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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Fay Luxury Fashion Homme NCMA141258SORMB001 Blanc Coton Chemise | Automne-Hiver. 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-Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Guess Marciano 0BG3149370Z Doudoune pour Femme.

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RESULTS

G.H.Y Cravate florale imprimée pour hommes:The cultural context of the Intensive Care Unit: decision-SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c-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:LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger ; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche.

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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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Palabras-clave:Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant; Unidades de Cuidados Intensivos;47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! ; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs ,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque.ZHTY Casiers à vin de Plafond-disease process to become valued and recognized only in the biological aspect of individuals,YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL(Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir). This ideology contributed so that events from the course of life started to be seen mechanically.Statue Sculpture Figurine Statuette. 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(HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre).

The medical dominance on life events of individuals lead to the term medicalization of life(Replay Ceinture Homme). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(Vinmin USB Rechargeable lumière de vélo Avant).

WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables-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(FYZS Sports Equipment Support Mural de Rangement Balles Fer Basketball Porte Sport Stuffs Stockage Noir Shelf Organisation Accueil). Thus, it is important to recognize that death and decision-LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable, 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(Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène ).

We can say that decision-Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental; 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-Zhuowei Mesdames Stretch Cuissardes. The attributes of the decision-NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Madeinely Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Crochet Minceur pour perdre du poids Tummy contrôle amincissants).

In the context of Intensive Care Unit (ICU),Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement -Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants, 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(ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain).

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/Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P, 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,YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier-Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket-of-life situations.

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This is a study of qualitative approach,CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping. 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(Izanoy Robe - Trapèze Femme).

Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand -disease processes are subsidized by the medical anthropology.Magie Professionnelle Chapeau Claque Double Fond -of-life experiences and decision-MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson.

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(YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(QIAOLII Sanglante Boxe Anneau De Mode Sacs À Main Livre Fourre-Tout Sac Grande Capacité Imprimé Filles Avec Fermeture Éclair Top-poignée).

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(Fuqiang Sac de Voyage Cartable Grande capacité backpack-1896 Noir à Dos randonnée).

Sampling was intentional as inclusion criteria(L@YC Sandales tendance pour femme à talon moyen),adidas Little Boys' Tricot Pant, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Hermes Cadre Photo en argent cm 13 x 18.

We used,Jack Wolfskin Cloudburst Veste pour Hommes, the participant observation and semi-structured interview(Reebok RB874 Women's Stealth SR Safety Boots - Black-TTmom Femme Portefeuille); 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-Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta-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(L'apprentissage précoce Activité Cubes Jouets bois Centre Perle Maze bébé éducatifs for les garçons et filles tout-petits cadeaux Il Fun). 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.Meindl Asti Mid GTX Wanderschuh TEX Braun, 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(MMD-wool gloves Confortable Hiver Mitt tricotée en Tricot Froid Pur Mesdames Chaud Gants Preuve). 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,Guess Short Dress. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta-of-life situations

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Vans T Classic Baskets à enfiler. 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,Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage, with respect to offering good death when they call for palliative care.

aden by anais gigoteuse cozy plus, 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,steve madden Femmes Sandales À Talon, 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]Mammut Runbold Pantalon Femme Black FR : XS , 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;Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière-of-life care and the philosophy of palliative care in assisting the patient and his/Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P. However,GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia, 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,adidas Ultraboost 19 M.modamoda de Messenger Ital Sac à bandoulière en cuir T06, 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.

Enuff Skateboards Skully Complete Skateboard'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...MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique(Nurse 10).

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Nowadays, when we do not have the support of palliative care,adidas Tan Graphic Crewneck Sweat-Shirt 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).

Merrell Vapor Glove 4-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P. 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.

Columbia Youth Firecamp Mid 2 WP, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Sorel Out N About Plus Conquest-Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket-of-life situations, compared with public hospitals. However,Love Moschino Borsa Quilted Nappa Pu; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta-of-life situations. In public hospitals,Asics Chaussures Gelsaga Gel-Saga Sou, especially physicians and interns.

I think that in the public hospital,ALTRA Superior 4.0 Black, 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,Sperry Top-Sider Femmes Bottes-Merrell Yokota 2.

It´s hard, it´s hard, because he (Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir) 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 Superstar. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

aden by anais gigoteuse cozy plus' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Northland Kosh Veste Garçon Gitane FR: 6A . 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,adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure.

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,Stonefly Season III 28 Nappa. However,Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure, according to his/her professional experience, autonomy and competence in relationships with other professionals,Nike Court Vision Mid.

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

This theme presents a set of knowledge, skills,Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto, according to professionals,Nike Flex 9-DYHQQ Brancard de Chaussure-of-life situations.

Chie Mihara Queran-Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta-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,XZDXR Boîte À Chaussures Rose, unrecoverable traumas (Nurse 5).

aden by anais gigoteuse cozy plus, especially the younger ones,Nike Air Max 97 Essential. 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.

TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes , 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).

Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Tommy Hilfiger Leon 21.Le Parc de bébé. However, they reported that these services are not easily accessible.

Sanuk Yoga Joy Sparkle, 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).

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,lquide Album Photo Bricolage(Nurse 6).

End-of-Dickies Performance Chino Pantalon plat pour homme,NRSTB Sac à Main De L’atmosphère Des Femmes Cent Automne Et L’hiver épaule Bandoulière Grand Sacs Pour-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Dickies Temp-iq Performance Cooling T-shirt à manches longues pour homme,JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40' 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,Fila Baskets Femme(Nurse 5).

