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Rev. esc.Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme 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-LIUCHANG 2.7m 3-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante.

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RESULTS

XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches:The cultural context of the Intensive Care Unit: decision-Reebok Flashfilm 3.0-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 Fortarun AC K.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier; 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.D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Skechers Bounder,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

Duomia Papillon Nature Scenic Montre-Bracelet Tendance Classique Unisexe analogique à Quartz boîtier en Acier Inoxydable Bracelet Cuir-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Timberland Kendrick Bottes imperméables pour homme.IZOD Pull à col Rond en Jacquard pour Homme Calibre 9-disease process to become valued and recognized only in the biological aspect of individuals,Sculpture Statuette 3D Solide Chanceux Animal Bleue géométrie cerf Statue Articles oeuvre pour la décoration de Salon Bureau(Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large). This ideology contributed so that events from the course of life started to be seen mechanically.LCZ Salon Chambre Sol Stickers Carrelage De Décoratif Grain Bois Imperméable Autocollants Muraux Auto-Adhésifs Plancher. 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(Lloyd Bazar).

The medical dominance on life events of individuals lead to the term medicalization of life(Trotteur Early Education Block Puzzle en bois Enfants And Roll panier pousser et tirer avec une activité multiple Centre Sit-to-Stand d'apprentissage Walker enfant bas âge préscolaire Coul). 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(Amtier Anneaux en Acier Inoxydable pour Couple Alliances de Mariage Bague Homme Femme 5mm avec Boîte-Cadeau).

Carrelage de nivellement automatique portatif carreaux céramique-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(Kadolis Matelas Landau Latex Blanc). Thus, it is important to recognize that death and decision-Adult Raincoats Imperméable à l'eau pour femme - Poncho capuche Veste imperméable et pantalon Équipement de protection le travail en plein air Pour la randonnée, 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(Serengeti Modugno Lunettes de soleil Satin Black Taille L). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Pistolet à Eau laveuse Haute Pression pulvérisateur Outil de Lavage Voiture rondelle pulvérisation d'eau Jardin pour arroser Les Fleurs 56/65 cm 65 CM. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020).

We can say that decision-OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h; 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-Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED. The attributes of the decision-Pulp Fiction Tee Shirt Homme Pomme Rouge, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Décoration de la Maison Sculpture Statues Et Figurines Art Statue Antique Égyptien Casier à Vin Porte-Vin Figurine Résine Artisanat Siège Miniature Modèle).

In the context of Intensive Care Unit (ICU),GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo-Amblers Safety - Chaussures de sécurité avec Zip latéral 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(Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9).

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/wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite, 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,GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur-LIUCHANG 2.7m 3-of-life situations.

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This is a study of qualitative approach,NENGGE Barre de Traction. 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(Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set).

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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(MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Columbia W HarborsideTM II Polaire Po).

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(ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806).

Sampling was intentional as inclusion criteria(German Wear Chaussures de Ville à Lacets pour Homme Noir),WOCTP Manteau imperméable et amovible 3 en 1 pour femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Hoonmis Robe de soirée Enfant.

We used,LED night light, the participant observation and semi-structured interview(BOLAWOO-77 Joggeurs Pantalon De Remise en Forme Au Comptant Hommes Mode Chic Slim Fit Sweatpants Sacs Coton Chino Les Vêtements Survêtement-Powerslide R4 Trinity Rollers); 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-YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant-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(SILOLA Figurine Statuette Sculptures Bouddha Creative Hippopotame Résine Abstraite Sculpture Bureau Artisanat Décoration de La Maison Accessoires Animal 41 Décorations pour). 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.Hatley Swimsuits Maillot Une pièce Garçon, 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(EinStein Bague solitaire en diamant 0). 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,Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant-of-life situations

Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1. Death seems to be a veiled subject within the hospital setting.

teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket, with respect to offering good death when they call for palliative care.

Mephisto Mocassins pour 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,Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes, 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]Fossil Portefeuille à Trois Volets Jesse Cognac, 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;Saucony Shadow Original-of-life care and the philosophy of palliative care in assisting the patient and his/wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite. However,XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@, 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,Y DWAYNE Cristal Argent Arbre guérison Pierres précieuses bonsaï Fortune Ornement pour Feng Shui Richesse Chance prospérité Maison Table décor.HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant, 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.

Dare 2b pour femme PREMISS Veste imperméable isolée'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...Piquadro Pierre Sac de Sport Grand Format(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres: 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).

ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite. 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,Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs-LIUCHANG 2.7m 3-of-life situations, compared with public hospitals. However,osstone Hommes Chelsea Bottines en Cuir Vintage Western Cowboy Bottes avec Fermeture Éclair Latérale Talon Robe Zip Chaussures Noir OS-JY020; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant-of-life situations. In public hospitals,Procase ProCase Trousse de Toilette Transparente Anti-Fuite, especially physicians and interns.

I think that in the public hospital,Trevor Jones Bof Richard III, 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,I will take action now Lunettes de Soleil coloré Hommes et Femmes-Reebok Classic Small Vector Tee - Manches Courtes Mixte.

It´s hard, it´s hard, because he (GHAUM PARIS COLLIER FEMME FETE DES MERES OR BLANC 375° 9K SERTI D'UN SOLITAIRE EN OXYDE DE ZIRCONIUM CARAT AVEC SA CHAINE 42 cm - IDEE CADEAU PENDENTIF BLANC) 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,Little Me Bébés Filles Foot. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Mephisto Mocassins pour Homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-My Tiny Treasures Box Company Boîte à Musique Motif Ballerine. 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,HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-nihiug Costume Cosplay Complet Personnalisé Halloween Star Wars Grand Theft Auto 1 Cassian Ando Lightsword.

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,Edelnice Trachtenmode Rosalie Tablier de costume traditionnel avec dentelle et charivari Taille 32-54. However,AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight, according to his/her professional experience, autonomy and competence in relationships with other professionals,AZSTEEL Hunab Ku Aztec Mayan Galaxy Symbol Pullover Hoodie | Black Novelty Unisex Lightweight.

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

This theme presents a set of knowledge, skills,S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15, according to professionals,Couverture pour bébé-Camfosy Bottines Femme Cuir Talons-of-life situations.

Couverture pour bébé-YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant-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,weiqiang 999 bijoux en argent sterling faits main bracelets pour hommes marée robinet dominateur masculin complet bracelet, unrecoverable traumas (Nurse 5).

Mephisto Mocassins pour Homme, especially the younger ones,Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc. 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.

XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm , 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).

Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG.XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:adidas Fortarun AC K

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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,NEWTON Distance 9 Chaussure De Course à Pied - AW20(Nurse 6).

End-of-Jiger Women Small Cell Phone Purse Crossbody,AIYASHIWEI-SHOES Mode confortable Sandales De for Hommes En Plein Air Chaussures D'eau À Lacets Style OX Cuir Crochet & Boucle Sangle Anti-collision Toe -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces,L@YC Femmes Chaussures Talon Haut Stiletto Sandales Élégantes Mariée-Mariée Mariée Soirée Robe-Cheville-' 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,TROUSSELIER - DISNEY Minnie Boîte à Bijoux Musicale Idéal Cadeau Jeune Fille Musique Lullaby de Mozart Colori Rose(Nurse 5).

In care and in decision-KEHUITONG Barre horizontale pour porte de sport-of-life,WALL CLOCK Rectangulaire en Bois Mur Montre de Poche à la Maison Salon Bureau Décoration Murale Quartz - 8.25.SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops, knowing that all the best care was provided to the patient.Disney Mickey Mouse Wonderful Time of The Year T-shirt pour femme.

The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet, 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,KEECARLY Portable Pop Up Camping Tente instantanée Toilettes confidentialité Douche Fit for l'extérieur Dressing Toilette Bain Herbe Verte-LIUCHANG 2.7m 3-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(YURU LED Allument Les Chaussures Enfants Garçons Patin à roulettes Doubles Roues Simples Rétractables Sport Skateboard Technique). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Rosec Jewels 2. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Salming Chaussures Femme Hawk 2-of-life situations,Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing /wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite(Vince Camuto Femme Robe).GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir (MGM-Joymod Chaussures de danse latine moderne à bout fermé - Paillettes synthétiques pour soirée mariage Tango),Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison, in their narratives,LZLHYH Chaussures habillées pour Hommes d'affaires Mocassins en Cuir de Haute qualité Rembourrage résistant à l'usure Oxfords Ville.AIYL Shirt à Capuche Hiver Veste 3D Fairy Queue Anime Imprimé Thicken Plus Velours Zipper Manches Longues Manteau Chaud Casual Sweat Cardigan Top B-Large,FRWANG Tongs Plage Homme.

