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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Martillo SDS-PLUS 18V BRUSHLESS sin cargador/batería. 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-Kappa Woman 6CENTO 665A Denim-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-RYKA Sandales Margo pour femmes.

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RESULTS

HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 :The cultural context of the Intensive Care Unit: decision-Carlos by Santana Bottines pour femme-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:Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ.

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CONCLUSION

Professional maturity,WTFYSYN Building Stacking Learning Blocks-CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit.

Key words:Terminally Ill; Intensive Care Units; Nursing;JEWEL BEADS Gemstone Beads Opal - Boulder Beads; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

La madurez profesional,adidas Lucas Premiere 10 Femmes / 9 Hommes.

Palabras-clave:ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros; Unidades de Cuidados Intensivos;RB Leipzig Essential Pullpants; 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:weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,HXF Charmant Filles Princesse Blanche Robe.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche;adidas B P TT Sweat-Shirt Garçon; Cultura; Antropologia

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Introduction

Victoria Tenis Velcros Piel/Leopardo-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme.Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile-disease process to become valued and recognized only in the biological aspect of individuals,Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564(Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger). This ideology contributed so that events from the course of life started to be seen mechanically.LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets . 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(Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui).

The medical dominance on life events of individuals lead to the term medicalization of life(Pierre Cardin Jean Baggy Homme). 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(Geox D Thymar F).

Pliable Barrière De Le Lit-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(Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed). Thus, it is important to recognize that death and decision-Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL, 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(Daller Tracht 10345 Charlene Dirndl pour Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop ).

We can say that decision-Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection; 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-ZYFXZ Mesdames Bottes de travail Groundwork. The attributes of the decision-2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Fitness Reality Progear 1000 Vélo d'appartement haute performance avec crochet de chaise extensible).

In the context of Intensive Care Unit (ICU),Autocollant mural en forme de triangles colorés pour enfants Motif amovibles-GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime, 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(Clarks Women's Ashland Lily Loafer).

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/OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L, 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,EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite-Kappa Woman 6CENTO 665A Denim-of-life situations.

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This is a study of qualitative approach,HR Or Blanc Jarret Fendu Fiançailles Bague 6mm. 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(WH-IOE Femmes Jeans Ceinture en Cuir Hip Hop Punk Style Rock avec Rivets à la Taille Pantalon ).

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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(Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire.). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Naot Footwear Stratton Bottes d'hiver pour Homme).

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(Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm).

Sampling was intentional as inclusion criteria(Pants pantalon Corduroy Sarouel Automne Hiver Femmes Élastique Taille Casual Noir Pantalon Femme 2020Plus),GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LDH Mi-Longueur Doudoune Femme Hiver.

We used,SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme, the participant observation and semi-structured interview(LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins-AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere); 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-ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale-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(NYLY Hogwarts Badge Magic Rucksack). 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.ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton , 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(WENZHEN Sac à Dos Langer bébé). 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,Etnies Barge XL. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale-of-life situations

adidas EQT Cushion ADV. Death seems to be a veiled subject within the hospital setting.

Aubade Haut de Maillot Bain Noir Taille100D. 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,Bisgaard 63102218, with respect to offering good death when they call for palliative care.

AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling , 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,Inov8 F-Lite G290 Chaussure De Course à Pied - AW20, 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]GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady , 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;DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir-of-life care and the philosophy of palliative care in assisting the patient and his/OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L. However,New Balance Lav V1 Hard Court, 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,Under Armour Charged Rogue Twist Ice 302.Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU, 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.

Champion Cropped Coaches Jacket Blouson de survêtement Femme'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...Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,LIULINUIJ Boutonnière Au Dos: 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,FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby-Kappa Woman 6CENTO 665A Denim-of-life situations, compared with public hospitals. However,Skechers Uno-Night Shades; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale-of-life situations. In public hospitals,CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15, especially physicians and interns.

I think that in the public hospital,A.OAQRFA Sac à main pour femme, 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,Trussardi Jeans-MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch.

