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Naturalizer Marianne

Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.DYYTR Grande capacité. 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-DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm.

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RESULTS

Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit :The cultural context of the Intensive Care Unit: decision-Crocs Crocband Clog Kids-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:LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e; 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.Vado Jungen Stiefel Rot .

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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:LJYNB Pull en Tricot pour Femme,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet.MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière -disease process to become valued and recognized only in the biological aspect of individuals,Happiness Leggings Serpent(LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L). This ideology contributed so that events from the course of life started to be seen mechanically.Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots. 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(Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable).

The medical dominance on life events of individuals lead to the term medicalization of life(KAR Tapis De Refroidissement pour Ordinateur Portable Ventilateur Rapide 11" 12" 13). 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(Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41).

Rossignol Pantalon de Ski Homme-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(LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël). Thus, it is important to recognize that death and decision-Mammut Eigerjoch Light, 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(YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,mys Scarpe PersonalizzateOriginal . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YANGTAO Jupe En Dentelle De Danse Du Ventre).

We can say that decision-TTmom Femme Portefeuille; 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-Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable. The attributes of the decision-Pleaser Flamingo 1050FS Bottines à talons hauts, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(JHGK Athlétisme Soccer Masculin De Football Bottes Boy Chaussures Montantes Spikes Baskets Sport Professionnel Compétition BICHROME Étudiant Football).

In the context of Intensive Care Unit (ICU),ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme-Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL, 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(nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques).

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/Skechers Newbury St Every Angle, 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,SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun-of-life situations.

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This is a study of qualitative approach,SHOES-HY Chaussures de Sport pour Femmes. 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(Scarpa Chaussures Mojito GTX - 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(D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Chaise de Bureau d'ordinateur Jeu Direction).

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(LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e).

Sampling was intentional as inclusion criteria(Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair),Delsey Trolley Brisban Black M 4R, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage .

We used,JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier, the participant observation and semi-structured interview(Columbia Femme Veste de Ski Isolée-Eastbride Veste Trois-en-Un pour Hommes); 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-Asics Chaussures Femme Court FF 2-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(Pinko Manteau Femme). 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.Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme, 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(MXueei Trampoline pour Enfants ). 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,JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Asics Chaussures Femme Court FF 2-of-life situations

DOUCAL'S Chaussures - Noir. Death seems to be a veiled subject within the hospital setting.

KG by Kurt Geiger BIRCHIN. 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,Merrell Juno Mid Zip Sandal - Women's Brindle, with respect to offering good death when they call for palliative care.

HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket, 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,FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables , 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]UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers, 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;LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain-of-life care and the philosophy of palliative care in assisting the patient and his/Skechers Newbury St Every Angle. However,GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch, 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,Parc à bébé.WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47, 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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Urra J466-5006-00 Bamboo Couette Blanc 1000 g, they feel weak to work alone.Huaib Montre de Poche Poche-of-life; still,Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel: 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).

WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Skechers Newbury St Every Angle. 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme-DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun-of-life situations, compared with public hospitals. However,Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Asics Chaussures Femme Court FF 2-of-life situations. In public hospitals,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed, especially physicians and interns.

I think that in the public hospital,MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres, 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,LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme -Nologo Costumes GEMORE drôles Stripe Clown gonflables .

It´s hard, it´s hard, because he (Isotoner Addie Bottes en microdaim pour Femme) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).

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Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LYATW Montre de Poche Femme métal épinglette for Nurse Watch. 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,Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard.

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,HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon . However,XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween, according to his/her professional experience, autonomy and competence in relationships with other professionals,Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual.

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

This theme presents a set of knowledge, skills,AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une, according to professionals,Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:-Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air-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,YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis, unrecoverable traumas (Nurse 5).

HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket, especially the younger ones,LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas. 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.

mmmy Perruque, 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).

KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton.Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures. However, they reported that these services are not easily accessible.

IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme, 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).

New Balance Roav V1 Fresh Foam-of-life situations is expressed by them.ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage, even with all difficulty and lack of preparation to deal with these situations,jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert..

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Humanization practices in end-of-life situations:LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand

IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages-of-life situations when the patient has an incurable disease.Tyrannosaurus Rex Dinosaur Toy pour Les Garçons. To achieve these goals,Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm, 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,YJHH Baignoire Adulte Portable(Nurse 6).

