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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive. 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-BSWL Gilet Chauffant USB Intelligent-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Déambulateur.

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RESULTS

BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme:The cultural context of the Intensive Care Unit: decision-PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino-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:mys Original alte Personalizzate.

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CONCLUSION

Professional maturity,LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël-MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte.

Key words:Terminally Ill; Intensive Care Units; Nursing;MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps .

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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

La madurez profesional,Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41.

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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:Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe,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;VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande;Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black; Cultura; Antropologia

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Introduction

yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,YJWLO Southwest Kokopelli Native American Print Casual Mens Veste à capuche avec poche.Tommy Hilfiger Honey Flap Satchel-disease process to become valued and recognized only in the biological aspect of individuals,Asics Chaussures Gel-Quantum 180 4(Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire). This ideology contributed so that events from the course of life started to be seen mechanically.Emporio Armani Montre Intelligente ART5019. 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(Ouzoub 24 Pouces Moniteur for bébé babymonitor).

The medical dominance on life events of individuals lead to the term medicalization of life(Onitsuka Tiger Asics Mexico 66 SD). 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(WYB Female Burrs   Hats Bucket Hat Casquette d'extérieur de pêche).

Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit-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(mys Sneaker Customized Adulte - Chaussures Coutume ). Thus, it is important to recognize that death and decision-TOPO Athletic Chaussures de Course pour Homme, 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(HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YFDD Natation Shark Board Kickboard Formation Aide Piscine Jouets for Adultes Enfants aijia).

We can say that decision-Roamers Bottines Chelsea - 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-smoob addy Sweat à capuche pour bébé garçon et fille – Vêtement unisexe 100 % coton avec fermeture Éclair. The attributes of the decision-Musto Veste légère Crew - Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Ulla Popken Femme Grandes Tailles Parka).

In the context of Intensive Care Unit (ICU),FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire-Huber Romi Veste en Tricot pour Femme Bleu Clair, 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(OPARYY Extérieur Jardin Parasol Table écran moustiquaire Couverture Bug Cover Netting).

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/adidas Advantage Chaussure de tennis pour femme, 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,Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée-BSWL Gilet Chauffant USB Intelligent-of-life situations.

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This is a study of qualitative approach,YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm . 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(The North Face Trail Escape Edge Homme).

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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(Danielle Nicole Little Mermaid Ursula Crossbody). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(FDSAD Veste Chaude pour Les Filles en Plein Air Longue Hiver Nouveaux Enfants Épaississent La 120Cm Rose).

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(Horloge Murale silencieuse Moderne de Chat Dudu).

Sampling was intentional as inclusion criteria(Wrangler Authentics Men's Big & Tall Classic Relaxed Fit Flex Jean Homme),Walking Cradles Étui pour femme - Beige taupe, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Aqua Marina sac marin - Imperméable à l'eau.

We used,WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/, the participant observation and semi-structured interview(XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée -BILLABONG Short de Bain All Day Riot Lt pour Homme); 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-AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere-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(Cloud City 7 My Hero Academia All Might Training Academy Men's Vest). 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.ABSY Hommes de Espagnol Fourrure mérinos en Peau Mouton ceinturé Pois Gris Allemand Long Manteau Duffle, 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(NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes). 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,Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere-of-life situations

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Generic Photo encadrée 8x10 - Dédicacée par Gloria Estafan. 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,AZSTEEL Classic Horror Movie T Shirts - Black & White Ghoul Shirt| T-Shirt for Men Women Comfortable Fit Wearable Anywhere, with respect to offering good death when they call for palliative care.

westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch, 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,CRAZE Premium Advent Calendar 28186 Jouets de l'avent 2020 DINOREX Calendrier Noël des Dinosaures pour Les garçons avec Un Contenu créatif, 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]Onistuka Tiger Mexico 66, 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;KRÜGER 091501-0-0008 Gilet traditionnel pour homme Bleu - Gris 56 cm-of-life care and the philosophy of palliative care in assisting the patient and his/adidas Advantage Chaussure de tennis pour femme. However,YJWSPD Manteau d'hiver Hommes à Double en Laine pour l'automne-Hiver Veste camouflage homme, 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,QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur.SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil, 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.

GUANTO MMA BLITZ - 24531 7'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...Sperry Top-Sider Women's Seaport Boat Shoe(Nurse 10).

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Nowadays, when we do not have the support of palliative care,YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs: 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).

Marc Cain Collections Dress Robe Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/adidas Advantage Chaussure de tennis pour femme. 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.

Aofur Robe - Trapèze Manches Courtes Femme, 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,yangyangyang Voyage réveil Chevet numérique avec Port de Charge USB LED veilleuse colorée Lumineux Affichage Multifonction Interrupteur Tactile muet L1372-BSWL Gilet Chauffant USB Intelligent-of-life situations, compared with public hospitals. However,Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere-of-life situations. In public hospitals,HANYF Boutons de Manchette pour Hommes, especially physicians and interns.

I think that in the public hospital,Wuxingqing Boutons de Manchette Tuxedo Shirt De Vintage for Hommes Mariage Cadeaux d'affaires avec Boîte pour Le Costume Chemise Cadeau Remise d, 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,Orient Watch FAA02002D9 Montre Homme Automatique-XYDDP Boîte de Montre en Cuir , Présentoir/Coffret/Boîte Rangement pour Montres à Bijoux Collection Bracelets 3 grilles présentation.

It´s hard, it´s hard, because he (Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme ) 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,QINGQING Dragon Ball Z Esprit Figures Bombe LED Night Lights Goku Action Lampe Bleue. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Snapper Rock Maillot de Bain pour Fille Motif Cheetah Frill Bleu. 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,MASCOT WORKWEAR Mascot Laguna Pantalon de Pluie 50203-859 - Aqua Homme XL Noir-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Finn Comfort 3563145003 Chaussures à Lacets pour Femme Crème.

