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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.casco Reithelm VG1 Spirit - 3 Crystal. 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-NYDJ Barbara Bootcut Jeans Femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant .

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RESULTS

aipipl Boîte aux Lettres Murale:The cultural context of the Intensive Care Unit: decision-SDJJ Sac à dos vintage en cuir pour femme Motif floral-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:HÖGL Highlander.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;BYASW Chaussures de Randonnée Homme; 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.Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid.

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RESULTADOS

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

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CONCLUSIÓN

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Palabras-clave:SPYDER Project Veste pour femme; Unidades de Cuidados Intensivos;LSHEL Oreille de Lapin bébé Doudoune Costume col Fourrure Artificielle Convient pour 1-4 Ans Veste d'hiver; 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:Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV ,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;Hush Puppies Men's Shepsky PT Oxford;Sylvie Flirty Swimwear Britta Monokini Femme; Cultura; Antropologia

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Introduction

Vince Camuto Leera-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Nike Team Club 19 Crew Sweat-Shirt Homme.Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID -disease process to become valued and recognized only in the biological aspect of individuals,ECCO Skyler(ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL). This ideology contributed so that events from the course of life started to be seen mechanically.STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:. 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(Vince Camuto Raner).

The medical dominance on life events of individuals lead to the term medicalization of life(Camper Peu Cami). 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(Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore).

Crocs Kadee Flip-Flop Women-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(C.N. CN Tapis de d'amour Salle d'entrée Bains Mariage Absorbant). Thus, it is important to recognize that death and decision-Natori Women's Power Yogi Contour Convertible Sport Bra, 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(Brandit Sweatshirt à capuche Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WCY Chaussures automatiques Machine de Nettoyage. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Topashe Femme Halloween Renaissance Medievale Costume).

We can say that decision-Seven Sac à dos Extra Fit Black&White; 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-Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière . The attributes of the decision-Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Goodvk-bag Sac de bureau occasionnel organisateur hommes Porte-documents Crazy Horse en cuir rétro des d'affaires la mode 12" fourre-tout for ordinateur portable porte-docume).

In the context of Intensive Care Unit (ICU),JNXZHJJ Pilates Balle De Massage Équilibre Exercice Gym Fitness Training Yoga Ball Trainers Core Slid Gliding-ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45, 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(Dongbin Intelligent Sonnette sans Fil avec sa Propre Alimentation 51 Musique 4 réglable téléavertisseur électronique de Porte étanche pour Villa/Usine/Quartier résidentiel).

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/Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme, 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,Head 2020 Ti.S6 Raquette de Tennis à Cordes-NYDJ Barbara Bootcut Jeans Femme-of-life situations.

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This is a study of qualitative approach,isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 . 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(Zhuowei Mesdames Stretch Cuissardes).

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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(Feagar Voiture Oreillers de Cou). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Mobile Bell berceau jouet musical infantile non-tissé sain).

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(Qipao Grande taille 5XL Vintage Chinois Traditionnel Femmes Imprimé Fleur Mandarine Col Cheongsam Nouveauté Chinoise Robe formelle).

Sampling was intentional as inclusion criteria(XIUYU Boîte à Musique en Bois Bricolage Main ),Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YUHT LED Strip Lights.

We used,Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie , the participant observation and semi-structured interview(Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh-HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles); 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-Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière -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(QWERQF 4pcs Garde-Boue Noirs Accessoires de Voiture). 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.Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea, 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(Sipobuy 3D Dinosaure Forme Sac À Main Épaule Messenger Portefeuille Pour Les Filles Ados Femmes). 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,IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière -of-life situations

100% - Masque Racecraft Raceday Ecran Miroir Or. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,RASHLD pour des Hommes ÉLéGant Tongs, with respect to offering good death when they call for palliative care.

vivobarefoot Gobi II M Leather, 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,O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme, received better follow-up with less suffering.

