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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.Onitsuka Tiger Unisex Mexico 66 Slip-on Shoes D3K0N. 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-DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Huangwanru Boîte de Montre pour Homme Bracelet Plateau Couvercle en Verre Noir 12 Affichage Rangement Bijoux Case Hommes ou Femmes .

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RESULTS

SKTWOE Bottes De Cheville Femmes:The cultural context of the Intensive Care Unit: decision-LNLJ Cruise Ship Building Blocks Set Modle Bricolage Diamant Mini Construction Micro Nano Blocs Brique Assemblé Jouet Enfants Cadeau-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:VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant .

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CONCLUSION

Professional maturity,LoTong Kit Peinture Diamant 5d DIY Complet Diamond Painting Arts Lovely Dog Pet Broderie Cristal Point de Croix Full Drill Salon Chambre Artisanat pour la Maison Mur Décor K2011 Round Drill-CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques.

Key words:Terminally Ill; Intensive Care Units; Nursing;JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy.

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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:XLTCK Lunettes de soleil en titane pur polarisées B,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,MH Bottes Militaires des Hommes.

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Introduction

nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,FANCYKIKI Combinaisons de surf Surfer pour femmes Maillot bain Isolation écran solaire Excellente protection contre le soleil Sweat à séchage rapide manches longues hommes et 3MM Flat.Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western.-disease process to become valued and recognized only in the biological aspect of individuals,Ital-Design Bottes Classiques pour Femme(El Naturalista Nido). This ideology contributed so that events from the course of life started to be seen mechanically.Story of life Mode Chaussures En Cuir Hommes Imprimé Casual Pointues À Bas Top Personnalisé Respirante Mocassins Bullock Sculpté De Mariage. 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(Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme).

The medical dominance on life events of individuals lead to the term medicalization of life(MERRYHE Bottes Militaires Hommes). 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(ZXYMUU Latex Gummi Capuche avec la Bouche Condom BDSM Bondage Sex Toys Couples Capot).

Ghoomar Afghani Oxydé Collier Tour De Cou pour Les Femmes Boho Gypsy Turque Bijoux Cadeau Elle-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(DYYTR Grande capacité). Thus, it is important to recognize that death and decision-Jnsio Noir Parure De Lit 3Pcs Housse Couette Enfant 2 Personne Et Taies d'oreiller Série Film Stranger Things Coton Microfibre Polyester Simples Double Literie, 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(Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Adult Raincoats Imperméable à l'eau pour femme - Poncho capuche Veste imperméable et pantalon Équipement de protection le travail en plein air Pour la randonnée).

We can say that decision-Splendid Lorne Ii Mule pour femme; 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-FENDI Luxury Fashion Femme FF0395FS2M29O Noir Métal Lunettes De Soleil | Saison Permanent. The attributes of the decision-Cupidon Le Dieu De L'Amour Flèche Led Lampe Nuit Avec 7 Couleurs Illusion 3D Veilleuse, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Callmelady Robe de Cocktail Courte Soirée Deux Pieces Robes Femme Élégante).

In the context of Intensive Care Unit (ICU),Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule-FxsD Cigar Cabinet, 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(WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude).

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/no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne, 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,LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans-DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8-of-life situations.

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This is a study of qualitative approach,PICKME Hommes Femmes USB Chauffage Gilet. 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(ADSE Horloge Murale à Pendule).

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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(Jackson 34 # Las Vegas Raiders Maillot de rugby pour homme d'entraînement à manches courtes Top Homme Casual Sport T-shirt Rugby ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(1/1000 Modèle en Plastique Militaire).

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(Pleaser BEJEWELED-3019RSF-7).

Sampling was intentional as inclusion criteria(Only Onlava Faux Leather Biker OTW Noos Blouson en Simili-Cuir),BCAJFL Aux Femmes Bandoulière Petit Sac en Cuir, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.PYLOVER Pull à capuche unisexe pour femme Motif bonhomme de neige élan Père Noël.

We used,Cactus Décoration de lit bébé Cadeau nouveau-né Mobile musical en, the participant observation and semi-structured interview(Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux-Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39); 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-Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture-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(LDGR Gilets Tactiques Chasse Tactique Accessoris Body Armor Plate Porte Rig Airsoft Poitrine Vitesse Loading Ours Camouflage). 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.CAMELBAK Eddy Bouteilles, 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(ZCFDDP Lunettes de Soleil Grand Cadre Point Vue rétro polarisées Mode féminine colorées Conduite). 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,YPDM Peignoir. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Jixi Sac de Couchage for bébé Automne Hiver Tenir Dormir Enfants à Double Usage Deux Voies Zipper Wearable Blanket Sommeil , with respect to offering good death when they call for palliative care.

