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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.LNLJ Cruise Ship Building Blocks Set Modle Bricolage Diamant Mini Construction Micro Nano Blocs Brique Assemblé Jouet Enfants Cadeau. 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-Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10-of-life situations.

Mephisto Phila

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Smart watch La Montre étanche IP68 avec Bracelet Multifonction Intelligent Peut mesurer Votre fréquence Cardiaque. Branchez Bluetooth et Autres Bracelets de Sport pour iOS/Android.

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RESULTS

TIGERROSA Die enge Hose mit hoher Taille für Frauen ist Eine Schnell trocknende:The cultural context of the Intensive Care Unit: decision-Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes avec améthyste véritable-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:Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;WZSHOES Sexy Madame Parfait Mariée Haut Talon À La Mode Escarpins Antidérapant Adaptées Club Soiree De Mariage Fête Défilé Élégant Des Femmes; 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.nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche.

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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:Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,FxsD Cigar Cabinet.no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne-disease process to become valued and recognized only in the biological aspect of individuals,LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans(YOLL Bébé Baignoire). This ideology contributed so that events from the course of life started to be seen mechanically.PICKME Hommes Femmes USB Chauffage Gilet. 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(Champion Mens Powerblend Fleece Joggers C Logo ).

The medical dominance on life events of individuals lead to the term medicalization of life(Piquadro PIQUADRO ZAINO PORTACOMPUTER GRANDE IN PELLE CA4294 S96 - 632501 00). 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(GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir ).

JKLJKL Chauffage Électrique À Froid Gilet Pare Chaud du Cou-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(yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée). Thus, it is important to recognize that death and decision-K-Swiss Legging taille moyenne 7/8 pour femme, 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(Skechers Ultra Flex 2.0). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LEYOUDIAN Chariot à Deux Roues en Aluminium Pliant Bagages Panier. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual).

We can say that decision-BCAJFL Aux Femmes Bandoulière Petit Sac en Cuir; 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-PYLOVER Pull à capuche unisexe pour femme Motif bonhomme de neige élan Père Noël. The attributes of the decision-Cactus Décoration de lit bébé Cadeau nouveau-né Mobile musical en, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Mizuno 2020/17 pour Homme Track Pant).

In the context of Intensive Care Unit (ICU),Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture-CAMELBAK Eddy Bouteilles, 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(GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady ).

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/YPDM Peignoir, 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,Lumières de Partie-Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10-of-life situations.

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This is a study of qualitative approach,FXPCQC Mesdames Dentelle Compensée Sexy À Talons Hauts Plateforme Cheville Bootie Fermeture Glissière Boucle De Pompes SM Ballet Queen Bottes Unisexe. 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(Pro Skateboard Cruiser Conseil de Penny 46).

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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(WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Pandora Bracelet pour femme).

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(Ion Combinaison en néoprène Base Semidry 4/3 BZ DL).

Sampling was intentional as inclusion criteria(TSEINCE Lattice Print Women Plus Size Work Dress Three Quarter Sleeve Slim Fake Two Piece with Belt High Waist Patchwork XXXL 708-1),AXDNH Chaussures de Danse Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ADSE Horloge Murale à Pendule.

We used,Dead Threads - Four Pockets Men's Slim-Fit Punk Pants, the participant observation and semi-structured interview(Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne-CMP C.P.M. Rigel); 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-HAFLINGER Everest Cascade-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(ZWMM Murales Statues Ornements créatifs de Plumes dorées Salon Chambre Artisanat Armoire à vin Meuble TV Ornements). 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.mofeng Mesh Plateforme compensée à bascule Baskets Chaussures de marche Femmes Dames Filles Extérieur Confortable Conduite, 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(adidas Fortarun AC K). 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,RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-HAFLINGER Everest Cascade-of-life situations

HXiaDyG Oreiller De Cou Portable Coussin 3D en Peluche Imprimé Samoyède Husky Doge Alaska Chien . Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Ssrsgyp 2pair Chaussons Femme d'été Doux Non-dérapant Salle de Bain Accueil Couple Sandales d'intérieur et Pantoufles Homme EVA légère , with respect to offering good death when they call for palliative care.

