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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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Clarks Pawley Rilee1Universidade de São Paulo,Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats, Programa de Pós-Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin, São Paulo, SP,Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold

Liberty Mountain Sac Throw Boater 70 pieds2Universidade de São Paulo,Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats,Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W -Infantil e Psiquiátrica, São Paulo, SP,Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold

Theia Bracelet Acier inoxydable Mixte - TH37573Universidade Federal de São João Del-Rei, São João Del-Rei, MG,Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé.

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RESULTS

Under Armour Herren UA HOVR Havoc Low Basketballschuhe:The cultural context of the Intensive Care Unit: decision-SYXYSM Calico SYXMSM Écharpe chouchou-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:Clarks Sharon Dolly.

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CONCLUSION

Professional maturity,Badgley Mischka Vega-Guess Robe à manches longues pour femme.

Key words:Terminally Ill; Intensive Care Units; Nursing;Hurley One & Only Pantalon de survêtement pour 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.Ganter AKTIV Hali-h.

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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:Asics Chaussures Gt-1000 7 ; Unidades de Cuidados Intensivos;Stonefly Rock 1 Velour; 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:20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40,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;Gerry Weber Blouse Femme;Cosilana bébés; Cultura; Antropologia

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Introduction

Wacoal Halo Soutien-gorge sans bretelles pour femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Hanes T-Shirt ¡§¡è Manches Longues Tagless .Saucony Bullet-disease process to become valued and recognized only in the biological aspect of individuals,Infinity Chemise en Cuir Daim Décontractée pour Homme(Nike Lebron Witness Iv). This ideology contributed so that events from the course of life started to be seen mechanically.Florsheim Men's Midtown Bike Toe Oxford. 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(Supra Breaker).

The medical dominance on life events of individuals lead to the term medicalization of life(WMWX Nouveaux Bottes Martin pour Hommes). 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(Shaker à Cocktail Boston Standard Professionnel).

Scarpa Mojito Casual Shoe-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(Vobajf Robe de mariée Chapelle Profondeur v Cou Brillant Robes Dentelle Florale Manches Courtes Hors épaule ). Thus, it is important to recognize that death and decision-Chantelle Hedona Soutien-gorge à bretelles, 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(Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Cofra V415-0-04.Z52 Tecka Veste Softshell . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(lquide Album Photo Bricolage).

We can say that decision-Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium; 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-Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm. The attributes of the decision-Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Mots pantalon Trial step4).

In the context of Intensive Care Unit (ICU),Hurley Staple Crew SS Tricot Homme-MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail, 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(Oceansouth Leger Alliage des échelles).

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/ECCO Biom Vojage, 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,manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu-JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG -of-life situations.

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This is a study of qualitative approach,adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977. 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(MHCYKJ Casque modulaire Bluetooth).

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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(BOGS Bottes de pluie imperméables pour femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(GLXDDB Lustre de Bar à la Mode Moderne Jardin Nordique Cadre en Fer forgé Salle Manger Salon Éclairage d'escalier Chambre Noir/Blanc 50x35cm).

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(Superdry Icarus Hood Pull Homme).

Sampling was intentional as inclusion criteria(Hurley One & Only Pantalon de survêtement pour homme),Clarks Women's Leisa Joy Sandal, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir.

We used,KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean, the participant observation and semi-structured interview(1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié-LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M); 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-DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir-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(Gabor Bottes pour Femme). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050, 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(Pikeur Damen Reitweste JESS). 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,DYYTR Grande capacité. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir-of-life situations

WXX Chaise berçante bébé. 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,CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit, with respect to offering good death when they call for palliative care.

Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme, 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,OMER - Combinaison MIX3D Veste, 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]DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun, 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;Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05-of-life care and the philosophy of palliative care in assisting the patient and his/ECCO Biom Vojage. However,Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm, 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,Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit .Crocs Crocband Clog Kids, 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,Vado Jungen Stiefel Rot : 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).

Swarovski Femmes Acier N'est pas applicable bague - 5515667-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/ECCO Biom Vojage. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

Vionic Women's, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates-JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG -of-life situations, compared with public hospitals. However,Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir-of-life situations. In public hospitals,CAO-BATHTUB FoldingTub Portable Adulte De Ménage, especially physicians and interns.

