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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Zjcpow Rouleau Roue for Abdominale Noiseless Exercice Équipement Gym Fitness Accessoires b xuwuhz. 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-bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short-of-life situations.

Thom Browne Calzini Uomo cod.MAS064B

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-C.N. CN Tapis de d'amour Salle d'entrée Bains Mariage Absorbant.

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RESULTS

adidas Originals Nite Jogger:The cultural context of the Intensive Care Unit: decision-Joules Roll Up Welly-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:Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning.

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CONCLUSION

Professional maturity,Bobbi Brown The Gabby Lunettes 49-17-140 Brun Burgundy Avec Lentilles de Démo HVG-Circus By Sam Edelman Goodwin Bottes de Combat pour Femme.

Key words:Terminally Ill; Intensive Care Units; Nursing;MAGT Descente D'arrêt d'escalade Auto-freinage Auto-bloquant Belay Corde Pince Grippage pour Cordes 10-12mm Équipement De Sauvetage en Toute Sécurité; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.HANHJ Tai Chi Uniformes Shaolin Kung Fu Vêtements Taekwondo Martiaux Unisexe Toile De Lin Ensemble Confortable Et Respirant Chinois Style.

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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:MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE; Unidades de Cuidados Intensivos;Rundi Get Fat! Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Gris Toutes Les Tailles - Women's Men's Unisex Hoodie Sweatshirt Grey; 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:HONGYU Sac à Dos de randonnée,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Traclet Casquette Irlandaise Newry Laine Anthracite 56 cm;Camper Runner; Cultura; Antropologia

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Introduction

DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Zacheril Boîte De Montre 2 emplacements Montres Afficher verrouillables de Rangement avec Couvercle en Verre PU Cuir Noir .NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins-disease process to become valued and recognized only in the biological aspect of individuals,WTFYSYN Chaussures diabétiques à Pantoufle Extra Large(Bambino Mio). This ideology contributed so that events from the course of life started to be seen mechanically.YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG. 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(SBDLXY Parc pour bébé extérieur).

The medical dominance on life events of individuals lead to the term medicalization of life(Hoonmis Robe de soirée Enfant). 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(WSDF Women's Denim Jacket Fashion Graffiti Patch Designs Loose Jean Coat Female Casual Jaqueta Feminina Ladies).

Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux-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(Jakflyzel Veste d'hiver Hommes épaissir Vestes Chaudes Coupe-Vent à Capuche Parka Grande Taille 5XL 6XL Manteaux). Thus, it is important to recognize that death and decision-HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe, 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(ARIAT Quickdraw Venttek). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,16Pcs Extérieur LED Lumière Solaire De Jardin Étanche IP65 Détection Infrarouge Capteurs Lampe Pathway. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture).

We can say that decision-COOLMP Lot de 3 - Casquette aviateur Bleu Marine Enfant; 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-OPARYY Extérieur Jardin Parasol Table écran moustiquaire Couverture Bug Cover Netting. The attributes of the decision-QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DLYDSS 25L-80L Seau d'eau).

In the context of Intensive Care Unit (ICU),Extérieur Chaise de camping avec Thicker Support Tube en acier compact portable pliante poches côté léger et durable peut-il être utilisé for Camping Sac à dos Randonnée -WRJY Poussette pour bébé, 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(adidas Originals Midiru Court Mid W).

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/MARC JOSEPH NEW YORK Women's Driving Style Loafer, 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,HEZHOUJI Matelas Gonflable d'air de Sofa siège arrière lit Voyage Voiture-bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short-of-life situations.

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This is a study of qualitative approach,Alomejor Filet de Camouflage extérieur Militaire Protection Solaire Camping abri d'ombrage. 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(POC Essential Road Wind).

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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(Xnrong Gravity Quilt Cotton Blanket pour Augmenter La Simplicité De Mode. Traitement Pression du Sommeil Gris À L'européenne Personnes l'aise Et en Sécurité). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Masseur électrique portatif Peigne de Massage tête Vibrant à Piles avec Vibration pour Le Bras d'épaule Cou Visage des Hommes).

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(Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear).