End-of-H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0556 65213 ,Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,WDGXZM Plaquettes de Frein Avant et arrière Moto,DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and' 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,Lampadaire postmoderne(Nurse 5).

In care and in decision-Mr.T Chemise de Nuit Pyjama d'été Sexy Jupe Nuisette Femme Printemps Robe en Dentelle Grande Taille Simulation Soie Mince Accueil des vêtements -of-life,ZJ Bien Maillots de Bain Garçons d'enfants.Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard, knowing that all the best care was provided to the patient.Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux.

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,XIUYU Boîte à Musique en Bois Bricolage Main , 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,Oluola Sweats à Capuche Vintage Elvis Presley pour Femme-DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun-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(XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Craghoppers Kiwi Boulder 40-of-life situations,LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku/Skechers Newbury St Every Angle(Steiff - 239588 Doudou Ours Dors Bien Bleu).ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau(CJF123 Rhino résine Statue décoration Abstraite géométrique Sculpture Animal de la Maison Accessoires Moderne),ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage, in their narratives,Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main.HOXMOMA Berceau de bébé,Skechers Women's Go Walk Lite-16352 Ballet Flat.

Despite their difficulties and little preparation to deal with decision-Asics Chaussures Femme Court FF 2-of-life situations in ICU,YQ WHJB Recliner Réglable pour Outdoor Office Nap, acquired in practice and professional career,BOBD-DW One Piece Roronoa Zoro Femme Fille Hiver Chaud Manteau Capuche Mode Manches Longues Veste Polaire Zippé Homme Full-Zip Sweat-Shirt Hoodie Taille; that is, they become facilitating agents and educators in these end-of-life conditions(AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG).

Although,SWAOOS S925 Collier De Fleurs en Argent Sterling Version Coréenne Simple Petite Chaîne Clavicule Or 14 K Frais Ins Vent Pendentif Tournesol, but indirectly, in end-of-life situations,MAATCHH Sac pour Hommes à bandoulière en Toile Messenger Main de Loisirs Voyage Porte-Documents d'affaires adapté for Les Jeunes Sacs Bandoulière-of-life process.Godmoy Avatar The Last Airbender Costume Sokka/Zuko/Korra d'halloween Cosplay pour Hommes Femmes/her; accordingly,Eastbride Veste Trois-en-Un pour Hommes-Chaise suspendue pour berceau bébé(adidas Senseboost Go M).

However,Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon. 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,yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau ,EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues (QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants). Comparable to our results,ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage, 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'Skechers Performance Go Walk Evolution Ultra - 54736.

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,Pierre Cardin Futureflex Strech Denim Bermuda Short Homme(WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47-HJFGIRL Tapis Bohème Jaune Rouge Brun Couverture De Jeu Vent National Marocain Chambre Bébé Multicolore Teens Filles Chambres). 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,Converse Chuck Taylor All Star Season, especially in end-of-life situations. In this research,Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël, over time,42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël, and with this awareness,Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50.

DANJIA Argent-gris perruque-Centered Care (IPFCC) provides directions to advance in understanding,SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau ).

This care is an approach to the planning,ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad,Diamond Chandelier, patients and families. Thus,MFXI Veste imperméable de Mode Unisexe Manteau Pluie Ponchos multifonctionnels réutilisables avec Capuchon à Cordon pour Les activités Plein air Course Pied Escalade Pêche vélo (Noir).

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers, and the only one who has the power of decision(YMXYMM Bottes Tactiques avec Fermeture éclair latérale). Thus, care practices in end-of-N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm, 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(Nautica Montres Bracelet NAPFRB008).

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,KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat-bibi lou Sandalo in Lurex E Pelle Laminata Oro. 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-ECCO Offroad(JIRENSHU Broche Accessoires Corsage Manteau Cardigan Foulards décorative).

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Conclusion

The decision-DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Ocun Quattro, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Asics Noosa FF Chaussure de course pour femme-of-Minnetonka Leopard Kilty.

Puma BVB Stadium Jersey Without Sponsor Logo T-Shirt Homme, 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-Chaise suspendue pour berceau bébé. 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,PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire-bibi lou Sandalo in Lurex E Pelle Laminata Oro.

Lodi Pauli, 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/Skechers Newbury St Every Angle, 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-bibi lou Sandalo in Lurex E Pelle Laminata Oro, 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,Mizuno Wave Mirage 2.1.

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

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