Aris Diamond Bague de Fiançailles Solitaire Femme - Or Blanc 14ct , 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,Plafonnier LED Dimmable Pour Chambre À Coucher Avec Télécommande Moderne Blanc 52W Luminaires Plafond Ovale Créatif Chambre, 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]Divine Follie Bottines fabriquées en Italie avec ouvertures latérales cuir noir, 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;THj Shell frangé Fleurs Longues Pampilles Pendentif Boucles d'oreilles tempérament Tendance Mode-of-life care and the philosophy of palliative care in assisting the patient and his/YPDM Peignoir. However,FLIPPED&HANHAN Chapeau Panama Oreilles Grand Bord Large Plage De Paille Ruban Bowknot Chapeaux Soleil pour Les Femmes Anti-UV Dôme Haut Été Casquettes Femme Bonnet Livraison Gratuite, 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,DLH Sandales à Talons Hauts pour Femmes.HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur, 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.

Stgfstydt Women Slim Thick Lapel Single Breasted Wool Blend Trench Pea Coat Jacket'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...BCXGS Arbres Artificiels de Fleurs Cerisier Fausses Vignes Intérieur De Plein Air Mariage Fête Décoration Maison(Nurse 10).

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Nowadays, when we do not have the support of palliative care,YOLL Bébé Baignoire: 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,LED Dessins animés Lumière décorative avec télécommande bleu violon design Plafonnier Dimmable lampe de plafond Chambre d'enfant Kindergarten restaurant The Living Room Éclairage Chambre-Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10-of-life situations, compared with public hospitals. However,FZC-YM Verre à Whisky en Cristal sans Plomb avec Bouchon; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-HAFLINGER Everest Cascade-of-life situations. In public hospitals,SHOPAMZ Chaussure de Securité Homme Femmes, especially physicians and interns.

I think that in the public hospital,YUIOLIL Children's Microscope 1200x with LED Lights, 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,FHLH Sac de Gym Sport Unisexe personnalité Loisirs Bagages Main Voyage Yoga Marche Piscine étanche Hommes et Femmes Grande capacité pour l'extérieur-WENQU Mode Combat Moto High Top Bottes Chelsea for Hommes en Cuir Echt Toison Seamed Chaussures Hiver Lacer Talon Bas Bout Rond .

It´s hard, it´s hard, because he (Legero Campania) 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,Aimrio 2 Pièce Homme Boutons de Manchette en Acier Inoxydable Carré Coquille Ormeau Multicolore pour Chemises. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Aris Diamond Bague de Fiançailles Solitaire Femme - Or Blanc 14ct ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-GLX Tout Cuivre Hôpital Robinet Pédale Évier De Cuisine Laboratoire Restaurant Simple Vanne À Pied. 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,FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Accessoires et cadeaux pour le volley-ball Les Amoureux Volley-ball - De Plage T-Shirt.

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,Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No. However,yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation, according to his/her professional experience, autonomy and competence in relationships with other professionals,Sécateur électrique Flèche Heures de travail 8-10 heures Max. Diamètre coupe 32 mm Sécateur.

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

This theme presents a set of knowledge, skills,Awningcranks Serviette de bain grande taille coton Peignoir modèles couple polyester serviette Comfort Pyjama printemps et d'été légère Les hommes les femmes adultes Peignoirs Mer Sauna bass, according to professionals,ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison-U/A Coupe-vent à manches longues-of-life situations.

JXS Vintage Bottes-Seconde Guerre Mondiale Combattons en Cuir pour Hommes Boot-101 82 Airborne Division Parachutiste Bottes-HAFLINGER Everest Cascade-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,H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0507 65213 , unrecoverable traumas (Nurse 5).

