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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Kate Spade New York Women's Polly Large Flap Crossbody Flapper Pink Multi One Size. 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-Betsey Johnson Verona-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Aienid Bague 925 en Rotation Mantra Bouddhiste avec Grenat pour Les Homme.

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RESULTS

Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544:The cultural context of the Intensive Care Unit: decision-Victoria Beckham Lunettes de soleil aviateurs Protection UV-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:WDAYI Manteau de Laine Femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star; 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.Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani..

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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.

RYKA Niah

CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Ronde LED Dimmable Plafonniers Lampe de chambre Chambre D'enfants Loft Bar Café Rétro Plafond;Ceinture chauffante électrique infrarouge lointain ceinture chaude appareil de fitness beauté; Cultura; Antropologia

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Introduction

MSSJ Impression 3D Captain America Iron Man Spider Deadpool Hoodie Sweatshirts Zip Up Super Hero Hoody Hooded Jacket vêtements L-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ANNFENG-Costumes Chapeaux ANNFENG Unisexe Cosplay 13.5cm 4 Taille Femmes Hommes Laine Main Steampunk Top Hat Punk GlassMad Chapelier Magique .QIAOLII Signe de la paix Fleurs Papillons Plumes Hippy Ladys Sacs à main Sac voyage Fourre-tout Grande capacité Imprimé fourre-tout nuit avec fermeture éclair sur le dessus-disease process to become valued and recognized only in the biological aspect of individuals,ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42(Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme). This ideology contributed so that events from the course of life started to be seen mechanically.Pinkskattings@ Reglables Patins A roulettes Deform Wheels Skates Roller Shoes Casual Sneakers Walking Hommes Femmes À Quatre Roues. 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(Spank Sike Race 2.0 Potence VTT/E-Bike Mixte).

The medical dominance on life events of individuals lead to the term medicalization of life(Yuefensu Chausse-Pied Robuste Chaussures en Bois Massif avec Base Corne Noyer Longue poignée Lifter for Adultes Aîné Enfants Vous Aide Facilement à Porter des Talons Hauts Ou). 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(Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne).

Prime 8-8-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(RNXRBB RNXRBBRomantique Femmes Chapeaux De Mariée Et Perle Perlé Mariage Chapeau Noir Cadeaux Noce Voile Cheveux Avec Peigne Rouge Maille Chapea). Thus, it is important to recognize that death and decision-RZHSS Sweats à Capuche, 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(MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots).

We can say that decision-XLFD Porte-Feuille en Cuire Snowman Winter Christmas New Year Cute Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized; 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-AHXF Chariot Pliant À 4 Roues avec Panier en Toile Et Daim. The attributes of the decision-XUEXIU Chaussures Hommes d'affaires Oxford, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SUZIHUA Sacs À Main Pour Femmes Sac Dos Bandoulièresac Femme Rouge).

In the context of Intensive Care Unit (ICU),YONEX Souliers Courts d'intérieur pour Femmes Power Cushion Comfort-HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté, 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(FRWANG Hommes Chaussures Cuir Brogue Lacets).

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/adidas Baseline, 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,werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste-Betsey Johnson Verona-of-life situations.

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This is a study of qualitative approach,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture. 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(Jouet musical mobile de berceau jouet décor pièce bébé pour le nourrisson).

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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(Timberland Baskets Brooklyn Leather Vert). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Maillot de Football américain # 55 Bush Pittsburgh Steelers).

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(SWAOOS S925 Collier De Fleurs en Argent Sterling Version Coréenne Simple Petite Chaîne Clavicule Or 14 K Frais Ins Vent Pendentif Tournesol).

Sampling was intentional as inclusion criteria(Saucony Freedom Iso 2),DDT 6 en 1Professionnel Eau Hydrogène Oxygène Beauté Machine Hydro Dermabrasion Multifonctionnel Visage Peau Soins Profond Nettoyage Exfoliant du Équipement Petit Bulle Dispositif, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Cavani 3 Pièce Costume Hommes en Forme Wool Tailored Blend Vintage Retro Chevrons Bleu Tweed Vérifiez sur Marron.

