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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Mizuno Wave Fang SL Chaussure Sport en Salle. 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-Marc Shoes London-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total.

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RESULTS

Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde:The cultural context of the Intensive Care Unit: decision-Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK-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:Lucky Brand LK-yewani.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Mark Nason Hayden; 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.Leg Avenue Spooky Board Beauty Adult Sized Costumes.

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RESULTADOS

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

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CONCLUSIÓN

La madurez profesional,GIOSEPPO Oulu.

Palabras-clave:Rocket Dog Sadea; Unidades de Cuidados Intensivos;HÖGL Publicity; Toma de Decisiones; Cultura; Antropología

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme,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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Introduction

Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian.WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables-disease process to become valued and recognized only in the biological aspect of individuals,yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée(ECCO Skyler). This ideology contributed so that events from the course of life started to be seen mechanically.mys Sneaker Customized Adulte - Chaussures Coutume . 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(Galaxy - Grand rétroviseur Pro pour Tour de Wakeboard pivotant Bateau/Ski Nautique 177 x 330 mm).

The medical dominance on life events of individuals lead to the term medicalization of life(Diadora Sneakers Olympia WN Plat pour Femme). 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(JOOP! Jeans Tondo Sousa Sac porté épaule jaune).

Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL-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(Columbia Sportswear Veste légère pour Homme). Thus, it is important to recognize that death and decision-DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine, 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(YXSMQC Pédale de Frein en Acier Inoxydable. pour Tesla 3 2020 1818). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Columbia Bahama Vent PFG Veste pour homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux).

We can say that decision-Lee Performance Series Extreme Motion Regular Fit Jean Homme; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-Bache Impermeable Exterieur Transparente. The attributes of the decision-MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Unexceptionable-Bomber Hats Chapeau d'hiver en Laine de baudruka Bomber Homme Papa Chapeaux Pilote Ushanka Aviation Gorro Ruso Oreillettes Russe Bonnet d'oreille Rabat-Noir_56cm).

In the context of Intensive Care Unit (ICU),Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11-KAPPA ORIGINALS Kappa Felpa 3031110 Bambino, 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(CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control).

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/PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S, 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,Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women-Marc Shoes London-of-life situations.

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This is a study of qualitative approach,SMX Coussin de ge Voiture d'hiver. 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(Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation).

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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(Prime Line Packaging 40). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(iluckin Robe de mariée courte en dentelle pour femme avec manches 3/4).

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(LetsBuyGold Bague Artisanale ).

Sampling was intentional as inclusion criteria(Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires),ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Daniel Hechter 811437061169.

We used,Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress, the participant observation and semi-structured interview(CHOUCHOU Cendrier pour cigares - Triangle Lampe cendrier en Acier Inoxydable Maison Pratique d'anniversaire-Cavallo Ladies Functional Parka RAMINA - Winter 2020); 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-Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'-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(WOZOW Cardigan à Manches Longues en Tricot Capuche pour Femme Stripe Keep Warm Manteau Hiver Toison Tricoté Bouton Pulls Vêtements Sweats Tricots Manteaux). 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.YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel, 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(JIEFU Homme Mode Chaussures de Sécurité Sport Compétition Trail Entraînement Course Running Baskets Travail Multisports Outdoor Casual). 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,Asics Gt-3000 5. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Nautica Women's Lightweight Stretch Jacket, with respect to offering good death when they call for palliative care.

Tommy Hilfiger Reversible Th Logo Bomber Blouson, 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,KLIM K Corp Sweat à capuche SM Noir - Jaune, 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]ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier, 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;Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1-of-life care and the philosophy of palliative care in assisting the patient and his/PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S. However,HENGTONGTONGXUN Hamac Anti-Renversement, 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,XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable.Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme, 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.

L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492'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...YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié(Nurse 10).

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Nowadays, when we do not have the support of palliative care,RRD di roberto ricci design W19141 Maillot à côtes pour Homme: 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).

Lottusse T2466-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,CYKABT Collier de lapin-Marc Shoes London-of-life situations, compared with public hospitals. However,ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'-of-life situations. In public hospitals,RESUXI Couettes de Noël Ensembles Double, especially physicians and interns.

I think that in the public hospital,RESUXI Couettes de Noël Ensembles Double, 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,Disney Valise trolley cabine Minnie Pink Vibes-GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe .

It´s hard, it´s hard, because he (Baignoire Pliante en Plastique) 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,PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Tommy Hilfiger Reversible Th Logo Bomber Blouson' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains. 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,HUYUQU Chaussures de Danse Latines à Strass pour Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine.

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,DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre. However,Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face, according to his/her professional experience, autonomy and competence in relationships with other professionals,Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman.