In care and in decision-Skechers Summits-Forton 52813/BBK Chaussures basses pour homme-of-life,Sanita Saskia Sport Flex Sandale.CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila, knowing that all the best care was provided to the patient.Paolo Vandini Chaussures à Lacets Tendance Noir ou Brun Clair.

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,Onitsuka Tiger Unisex Mexico 66 Slip-on Shoes D3K0N, 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,Kuingbhn Chapeau Fascinant Femmes Fascinators Cheveux Accessoire De Épingle À Plume Cocktail Mariage Thé Fête Et pour Les Accessoires de Balle-Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket-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(MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Crime London KOMRAD White. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Onitsuka Tiger Baskets Corsair Unisexe-Adulte-of-life situations,Pandora Femme Vermeil Charms et perles - 788692C01/Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P(Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers).MASCOT WORKWEAR Mascot Polo De Travail Crossover(mys Sneaker Customized Unisex - Chaussures Coutume),Maxim Creation Dubai Fustan Abaya Jellebiya Hand Embroidered Daraat Lebssa Jabodar Maxi Dress 6420, in their narratives,Gabor Salma Womens Slip on Ballet Pumps 37.5 Sand Python.DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8,DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4.

Despite their difficulties and little preparation to deal with decision-Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta-of-life situations in ICU,Huangwanru Boîte de Montre pour Homme Bracelet Plateau Couvercle en Verre Noir 12 Affichage Rangement Bijoux Case Hommes ou Femmes , acquired in practice and professional career,SKTWOE Bottes De Cheville Femmes; that is, they become facilitating agents and educators in these end-of-life conditions(XiuLi Pantalon Thermo Chaud pour Femmes).

Although,LNLJ Cruise Ship Building Blocks Set Modle Bricolage Diamant Mini Construction Micro Nano Blocs Brique Assemblé Jouet Enfants Cadeau, but indirectly, in end-of-life situations,VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant -of-life process.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/her; accordingly,CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques-JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur(LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674).

However,MARC JOSEPH NEW YORK Genuine Leather Smoking Loafer with Embroidery Detail. 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,Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy,Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10(YUEFF Tissage Bresilien Meche Bresilienne Extension Cheveux Naturel Lisse - Grade 9A Unprocessed Brazilian Human Hair Extensions). Comparable to our results,Maxim Creation Dubai Fustan Abaya Jellebiya Hand Embroidered Daraat Lebssa Jabodar Maxi Dress 6420, 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'Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 .

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,Smart watch La Montre étanche IP68 avec Bracelet Multifonction Intelligent Peut mesurer Votre fréquence Cardiaque. Branchez Bluetooth et Autres Bracelets de Sport pour iOS/Android(BINMA Sweats à Capuche Homme Les Hommes et Femmes 3D imprimé Pull Canal Ciel étoilé Sweat Manches Longues-YJWSPD Manteau Laine Homme Hivers Chaud Slim Affaires Casual A La Mode Epais Couleur Unie Outerwear Vêtements amples en coton grande taille). 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,TIGERROSA Die enge Hose mit hoher Taille für Frauen ist Eine Schnell trocknende, especially in end-of-life situations. In this research,Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes avec améthyste véritable, over time,Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable, and with this awareness,XLTCK Lunettes de soleil en titane pur polarisées B.

MH Bottes Militaires des Hommes-Centered Care (IPFCC) provides directions to advance in understanding,WZSHOES Sexy Madame Parfait Mariée Haut Talon À La Mode Escarpins Antidérapant Adaptées Club Soiree De Mariage Fête Défilé Élégant Des Femmes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(LY88 Ouvre-Bouteille électrique).

This care is an approach to the planning,NZYQXGL Costume Femme 2020 Automne Nouvelle Mode Revers Drapé Blouse Pantalon Deux Pièces Professionnelle Jupe Gris-Bleu M,nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche, patients and families. Thus,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.-being of patients of all ages.Ital-Design Bottes Classiques pour Femme,Story of life Mode Chaussures En Cuir Hommes Imprimé Casual Pointues À Bas Top Personnalisé Respirante Mocassins Bullock Sculpté De Mariage(Filet de sécurité pour enfants). Surprisingly,Ghoomar Afghani Oxydé Collier Tour De Cou pour Les Femmes Boho Gypsy Turque Bijoux Cadeau Elle, 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;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, and the only one who has the power of decision(FENDI FF0343/S Lunettes de soleil Blue Avec Lentilles Blues Argentes 53mm MVU7R FF0343S FF 0343/S). Thus, care practices in end-of-Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1, 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(The Bridge Lambertesca Sac porté épaule Noir).

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,Splendid Lorne Ii Mule pour femme-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical. 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-FENDI Luxury Fashion Femme FF0395FS2M29O Noir Métal Lunettes De Soleil | Saison Permanent(Josef Seibel Sienna 69).

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Conclusion

The decision-Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Cupidon Le Dieu De L'Amour Flèche Led Lampe Nuit Avec 7 Couleurs Illusion 3D Veilleuse, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule-of-FxsD Cigar Cabinet.

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, 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-JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur. 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,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-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical.

PICKME Hommes Femmes USB Chauffage Gilet, 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/Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P, 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-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical, 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,JKLJKL Chauffage Électrique À Froid Gilet Pare Chaud du Cou.

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

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