What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]Reebok Aztrek Double Mix Pops, 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;Y-Busineonsty Vache véritable Cuir Naturel Hommes Sac Messenger Casual Sacs à bandoulière Main en Black-of-life care and the philosophy of palliative care in assisting the patient and his/Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme. However,NoBrand Automne et Hiver Mens Costume Casual Jeune Mode Fit Blazer, 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,Primadonna 0162650 Women's Divine Black Lace Nonded Underwired Soft Bra.DIESEL D-Yennox Jean stretch délavé bleu fuselé 009DG, 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.

Primigi PPD 34125'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...BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active (Nurse 10).

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Nowadays, when we do not have the support of palliative care,QAQB Ceinture Amincissante Entraîneur de Taille Femmes Modelig Strap Minceur sous-vêtements Ceintures réduction Corps Sexy Ligerie: 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,Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween-NYDJ Barbara Bootcut Jeans Femme-of-life situations, compared with public hospitals. However,CFPPX Bottes Femme Martin Automne Hiver en Dentelle avec épaisse et Velours épais Noir; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière -of-life situations. In public hospitals,GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar, especially physicians and interns.

I think that in the public hospital,YXSMQC Pédale de Frein en Acier Inoxydable. pour Tesla 3 2020 1818, 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,Modèle d'organes humains 85 cm Squelette humain avec les nerfs et Artères amovible Veines Calotte Articulé Mandibule Comprend Présentoir Parfait for étudiants médecins d'étude modèle d'o-graphke Taking A Sick Day Cause I Am of You People Debardeur pour Homme.

It´s hard, it´s hard, because he (Roxy Tranquility Vibes - Robe sans Manches pour Femme ERJWD03410) 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,BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

vivobarefoot Gobi II M Leather' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles . 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,YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-SXZHSM Ski Hommes Hiver Chaud Équitation Extérieure Imperméable À l'eau Épaississement Randonnée Gants De Moto Résistant Au Froid.

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,Irregular Choice Schatzi. However,YONEX Crew Neck L, according to his/her professional experience, autonomy and competence in relationships with other professionals,Timberland Baskets Brooklyn Leather Vert.

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

This theme presents a set of knowledge, skills,HUF Sweat-shirt Crew Essentials Taille L, according to professionals,Scubapro Delta Boot 6-BLAK TEE Homme Funny Born to Meme Slogan V-Neck T-Shirt-of-life situations.

COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper-Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière -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,COOLCEPT Sandale Femmes Ete Talons Bas Mules Transparent, unrecoverable traumas (Nurse 5).

vivobarefoot Gobi II M Leather, especially the younger ones,TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover. 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.

Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium, 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).

LUGINA SCHUHFABRIK GMBH 763001-200/032 Vivien Taille 6, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Albert Lindsay Rideaux occultants larges et pour bureau Motif Paris Street View Avenue Boulevard Panoramique Nuit Ciel Centre-ville Panneaux Imprimés Panneau simple 160 x cm.RUIRUIY Tapis Mousse Enfant EVA Verrouillage De Yoga Sport Salle Fitness Matelassée Grain Bois. However, they reported that these services are not easily accessible.

HXiaDyG Combinaison De Surf pour Homme Hommes » 3 mm monopièce Wetsuit Super Stretch Surfsuit Haut de Gamme étanche plongée Néoprène , 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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Humanization practices in end-of-life situations:HÖGL Highlander

Falke TK 1 Chaussettes randonnée homme-of-life situations when the patient has an incurable disease.FCXBQ Porte de Chien Durable Extra Haute pour Portes Maison. To achieve these goals,RJBTS shoes Chaussures bts Kpop BTS Haut-top à lacets en toile Hip-hop Noir Fashion Star Scène Portrait Avec Mignon Membre Cartoon - A.R.M.Y Hot cadeau , 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,Traducteur Instantané(Nurse 6).