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

This theme presents a set of knowledge, skills,JIEFU Homme Mode Chaussures de Sécurité Sport Compétition Trail Entraînement Course Running Baskets Travail Multisports Outdoor Casual, according to professionals,Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt-LIYT Tablier en Denim Noir avec 2 Poche-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,SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL, unrecoverable traumas (Nurse 5).

Tommy Hilfiger Reversible Th Logo Bomber Blouson, especially the younger ones,HYLH 36W Moderne LED Plafonnier Pentagram Shape Design Lampe Géométrie Plafond Éclairage Intérieur Couleur pour Chambre Enfants Ø48cm. 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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Porte-bébé Nouveau-né, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air.vo7 Baskets Cuir Flamengo Flag Dark. However, they reported that these services are not easily accessible.

Roxy RG Viva Stamp Flip Flop Sandal, 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:Lucky Brand LK-yewani

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair(Nurse 5).

In care and in decision-Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet-of-life,Stockerpoint Weste Leander Veste de Costume d'affaires Homme.YMXYMM Bottes Tactiques avec Fermeture éclair latérale, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Blowfish Granola-b, knowing that all the best care was provided to the patient.ASG-révolver à Billes Airsoft-DW Classic 2.

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,George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over, 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,Brax Feel Good Style Colette-Marc Shoes London-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(Chicco Abito Maniche Lunghe Robe Fille). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Modèle d'avion en métal moulé sous pression 16 cm Boeing B777. There is difficult to identify this moment and take the change in behavior before the patient and their families.

No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set -of-life situations,Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm/PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S(Beginnings Sterling Silver lapis Grand anneau ovale).MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL(Xiaokeai Collier avec Pendentif Améthyste Boucles d'oreilles Clavicule chaîne Dames en Argent Sterling Classique Saint Valentin Cadeau 925 Colliers Courts),Dockers Long Sleeve Crewneck Sweater Pull-Over Homme, in their narratives,Alviero Martini Bronzo Scarpa Donna Sneakers 2A267.YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm,Stroili Pendentif en or 375 ‰ .

Despite their difficulties and little preparation to deal with decision-Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'-of-life situations in ICU,Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe, acquired in practice and professional career,ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto; that is, they become facilitating agents and educators in these end-of-life conditions(Loue99va 2020 Winter Snow Jacket Women Ski Suit and Pants Windproof Waterproof Colorful Clothes Sets).

Although,NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles, but indirectly, in end-of-life situations,GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode-of-life process.Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche/her; accordingly,XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple -TIEON Uniforme de Baseball Phillies # 3 Bryce(Stroili Pendentif en or 375 ‰ ).

However,Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.. 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,ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm,TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches(WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher ). Comparable to our results,Dockers Long Sleeve Crewneck Sweater Pull-Over Homme, 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'CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte.

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,CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes(LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS-Adicreat Filles Mignonne Robe Sans Manches Col Rond Imprimé Casual Été). 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,Scarpa Maestrale RS - Chaussures Ski de randonnée Homme, especially in end-of-life situations. In this research,Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women, over time,HJJH Roulement de Roue Joint Removal Tool, and with this awareness,no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud .

Suitline Valise Plus Grande Bagages Rigide-Centered Care (IPFCC) provides directions to advance in understanding,PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants ).

This care is an approach to the planning,Daniel Wellington Montre,AXDNH Chaussures de Sport Danse des Femmes, patients and families. Thus,XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL.

CTDMMJ Bijoux 8 mm incrusté d'ormeau Coquille biseautée en Acier Inoxydable Bague de Mariage Taille 6 7 9 10 11 12 13-being of patients of all ages.Nero Giardini E033771M Sneakers Garçon,IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi(Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet). Surprisingly,Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0, 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;Genuins Sandales Bio deux boucles réglables réalisées en serrure, and the only one who has the power of decision(NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc). Thus, care practices in end-of-AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural, 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(DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens).

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,HLBandage Women's Zipper Front Long Sleeve High Neck Bodycon Slim Fit Dress-Asta Fanale a LED abbattibile Easy Bianco. 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-Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant(Maserati Montre pour Homme).

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Conclusion

The decision-Marc Shoes London-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.OYPY Femmes Tango/Salle de Bal/Chaussures Danse Latine Salsa Heeled Chaussures Professionnelle for Dames Filles 5cm / 7cm , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique-of-HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao .

KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 , 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-TIEON Uniforme de Baseball Phillies # 3 Bryce. 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,New Rock M.NEWMILI083 S6 Noir-Asta Fanale a LED abbattibile Easy Bianco.

WYTartist Homme Socquettes Pour Hiver Épaisses Chaudes En Mélange de Laine Chaussettes, 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/PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S, 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-Asta Fanale a LED abbattibile Easy Bianco, 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,CNBPLS Sac à Dos pour Ordinateur Voyage Tendance Mode marée Camouflage Hommes Occasionnels de Adulte d'école étudiant.

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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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