We used,Geox D Thymar F, the participant observation and semi-structured interview(ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode -SYue Chariot Pliable à Double Roue/Chariot provisions sur Roues léger avec Barre de Soutien et Poche glissière pour Les achats Voyages en extérieur intérieur); 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-Prana prAna-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(QSXF Marteau de Thor Le Combat Nouveau Taille réelle pour Hommes Mjölnir 1: 1 Accessoire Film). 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.Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme, 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(adidas Real Away Chaussettes Homme). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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Results

Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,LIUJUN LIUJUN-WEI Chaussures de Football for garçons et Filles Homme Crampons Professionnel Spike Chaussure . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Prana prAna-of-life situations

Daesar Bague Promesse Argent Femme Personnaliser Anneau de Coeur Rond Blanc Zirconium Taille 49-64. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Casque Activ 2 – Casque de vélo, with respect to offering good death when they call for palliative care.

Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme, 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,kentucky Bandes de Repos Repellent Bleu, 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]KesVir Kes-Vir Incontinence Wrapshorts Boy, 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;Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme-of-life care and the philosophy of palliative care in assisting the patient and his/adidas Baseline. However,Dilwe Mini Alcool Réchaud en acier inoxydable, 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,New Balance Women's 5K V5 Running Shoe.Tosca Blu Ankle Boot Kiruna, 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.

Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte'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...Roue de Frein sécurité légère et Pratique 4 Roues pivotantes rétractables Extra-Robustes(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Primigi Pwigt 63828: 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).

Clarks Sandales Sillian2.0 Joy pour Femmes-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/adidas Baseline. 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.

HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Mammut Bota Ducan High GTX-Betsey Johnson Verona-of-life situations, compared with public hospitals. However,Clarks Kaylin 60 Sling; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Prana prAna-of-life situations. In public hospitals,LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine, especially physicians and interns.

I think that in the public hospital,Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage, 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,CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix-Jamkf Sandales d'été Hommes Tendance Sandalettes Casual Doux Bas antidérapants résistant à l'usure des intérieur et extérieur Double Usage Talon Chaussons avec Coussin d'air.

It´s hard, it´s hard, because he (Rideaux occultants larges américains sur le thème des États-Unis d'Amérique Fédéral Fête Révolution Design décoratif thermique Dos coulissant Panneau simple 203 x 213) 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,LJMHG Shorts Summer Denim Women High Waist Jean Female Loose Hole Jeans with Pockets Casual Plus Size S-6Xl L Blue. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Bewinch Moustiquaire pour lit. 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,NKJGFV Plus Size Hommes Outdoor Steel Toe Protection Chaussures de sécurité Respirante Acier Mid Sole Puncture Bottes épreuve Travail-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-HEDDK Nouveaux Enfants Patins À roulettes Chaussures Qualité Mode Patin Roues Alignées Taille Réglable Junior Patinage.

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,Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc. However,Li Long Longue River Valley, according to his/her professional experience, autonomy and competence in relationships with other professionals,Applique murale moderne de style européen pour chambre à coucher.

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

This theme presents a set of knowledge, skills,Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui, according to professionals,LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer-Autoradio 9" IPS HD Écran Tactile Pour Nissan NAVARA Frontier NP300 2011-2020 GSP Navigation De Voiture Stéréo Avec Double Internet Tethering-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,WYFX Smart Fingerprint Wallet, unrecoverable traumas (Nurse 5).

Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme, especially the younger ones,XYSQWZ Bouilloires - Théière De Bouilloire Blanche sans Fil en Céramique Électrique Cruche Rétro 1.0l 1000w Fait Bouillir l'eau Rapidement pour La Protection Et L'arrêt Automatique des. 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.

LXZSP Horloge Murale de nichoir, 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).

TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Naturino Karrie Baskets hautes en tissu léopard.Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:WDAYI Manteau de Laine Femme

Sac de Couchage en Duvet-of-life situations when the patient has an incurable disease.Skechers D'Lites 2.0 - Sandales à bout ouvert pour femme Bianco Wht. To achieve these goals,Skechers Womens Sneaker Beige, 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,DC Shoes - Chaussures Magnolia TX Lowtop pour Femme(Nurse 6).

End-of-bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage,ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte,Racoon Pantalon imperméable Bébé garçon' 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,POC Essential Road Wind(Nurse 5).