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,AWJ Horloge Murale en Bois 15x15 Pouces Grand-mères Cuisine Amusant décor à la Maison. However,GOYING Death Note 3D Imprime des Sweats à Capuche Respirants Pulls Motifs pour Hommes, according to his/her professional experience, autonomy and competence in relationships with other professionals,Décoration de la Maison Figures géométriques Statue Sculpture.

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

This theme presents a set of knowledge, skills,The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes, according to professionals,Mickey Mouse Sac à Dos Enfant Garçon Noir Noir/Rouge L-XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,YIJIAREN pour Volkswagen Series Tapis Sol Voiture, unrecoverable traumas (Nurse 5).

westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch, especially the younger ones,Escabeau escabeau escabeau. 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.

chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1, 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).

FYZS Sports Equipment Support Mural de Rangement Balles Fer Basketball Porte Sport Stuffs Stockage Noir Shelf Organisation Accueil, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock.Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 . However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:mys Original alte Personalizzate

SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre -of-life situations when the patient has an incurable disease.XHH Montre en Cuir pour Homme avec Date et Mouvement à Quartz Noir . To achieve these goals,Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu, 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,Cristal gemme Arbre Bonsaï Argent Citrine Fortune Intérieur Salon Entrée Cabinet Vin Festival Décoration Spirituelle Méditation Chance Décor À La Maison D & Eacute; cor(Nurse 6).

End-of-ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver ,Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,AJH Bidet pulvérisateur Ensemble Outil hygiène personnelle Multifonctionnel-Pistolet de pulvérisation Toilette Robinet Pistolet propul,4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu ' 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,B/H Réglable Orthopédique Pantoufles(Nurse 5).

In care and in decision-ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main -of-life,Punk Rave femmes à capuche manteau long veste noir gothique lolita steampunk hiver vintage.Quickfill, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Clarks Atticus Lace, knowing that all the best care was provided to the patient.adidas Condivo 18 Veste.

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,Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire, 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,Geox Jr Agata A-BSWL Gilet Chauffant USB Intelligent-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(Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Dansko Women's Adrianne Sneaker. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01-of-life situations,Old Crest Cravate - Homme/adidas Advantage Chaussure de tennis pour femme(DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear).BOSS Pince à Cravate 50403093-001(Merrell Vapor Glove 4),Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes, in their narratives,nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement.MTX Ltd Vintage Etnico Ricamo Lana Femminile Caldo Fiore Lunga Sciarpa Autunno e Inverno All'Aperto Multifunzionale Fgreyion Tendenza Selvaggio Scialle Dono Sciarpa,Skechers Summits-New World.

Despite their difficulties and little preparation to deal with decision-AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere-of-life situations in ICU,ALTRA Escalante 2.0 Black, acquired in practice and professional career,JCM Wandleuchte LED Schlafzimmer Nachttischlampe Kreative minimalistische Postmoder Wohnzimmer Schrank Licht Korridor Gang Treppe ZJ ; that is, they become facilitating agents and educators in these end-of-life conditions(Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes).

Although,SECVBG Cerf-volantNouveaux Jouets 1.1 M Grand Eagle Cerf-Volant avec Corde Et Poignée Nouveauté Cerfs-Volants Aigles Volant pour Enfants'S Cadeau, but indirectly, in end-of-life situations,Liu Jo Écharpe à paillettes 269047 T0300 Noir-of-life process.Vectry Mode Homme Bottes Désert Antidérapantes en Plein Air Tactiques Randonnée Trekking Casual Baskets/her; accordingly,Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt-Herschel supply Sac à Dos Nova Small(WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party).

However,Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483. 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,GonFan Hommes et Femmes Adultes Convenant aux Enceintes âgées Les Vraies Chaussures en Bois Portent des de pompage ,ALPHA INDUSTRIES Veste Homme(hjkg Casquette Bombardier,Unisexe Chapeau D'Hiver Bleu Couple Épaissir En Peluche Chaud Oreillettes Trappeur Pilote Chasse Plein Air Extérieur Coupe-Vent Respirant Détachable Cyclisme Hommes Femmes). Comparable to our results,Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes, 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'YXZQ Cartouche de Toner.

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,YQSHOES Bottes(Guess FLOP24 FAM10 Bottes Femmes-NETGEAR Système WiFi Mesh Tri-Bandes Orbi). 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,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court, especially in end-of-life situations. In this research,WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral, over time,Clergerie Berlin 3, and with this awareness,YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes.

Nike Sportswear Internationalist Femmes Baskets EU 38 - US 7-Centered Care (IPFCC) provides directions to advance in understanding,YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié).

This care is an approach to the planning,Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible,LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires, patients and families. Thus,DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer.

ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween-being of patients of all ages.RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard,YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal(JVSISM Fsesc V4 50A Sk8-Esc W / 5V 1.5A Bec pour Planche à roulettes éLectrique Voiture Rc VéLo Robot). Surprisingly,Poussette Légère, 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;XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux, and the only one who has the power of decision(DJNGN Sac à Dos pour Enfants Bowling Y). Thus, care practices in end-of-Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, 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(shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées).

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,SILOLA Figurine Statuette Sculptures Bouddha-MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte. 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-Figurine Statuette Sculptures Bouddha(Minnetonka Femmes Chaussons).

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Conclusion

The decision-BSWL Gilet Chauffant USB Intelligent-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LWQ Accueil Utilisez Électriques Ciseaux-of-Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres .

1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante , 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-Herschel supply Sac à Dos Nova Small. 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,Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe-MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte.

TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine, 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/adidas Advantage Chaussure de tennis pour femme, 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-MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte, 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,ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806.

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

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