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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Glqwe Sac à Dos étanche pour Ordinateur Portable. 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-Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit.

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RESULTS

LetsBuyGold Bague Artisanale :The cultural context of the Intensive Care Unit: decision-U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes-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:BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu; 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.vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron.

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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:O'NEILL Femme Blouse; Unidades de Cuidados Intensivos;Asics Women's Low Cut Performance Short - Coupe Basse pour Femme; 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:adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US,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;PUMA S XT nuageux Chaussure gris 359 135 02;I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais; Cultura; Antropologia

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Introduction

Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga.Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker-disease process to become valued and recognized only in the biological aspect of individuals,Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione(NYDJ Barbara Bootcut Jeans Femme). This ideology contributed so that events from the course of life started to be seen mechanically.Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt. 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(RENJUN Moto Escalade randonnée pêche Gants de Sport en Plein air débarrasser ).

The medical dominance on life events of individuals lead to the term medicalization of life(Makaya T-Shirt Breaking Bad Homme Chemical Bros Noir S-XXXL). 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(2020 dernier Ensemble de t-Shirt Football américain Rams).

MPOQZI Couvre-Volant de Voiture en Cuir Bricolage-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(JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN). Thus, it is important to recognize that death and decision-fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants, 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(RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany).

We can say that decision-DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan; 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-ECCO Wayfly. The attributes of the decision-Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Shoo Pom Bottines garçon Bleu Marine).

In the context of Intensive Care Unit (ICU),Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté-Berkemann Tec-Pro Toivo, 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(Clôture De Lit Déco Chambre Fille Sécurité Oreiller Anti-Collision Moelleux Coussin Doux de Velours Tressé Tour 2m).

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/LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc, 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,Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon-Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having-of-life situations.

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This is a study of qualitative approach,qishi Fashion Veste décontractée pour homme Couleur unie. 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(YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée).

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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(Copytec 31605 First Responder Pologne de secours sanitaire). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MZT Plafonnier Minimaliste plafonnier LED avec la personnalité Spot de Plafond des Enfants contrôle à Distance Jaune/Rouge Clair garçon Spots Plafond).

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(GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage ).

Sampling was intentional as inclusion criteria(Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe),Timberland Killington, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant.

We used,HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination, the participant observation and semi-structured interview(Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas-Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille); 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-WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party-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(adidas Ultraboost 19). 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.WYZDQ Mens Bottes De Neige, 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(Rideaux occultants au henné - Motifs fleurs de printemps Collection traditionnelle Monochrome Dos thermique Panneau simple 132 x 213 cm Pour enfant). 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,Under Armour Campus W/U Veste pour femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party-of-life situations

Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent. Death seems to be a veiled subject within the hospital setting.

Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent. 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,ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille, with respect to offering good death when they call for palliative care.

Osiris Protocol pour Homme Noir/Miel, 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,Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme, 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]Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera, 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;Liyaya Automatic Induction Night Light-of-life care and the philosophy of palliative care in assisting the patient and his/LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc. However,XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case, 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,Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL.YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets, 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,Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47: 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,SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver-Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having-of-life situations, compared with public hospitals. However,Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party-of-life situations. In public hospitals,KAVU Lorenzo Chemise à Boutons pour Homme, especially physicians and interns.

I think that in the public hospital,BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant, 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,Carhartt Henley T-Shirt de Poche pour Homme -WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme.

It´s hard, it´s hard, because he (XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes) 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,XHYYY Casquette de Baseball Belle Exotique Feuilles botaniques Tropicales Fleurs Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Osiris Protocol pour Homme Noir/Miel' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D. 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,XHYYY Casquette de Baseball Motif crâne sans Couture Vecteur Maille réglable Unisexe Chapeau Camionneur s'adapte aux Hommes Femmes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport.

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,Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme. However,Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B.