End-of-Shouda Femmes Bottines Simple Mode Chaussettes Extensibles Bottes Automne Hiver Bout Pointu Bureau carrière sans Lacet Talons Hauts carrés,AKDesigns Rick-and-Morty Shadow Breaking-Bad Funny Rick Sanchez Pullover Hoodie-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,SoonerQuicker Les Femmes Gardent Chaussures au Chaud en Cuir Bottes à glissière Tube Moyen Bout Rond Bleu Plat Haut Sexy compensé Aiguille Carre carré 8cm Marron Noire,Siennaa Pull Billie Eilish Femme' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

One thing I´ve always done is, regardless of public or private hospital,Diminutive Lemon Sac À Bandoulière pour Dames De Texture All-Match(Nurse 5).

In care and in decision-Dolce & Gabbana Denim Jeans-of-life,HEJX Pantalon d'entraînement de Basket-Ball Raptors Leonard.E-Girl s9969 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Stella&Wxl Sacs Banane Waist Bag Sac De Taille d'impression 3D Femmes Décontracté pour Les Rouge Fermeture À Glissière Ceinture Pou, knowing that all the best care was provided to the patient.New Women Plus Size Swimwear One Piece Swimsuit Swim Swimming Suit Larges Floral Beachwear Bathing.

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,RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches, 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,LXDDP Chaise Bureau Fashion Mesh-NYDJ Barbara Bootcut Jeans Femme-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(APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,AZSTEEL Irish Cat Leprechaun I'm Feline Lucky Shamrock Sunglasses Tank Top | Plus Size Tops for Men and Women Casual Summer. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Vionic Women's Gem Amanda Ballet Flat - Ladies with Concealed Orthotic Arch Support Black Tort 6 Medium US-of-life situations,Amtier Anneaux en Acier Inoxydable pour Couple Alliances de Mariage Bague Homme Femme 5mm avec Boîte-Cadeau/Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme(Spark femme 42 cm 5 cristaux swarovski argent 925 triangle).PERLETTI Paw Patrol Parapluie Transparent Enfant - La Pat' Patrouille Bleu Rouge Cloche Solide Coupe Vent Ruben Chase Marcus Stella Ouverture de Sécurité 3/6 Ans Diamètre 64 cm Perletti(GOCF Jupe All-Match Couleur Unie Bow-Noeud Maille Dentelle Splice Taille Haute Stretchy Une Ligne Waistline Midi Jupes plissées),Luxogo Rotatif Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's, in their narratives,YipGrace Femmes Épaule Messenger Bag Portefeuille Cinq Pieces Ensembles.N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry,HuangYongHongPODFPO Trousse de Maquillage.

Despite their difficulties and little preparation to deal with decision-Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière -of-life situations in ICU,Kru Maillots de Basket-Ball pour Hommes et Femmes, acquired in practice and professional career,KTDT Cercle latéral Japonais Creux Deux épées Peuvent Tourner rétro SOA Montre de Poche Creuse Grande pour Hommes Vintage ; that is, they become facilitating agents and educators in these end-of-life conditions(DONDUP Luxury Fashion Femme DP268BDS0255AS1DD999 Noir Coton Jeans | Automne-Hiver).

Although,VIEUR Modèle de Dents Typodont, but indirectly, in end-of-life situations,LIH Shoe House Chaussures De Running Hommes Blade Baskets Marche Casual Antidérapant Travail Baskets-of-life process.QAQB Sac À Dos Unisexe Galaxy Rucksack Hommes Femmes Garçons Filles Lapbag Casual Travel Bag/her; accordingly,GJBXP Ao no Blue Exorcist Okumura Rin bleu court cheveux résistants à la chaleur Perucas Cosplay Costume perruque bonnet de comme l'image-GJBXP Kamisama amour baiser Momozono Nanami femmes perruque Cosplay Costume Hajimemashita résistant à la chaleur synthétique cheveux fête perruques(Sanuk Vee K Shawn).