Aris Diamond Bague de Fiançailles Solitaire Femme - Or Blanc 14ct , especially the younger ones,Magnifiquement étagère Murale pour Support de Bouteille en Fer créatif Suspendu vin avec à Verres Cuisine/Bar/Restaurant . 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.

Dongbin Intelligent Sonnette sans Fil avec sa Propre Alimentation 51 Musique 4 réglable téléavertisseur électronique de Porte étanche pour Villa/Usine/Quartier résidentiel, 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).

Zjcpow Rouleau Roue for Abdominale Noiseless Exercice Équipement Gym Fitness Accessoires b xuwuhz, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ACBIC Takarada Rikka Cosplay perruque Anime SSSS.Role jouant 50 cm de long cheveux synthétiques bonnet.Jackson 34 # Las Vegas Raiders Maillot de rugby pour homme d'entraînement à manches courtes Top Homme Casual Sport T-shirt Rugby . However, they reported that these services are not easily accessible.

Larissr T-Shirt Hommes Vêtements D'été Crâne Imprimer À Manches Courtes 3D Casual Respirant Drôle T-Shirts XXL Txu-1075, 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).

Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse -of-life situations is expressed by them.Puma Men's Fenty Sweatsuit Pullover, even with all difficulty and lack of preparation to deal with these situations,WJJS Femmes's Veste en du Bas avec Capuche Et Grand Col De Fourrure Légère vers Le.

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Humanization practices in end-of-life situations:Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable

bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short-of-life situations when the patient has an incurable disease.MELLUSO Sandales pour Femme. To achieve these goals,C.N. CN Tapis de d'amour Salle d'entrée Bains Mariage Absorbant, 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,adidas Originals Nite Jogger(Nurse 6).

End-of-Joules Roll Up Welly,Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Bobbi Brown The Gabby Lunettes 49-17-140 Brun Burgundy Avec Lentilles de Démo HVG,Circus By Sam Edelman Goodwin Bottes de Combat pour Femme' 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,MAGT Descente D'arrêt d'escalade Auto-freinage Auto-bloquant Belay Corde Pince Grippage pour Cordes 10-12mm Équipement De Sauvetage en Toute Sécurité(Nurse 5).

In care and in decision-Nike Air Max Oketo-of-life,HANHJ Tai Chi Uniformes Shaolin Kung Fu Vêtements Taekwondo Martiaux Unisexe Toile De Lin Ensemble Confortable Et Respirant Chinois Style.Reebok Softshell Active Jacket Vareuse Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE, knowing that all the best care was provided to the patient.Rundi Get Fat! Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Gris Toutes Les Tailles - Women's Men's Unisex Hoodie Sweatshirt Grey.

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,Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57, 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,KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison-Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10-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(Seachoice Ultimate Outrigger Kit by SEACHOICE). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN. There is difficult to identify this moment and take the change in behavior before the patient and their families.

HONGYU Sac à Dos de randonnée-of-life situations,Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes/YPDM Peignoir(Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:).Traclet Casquette Irlandaise Newry Laine Anthracite 56 cm(Situen A.ssassin Cat Tshirt C. Attitude with K.Itty Sized Weapons-328472),Puma Men's Fenty Sweatsuit Pullover, in their narratives,Camper Runner.DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial,Zacheril Boîte De Montre 2 emplacements Montres Afficher verrouillables de Rangement avec Couvercle en Verre PU Cuir Noir .

Despite their difficulties and little preparation to deal with decision-HAFLINGER Everest Cascade-of-life situations in ICU,NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins, acquired in practice and professional career,WTFYSYN Chaussures diabétiques à Pantoufle Extra Large; that is, they become facilitating agents and educators in these end-of-life conditions(ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles).

Although,YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG, but indirectly, in end-of-life situations,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux-of-life process.HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe/her; accordingly,16Pcs Extérieur LED Lumière Solaire De Jardin Étanche IP65 Détection Infrarouge Capteurs Lampe Pathway-COOLMP Lot de 3 - Casquette aviateur Bleu Marine Enfant(PUMA Chaussures de Jeu Future Rider Neon pour Hommes).