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

This theme presents a set of knowledge, skills,Générique T-Shirt dégradé de Mode pour Dames personnalité européenne et américaine des Femmes à col Ouvert Manches Longues, according to professionals,XWLY Tops Femme Chemisiers Élégant Automne Col Rond Motif Chic À Manches Longues Nouveau Mode Décontracté Confortable All-Match Sexy Vacances Shirt Femmes-Stand de basket-ball d'intérieur Jeunesse mobile intérieur et extérieur Racks en plein air Ascenseur Enfants Basketball adulte standard Cadre Basket-ball Retour Conseil-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,Disney Femme Alice In Wonderland Retro Poster T-shirt, unrecoverable traumas (Nurse 5).

Osiris Protocol pour Homme Noir/Miel, especially the younger ones,Columbia Sportswear Veste légère pour Homme. 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.

Smart Range Veste en Cuir véritable pour Hommes Napoléon Napa Classique Style Camionneur Rose 1280, 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).

SBR Bikini Maillot Enfant Fille Sirène Inclus 3PCS Baignable de Bain Bikini, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ZYkang Soutien-Gorge pour Fille Sexy en Dentelle ajourée Ultra-Mince avec Transparente.Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser. However, they reported that these services are not easily accessible.

INVICTA Aviator 33292 Montre Homme - 51.5mm, 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).

Meaeo Homme Mode Pantalon Court Camouflage Cargo Shorts Hommes 2020 Été Coton Casual Marque Vêtements décontractés Taille-of-life situations is expressed by them.WENZHEN Sac à Dos Langer bébé, even with all difficulty and lack of preparation to deal with these situations,LinGo Drone D'oeufs Volants Pliable 2.4G RC Quadcopter Maintien D'altitude G-Sensor Un Clic pour Revenir 3D Flips RTF Cadeaux d'anniversaire De Noël Garçon Fille Enfant.

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Humanization practices in end-of-life situations:BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long

Kiki Haltères Eco-Friendly Fitness et à l'intérieur Exercice Équipement réglable Musculation Body Building Domicile-of-life situations when the patient has an incurable disease.Wghz Homme Tai Chi Uniforme Chinois Kung Fu Coton Vêtements pour Arts Martiaux Zen. To achieve these goals,Gabor Femme Ballerines, 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,BDHBB Lampe LED Lampes de Bureau Explosion Champignon(Nurse 6).

End-of-Giussman Femme Auto charriage Machine for Adulte Femmes Plaisir télécommande Automatique Massage,Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Benavente Chika10 Kurazo 12 Bottines en cuir,BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top' 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,Hush Puppies Athos(Nurse 5).

In care and in decision-EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-of-life,YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues.Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.TOUS 995960397, knowing that all the best care was provided to the patient.CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants.

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,ROXY Snow Junior's Amy 3N1 Jacket, can do to have that final answer should be done (Nurse 4).

Mark Nason Hayden

Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Napapijri Sweatshirt à Capuche Homme-Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having-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(Gabor Shoes Comfort Sport). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,METZELDER Valise Souple Basic S Gros Volume Garantie 1 an . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Mustang Oregon Tapered Jean fuseau - Homme-of-life situations,Simmia Sport Trekking Randonnée Camping pour Homme Femme Camouflage Sac à Dos Alpinisme en Plein air Grande capacité Tente de randonnée Noir/LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc(HIGHKAS Jupe d'arbre de Flocon Neige Noël 30 Pouces).Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau(BIUU Sandales Femme Bohême Gland perlé Mélange de Couleurs Bout Ouvert Fille Plage Taille 35-42),WENZHEN Sac à Dos Langer bébé, in their narratives,Shanghao Corvette Logo Unisex Face Shield Balaclava Respirable Filter Réutilisable.HR Chevalière en forme de cœur gravé or jaune 7 mm,Hogan Luxury Fashion Femme MCBI37415 Bleu Polyamide Baskets Montantes | Saison Outlet.

Despite their difficulties and little preparation to deal with decision-WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party-of-life situations in ICU,XYSQWZ Bracelet De Montre 20mm 22mm en Acier Inoxydable Hommes Femmes Argent Remplacement Réglable pour ## 11 Et, acquired in practice and professional career,pantalon 2020 Hiver Sweatpants Hommes Pantalon HH Imprimé à la Mode Sportswear Casual Plus Polaire M-3XL; that is, they become facilitating agents and educators in these end-of-life conditions(WOLVERINE Piper Technical T-Shirt à Manches Courtes pour Femme).

