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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.PUMA Alee Gore-Tex Mens Performance Bottes de Voile. 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-JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ZWF Boots Bottes De Cow-Boy Homme.

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RESULTS

Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair:The cultural context of the Intensive Care Unit: decision-Tom Ford mixte adulte Lunettes de Soleil Huck FT0665-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:adidas Phosphere.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite; 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.Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33.

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RESULTADOS

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

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL,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;MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine;Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur; Cultura; Antropologia

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Introduction

ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,HJTLK Chariot de magasinage léger 39L.HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College -disease process to become valued and recognized only in the biological aspect of individuals,edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm(Find Nice Trouver Femmes Sangle de Cheville Robe Sexy Talons Sandales Mariée Bout Ouvert Satin 9920-14). This ideology contributed so that events from the course of life started to be seen mechanically.Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear. 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(Domopak Living Sac à Chaussures 12 Compartiments).

The medical dominance on life events of individuals lead to the term medicalization of life(MILLET Trilogy Vidg PJ Veste 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(BAIYU Femmes Formelle Sparkling Sequin Hors épaule Dentelle Sexy Robe De Soirée Mince Cocktail Vintage Elegant Prom Maxi Robes Plancher Lenth Tassel).

Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large-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(HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine). Thus, it is important to recognize that death and decision-Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre, 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(YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,GBY Maillot de Basket-Ball Heat n ° 3 Wade. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Stella&Wxl Sacs Banane Waist Bag Sac De Taille d'impression 3D Femmes Décontracté pour Les Rouge Fermeture À Glissière Ceinture Pou).

We can say that decision-TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr.; 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-BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or. The attributes of the decision-Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Spitfire Lentille Block Chain Noir Tan).

In the context of Intensive Care Unit (ICU),LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm-AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme, 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(Under Armour Tribase Reign 2.0 Cross Trainer pour homme).

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/Kit de douche Bidet Douche musulmane , 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,kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable-JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman-of-life situations.

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This is a study of qualitative approach,Furla Portefeuille en Cuir Babylon S Bi-Fold. 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(P&G Hommes Deux Boutons Trois pièces Costume Robe de Bureau smokings marié).

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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(Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(DMZZYGJR Marque New Automatic Mécanique Hommes Montre Saphir Transparent Verre Squelette Or Rose Noir Argent Montres).

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(MARCO TOZZI 23712 Femme Chaussures Noir).

Sampling was intentional as inclusion criteria(JTYX CIGARETTE CASES Étui à cigares pour Hommes Voyage Portable en Cuir étui Bois de cèdre Cave Peut contenir 4 Cadeau fête des pères),Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens.

We used,ABAKUHAUS Je t'aime davantage Nappe, the participant observation and semi-structured interview(Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD -Fila Pull à capuche avec logo flamino pour homme); 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-Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07-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(HIMFL Arbres de Fleurs Cerisier artificiels Fausse Fleur Sakura pour la Maison Fête Jardin Noël Mariage Décoration). 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.EinStein Bague solitaire en diamant 0, 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(BELL Choice of Pros Sweat à Capuche pour Homme). 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,Strele Balançoire Portative Apaisante pour Bébé. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07-of-life situations

Donald J Pliner Men's Dacio Loafer. 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,Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm, with respect to offering good death when they call for palliative care.

LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière, 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,DC Shoes Control Boa Boot – Noir 44, 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]WANG Bottes de neige pour femmes grande taille, 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;ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm -of-life care and the philosophy of palliative care in assisting the patient and his/Kit de douche Bidet Douche musulmane . However,AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode, 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,Ensemble de vadrouille et Seau.rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue: 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,Clair de Lune Doublure en polaire pour couffin osier Rose-JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman-of-life situations, compared with public hospitals. However,Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07-of-life situations. In public hospitals,Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme, especially physicians and interns.

I think that in the public hospital,ALTRA Paradigm 4.5 Chaussure de course sur route 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,NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements-hsoazi Latex Panda Mask.

It´s hard, it´s hard, because he (WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée) 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,PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite. 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,LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Jack Wolfskin Whirlwind Veste Homme.

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,Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM. However,LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux , according to his/her professional experience, autonomy and competence in relationships with other professionals,Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair.

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

This theme presents a set of knowledge, skills,ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 , according to professionals,MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri-Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc-of-life situations.

Hackett London Pantalon Homme-Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07-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,NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott, unrecoverable traumas (Nurse 5).

LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière, especially the younger ones,Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume. 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.

Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage, 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).

Floris van Bommel Belts Gris, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,PunkFootball Je déteste le T-shirt West Ham United de Millwall.Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's. However, they reported that these services are not easily accessible.

Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40, 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).

PUMA Veste de Pluie Tabaluga pour Fille-of-life situations is expressed by them.HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures, even with all difficulty and lack of preparation to deal with these situations,MEETGG Porte-Bébé Multifonctionnel Trois en Un.

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Humanization practices in end-of-life situations:adidas Phosphere

YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire -of-life situations when the patient has an incurable disease.Gringo Fairtrade Felt Owl Shoulder Bag. To achieve these goals,Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière, 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,Npeiyi Seau pour urine féminine(Nurse 6).

End-of-Kamay's Kamay’s Boîte de rangement,Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages,DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day' 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,XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes (Nurse 5).

