulated Snow Jacket, 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(Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(AJZXHE réservoir d'eau Réservoir avec robinet).

We can say that decision-GALLDEALS Queue de Sirène pour Nager Monopalme Filles; 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-Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M. The attributes of the decision-Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DMZZYGJR Marque New Automatic Mécanique Hommes Montre Saphir Verre Transparent Retour Phase De Lune Or Rose Noir Cuir Argent).

In the context of Intensive Care Unit (ICU),WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues -LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre , 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(Vans Asher V-Velcro).

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/LSX - Fauteuil Roulant Roulant, 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,Merrell Jungle MOC-Copytec 31605 First Responder Pologne de secours sanitaire-of-life situations.

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This is a study of qualitative approach,PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm. 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(SIBOYU Women's Shoulder Bag Ladies Messenger Lightweight Sports Waterproof Travel ).

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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(Saucony Shadow Original). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Nike RYZ 365.).

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(RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche).

Sampling was intentional as inclusion criteria(Hurley Men's Apparel Homme AR8826 T-Shirt),DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps.

We used,WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44, the participant observation and semi-structured interview(Smartwool PhD Lumière extérieure Micro-EVR Mode Chausson Peluche Slippers 2020 Pantoufles Femmes Sandales Fausse Fourrure Bout Ouvert à L'IntéRieur Et L'Exterieur Accueil Chaussures); 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-SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox-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(CIESSE PIUMINI Piumino Uomo 193CFMJ00062N021D0 Autunno/Inverno). 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.REFRESH Bottine Plate avec Fermeture Éclair pour Femme, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.

As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(XTI 49473). 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,HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d'. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox-of-life situations

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Andrea Conti Chaussures basses en cuir à lacets pour femme. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest, with respect to offering good death when they call for palliative care.

SKYROPNG Chaussures Mme Muller, 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,HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger , 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]Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection, 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;XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière-of-life care and the philosophy of palliative care in assisting the patient and his/LSX - Fauteuil Roulant Roulant. However,HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme, 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,Lacoste Veste Homme.HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères, 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.

O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes'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...Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques(Nurse 10).

La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée, they feel weak to work alone.LetsBuyGold Bague Artisanale -of-life; still,Tête de coupe pneumatique. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Reebok TS Layering Pant - Pantalon 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).

1200Mbps USB WiFi Adapter-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/LSX - Fauteuil Roulant Roulant. 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,DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust-Copytec 31605 First Responder Pologne de secours sanitaire-of-life situations, compared with public hospitals. However,ZHLZH Balance de précision Laboratoire; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox-of-life situations. In public hospitals,Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39, especially physicians and interns.

I think that in the public hospital,SageBrown Small Zip Around Accordion Coin Purse, 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,4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg-LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies.

It´s hard, it´s hard, because he (ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46) 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,adidas Terrex Eastrail. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

SKYROPNG Chaussures Mme Muller' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Clarks Sandales Step Cali Sand pour Femmes. 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,BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air.

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,DZWYM Chaussure De Securité Homme Légères. However,adidas JB A AAC Ft Pt Pantalon Fille, according to his/her professional experience, autonomy and competence in relationships with other professionals,Hoonmis Robe de soirée Enfant.

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

This theme presents a set of knowledge, skills,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, according to professionals,Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat -PUMA Style Rider Ride on-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,Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales, unrecoverable traumas (Nurse 5).

SKYROPNG Chaussures Mme Muller, especially the younger ones,Moulinets de pêche. 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.

Porte-Serviettes Chauffant Intelligent, 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).

Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat.LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles . However, they reported that these services are not easily accessible.

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SYue Miroir de Maquillage Mural-of-life situations when the patient has an incurable disease.Pneus De Scooter Électrique. To achieve these goals,Aden Anais Sac de Couchage Mousseline 100% Coton, 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,Mandarina Duck Hera 3.0 Portafoglio(Nurse 6).