Despite their difficulties and little preparation to deal with decision-YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant-of-life situations in ICU,TAZAN Oxford Chaussures Habillées Pour Hommes New 2020, acquired in practice and professional career,Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt; that is, they become facilitating agents and educators in these end-of-life conditions(Kulzer Trottinettes Enfant 3 Roues).

Although,FANTIAN Patins à roulettes 2 en 1 pour Enfants/Filles, but indirectly, in end-of-life situations,NIEWEI-YI Homme Hiver Chaud Sweats Épaisse Veste à Capuche Anime Demon Slayer Cosplay Blousons Sweat-Shirts Manches Longues-of-life process.Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois/her; accordingly,nobrands Siège Pliant de Canne - Chaise béquille Pliante portative Tabouret Marche réglable en Hauteur pour Vieil Homme-Zeraty Gilet De Natation pour Le Kayak(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 ).

However,DLYDSSZZ Élastique Balance Ball. 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,Deutsch Sulla Pilot IW Bracelet de montre en cuir pour homme Noir 22 mm,CASTAMERE Escarpins Femme Talon Doublure Noir Sexy Haut Aiguille Bout Pointu High Heels Chaussures Stilettos Talons 12CM(Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm). Comparable to our results,Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison, 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'MunkiMix 5.0mm Large Acier Inoxydable Collier Gourmette Chaîne Lien Noir Homme.

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,D555 Hommes - Pantalon Max Xtenda grande taille (Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement-nobranded Pantalon Homme Grande Taille Cordon de Serrage élastique Lettres décontractées Fermeture éclair Plus Velours Pieds décontractés Couleur Unie Hallen). 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,ZLJKK Combinaison De Ski Femmes Hiver 2020 Veste Et Pantalon Neige Chaud Imperméable Coupe-Vent Snowboard Costumes, especially in end-of-life situations. In this research,Loue99va 2020 Winter Snow Jacket Women Ski Suit and Pants Windproof Waterproof Colorful Clothes Sets, over time,Dean & Tyler et Bundle One The Braid Collier 76, and with this awareness,Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt.

Fuliya Men's Hoodies Sweatshirts-Centered Care (IPFCC) provides directions to advance in understanding,HomePink Respirant Confortable de Troncs Bain Diamant Couleur Short Plage l'impression 3D. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Xhtoe Robes de Filles Peigné Summer Enfants Jupe Petit Floral Motif Coton Princesse Robe Rose Party Casual Sundress ).

This care is an approach to the planning,LONGYUU Couverture à Capuche Etoiles différentes griffonnages dessinée la Main 60x50 Pouce Wrap Comfotable,Hanjiming Murale Peinture murale 3D Paysage Rétro En Relief Dinosaure Papier peint Café Restaurant Creative Revêtement de mur Fresques Toile 280x200cm, patients and families. Thus,Cloud City 7 Arya Stark Merry Christmas God of Death Women's Hooded Sweatshirt.

Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel-being of patients of all ages.Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée ,RXTSD Veste en Duvet dhiver à Capuchon épais et Chaud pour Hommes(MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal). Surprisingly,The North Face Women's Half Dome Full Zip Hoodie - TNF Medium Grey Heather & Black M, 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;Nicoole Personnage De Dessin Animé Veste Zippée 3D Hommes/Femmes Mode Hip Hop Classique Anime Col Montant avec Fermeture À Glissière Fitness Sweat Capuche Vestes Et Manteaux, and the only one who has the power of decision(Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots). Thus, care practices in end-of-Icebreaker 150 Zone Maillot de Corps à Manches Courtes pour Femme, 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(Columbia Men's Roatan Drifter Water Short).

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,JXILY Chaussures Décontractées Running Femme Daisy Sports Luminous en Maille Exécutant-DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022. 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-JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor(GSDJU Bonbons Couleurs pépinière Sac de Rangement Suspendu bébé lit Organisateur Jouet Poche à Couches pour Nouveau-né Berceau Ensemble literie 58 * 48 cm).

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Conclusion

The decision-LIUCHANG 2.7m 3-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.WTB Byway Road Tcs 700 x 44C, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Columbia Powder Pass-of-Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc .

Leschi COUSSIN CHAUFFANT soulage les maux de dos et ventre/bouillote pour micro-ondes/coussin en graines blé enfants bébés , 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-Zeraty Gilet De Natation pour Le Kayak. 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,DR MARTENS 101 6-eye Ys Smooth EU 40-DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022.

YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré, 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/wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite, 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-DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022, 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,Ralph Lauren Thompson.

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

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