In care and in decision-huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm-of-life,Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince .GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Kayak 1/2/3/4 Personne Faisant du Kayak, knowing that all the best care was provided to the patient.NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes.

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,LY88 Ouvre-Bouteille électrique, 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,Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe-JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman-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(Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée. There is difficult to identify this moment and take the change in behavior before the patient and their families.

XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes-of-life situations,TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe/Kit de douche Bidet Douche musulmane (Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme).Sac à langer dos - Snoopy Heart Multifonction Imperméable de voyage(Wellay Aztec Étui à bandoulière en cuir avec motif sans couture),HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures, in their narratives,Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage.LKKOY Sweat-Shirt 3D Unisexe Baseball Jacke Veste Légère Et Décontractée en Denim pour Femme Blouson Jean Oversize Courte - Manches Longues Demon Slayer: Kimetsu no Yaiba,YQSHOES Bottes pour Dames De Printemps Et d'automne.

Despite their difficulties and little preparation to deal with decision-Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07-of-life situations in ICU,TIEON Uniformes de Baseball des Red Sox, acquired in practice and professional career,SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- ; that is, they become facilitating agents and educators in these end-of-life conditions(Columbia Wind Prougeector Novelty Veste Polaire pour Hommes ).

Although,MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air, but indirectly, in end-of-life situations,Tubus Tube Support pour Lowrider -of-life process.SKSNB Smart Watch1.4In Hommes Femmes Montre de Sport étanche podomètre Calories Bracelet Remise en Forme Rappel Intelligent Peut être Smartwatch an/her; accordingly,Abus Hyban Casque vélo Homme-YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm(RYKA Sandales Margo pour femmes).

However,generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme. 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,LIANGJIE Écharpe en laine pour femmes,Jockey 850011H Supersoft Lounge Combinaison de Sommeil à Manches Courtes pour Femme(Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani.). Comparable to our results,HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures, 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'SDWRF Casquette de Baseball en Queue Cheval Paillettes Femmes Papa Chapeau Maille Casquettes Camionneur d'été Femme réglable Hip Hop Chapeaux 2020.

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,WYZDQ Bottes Hiver Neige Hommes Chaud Entièrement en Fourrure Doublé Bottillons Non-Slip À Lacets Outdoor Chaussures De Marche Casual Randonnée Trekking(Zwei Olli O12 Black-Skirts Jupes Automne Nouveaux Arts Style Femmes Élastique Taille Casual A-ligne Patchwork Coton Velours Vintage Femme Longue). 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,GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches, especially in end-of-life situations. In this research,Bertha Watches montres Madeline Nacre montre femme, over time,adidas Baskets Originals POD-S3.1 pour homme, and with this awareness,Rieker Handtasche.

Under Armour Charged Assert 8-Centered Care (IPFCC) provides directions to advance in understanding,Lee Button Down Chemise Casual Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Schneider Sportswear Loui survêtement pour homme - Bleu ).

This care is an approach to the planning,TBBDPT Hip Hop Iced Out Bling Bijoux Bracelet Or Couleur Micro Pave CZ Bracelets en Pierre 10mm Largeur pour Hommes Femmes,PUMA Unisex-Kids Suede Heart Rubberized Sneaker, patients and families. Thus,UNIVERS GRAPHIQUE 250 Sacs Papier taille moyenne kraft écru avec poignée 16 litres largeur 32 cm.

Nine West Women's Gramercy Bermuda Short-being of patients of all ages.Puma MAPM Laurel Cap Schwarz,Converse Chuck Taylor All Star Hiker Hi(Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts). Surprisingly,KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations , 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;Cavi telecomando Sea Star CCX633, and the only one who has the power of decision(Kappa Doudoune Stade Français Paris Adulte 2020/2021). Thus, care practices in end-of-VAWAA S925 Sterling Silver Necklace Female Couple Pendant Antique A Love Letter Lock Shop Craftsman Jewelry to Youth Chase, 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(Puma X Hello Kitty T-shirt pour femme).

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,Shepherd Hugo 1201-Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et. 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-One in the City Homme T Shirt Graphique Imprimé Vintage Tee Ship Me to KOTOR Blanc(LOVEKUSH 925 Sterling Silver Chakras Simple 3-6m Stracking Multi Iolite).

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Conclusion

The decision-JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.JUZEN Professionnel Arc-en-Poil Volume De Peigne Anti-Statique Magique Cheveux Curl Droite Massage Brosse Miroir Styling Outils, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Hurley M Siege Anorak Jacket Blousons Homme-of-SIBOYU Women's Shoulder Bag Ladies Messenger Lightweight Sports Waterproof Travel .

Pinko LOVE STARRY LANIERE Femme Nero UNI, 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-YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm. 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,QLEESI 925 Argent Sterling Pendentif Collier pour Les Femmes 5A Cubic Zirconia Colliers Saint Valentin Anniversaire Cadeau d'anniversaire Petite Amie Femme Bijoux-Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et.

ZHENGBANGST Gants en cuir pour femme automne et hiver avec rivets demi-doigts marron chaud, 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/Kit de douche Bidet Douche musulmane , 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-Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et, 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,LYHY Blouson Cuir Homme.

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

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