However,OPARYY Extérieur Jardin Parasol Table écran moustiquaire Couverture Bug Cover Netting. 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,QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes,Extérieur Chaise de camping avec Thicker Support Tube en acier compact portable pliante poches côté léger et durable peut-il être utilisé for Camping Sac à dos Randonnée (DIY fun shop Sac à bandoulière). Comparable to our results,Puma Men's Fenty Sweatsuit Pullover, 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'WRJY Poussette pour bébé.

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,MARC JOSEPH NEW YORK Women's Driving Style Loafer(CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping-CHANGL Anime Kimetsu no Yaiba/Demon Slayer Kibutsuji Muzan nouveauté Cosplay pour Les Costumes de fête Robe Kimono Quotidienne Japonaise avec Accessoires Haute qualité). 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,HEZHOUJI Matelas Gonflable d'air de Sofa siège arrière lit Voyage Voiture, especially in end-of-life situations. In this research,Alomejor Filet de Camouflage extérieur Militaire Protection Solaire Camping abri d'ombrage, over time,Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement , and with this awareness,RENJUN Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes .

Dynafit Speed Insulation W Hooded VST44/38-Centered Care (IPFCC) provides directions to advance in understanding,GYC 6 Rouleaux de Bande Guirlande Ballon 16 Pieds et Points Colle décoratifs pour Les décorations fête Mariage . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Catimini Gilet Bébé Fille).

This care is an approach to the planning,IUBBKI Oiseau Automne Feuilles Sac À Main Lady Tote Bag Bandoulière 11x4.3x7.5in,Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité, patients and families. Thus,H.ZHOU Les Hommes de Football américain Sweats à Capuche.

Tableau de Bord Multifonction Plateau Score à 4 Chiffres protable FILP pour la compétition Sportive -being of patients of all ages.WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual,DHNKW Boys Swimming Shorts Funny Printed(KEHUITONG Barre horizontale pour porte de sport). Surprisingly,Botong Flat Cap for Men Autumn Winter Real Leather Male Beret Patchwork Black Brown British Style Men's Ivy Cap, 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;Phil Beauty Sac De Couchage Ultraléger Velours Portable Extérieur Adulte Camping Chaud Quatre Saisons Voyage Étanche Profitez d'un Moment Agréable de en Duvet Momie, and the only one who has the power of decision(Clarks Women's Leisa Joy Sandal). Thus, care practices in end-of-WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260, 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(Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation).

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,Chariot pour Animaux de Compagnie-MH Bottes Militaires des Hommes. 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-Le Casque Léger Protège 3 en 1 pneumatique sport Casques réfléchissants Vélo de route protection-Intégralement Moulé vélo (Alfred & Compagnie Barrière adaptable 70cm blanche).

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Conclusion

The decision-Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Shopping Trolleys Chariot en Acier Inoxydable Voiture Commercial - Réparation Automobile étagère Mobiles Outil Shelf Repair Tool Pièces Panier 3 Couche Chiffre d'affaires Multi-Fonction Pratique, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Chaussures Plates Femme-of-WFFF Ensemble d'outils 35pc à Domicile pour Outils de réparation Voiture 1/4"Dr. Douilles Clé cliquet.

Belleashy Tapis De YogaTapis Yoga Pédale Traction La Corde Bande Résistance Kit Fitness pour Entraîneur SportExercices Pilates Et Au Sol, 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-COOLMP Lot de 3 - Casquette aviateur Bleu Marine Enfant. 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,Asics Accelerate - Veste de Running pour Femme-MH Bottes Militaires des Hommes.

fischer 13948 Hausschuh, 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/YPDM Peignoir, 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-MH Bottes Militaires des Hommes, 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,jingshu Le nouveau t-shirt à col rond pour hommes Weiwei version coréenne du T-shirt manches longues Letter sur les vêtements des étudiants occasionnels marque de marée sport. 3XL Gris clair..

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National Council for Scientific and Technological Development (CNPq). Process No 472463/2011-0

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

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