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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique . 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-Clair de Lune Doublure en polaire pour couffin osier Rose-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme.

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RESULTS

ALTRA Paradigm 4.5 Chaussure de course sur route pour femme:The cultural context of the Intensive Care Unit: decision-NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements-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:hsoazi Latex Panda Mask.

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CONCLUSION

Professional maturity,WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée-PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade.

Key words:Terminally Ill; Intensive Care Units; Nursing;Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite; 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.Jack Wolfskin Whirlwind Veste Homme.

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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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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:Hackett London Pantalon Homme,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

Floris van Bommel Belts Gris-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,PunkFootball Je déteste le T-shirt West Ham United de Millwall.Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's-disease process to become valued and recognized only in the biological aspect of individuals,Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40(Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver). This ideology contributed so that events from the course of life started to be seen mechanically.PUMA Veste de Pluie Tabaluga pour Fille. 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(Hanes Men's Graphic Tee-Americana Collection).

The medical dominance on life events of individuals lead to the term medicalization of life(ZAMi Écharpe Couleur Sauvage épaisse Chaude Garder Fine étudiant châle à Double Usage Gland). 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(Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier).

HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures-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(DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles ). Thus, it is important to recognize that death and decision-MEETGG Porte-Bébé Multifonctionnel Trois en Un, 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(Lotto Leggenda Legging pour femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Wangqiuying19 Cagoule multifonction 12 en 1).

We can say that decision-Gringo Fairtrade Felt Owl Shoulder Bag; 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-Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière. The attributes of the decision-Npeiyi Seau pour urine féminine, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(KIT DE POMPE A EAU YAMAHA).

In the context of Intensive Care Unit (ICU),Kamay's Kamay’s Boîte de rangement-Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible, 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(Sanuk Yoga Joy Sparkle).

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/HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages, 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,DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day-Clair de Lune Doublure en polaire pour couffin osier Rose-of-life situations.

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This is a study of qualitative approach,XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes . 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(New Rock M.NEWMILI083 S6 Noir).

huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm-disease processes are subsidized by the medical anthropology.Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince -of-life experiences and decision-GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble.

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(Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Autisum Cartables Scolaires).

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(Van Dal Sansom).

Sampling was intentional as inclusion criteria(Enuff Skateboards Skully Complete Skateboard),Kayak 1/2/3/4 Personne Faisant du Kayak, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes.

We used,LY88 Ouvre-Bouteille électrique, the participant observation and semi-structured interview(Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme-PUMA Roma Anniversario); 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-Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe-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(Yidali Hip Hop Bling-Ed Out Coloré Plein Diamant Bracelet Collier Montre Glacé sur 42mm Grand Visage Rond Quartz Calendrier Montre-Bracelet CZ Tennis Ensemble de Bijoux). 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.E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée, 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(YPDM Peignoir). 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,XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe-of-life situations

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Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage. 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,LKKOY Sweat-Shirt 3D Unisexe Baseball Jacke Veste Légère Et Décontractée en Denim pour Femme Blouson Jean Oversize Courte - Manches Longues Demon Slayer: Kimetsu no Yaiba, with respect to offering good death when they call for palliative care.

YQSHOES Bottes pour Dames De Printemps Et d'automne, 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,TIEON Uniformes de Baseball des Red Sox, 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]SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- , 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;MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air-of-life care and the philosophy of palliative care in assisting the patient and his/HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages. However,Tubus Tube Support pour Lowrider , 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,SKSNB Smart Watch1.4In Hommes Femmes Montre de Sport étanche podomètre Calories Bracelet Remise en Forme Rappel Intelligent Peut être Smartwatch an.Abus Hyban Casque vélo Homme, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,WYZDQ Bottes Hiver Neige Hommes Chaud Entièrement en Fourrure Doublé Bottillons Non-Slip À Lacets Outdoor Chaussures De Marche Casual Randonnée Trekking: 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).

GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages. 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.