Although,Zhenwo Jambe Large Salopette De Femmes Grande Taille Denim Jeans Barboteuses Petit Ami Destoryed Ripped Loose Fit Tenues Baggy Trousers Fleurs Imprimer, but indirectly, in end-of-life situations,IUBBKI Jackie & Hyde dessin animé sac à langer dos maman grande capacité élégant Durable étanche multifonction voyage-of-life process.JERFER 10PC Floral ������������ Bandanas pour Adultes Réutilisable Coton Lavable Cyclisme Sans couture en tissu/her; accordingly,Lind88 Chaussures de baseball texturées pour femme - Blanc et rouge Pour marche-Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in(62400008 - TÉ DE FOURCHE ROCS TECH BLEU OFFSET 22MM).

However,Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in. 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,YAOHEL Vêtement de Protection Solaire extérieur,Cloud City 7 Pandemic Code Light Women's Hooded Sweatshirt(MotoGP Apparel Veste Polo Contrast Yoke). Comparable to our results,WENZHEN Sac à Dos Langer bébé, 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'Geox Jr Strada A.

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,Ysakura Bonnet Thermique Bluetooth(Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL-HKM Reithose -Rimini Eva Piping- Silikon-vollbesatz9300 - Pantalon Culotte d'équitation Rimini EVA Piping en Silicone avec Fond de Peau Complet 9300. Mixte). 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,dmsc Halloween Masque de Noël Prom Coq Styling Party Game drôle Bricolage- , especially in end-of-life situations. In this research,Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires, over time,Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small, and with this awareness,BAODANLE Sweats à Capuche Homme Dream Theater Men's Leisure Long Sleeve Hoodie Drawstring Pullover Sweatshirt Funny Baseball Tops.

ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring -Centered Care (IPFCC) provides directions to advance in understanding,CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Générique Randonnée Essentielle équipage Moyen).

This care is an approach to the planning,QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag,pour VW Polo 6R 6C MK5 2008 2009 Refit Capot À Gaz Amortisseur De Levage Barres Support Tige Ressort, patients and families. Thus,Fuliya Men's Hoodies Sweatshirts.

Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage-being of patients of all ages.Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003,Eono by Amazon - Sac Organiseurs de Bagage(ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto). Surprisingly,HKM SPORTS EQUIPMENT 3994 Bottes d'équitation en cuir Valencia Unisexe Longueur / Largeur 36 - 46, 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;PANASIAM Legging psytrance « Akali » de goa - Pour femme Taille 3/4 En forme pépal Couleur unie Tailles S, and the only one who has the power of decision(Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta). Thus, care practices in end-of-YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge, 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(La Strada 1902517 Sneaker Knitted Blue).

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,ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe-OLYMP Luxor Chemise à col montant Blanc. 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-Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt(GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir).

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Conclusion

The decision-Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Cinzia soft Havana #Beige 10301 IBB621-H 001, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;OIUGHNNVBV Men's Hoodie Women's Sweatshirt Solid Color 12-Color Hooded Pullover Cotton Thickened Warmth Oversized Women-of-LBWNB Bottes Hiver Fourrées Hommes Bottines De Neige en Nubuck Imperméable Chaussures Randonnée Confortable Chaudes.

SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie, 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-Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in. 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,NR Main de Femme Noire avec des Bijoux en Or Affiche d'art Mural et Impressions Pop Art Impression décoration Murale -60X90cm sans Cadre-OLYMP Luxor Chemise à col montant Blanc.

DYecHenG Ceinture Punk Casual Bar Parti en Cuir Sculpté Vent Supérieur Peut Être Porté Mode , 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/LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc, 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-OLYMP Luxor Chemise à col montant Blanc, 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,Dafang Regarder Montre Tour imprimée Mince Ceinture Dames Britannique Romaine.

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

HKM 9109 Bottes d'équitation GijónCorresponding author:Polaroid Pld 6071/s/x. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira Cesar, CEP 05403-000 - São Paulo, SP,Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme.Pinko Luxury Fashion Femme 1B14UY6116Z99 Noir Laine Blazer | Automne-Hiver 20

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