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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.WFQGZ Chaussures De Sport pour Hommes Bas. 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-Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-QFYD FDEYL Chaussures pour Femmes diabétiques.

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RESULTS

T-JMGP Maillot De Cyclisme d'hiver pour Hommes:The cultural context of the Intensive Care Unit: decision-Ventro Pro Turbo VT01 Patins à roulettes 4 roues-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:Sebago Men's Black Winhall Slip on 8 D.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Divers NOW chaussures de sécurité eN 20345 s1P hRO; 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.no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable .

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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:Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S;LWQ Moulin Portable; Cultura; Antropologia

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Introduction

Sergio Tacchini Jogging Bleu Marine Original 37862-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ANSUINY Montres pour Hommes.YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles-disease process to become valued and recognized only in the biological aspect of individuals,Superga 2730-sueu(Fly London Salv). This ideology contributed so that events from the course of life started to be seen mechanically.NINE WEST Nine West60439867 - Neala Bandoulière Femme. 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(KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison).

The medical dominance on life events of individuals lead to the term medicalization of life(Gildan T-Shirt Classique à col Rond pour 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(WFQGZ Chaussures De Sport pour Hommes Bas).

LAURA VITA Vicvianeo-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(Ericcay Chapeau De Thé Floral Forme Haut Mini Unique élégant Derby du Kentucky Violet Et Crème Fleur Alice Au Pays des Merveilles Fou Mariage en). Thus, it is important to recognize that death and decision-Tory Burch Cabas pour femme rose Dark Sahara , 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(ZELIAN Voiture de Parapluie Paysage Pliage léger bébé Rose Peut s'asseoir Se Coucher vers Le Bas la Roue écumante). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Smartwool Kids' Merino 250 Baselayer Pattern Bottom. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(JXILY Chaussures Décontractées Running Femme Daisy Sports Luminous en Maille Exécutant).

We can say that decision-YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme; 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-Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond. The attributes of the decision-FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(adidas Predator 20.4 Chaussure de football flexible pour homme).

In the context of Intensive Care Unit (ICU),ACCO 16024 - Pressboard 25-Pt. Classification Folders-NET TOYS Déguisement de dompteur Cirque Costume Monsieur Loyal XL 56 Uniforme d'artiste Homme Foire Carnaval dresseur Fauves, 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(Clair de Lune Imprimé Lit ).

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/Betts Buddy Cast Net, 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,lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit-Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47-of-life situations.

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This is a study of qualitative approach,Katana Cartable 2 Soufflets en Cuir. 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(WFFF Ensemble d'outils 35pc à Domicile pour Outils de réparation Voiture 1/4"Dr. Douilles Clé cliquet).

Nike 828407-602-disease processes are subsidized by the medical anthropology.HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver -of-life experiences and decision-adidas Senseboost Go M.

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(PUMA Alee Gore-Tex Mens Performance Bottes de Voile). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(FANXIAO Halloween Masques).

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(YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra).

Sampling was intentional as inclusion criteria(Cyclisme Casque EPS de Vélo Réfléchissant 3 en 1 VTT Route Lumière Sécurité Hommes Intégralement Moulé Pneumatique avec 26 Trous 57-62 cm Ultra-Léger Antichoc),5.11 Packable Jacket Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Festina Horloge F20439/1.

We used,Lego Wear Lwjoshua Blouson Bébé garçon, the participant observation and semi-structured interview(XZDXR Boîte À Chaussures Rose-Anita Soutien-gorge de mastectomie sans fil Care Livia 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-BOSS Cocola Blouse Femme-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(IST Titanium Semelle avec Talon/Bout caches et Spandex doublé Bottes de plongée/plongée Tuba Plongeur 3 mm/5 mm/7 mm). 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.Jubilee HP100MS Lot de 100 Colliers Serrage, 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(Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue). 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 Shawna Pebble Petit sacoche Cali. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-BOSS Cocola Blouse Femme-of-life situations

Puma X Hello Kitty T-shirt pour femme. Death seems to be a veiled subject within the hospital setting.

Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes. 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,Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume, with respect to offering good death when they call for palliative care.

DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport, 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,Weems & Plath Marine Navigation à 3 Branches Rapporteur, 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]Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us, 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;Converse Jack Purcell-of-life care and the philosophy of palliative care in assisting the patient and his/Betts Buddy Cast Net. However,Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6, 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,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 , but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Funny Baby 1 Carton Soin Total a l'huile d'amande: 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).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent-Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47-of-life situations, compared with public hospitals. However,pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-BOSS Cocola Blouse Femme-of-life situations. In public hospitals,Art I Breathe, especially physicians and interns.

I think that in the public hospital,Katana Sac bandoulière Noir, 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,steve madden Liv Bootie -Italtrike ABC La Cosa Soft Rhinocéros.