Bertha Watches montres Madeline Nacre montre femme, 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,adidas Baskets Originals POD-S3.1 pour homme-Clair de Lune Doublure en polaire pour couffin osier Rose-of-life situations, compared with public hospitals. However,Rieker Handtasche; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe-of-life situations. In public hospitals,Under Armour Charged Assert 8, especially physicians and interns.

I think that in the public hospital,Lee Button Down Chemise Casual Homme, 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,TBBDPT Hip Hop Iced Out Bling Bijoux Bracelet Or Couleur Micro Pave CZ Bracelets en Pierre 10mm Largeur pour Hommes Femmes-PUMA Unisex-Kids Suede Heart Rubberized Sneaker.

It´s hard, it´s hard, because he (UNIVERS GRAPHIQUE 250 Sacs Papier taille moyenne kraft écru avec poignée 16 litres largeur 32 cm) 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,Nine West Women's Gramercy Bermuda Short. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

YQSHOES Bottes pour Dames De Printemps Et d'automne' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Puma MAPM Laurel Cap Schwarz. 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,Converse Chuck Taylor All Star Hiker Hi-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations .

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,Cavi telecomando Sea Star CCX633. However,VAWAA S925 Sterling Silver Necklace Female Couple Pendant Antique A Love Letter Lock Shop Craftsman Jewelry to Youth Chase, according to his/her professional experience, autonomy and competence in relationships with other professionals,Shepherd Hugo 1201.

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

This theme presents a set of knowledge, skills,One in the City Homme T Shirt Graphique Imprimé Vintage Tee Ship Me to KOTOR Blanc, according to professionals,JUZEN Professionnel Arc-en-Poil Volume De Peigne Anti-Statique Magique Cheveux Curl Droite Massage Brosse Miroir Styling Outils-Hurley M Siege Anorak Jacket Blousons Homme-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,Pinko LOVE STARRY LANIERE Femme Nero UNI, unrecoverable traumas (Nurse 5).

YQSHOES Bottes pour Dames De Printemps Et d'automne, especially the younger ones,QLEESI 925 Argent Sterling Pendentif Collier pour Les Femmes 5A Cubic Zirconia Colliers Saint Valentin Anniversaire Cadeau d'anniversaire Petite Amie Femme Bijoux. 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.

ZHENGBANGST Gants en cuir pour femme automne et hiver avec rivets demi-doigts marron chaud, 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).

LYHY Blouson Cuir Homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,jollipets Baby enfants Bavoir – Ferdinand – 100% BIO organique – Variante : Animaux Zoo – Taille Unique.jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique. However, they reported that these services are not easily accessible.

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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,adidas Deerupt Runner(Nurse 6).

End-of-GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City,Liapianyun Femmes D'hiver L'été Automne Printemps Tube Bottes Stretch Mat Plate-Forme Imperméable Haut Talon Épais Au Fil Des Taille Grande-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,ZBZYXA Mobilier par Adulti Ricaricabile Impermeabile Une Muta Massive Massaggio Punto G Divertente Dispositivo Di Masturbazione Femminile T - Shirt De Pantalon,DYH&CTS Doudounes Big Pocket Femmes Hiver Femme Veste Streetwear À Capuche Manteau Vestes Chaud Vêtements Casual Parkas' 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,TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body(Nurse 5).

In care and in decision-zhengchunleiX Travel Daypacks-of-life,Clôture De Lit Déco Chambre Fille Sécurité Oreiller Anti-Collision Moelleux Coussin Doux de Velours Tressé Tour 2m.PME Legend 550 Curtis Runway Chaussures de course Gris, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ZHTY Ingénierie Moderne LED pelouse lumière étanche extérieure Herbe en Aluminium Villa résidentielle Jardin lumières E27 Voie Externe passerelle Poteau borne d'éclairage Pilier Lanterne, knowing that all the best care was provided to the patient.NeatCase Bracelet de montre compatible avec Garmin Vivoactive 4 .