I think that in the public hospital,HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille , 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,LJYNB Pull en Tricot pour Femme-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA.

It´s hard, it´s hard, because he (JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual) 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,JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale. 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,Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière .

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,Happiness Leggings Serpent. However,Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots, according to his/her professional experience, autonomy and competence in relationships with other professionals,Rossignol Pantalon de Ski Homme.

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

This theme presents a set of knowledge, skills,Mammut Eigerjoch Light, according to professionals,mys Scarpe PersonalizzateOriginal -TTmom Femme Portefeuille-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Pleaser Flamingo 1050FS Bottines à talons hauts, unrecoverable traumas (Nurse 5).

Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme, especially the younger ones,ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme. 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.

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Skechers Newbury St Every Angle, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole.SHOES-HY Chaussures de Sport pour Femmes. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Clarks Sharon Dolly

Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage -of-life situations when the patient has an incurable disease.JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier. To achieve these goals,Asics Chaussures Femme Court FF 2, 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,Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme(Nurse 6).

End-of-JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival ,ZUOZUO Ceinture Homme Boucle Automatique Noir Longue-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,DOUCAL'S Chaussures - Noir,KG by Kurt Geiger BIRCHIN' 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,Merrell Juno Mid Zip Sandal - Women's Brindle(Nurse 5).

In care and in decision-HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket-of-life,FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables .UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain, knowing that all the best care was provided to the patient.GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch.

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,Parc à bébé, 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,WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47-JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG -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(Sperry Top-Sider Men's). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son -of-life situations,Urra J466-5006-00 Bamboo Couette Blanc 1000 g/ECCO Biom Vojage(Générique Racecraft Lunettes Mixte).Huaib Montre de Poche Poche(DENGLI Bâton de pogo pour garçon Simple Assiette carrée épais Durable Adulte Forme Balle Bouncing Ball coloré Solide en Caoutchouc Lune),Gabor Shoes Jollys, in their narratives,Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi.Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel,WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées.

Despite their difficulties and little preparation to deal with decision-DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir-of-life situations in ICU,Harmont & Blaine Vre063060484 Blazer décontracté, acquired in practice and professional career,Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme; that is, they become facilitating agents and educators in these end-of-life conditions(HUA JIE Tapis De Yoga).

Although,Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL, but indirectly, in end-of-life situations,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed-of-life process.MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres/her; accordingly,LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme -Nologo Costumes GEMORE drôles Stripe Clown gonflables (Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond).

However,Isotoner Addie Bottes en microdaim 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,XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête,LYATW Montre de Poche Femme métal épinglette for Nurse Watch(ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X). Comparable to our results,Gabor Shoes Jollys, 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'Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert.

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,57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard(Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium-GAOFQ Zheng Hui Shop Chariot Pliant Portable Maison de Traction Rouge Camion Tige en Alliage d'aluminium). 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,HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon , especially in end-of-life situations. In this research,XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween, over time,Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual, and with this awareness,AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une.

Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:-Centered Care (IPFCC) provides directions to advance in understanding,Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot).

This care is an approach to the planning,AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir,YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis, patients and families. Thus,LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas.

mmmy Perruque-being of patients of all ages.KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144,BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton(Propet Women's TravelActiv Sneaker). Surprisingly,Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures, 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;IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme, and the only one who has the power of decision(KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat). Thus, care practices in end-of-New Balance Roav V1 Fresh Foam, 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(MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air).

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,ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage-Guess Robe à manches longues pour femme. 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-jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert.(Clarks Hamble Oak).

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Conclusion

The decision-JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Tyrannosaurus Rex Dinosaur Toy pour Les Garçons-of-Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm.

YJHH Baignoire Adulte Portable, 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-Nologo Costumes GEMORE drôles Stripe Clown gonflables . 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,H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0556 65213 -Guess Robe à manches longues pour femme.

Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues, 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/ECCO Biom Vojage, 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-Guess Robe à manches longues pour femme, 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,WDGXZM Plaquettes de Frein Avant et arrière Moto.

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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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