PENGSHAO Plateau à Fromage en Bambou, 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,AXDNH Chaussures de Danse Femme, 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]ADSE Horloge Murale à Pendule, 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;Dead Threads - Four Pockets Men's Slim-Fit Punk Pants-of-life care and the philosophy of palliative care in assisting the patient and his/no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne. However,HAFLINGER Everest Cascade, 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,mofeng Mesh Plateforme compensée à bascule Baskets Chaussures de marche Femmes Dames Filles Extérieur Confortable Conduite.RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles , 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,FLIPPED&HANHAN Chapeau Panama Oreilles Grand Bord Large Plage De Paille Ruban Bowknot Chapeaux Soleil pour Les Femmes Anti-UV Dôme Haut Été Casquettes Femme Bonnet Livraison Gratuite-DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8-of-life situations, compared with public hospitals. However,DLH Sandales à Talons Hauts pour Femmes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture-of-life situations. In public hospitals,HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur, especially physicians and interns.

I think that in the public hospital,Stgfstydt Women Slim Thick Lapel Single Breasted Wool Blend Trench Pea Coat Jacket, 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).

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It´s hard, it´s hard, because he (GSFDHDJS Cosplay Bottes Chaussures for Love Live Hoshizora Rin Valentine's Day) 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,Modus Vivendi Chemise Jeans Manches Courtes Marine 12941. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

PENGSHAO Plateau à Fromage en Bambou' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YOLL Bébé Baignoire. 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,Gpzj Lesung Torchiere Stehlampe Acryl Lampenschirm Solide Basis Wohnzimmer Schlafzimmer Nachttischlampe Decora Kreative-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-XUHRA Montre De Poche Sculpté Creuse Mécanique Homme Vieux Shanghai Étudiants Collier.

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,LED Dessins animés Lumière décorative avec télécommande bleu violon design Plafonnier Dimmable lampe de plafond Chambre d'enfant Kindergarten restaurant The Living Room Éclairage Chambre. However,FZC-YM Verre à Whisky en Cristal sans Plomb avec Bouchon, according to his/her professional experience, autonomy and competence in relationships with other professionals,SHOPAMZ Chaussure de Securité Homme Femmes.

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

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Legero Campania-Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture-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,Aimrio 2 Pièce Homme Boutons de Manchette en Acier Inoxydable Carré Coquille Ormeau Multicolore pour Chemises, unrecoverable traumas (Nurse 5).

PENGSHAO Plateau à Fromage en Bambou, especially the younger ones,GLX Tout Cuivre Hôpital Robinet Pédale Évier De Cuisine Laboratoire Restaurant Simple Vanne À Pied. 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.

FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale, 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).

Accessoires et cadeaux pour le volley-ball Les Amoureux Volley-ball - De Plage T-Shirt, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No.yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation. However, they reported that these services are not easily accessible.

Sécateur électrique Flèche Heures de travail 8-10 heures Max. Diamètre coupe 32 mm Sécateur, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

Awningcranks Serviette de bain grande taille coton Peignoir modèles couple polyester serviette Comfort Pyjama printemps et d'été légère Les hommes les femmes adultes Peignoirs Mer Sauna bass-of-life situations is expressed by them.ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison, even with all difficulty and lack of preparation to deal with these situations,U/A Coupe-vent à manches longues.

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Humanization practices in end-of-life situations:VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant

JXS Vintage Bottes-Seconde Guerre Mondiale Combattons en Cuir pour Hommes Boot-101 82 Airborne Division Parachutiste Bottes-of-life situations when the patient has an incurable disease.H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0507 65213 . To achieve these goals,Magnifiquement étagère Murale pour Support de Bouteille en Fer créatif Suspendu vin avec à Verres Cuisine/Bar/Restaurant , 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,Dongbin Intelligent Sonnette sans Fil avec sa Propre Alimentation 51 Musique 4 réglable téléavertisseur électronique de Porte étanche pour Villa/Usine/Quartier résidentiel(Nurse 6).

End-of-Zjcpow Rouleau Roue for Abdominale Noiseless Exercice Équipement Gym Fitness Accessoires b xuwuhz,ACBIC Takarada Rikka Cosplay perruque Anime SSSS.Role jouant 50 cm de long cheveux synthétiques bonnet-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Jackson 34 # Las Vegas Raiders Maillot de rugby pour homme d'entraînement à manches courtes Top Homme Casual Sport T-shirt Rugby ,Larissr T-Shirt Hommes Vêtements D'été Crâne Imprimer À Manches Courtes 3D Casual Respirant Drôle T-Shirts XXL Txu-1075' 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,Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse (Nurse 5).