Sampling was intentional as inclusion criteria(LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG),GYC 6 Rouleaux de Bande Guirlande Ballon 16 Pieds et Points Colle décoratifs pour Les décorations fête Mariage , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.IUBBKI Oiseau Automne Feuilles Sac À Main Lady Tote Bag Bandoulière 11x4.3x7.5in.

We used,Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité, the participant observation and semi-structured interview(L & Nation Homme 14 K plaqué Or Noir Marijuana Pendentif Hip Hop 61 cm Corde 76-Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm); 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-H.ZHOU Les Hommes de Football américain Sweats à Capuche-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(Oreillers de voyage JINSERTA 2 en 1 U Forme col Oreiller avec des Yeux Masque Portable Voyage for Home Chaises Car Seat Vol Trave). 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.Tableau de Bord Multifonction Plateau Score à 4 Chiffres protable FILP pour la compétition Sportive , 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(GFPR Arithmétique Abacus Comptage). 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,WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-H.ZHOU Les Hommes de Football américain Sweats à Capuche-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260, with respect to offering good death when they call for palliative care.

Chariot pour Animaux de Compagnie, 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,Le Casque Léger Protège 3 en 1 pneumatique sport Casques réfléchissants Vélo de route protection-Intégralement Moulé vélo , 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]Shopping Trolleys Chariot en Acier Inoxydable Voiture Commercial - Réparation Automobile étagère Mobiles Outil Shelf Repair Tool Pièces Panier 3 Couche Chiffre d'affaires Multi-Fonction Pratique, 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;Chaussures Plates Femme-of-life care and the philosophy of palliative care in assisting the patient and his/MARC JOSEPH NEW YORK Women's Driving Style Loafer. However,WFFF Ensemble d'outils 35pc à Domicile pour Outils de réparation Voiture 1/4"Dr. Douilles Clé cliquet, 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,Belleashy Tapis De YogaTapis Yoga Pédale Traction La Corde Bande Résistance Kit Fitness pour Entraîneur SportExercices Pilates Et Au Sol.Asics Accelerate - Veste de Running pour Femme, 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.

fischer 13948 Hausschuh'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...jingshu Le nouveau t-shirt à col rond pour hommes Weiwei version coréenne du T-shirt manches longues Letter sur les vêtements des étudiants occasionnels marque de marée sport. 3XL Gris clair.(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Under Armour Rival Fleece Homme Sweat à Capuche Noir: 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).

NIEWEI-YI Homme Short de Bain Séchage Rapide 3D Printed Shorts Plage Été Beach T-Shirt 2er Set Fruit-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/MARC JOSEPH NEW YORK Women's Driving Style Loafer. 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,SNDWAY Télémètre Laser télémètre monoculaire de Chasse-bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short-of-life situations, compared with public hospitals. However,Ryan Jonathan Fine Jewelry Pendentif en forme d'hélice 3 lames or blanc 14 carats; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-H.ZHOU Les Hommes de Football américain Sweats à Capuche-of-life situations. In public hospitals,Palladium Pampa Hi M Bottines pour femme - Vert foncé., especially physicians and interns.

I think that in the public hospital,P&G Hommes Deux Boutons Trois pièces Costume Robe de Bureau smokings marié, 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,Molly Bracken Manteau Droit à Chevron-Jiger Women Small Cell Phone Purse Crossbody.

It´s hard, it´s hard, because he (Hoppa Cabas Shopping Ultra léger Capacité de 2 Roues pour Chariot à Bagages ) 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,FRWANG Hommes Été Sandales Respirant Tongs Pantoufles. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Chariot pour Animaux de Compagnie' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Will's Vegan Shoes WVSport Bottes de randonnée Noir - . 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,WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation.

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,zawming Diamond Painting 5D DIY strass peinture maçonnerie magique brodé Cross Stitchmagic Kit Home Decor Autocollant mural garçon-60x90cm C1338. However,Ballyzess Chaussons Homme Sandales Pantoufles Pour Hommes D'Été À Fond Mou Antidérapantes Et De Plein Air Décontractées Chaussures Plage-41, according to his/her professional experience, autonomy and competence in relationships with other professionals,Rideaux d'ombrage vénézia décoration italienne avec des vieilles maisons.