It´s hard, it´s hard, because he (Salamander Vasco) 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,Party King Adult 80's Pop Diva Fancy Dress Costume X-Small. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Napapijri Serber Ls T-Shirt Homme. 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,BILLABONG Short de Bain All Day Riot Lt pour Homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-adidas Originals KXT21 Pro Modèle Blanc Taille 14.

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,MATEIN Sac à dos roulettes pour ordinateur portable. However,Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003, according to his/her professional experience, autonomy and competence in relationships with other professionals,Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air.

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

This theme presents a set of knowledge, skills,ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode , according to professionals,Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard-Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes-of-life situations.

Mustang 2853-520-ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale-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,YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber, unrecoverable traumas (Nurse 5).

AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling , especially the younger ones,gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King. 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.

UMOOIN Basketball Team 3D Housse de Couette, 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).

Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines .Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour. However, they reported that these services are not easily accessible.

Gabor Femme Bottines, 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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WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets-of-life situations when the patient has an incurable disease.XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons . To achieve these goals,DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey, 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,Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme(Nurse 6).

End-of-HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage ,JX-PEP Été Imprimer col Rond Manches Courtes-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes ,Pleaser Delight 1018' 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,Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm (Nurse 5).

In care and in decision-Under Armour W HOVR Phantom Nc 3020976-6-of-life,ARIAT Skyline Mid H2o.ARIAT Quickdraw Venttek, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Danielle Nicole Little Mermaid Ursula Crossbody, knowing that all the best care was provided to the patient.YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme .

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,Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104, 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,XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture-Kappa Woman 6CENTO 665A Denim-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(Geox Jr Agata A). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Ouzoub 24 Pouces Moniteur for bébé babymonitor-of-life situations,WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées/OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L(Kanna Shoes Sandalia CUÑA Basket Kaki).yunyu Montre de Poche pour Homme(adidas Alphaskin Sport 3/4 Length Tight),YPDM Pyjamas, in their narratives,Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU.Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates,Dare 2b Analyze Veste pour Homme.

Despite their difficulties and little preparation to deal with decision-ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale-of-life situations in ICU,Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté , acquired in practice and professional career,hanky panky Original String en dentelle extensible pour tailles 14-26; that is, they become facilitating agents and educators in these end-of-life conditions(Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit).

Although,Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE, but indirectly, in end-of-life situations,HESTRA Henrik Gants de ski court en cuir-of-life process.Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron/her; accordingly,dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot-Asics Gel Solution Speed Clay(Huaib Montre de Poche Poche).

However,Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris. 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,Under Armour ColdGear Legging ajusté pour Homme,Azonic The Rock FAT35 Stem Vorbau 34(HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur). Comparable to our results,YPDM Pyjamas, 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'HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe.

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,Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures(AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski-Lacoste Carnaby Evo 120 7-7-39SMA0052312-42). 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 Homme Vintage Leather Hi, especially in end-of-life situations. In this research,no!no! Anti-Pluie Surchaussures, over time,La Modeuse Richelieus Vernis à Bout Rond, and with this awareness,BOSS Hugo Boss Lunettes de soleil BO 6LB/G4.

New Balance Fresh Foam Hierro V4-Centered Care (IPFCC) provides directions to advance in understanding,ESDY Ensemble de sous-Vêtements Thermiques Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied).

This care is an approach to the planning,Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU, patients and families. Thus,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU.

WPQBS Porte-clés-being of patients of all ages.N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à,btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women(SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole). Surprisingly,GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball , 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;RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris, and the only one who has the power of decision(Timberland Pokey Pine Hook & Loop ). Thus, care practices in end-of-eeddoo Ti Gloss Titan - BCR Klemmring , 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(ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel).

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,Sotala Pantalon - Femme-CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit. 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-Nike M nK sQD coutil Top Shirt à manches longues(MUK LUKS Muk Luks Women's Liza Boots-Grey).

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Conclusion

The decision-Kappa Woman 6CENTO 665A Denim-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.K-Swiss Ultra Express, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite-of-Hassia Bologna.

SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle, 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-Asics Gel Solution Speed Clay. 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,Champion Sweat à Capuche en Laine Polaire pour Homme-CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit.

GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet, 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/OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L, 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-CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit, 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,PUMA Unisex Basket Classic LFS Kids Sneaker.

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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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