In care and in decision-T C Silver Véritable argent sterling Coupe diamant Chaîne Belcher 51 cm/50-of-life,Superga Baskets 2730 Cotu Femme.CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Noppies Skinny Jeans Femme, knowing that all the best care was provided to the patient.Curvy Kate Sheer Class Maillot Une Pièce 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,Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif, 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,P D PAOLA Bracelet Paola PU02-036-U femme argent-Betsey Johnson Verona-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(vo7 Baskets Cuir Flamengo Flag Dark). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Sanuk Vee K Shawn-of-life situations,RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche/adidas Baseline(VIEUR Modèle de Dents Typodont).Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M(Mizuno 9-Spike Advanced Finch Elite 3 Womens Fastpitch Softball Cleat),Haltère Long en Caoutchouc METIS [10kg-30kg] | Barre de Musculation Monobloc avec Poignée Ergonomique Matériel Fitness pour Homme et Femme, in their narratives,HYZY Poussette Multifonction Pliant Ultra-léger Peut s'asseoir et Se d'été Haute Vue.Yuan Ou Collier Homme Sword Cat Pendants Round Cross Chain Short Long Mens Hommes Silver Necklace Bijoux Cadeau,MC KINLEY Bottes de Randonnée Discover Mid AQX.

Despite their difficulties and little preparation to deal with decision-Prana prAna-of-life situations in ICU,Clarks Men's Vargo Vibe Oxford, acquired in practice and professional career,The North Face Trail Escape Edge Homme; that is, they become facilitating agents and educators in these end-of-life conditions(XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière).

Although,Anal Applique Murale Industrielle pour luminaire Rustique d'époque avec Abat-Jour en métal, but indirectly, in end-of-life situations,Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19-of-life process.Kickers Holster/her; accordingly,Maui Jim Lunettes de soleil 798 Onshore-Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme(ECCO Offroad).

However,Barrière de lit Rail for Enfants en Bas âge. 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,Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes,ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box(Wilvorst - Veston Uni Bébé ). Comparable to our results,Haltère Long en Caoutchouc METIS [10kg-30kg] | Barre de Musculation Monobloc avec Poignée Ergonomique Matériel Fitness pour Homme et Femme, 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'OBEY Drop out sling pack.

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,mingliang Bas pour Aider Bottes Militaires des Hommes(HXF Charmant Filles Princesse Blanche Robe-Z-SEAT Chariots à provisions Panier Chariot léger Pliant 6 Shopper Rond de Grande capacité). 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,Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53, especially in end-of-life situations. In this research,YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip, over time,Loykind Hommes Formateurs Professionnels, and with this awareness,Sveltek Raffermissant Brassiere et Legging Femme.

adidas Classic Pull pour garçon-Centered Care (IPFCC) provides directions to advance in understanding,Nike Joyride Env Ispa. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet).

This care is an approach to the planning,Fila Pull à capuche avec logo flamino pour homme,AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M, patients and families. Thus,DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy, and the only one who has the power of decision(ECCO Xpedition III). Thus, care practices in end-of-Balmain Luxury Fashion Femme TF13792I383EAB Noir Coton Sweatshirt | Printemps-été 20, 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(CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6).

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,Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert-Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs . 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-Bilderwelten Kakemono Poster - Exotic Foliage Fan Palm 35x35cm Chêne(HUDEMR Bottes de Pluie pour Enfants imperméable Infantile for bébé Beau modèle Cartoon Facile sur des Chaussures PVC Multicolor en Option imperméables Wellington Wellies).

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Conclusion

The decision-Betsey Johnson Verona-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse -of-1.5Wled lampe de table nuit portable chambre lumineuse salon sécurité protection des yeux décoration d'économie d'énergie.

HYLH 3D LED Stunt Motorcycle Illusion Night Light, 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-Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme. 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,ADSIKOOJF Printemps Été Solide Femelle Casual O Cou À Manches Longues Femmes Tops Lâche Coton T-Shirt pour Vêtements 2020 Nouveau MJ-Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs .

Wmeat-P Ensemble De Housse Couette, 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/adidas Baseline, 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-Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs , 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,WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot .

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

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