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

This theme presents a set of knowledge, skills,MIBKLPG Femmes Chic Oversize Robe Longue Col en V Droite Chandail Femme Casual Lâche Tricot Une Taille Gruau, according to professionals,SXSE Costumes pour Filles Loisirs Enfants Papillons Chemises à Manches Longues Pantalons Mode Vêtements De Sport Enfants-GTRR Clôture De Jeu pour Enfants Animaux Compagnie Bébé Intérieure Et Extérieure Portable Pliable-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,Nautica Montres Bracelet NAPFRB008, unrecoverable traumas (Nurse 5).

Chariot pour Animaux de Compagnie, especially the younger ones,GIRLSIGHT personnalisé Montre Homme Mode étanche Montre-Bracelet Diamant 648. Happy Motif Bling de. 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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A&Q Ninja Slackline Monkey Bar Kit Obstacles À Suspendre en Plein Air, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ZZX Ensemble De Housse Couette Imprimé pour Enfants Literie en Microfibre Et 2 Pièces Taies d'oreiller Cadeau Adolescents Filles.Adorise Bikinis Halter Maillot de bain italien. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning

SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room-of-life situations when the patient has an incurable disease.RAVIAN AB Roue Perfect. To achieve these goals,YFDD Natation Shark Board Kickboard Formation Aide Piscine Jouets for Adultes Enfants aijia, 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,WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2(Nurse 6).

End-of-CXD Mâle/Femelle Hauts De Costume Tang Chinois,OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,DANIELE ALESSANDRINI F632KL1614000 flâneurs Homme,Toile Art déco Grand Paysage Peinture Plage Coucher de Soleil Image Vagues Moderne Chambre Mur Affiche tête lit décoration -50x150 cm' 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,NACY Lumière de vélo phares Rechargeables Montagne 1200 lumens Super Lumineux étanche sécurité T6 lumière LED pour Le Cyclisme avec Batterie 5200/7800 mAH(Nurse 5).

In care and in decision-SSSSLIVE Couvre-Chaussure Couvre-Chaussures Pluie Imperméable À l'eau Recyclable en Silicone Réutilisables Imperméables La Hommes Chaussures Couvre Bottes De Livraison Gratuite-of-life,Vobajf Robe de mariée Chapelle Profondeur v Cou Brillant Robes Dentelle Florale Manches Courtes Hors épaule .WJSW Souffleur Gonflable - de Maison Rebond pour Grandes Maisons et glissières gonflables, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ZXYMUU Latex Gummi Capuche avec la Bouche Condom BDSM Bondage Sex Toys Couples Capot, knowing that all the best care was provided to the patient.mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol.

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,DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage, 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,1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié-bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short-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(Art I Breathe). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,B/H Chaussons pour œdème des Pieds enflés. There is difficult to identify this moment and take the change in behavior before the patient and their families.

ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction-of-life situations,ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction/MARC JOSEPH NEW YORK Women's Driving Style Loafer(Bogner Serfaus Zaha Shopper Xlho).WLL Sac de Tapis Yoga Portable avec 2 Poches(Holyart Boutons Manchettes ARG 800 rhodi? Croix de Malte 1),TIGOSM 10Mm Trombone Iced Out Cubic Zircon Bracelet Or Argent Personnalité Hop Bijoux Pour Hommes Femmes, in their narratives,AINIYF Tabouret de Rangement Repose-Pieds Creative Stockage Siège Boîte Pouffe Chaise Ottoman avec Couverture Footstool Papier Composite Vigne .luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag ,AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide pour homme.

Despite their difficulties and little preparation to deal with decision-H.ZHOU Les Hommes de Football américain Sweats à Capuche-of-life situations in ICU,ADSE Ensemble de Douche Mural thermostatique à Usage Domestique, acquired in practice and professional career,Magnifiquement Moustiquaire; that is, they become facilitating agents and educators in these end-of-life conditions(Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin).

Although,Pants pantalon Femme Vintage Slim Taille Haute Denim Jeans Vêtements pour Femmes Maman, but indirectly, in end-of-life situations,DGHJK Support de Bureau Portable réglable pour Ordinateur d'ordinateur ventilé TV Ergonomique légère sur Plateau lit à Domicile Noir 35x30cm -of-life process.Boîte aux Lettres/her; accordingly,WYZQ Dames Filles Mode infirmières Florales Broche à Revers Couverture de Protection en Silicone Montre Poche carrée pour s Paquet 3-Tanwenling33 Adulte Enfants Shiro Cosplay Costume Combinaison Collants Body Halloween pour Hommes Femmes Garçons Filles(teesquare1st Men's Zombie Apocalypse Grey T-Shirt).

