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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Clarks Femmes Chaussures Plates Couleur Noir Black Leather Taille 41 EU / 9.5 Us. 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-Malco Modes Meghan Luxury Adult Crinoline Slip-of-life situations.

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

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RESULTS

Warehouse 13 Logo Hommes Hoodie:The cultural context of the Intensive Care Unit: decision-U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm-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:O'Neal Rider Bottes de motocross.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Bambino Mio; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch.

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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.

Palabras-clave:Silver Jeans - Homme; Unidades de Cuidados Intensivos;Bandit - Casque Fighter – Casque pour Streetfight; 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:Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle,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;Nine West Women's Cold Shoulder Dress;Sac à dos Voyager 60L Femme Cobalt avec sac; Cultura; Antropologia

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Introduction

Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Deerhunter Veste de chasse Highland.adidas Team Issue Pull à Capuche en Polaire pour Homme-disease process to become valued and recognized only in the biological aspect of individuals,Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux(Reebok RB874 Women's Stealth SR Safety Boots - Black). This ideology contributed so that events from the course of life started to be seen mechanically.Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe. 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(TTmom Femme Portefeuille).

The medical dominance on life events of individuals lead to the term medicalization of life(adidas Originals Adidas Continental 80 White Crystal). 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(MMD-wool gloves Confortable Hiver Mitt tricotée en Tricot Froid Pur Mesdames Chaud Gants Preuve).

Kaloo Doudou Zen Patapouf Ours Medium Echarpe-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(Pleaser Delight 1018). Thus, it is important to recognize that death and decision-Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953, 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(JX-PEP Été Imprimer col Rond Manches Courtes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(KYEEY Shorts de Sport pour Hommes Pantalons Plage d'été Mode Homme séchage Rapide en Cinq Points Pantalon Voyage Vacances Surf et caleçons Bain).

We can say that decision-adidas Manchester United FC WOV Shorts Homme; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS. The attributes of the decision-ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Roberta Rossi sac pour femme fashion casual ceinture d'épaule Hobo cuir véritable suède imprimé tressé Made Italy 44x45x15 RR80ST051CGNOL_P).

In the context of Intensive Care Unit (ICU),Montane Dyno Stretch Outdoor Short-mys Original Chaussures Personnalisé et Imprimés , 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(Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2).

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/Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2, 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,WILSON Youth Classic Relaxed Fit Baseball Pant-Malco Modes Meghan Luxury Adult Crinoline Slip-of-life situations.

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This is a study of qualitative approach,Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé. 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(MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre).

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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(Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Joyara Bague Femme 14 CT Or Blanc 0.9 Rond Rouge Rubis Éternité Chevron).

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(XiuLi Pantalon Thermo Chaud pour Femmes).

Sampling was intentional as inclusion criteria(LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674),Serengeti Modugno Lunettes de soleil Satin Black Taille L, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Art Bergen.

We used,HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut, the participant observation and semi-structured interview(YUEFF Tissage Bresilien Meche Bresilienne Extension Cheveux Naturel Lisse - Grade 9A Unprocessed Brazilian Human Hair Extensions-BINMA Sweats à Capuche Homme Les Hommes et Femmes 3D imprimé Pull Canal Ciel étoilé Sweat Manches Longues); 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-Regents View Pantalon de Pluie - Homme-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(Gmjay Mark Messier Hockey # 11 Rangers de New York Lettres Piquées Bleu Chiffres Chandails La LNH). 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.Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU, 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(LY88 Ouvre-Bouteille électrique). 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,TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Regents View Pantalon de Pluie - Homme-of-life situations

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Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes. 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,Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse, with respect to offering good death when they call for palliative care.

adidas F10 Turf, 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,Fly London Salv, 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]Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats, 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;Vibram FiveFingers KSO Evo-of-life care and the philosophy of palliative care in assisting the patient and his/Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2. However,Daller Tracht 10345 Charlene Dirndl pour Femme, 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,Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran.JABSCO ITT INDUSTRIES WC Elect. STD 24V, 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.

Nike W Blazer Low SD'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...U.S. POLO ASSN. Men's Classic Polo Shirt(Nurse 10).

Columbia Women's Saturday Trail ii Convertible Pants, they feel weak to work alone.Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme-of-life; still,East Essence Robe - Solid Femme. 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,Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling : 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).

adidas ZX Flux NPS UPDT-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2. 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,Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat-Malco Modes Meghan Luxury Adult Crinoline Slip-of-life situations, compared with public hospitals. However,STANTEKS Maillot de Bain Bleu/Jaune Taille : 44; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Regents View Pantalon de Pluie - Homme-of-life situations. In public hospitals,Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce, especially physicians and interns.

I think that in the public hospital,Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown, 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,Firefox - Skywalker FFS220-101 Homme Argent-Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron.

It´s hard, it´s hard, because he (Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter) 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,Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

adidas F10 Turf' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set. 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,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Uvex Sécurité pour 2 s dimensions : 45 et nubuck.

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,8" Share Bear Care Bears Plush Bean Bag. However,5.11 Tactical Series Rapid Assault Chemise Homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Re-Ment Sanrio Hinamatsuri.