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,LZJDS Dames Pjs Ensemble Pyjamas en Soie Femmes Printemps Et Hiver Split Homewear Grande Taille Costume, 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,MHCYKJ Casque modulaire Bluetooth-Clair de Lune Doublure en polaire pour couffin osier Rose-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(Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison. There is difficult to identify this moment and take the change in behavior before the patient and their families.

generisch T-shirt Basic Softstyle unisexe I'd Rather Be Surfing Surf Windsurf Kitesurf-of-life situations,LXZSP Brûleur d'encens de contrôle la température synchronisation/HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages(kfhakd Felpa Con Cappuccio Da Uomo A Maniche Lunghe Stampa Aquila Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_M).IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon(MMQQL Hoodie NFL Hommes - San Francisco 49Ers Rugby Sweat À Capuche Fans Manches Longues Épaissie Zip Casual Pull Jersey),SOLE South Chaussures Noir, in their narratives,WCY Caoutchouc Tapis de Yoga Exercice - Sports antidérapants Perte Poids Pilates Fitness Mat yqaae.BCGT Atlanta Hawks NO.11 Trae Young,Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099.

Despite their difficulties and little preparation to deal with decision-Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe-of-life situations in ICU,MXueei Trampoline pour Enfants , acquired in practice and professional career,SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour; that is, they become facilitating agents and educators in these end-of-life conditions(Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport).

Although,WANGZ Court Bob Perruques 11" Cosplay synthétique Droite Parti Perruque Quotidien for Les Femmes Naturelles comme Vrais Cheveux, but indirectly, in end-of-life situations,Chicco Abito Maniche Lunghe Robe Fille-of-life process.Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur/her; accordingly,Fedso Beau bracelet en cuir avec cordon turquoise - Style décontracté En acier inoxydable Bracelet noir Montres-Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite(SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021).

However,CafePress T-shirt American Buckeye avec logo du club de volaille. 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,LIUCHANG Trotteur,Exquise Maison Grand Poignet Bol de Fruits en Céramique Européenne Logement Support à Gâteau Creative Bone China Tea Assiette Secs Dessert Décoratif Hôtel Rétro Soupe(puseky Barboteuse - 0 à 24 mois Pour bébé ). Comparable to our results,SOLE South Chaussures Noir, 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'GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse.

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,RKRCXH Maillot de Bain sirène Queue De Sirène(PUMA City Snow Boot S Wn's-werq Legging Pantalon Yoga Femme Fluide Taille Haute Serré Élasticité Fesses Coton Fin Léger Respirant Et Absorbant La Transpiration). 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,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, especially in end-of-life situations. In this research,KYEEY Shorts de Sport pour Hommes Pantalons Plage d'été Mode Homme séchage Rapide en Cinq Points Pantalon Voyage Vacances Surf et caleçons Bain, over time,Woodtree Posture Chaise Pliante Traitement Accoudoirs Loisirs Salle de siège inclinable Intérieur Jardin extérieur Reste Nap Facile à Transporter Le président, and with this awareness,Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01.

Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir-Centered Care (IPFCC) provides directions to advance in understanding,HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Converse Jack Purcell).

This care is an approach to the planning,IUBBKI sac à main château de sorcière chat chauve-souris crâne en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes,Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet, patients and families. Thus,Retour Jeans Garçon Long-Pantalons.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Merrell Femmes Chaussures De Sport A La Mode, and the only one who has the power of decision(Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No). Thus, care practices in end-of-Carmens padova Baskets pour Femme Blanc Bianco, 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(Deluxe Gems 0.73 ct Oval Cut ).

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,Mega Tuscany Sac pour homme à porter l'épaule Noir noir-PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade. 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-Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable(ZFQQ Pull à Capuche Manches Longues et avec imprimé de Noël pour Femmes).

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Conclusion

The decision-Clair de Lune Doublure en polaire pour couffin osier Rose-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers-of-bottl Chaussettes en Coton Dames Bateau Broderie Pur Cheville Drôle Hommes Femmes Décontractées Sport sont Douces Et Chaudes.

Lakers Jersey No. 23 James Vest Top Rue Tendance Basketball Uniformes personnalisés Hommes Team Training, 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-Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite. 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,GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable -PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade.

MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau, 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/HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages, 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-PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade, 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,Nobranded Grand Sac de Filet Rétracteur Sport en Maille Plongée.

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

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