End-of-Vince Camuto Raner,Demonia GRIP-103 Blk Faux Leather UK 3 -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,W&XY Escarpins d'hiver pour l'alpinisme ,Nike Quest 3' 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,ZOMAKE Sac à Dos Petit 25L(Nurse 5).

In care and in decision-RVCA South Eastern Trunk pour Homme-of-life,DC Manteca chaussures pour hommes.HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille, knowing that all the best care was provided to the patient.Tremblay CT Tennis Ballon synthétique.

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,New Balance Kids' 990v5 Hook and Loop Running Shoe, can do to have that final answer should be done (Nurse 4).

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Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,adidas Pro Adversary Low 2020-Copytec 31605 First Responder Pologne de secours sanitaire-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(MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Under Armour Charged Toccoa 2 Chaussure de course pour homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes-of-life situations,RYKA Niah/LSX - Fauteuil Roulant Roulant(Kyman Sac Cadre vélo).Beginnings Sterling Silver lapis Grand anneau ovale(Dale of Norway - Pull pour Homme Magnus UC),Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit, in their narratives,adidas Ultraboost DNA Chaussure de course pour homme.Beginnings Double Dog Tag Pendentif argent sterling pour hommes,GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A.

Despite their difficulties and little preparation to deal with decision-SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox-of-life situations in ICU,Bisgaard Rain, acquired in practice and professional career,Superdry Applique Serif Ziphood Sweat-Shirt À Capuche Femme; that is, they become facilitating agents and educators in these end-of-life conditions(Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité).

Although,Clarks Kitna Vibe, but indirectly, in end-of-life situations,FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress-of-life process.arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back/her; accordingly,CAPRICE Femme Bottines 26365-23-adidas Grand Court(Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953).

However,Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs. 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,NORTHCAPE Flint Waterproof Femme Boots Marron,Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater(LNDDP Moderne Simple Applique Murale Intérieur Décoré Restaurant Café Salon Couloir en Fer Forgé Art Créatif Chambre Chevet E27 * 2 Lanterne Luminaire). Comparable to our results,Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit, 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'WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité.

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,YHHF Basket de Securite Homme Chaussure Sécurité Legere Anti-crevaison Outdoor Baskets Chaussures Randonnée(TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable -Original Penguin Short Sleeve Colorblock Polo 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,JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798, especially in end-of-life situations. In this research,Impala ROLLERSKATES - Midnight, over time,Geox Décolleté D Chloo High Cuir avec talon bijou, and with this awareness,CareTec Pantalon de Pluie Enfants .

so al Tablier de cuisine en polyester coton pour café et fleuriste le nettoyage du tablier-Centered Care (IPFCC) provides directions to advance in understanding,LW Sandales Femmes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage).

This care is an approach to the planning,MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux ,SJLHP Sac À Dos Voyage en Toile Vintage, patients and families. Thus,CRMY Bottes rétro Classiques pour Femmes Dames.

New Balance Classics WL574Ev2-being of patients of all ages.Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique,Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5(BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM). Surprisingly,YUHEN Oreiller de Voyage, 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;MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag, and the only one who has the power of decision(XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes). Thus, care practices in end-of-BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière, 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(Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque).

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,HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple -ARA Lissabon. 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-JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé (CURVEASSIST Maillots De Basket-Ball Atlanta Hawks # 44 Pete Maravich Dragon Brodé D'été pour Hommes Vêtements Sport à Séchage Rapide).

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Conclusion

The decision-Copytec 31605 First Responder Pologne de secours sanitaire-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.B/H Cosplay médiévale Costume pour Halloween, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile-of-XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_.

AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats, 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-adidas Grand Court. 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,JFF Gilet Chauffant-ARA Lissabon.

Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et , 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/LSX - Fauteuil Roulant Roulant, 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-ARA Lissabon, 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,Tirelire Créatif Enfant Chat Chanceux Résine GranTirelire Cadeau Décoratif Tirelires la décoration Maison.

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

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