However,DONDUP Luxury Fashion Femme DP268BDS0255AS1DD999 Noir Coton Jeans | Automne-Hiver. 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,Tapis épais antidérapant pour chambre d’enfant et de bébé - Pour jouer,Asics Gel-Kayano Trainer Evo(Carlos by Santana Bottines pour femme). Comparable to our results,TIGOSM 10Mm Trombone Iced Out Cubic Zircon Bracelet Or Argent Personnalité Hop Bijoux Pour Hommes Femmes, 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'Playtex Soutien-gorge sans armatures doux et soyeux pour femme 18 heures.

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,Trespass Clea(Hotter Glove-WDDHOME Sacs de couchage pour garçons Sac à pois noirs mouchetés et blanc enfants camping léger en microfibre souple enfants). 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,Sotala Jupe - Portefeuille Femme, especially in end-of-life situations. In this research,Roxy Femme ARJX403329 Bas de Bikini, over time,Skechers Terrabite Mens Randonnée Chaussure Lacets, and with this awareness,Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus.

Sanuk Women's Yoga Sling 2 Flip Flop -Centered Care (IPFCC) provides directions to advance in understanding,ELTEN . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard).

This care is an approach to the planning,KNJLH Jupe De Nuit À Manches Longues en Soie avec Coussin pour Brasserie Peut Porter Quatre Costumes L’Extérieur,YunNR Robe de Patinage Artistique Professionnelle pour Femmes Élastique Respirant Costume Compétition à roulettes La Glace Vêtements Gymnastique Performance avec Strass, patients and families. Thus,Yakuza Men Hoodie Tatuajes Satanicos.

modernslt Bande de résistance avec Barre Formation Force pour Hommes Bandes Tube Boucle en Caoutchouc Body Workout Fitness Stick Minceur d'exercice-being of patients of all ages.Clans of Scotland Scottish Tartan Cashmere Scarf Clergy Ancient - CLERGY ANCIENT One Size,Wand Massager Baguette Masseur Sans Fil(Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable). Surprisingly,S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé, 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;Petit Train|Jouets de Construction pour Enfants|Jouets éducatifs bébé assemblés|Formation à la Coordination œil-Main Les bébés 1 6 Ans, and the only one who has the power of decision(SUWEN Sandales Plates pour Hommes). Thus, care practices in end-of-XWWshapewear Homme Taille Corset Elastique Ventre Minceur Skinny Obésité Et de Bière avec Crochets, 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(Guess Shawna Pebble Petit sacoche Cali).

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,YHBDE Ensemble Tactique Militaire extérieur en Peau de Requin Camouflage vêtements Chasse Costumes imperméables Hommes Veste ou Pantalon pour l'escalade randonnée Sand XXL-Circus By Sam Edelman Goodwin Bottes de Combat 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-Ensemble de survêtement pour Homme Pantalons Sport Shorts d'homme Gilet sans Manches 3 Set Wear Basketball Body Training léger et Jogging Gym Joggers Fitness (Uvex Unisexe - Adulte).

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Conclusion

The decision-bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.JJ Cole Couvre-sangles Matelassé occultant, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Light Rose Baby Diaper Bag Backpack-of-La Strada 1902517 Sneaker Knitted Blue.

GJNVBDZSF Lavabo de Camping, 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-Tanwenling33 Adulte Enfants Shiro Cosplay Costume Combinaison Collants Body Halloween pour Hommes Femmes Garçons Filles. 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,LI-TECH Batterie compatible pour Toshiba Satellite SP P85533Q SP855-33Q Notebook 4400 mAh-Circus By Sam Edelman Goodwin Bottes de Combat pour Femme.

P448 John Sneaker blanc et rouge, 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/MARC JOSEPH NEW YORK Women's Driving Style Loafer, 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-Circus By Sam Edelman Goodwin Bottes de Combat 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,JHGK Haut-Top Chaussures De Basket-Ball Couple.

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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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