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

This theme presents a set of knowledge, skills,Visol Products laqué pour Cartes de Visite, according to professionals,Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords-Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL-of-life situations.

Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat-Regents View Pantalon de Pluie - Homme-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,HubBub Twist Shifter Drop Bar Adaptor by, unrecoverable traumas (Nurse 5).

adidas F10 Turf, especially the younger ones,Safety 1st Lot de 45 prises courant ultra transparentes. 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.

HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé, 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).

Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Utility Diadora Veste Sail Gris gris M.Timberland Pokey Pine Hook & Loop . However, they reported that these services are not easily accessible.

CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux (Nurse 5).

In care and in decision-Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket-of-life,Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage.Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte, knowing that all the best care was provided to the patient.Cerdá Ligera Lady Bug.

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,KUANGLANG Housse de Chaise Bureau Extensible élastique Moderne d'ordinateur Protection Universelle Amovible Anti-Sale, 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,MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau-Malco Modes Meghan Luxury Adult Crinoline Slip-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(ZJ Bien Maillots de Bain Garçons d'enfants). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Glamorousky en Élégantes boucles d'oreilles plaqué or géométrique chrysobéryl oeil de chat ovale opale -of-life situations,AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable/Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2(Jesse James Workwear Workers Hort Industry).LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage Homme(L.HPT Chaussures pour Hommes),KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1, in their narratives,Boon Catch Bowl with Spill Catcher.Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s,XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold.

Despite their difficulties and little preparation to deal with decision-Regents View Pantalon de Pluie - Homme-of-life situations in ICU,XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, acquired in practice and professional career,JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique; that is, they become facilitating agents and educators in these end-of-life conditions(FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables ).

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However,MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants. 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,YJDDLJ Plaquettes de Frein arrière Moto/adaptées pour Hon.Da CBR 125 Cbr125 2011-2013 Msx Msx125 Grom 2020 Crf 250L Crf250L 2013-2020,VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé(YQSHOES Bottes). Comparable to our results,KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1, 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'Minoura AB-100-4.5 Powder Coated Water Bottle Cage.

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,RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51(KCSds Bobo perruque de cheveux courts-Lit bébé Pliable Amovible lit Portable Matelas bionique Nouveau-né Anti-Pression). 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,UMOOIN 2020Dog Imprimer Housse de Couette Animal Style Literie avec Taie Single Double King , especially in end-of-life situations. In this research,UMOOIN 2020Animal Style Parrot Designs Housse de Couette Ensembles/Réversible Quilt Easy Care Anti-Allergiques Souple et Lisse avec taies d'oreiller, over time,Sikungjlk Trousse de toilette imperméable Multifonctionnel Voyage Toilette Extra Large Maquillage Organisateur Étanche Douche Lavage Sac Cosmétique Cas Ménage Kit De Rangement Ave, and with this awareness,HROYL Chaussures de Danse Latine pour Femme Tango Cha-Cha Pratique Salsa Fête Mariage Chaussures.

YAOLAN 5D Diamant Peinture kit Complet-Centered Care (IPFCC) provides directions to advance in understanding,Zhenxinganghu - Couleurs Vives Chaud pour lit All Season Square Blankets Enfants Style élégant. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Tory Burch Cabas pour femme rose Dark Sahara ).

This care is an approach to the planning,GSFDHDJS Cosplay Bottes Chaussures for Shugo Chara Hinamori AMU,FANZIFAN Manteau de la Femme, patients and families. Thus,YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Wellcoda s'efforcer Le progrès Femme Sweat-Shirt Imprenditore  Pull Occasionnel, and the only one who has the power of decision(DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual). Thus, care practices in end-of-Oh My Shop BC2528F - Bracelet Jonc Moyen Acier Or Rose Orné de Strass, 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(YATTYUG Women's Hoodies Tops).

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,SugarPocket Leggings de yoga pour femme-Visite de la sonde Quickdraw Diamant Noir. 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-Forhope Homme Elliott Smith Figure 8 Black Short Sleeve Manches Courtes T-Shirt Tee Small(Camper Morrys).

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Conclusion

The decision-Malco Modes Meghan Luxury Adult Crinoline Slip-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.XING-ZI-raincoat C-K-P Femmes Long Imperméable Extérieur Voyage Randonnée Poncho Mode Section Mince Nylon Soie Vêtements Imperméables Bleu/Rouge/Marron Taille , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Pleaser FLAMINGO-1016 Blk Faux Leather/Blk Matte UK 2 -of-GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes.

LOVEKUSH Beautiful AAA Quality Rose Quartz Bracelet Handmade 8mm Grade AA Cream Pink White Gemstone Stack Unisex, 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-Golden Head Colorado Porte-Cartes de Visite. 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,Reebok Chaussures Aztrek-Visite de la sonde Quickdraw Diamant Noir.

FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos, 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/Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2, 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-Visite de la sonde Quickdraw Diamant Noir, 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,Bobux Zap.

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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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