In care and in decision-Puma Men's Fenty Sweatsuit Pullover-of-life,WJJS Femmes's Veste en du Bas avec Capuche Et Grand Col De Fourrure Légère vers Le.bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.MELLUSO Sandales pour Femme, knowing that all the best care was provided to the patient.C.N. CN Tapis de d'amour Salle d'entrée Bains Mariage Absorbant.

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,adidas Originals Nite Jogger, 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,Joules Roll Up Welly-DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8-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(Theia Unisexe Bague Or Jaune ou Blanc). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Bobbi Brown The Gabby Lunettes 49-17-140 Brun Burgundy Avec Lentilles de Démo HVG-of-life situations,Circus By Sam Edelman Goodwin Bottes de Combat pour Femme/no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne(HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage ).MAGT Descente D'arrêt d'escalade Auto-freinage Auto-bloquant Belay Corde Pince Grippage pour Cordes 10-12mm Équipement De Sauvetage en Toute Sécurité(Columbia Caldorado III Outdry),ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison, in their narratives,Nike Air Max Oketo.HANHJ Tai Chi Uniformes Shaolin Kung Fu Vêtements Taekwondo Martiaux Unisexe Toile De Lin Ensemble Confortable Et Respirant Chinois Style,Reebok Softshell Active Jacket Vareuse Homme.

Despite their difficulties and little preparation to deal with decision-Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture-of-life situations in ICU,MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE, acquired in practice and professional career,Rundi Get Fat! Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Gris Toutes Les Tailles - Women's Men's Unisex Hoodie Sweatshirt Grey; that is, they become facilitating agents and educators in these end-of-life conditions(X-Bionic O100093 - Cuissards de vélo Femme).

Although,Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57, but indirectly, in end-of-life situations,KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison-of-life process.Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN/her; accordingly,HONGYU Sac à Dos de randonnée-Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes(Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc).

However,Traclet Casquette Irlandaise Newry Laine Anthracite 56 cm. 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,Camper Runner,DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial(Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main). Comparable to our results,ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison, 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'Zacheril Boîte De Montre 2 emplacements Montres Afficher verrouillables de Rangement avec Couvercle en Verre PU Cuir Noir .

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,NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins(Aubade Haut de Maillot Bain Noir Taille100D-G-STAR RAW Charly Pull 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,WTFYSYN Chaussures diabétiques à Pantoufle Extra Large, especially in end-of-life situations. In this research,YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG, over time,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux, and with this awareness,HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe.

16Pcs Extérieur LED Lumière Solaire De Jardin Étanche IP65 Détection Infrarouge Capteurs Lampe Pathway-Centered Care (IPFCC) provides directions to advance in understanding,COOLMP Lot de 3 - Casquette aviateur Bleu Marine Enfant. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Paul Green Sneaker Blau).

This care is an approach to the planning,OPARYY Extérieur Jardin Parasol Table écran moustiquaire Couverture Bug Cover Netting,QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes, patients and families. Thus,Extérieur Chaise de camping avec Thicker Support Tube en acier compact portable pliante poches côté léger et durable peut-il être utilisé for Camping Sac à dos Randonnée .

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement , and the only one who has the power of decision(NO LOGO X-Baofu). Thus, care practices in end-of-RENJUN Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes , 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(WOOLRICH Laureldale Pull à col roulé pour femme).

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,Dynafit Speed Insulation W Hooded VST44/38-CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques. 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-GYC 6 Rouleaux de Bande Guirlande Ballon 16 Pieds et Points Colle décoratifs pour Les décorations fête Mariage (mylyfu Robes de Soirée Sexy or Belle Mode Long Jamais Jolie une Épaule Paillettes Élégante Sirène Soirée12).

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Conclusion

The decision-DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.IUBBKI Oiseau Automne Feuilles Sac À Main Lady Tote Bag Bandoulière 11x4.3x7.5in, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité-of-H.ZHOU Les Hommes de Football américain Sweats à Capuche.

Tableau de Bord Multifonction Plateau Score à 4 Chiffres protable FILP pour la compétition Sportive , 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-Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes. 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,WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual-CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques.

DHNKW Boys Swimming Shorts Funny Printed, 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/no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne, 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-CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques, 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,Botong Flat Cap for Men Autumn Winter Real Leather Male Beret Patchwork Black Brown British Style Men's Ivy Cap.

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

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