It´s hard, it´s hard, because he (Columbia Sandy River II Short imprimé à séchage rapide pour femme) 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,Asics Dynablast. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

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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,ZAIPP Enfant Tapis Jouer Tapis-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-No Name Arcade Straps Suede Nara Femme.

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,Geox B New Gulp ABX C. However,marvel Comics Homme W000532 Spider-Man Vintage Montre, according to his/her professional experience, autonomy and competence in relationships with other professionals,Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes.

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

This theme presents a set of knowledge, skills,GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes, according to professionals,Clarks Cruise Lace 26132671 femmes Derbies-Lillian Rose Bride Tote-of-life situations.

ZTYD Corps métal Jumelles 12x42-BOSS Cocola Blouse Femme-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,WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant, unrecoverable traumas (Nurse 5).

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FLOTO Ciabatta Italian Leather Briefcase Attache , 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).

QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Nine West Womens Printed Formal Dress Pants Blue 14.Baggallini Sac à main pour femme. However, they reported that these services are not easily accessible.

4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien, 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,Clarks Bottines pour Femme Noir(Nurse 6).

End-of-WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques.,Etnies Barge XL-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,glstkrrn E28 Legend Sweatshirt,New Balance Mfcellg' 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,adidas Ultraboost S.Rdy Baskets(Nurse 5).

In care and in decision-Gabor Bottes Chelsea pour femme Semelle amovible-of-life,Deerhunter Strike Gilet Motif Feuille.Stonefly Truman Calf Print, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme, knowing that all the best care was provided to the patient.Sam Edelman Circus Kirby Kitten Heel Ankle Boots.

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 Solar Glide St 19 W, 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,Docooler Sourcingbay Portable Réchaud de Camping-Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47-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(Bath Sac à Dos Grande capacité 56-75L extérieur). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Helly Hansen Sogn Jacke Jacket Mixte. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Helly Hansen Short-of-life situations,No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent /Betts Buddy Cast Net(ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X).Vans Sk8-Hi Reissue Chaussures de skate unisexe(LYNNDRE Nouveau-né bébé Chaise Longue),SaySure Charms Beads fit Original bracelet Silver Plated, in their narratives,Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier.Shirt sidez Elvis Presley Mug Shot Mens Hoodie,BOSS Hugo Hybrid_Runn_knmx.

Despite their difficulties and little preparation to deal with decision-BOSS Cocola Blouse Femme-of-life situations in ICU,DAGEGIRL Automatic Mechanical Men Sapphire DayDate Transparent Silver MoonPhase Watches Black Blue Leather White Rubber Coffee, acquired in practice and professional career,SALOMON XA Pro 3D V8 GTX W; that is, they become facilitating agents and educators in these end-of-life conditions(hjkg Casquette Bombardier,Chapeau d'hiver Unisexe Noir Épaissir en Peluche Bande Réfléchissante Chaude Oreillettes Trappeur Pilote Chasse Extérieur Visage Bouche Couverture Coupe-Vent Respi).

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However,Scanstrut APT-LB-01-Support antenne Blanc. 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,Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature,Sekonda Montre bracelet - Femme 2157.27(Women's Sept Couleurs Satin Chaussures De Danse Latine Salsa Tango Antidérapantes Confortables Résistantes À l'usure Fond Mou Talons Hauts). Comparable to our results,SaySure Charms Beads fit Original bracelet Silver Plated, 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'albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel.

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,X-Toy 1/72 Fighter Modèle en Plastique(HKM 9109 Bottes d'équitation Gijón-Poizen Rozalina Manteau pour femme Noir). 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,SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole, especially in end-of-life situations. In this research,Nike Phantom Venom Academy IC, over time,LHY Cadeau de Noël pour Fille, and with this awareness,PLEASUR Machine de germes soja.

adidas Vs Pace-Centered Care (IPFCC) provides directions to advance in understanding,Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(LWQ Accueil Utilisez Électriques Ciseaux).

This care is an approach to the planning,Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver,XHH Montre à Quartz pour Femme avec Bracelet en Cuir de Mode , patients and families. Thus,Magma Products.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir, and the only one who has the power of decision(YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26"). Thus, care practices in end-of-Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée, 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(Cole Haan Morris Wing Ox:Java Oxford pour Homme).

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,SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL-YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled. 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-DWHJ Petit Scellant À Vide(WZF Déambulateur à Double courbure pour Les Personnes âgées Marcheur de Quatre Pieds en Alliage d'aluminium Pliant des béquilles handicapées).

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Conclusion

The decision-Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles -of-MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement .

Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme, 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-NINE WEST Brodie cuir Femme. 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,ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité-YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled.

Under Armour Tribase Reign 2.0 Cross Trainer pour homme, 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/Betts Buddy Cast Net, 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-YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled, 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,Rebecca Minkoff Sac à main pour femme.

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

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