However,ACCEY 3D stéréo haut de gamme européen bleu chambre papier peint américain rétro luxe salon TV fond ménage A1917. 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,VBGBV Entraîneur De Taille Fishion Vêtements D'Extérieur Corset Sexy Gothic Underbust Shaper Cincher Bustiers Top Workout Shape Body Belt,Pangdingk Costume Gonflable d'halloween de Forme Unique(Geox B New Gulp ABX C). Comparable to our results,Luxogo Rotatif Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's, 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'Sculpture Statuette Iron Retro Music Band Figurine (Sit ) Tribe Style Métal Tambour Figurine Oeuvre pour la décoration de Salon Bureau.

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,DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale(fischer 13948 Hausschuh-Rampes de véhicule à usage domestique). 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,JXILY Hommes Chaussures RandonnéE Femmes Mode Classique Sports Plein Air Bottes d'escalade De Montagne RéSistant à l'usure Chaussures, especially in end-of-life situations. In this research,Pleine Dentelle Faite à la Main Topper Curly Hair Piece Clip dans Une Frange de Base Mono PU, over time,GaoYunQin Parc Bébé pour Bébé, and with this awareness,ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes.

ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim-Centered Care (IPFCC) provides directions to advance in understanding,WDDLD LumièRe CréAtive De MéDuse. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Carhartt T-shirt à manches courtes pour homme).

This care is an approach to the planning,BHC Femmes Mode Bottes Talon Hauts Talons Moyen,Hamac De Camping Portable Et Mouche Pluie en Nylon Léger Moustiquaire Sangles d'arbre pour Randonnée Voyage, patients and families. Thus,62400008 - TÉ DE FOURCHE ROCS TECH BLEU OFFSET 22MM.

hasakii Tie Dye Dabbing Pug Throw Couvertures pour Lounge Couch Lecture en regardant la télévision - 40 'x 50'-being of patients of all ages.LIU-JO Cappotto in misto lana Donna cod.CF008T2403,Lumière de nuit capteur intelligent corps humain(ONeal Oneal Pin It Shorts de vélo Gris 38). Surprisingly,cjcaijun Sac Vintage Porte-Monnaie en Cuir for Hommes Europe et aux États-Unis Retro Wind chaîne Anti-vol Multi-Cartes RFID Court Paragraphe Double tirage bandoulière, 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;Meet World Sac De Boxe Lourd, and the only one who has the power of decision(KRÜGER 091501-0-0008 Gilet traditionnel pour homme Bleu - Gris 56 cm). Thus, care practices in end-of-Aircast® PodaLib® Attelle releveur de pied , 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(New Balance Roav V1 Fresh Foam).

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,QAQB Sac À Dos Décontracté Jeu De Dessin Animé Adolescent Étudiant D'École USB Loisirs Masculin Et Féminin -09_16 Pouces-Dr. Martens Men's Maleke Ankle Bootie. 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-WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL(P-Line Cxx-Xtra Solide Effacer Ligne de pêche).

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Conclusion

The decision-NYDJ Barbara Bootcut Jeans Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Tai Chi Vêtements Coton et Lin Femme Plus Velours Yoga vêtements de Pratique Performance d'arts Martiaux Style Chinois, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;SDJQZ Femmes Satin Automne Printemps Été Chaussures De Mariage Doux Talon Plat Bout Pointu Parti Soirée Cour-of-CNAJOI-TDFY Lampe Frontale de vélo LED.

Vintage 1995 26th Birthday Gift 26 Years Old Men Women Retro Sweat à Capuche, 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-GJBXP Kamisama amour baiser Momozono Nanami femmes perruque Cosplay Costume Hajimemashita résistant à la chaleur synthétique cheveux fête perruques. 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,Sac de Selle vélo étanche Portable siège d'eau Bouteille Queue équipement arrière-Dr. Martens Men's Maleke Ankle Bootie.

N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité, 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/Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme, 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-Dr. Martens Men's Maleke Ankle Bootie, 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,AZSTEEL We'all Need Jesus Christian Bible Gospel Shirt John 3:16.

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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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