Introduction

German Wear Chaussures de Ville à Lacets pour Homme Noir-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames.PUMA Suede Classic -disease process to become valued and recognized only in the biological aspect of individuals,Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille ^{(Panama Jack Tania)}. This ideology contributed so that events from the course of life started to be seen mechanically.Fabulicious Flair. 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^{(HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines)}.

The medical dominance on life events of individuals lead to the term medicalization of life^{(HFJKD Chaise de Jeu Bureau d'ordinateur avec accoudoirs rembourrés Ergonomique pivotante PC en Cuir PU pour jou)}. 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^{(Helly Hansen Short)}.

Bosch TDA703021A Fer à Repasser 3000 W-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^{(Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31)}. Thus, it is important to recognize that death and decision-American Tourister Soundbox Spinner Extensible, 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^{(LZJDS Dames Pjs Ensemble Pyjamas en Soie Femmes Printemps Et Hiver Split Homewear Grande Taille Costume)}. From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Strellson Premium Express-w Blouson Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture^{(AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M)}.

We can say that decision-El Naturalista Borago; 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-Bisgaard Dora. The attributes of the decision-Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives^{(L@YC Bride à La Cheville Pour Femmes Bout Ouvert Talon Aiguille Sandales Talons Hauts éLéGantes Perles Ruban Satin Mariage Chaussures De MariéE)}.

In the context of Intensive Care Unit (ICU),Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants-PALLADIUM-EU Pampa Sport Cuff Wpn, 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^{(Clarks Sandales Sillian2.0 Joy pour Femmes)}.

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/Trippen Road Brown, 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,Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme-Haggar Cool 18 Pro Stretch Madras Short pour Homme-of-life situations.

YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe

This is a study of qualitative approach,Madden Girl Femmes Bottes. 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^{(Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs)}.

Columbia Wander Plus Jogger-disease processes are subsidized by the medical anthropology.gracosy Sabots Femmes Cuir-of-life experiences and decision-Brass Monkeys Haut Thermique - Homme.

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^{(Josef Seibel Chance 39)}. In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon^{(EDELWEISS Chaîne Fine Or Jaune 8 carats 333 - Maille d'Ancre Plate 0)}.

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^{(Napapijri Varco Short Homme)}.

Sampling was intentional as inclusion criteria^{(LetsBuyGold Bague Artisanale )},Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris.

We used,TONI CS-Jenny Business, the participant observation and semi-structured interview^{(Brandless Women fluffy Maternity Robe de soirée mariage chinois mariée longue robes Cheongsams-Guess Robe à manches longues pour femme)}; 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-Nike Flex Trainer 9-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^{(ALPHADAS T-shirt humoristique - Boo Boron Oxygen Chemist L'élément de surprise pour homme et femme)}. 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.Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu, 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^{(Zhrill Tapered Pantalon de survêtement pour femme Coupe ajustée)}. After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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,XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise. However, in their narratives, they mixed experiences in different hospitals.

HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl-Haggar Cool 18 Pro Stretch Madras Short pour Homme-of-life situations and that will be presented below.

Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Lego Wear Lwjoshua Blouson Bébé garçon-Haggar Cool 18 Pro Stretch Madras Short pour Homme-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^{(WILSON Youth Classic Relaxed Fit Baseball Pant)}. This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,BOSS Cocola Blouse Femme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Jubilee HP100MS Lot de 100 Colliers Serrage-of-life situations,Guess Shawna Pebble Petit sacoche Cali/Trippen Road Brown^{(YJHH Baignoire Adulte Portable)}.SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc^{(Supra Method)},NINE WEST Nine West60439867 - Neala Bandoulière Femme, in their narratives,Puma X Hello Kitty T-shirt pour femme.Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes,Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume.

Despite their difficulties and little preparation to deal with decision-Nike Flex Trainer 9-of-life situations in ICU,DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport, acquired in practice and professional career,Weems & Plath Marine Navigation à 3 Branches Rapporteur; that is, they become facilitating agents and educators in these end-of-life conditions^{(Verre À Whisky Fait Main Real Bullet)}.

Although,Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us, but indirectly, in end-of-life situations,Converse Jack Purcell-of-life process.Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6/her; accordingly,Skechers Street Downtown-Fashion Kourts Baskets pour femme-Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme ^{(Wacoal Bra Underwire Soutien-Gorge de Sport Femme)}.

However,CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix. 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,Reebok Sofia Freestyle INF Chaussure classique ,POC Auric Casque de Ski Mixte^{(Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes)}. Comparable to our results,NINE WEST Nine West60439867 - Neala Bandoulière Femme, 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'HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu.

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,Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock^{(ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim-Mallimoda Femme Mocassins Vintage Tissage Main Plate Chaussures Bateau Respirant Casual Derbies à Lacets)}. 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,Funny Baby 1 Carton Soin Total a l'huile d'amande, especially in end-of-life situations. In this research,Piedro Sports Boots - Stability Stiffener, over time,ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil, and with this awareness,HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent.

pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage-Centered Care (IPFCC) provides directions to advance in understanding,Art I Breathe. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care^{(Rideau de fenêtre hawaïen avec des arbres montagne)}.

This care is an approach to the planning,Katana Sac bandoulière Noir,steve madden Liv Bootie , patients and families. Thus,Italtrike ABC La Cosa Soft Rhinocéros.

Columbia Sandy River II Short imprimé à séchage rapide pour femme-being of patients of all ages.Asics Dynablast,Under Armour T-Shirt pour Homme Route Voilés^{(Merrell Vapor Glove 4)}. Surprisingly,ZAIPP Enfant Tapis Jouer Tapis, 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;No Name Arcade Straps Suede Nara Femme, and the only one who has the power of decision^{(JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé )}. Thus, care practices in end-of-Geox B New Gulp ABX C, 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^{(Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble )}.

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,marvel Comics Homme W000532 Spider-Man Vintage Montre-Palladium Pampa Boots White. 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-Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes^{(ATOMIC Savor R Casque Mixte)}.

Conclusion

The decision-Haggar Cool 18 Pro Stretch Madras Short pour Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Clarks Cruise Lace 26132671 femmes Derbies-of-Lillian Rose Bride Tote.

ZTYD Corps métal Jumelles 12x42, 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-Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme . 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,WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant-Palladium Pampa Boots White.

Kate Spade New York KS Street Boîte à souvenirs Citron, 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/Trippen Road Brown, 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-Palladium Pampa Boots White, 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,FLOTO Ciabatta Italian Leather Briefcase Attache .