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Rev. esc.Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large. 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-AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable.

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RESULTS

Furla Portefeuille en Cuir Babylon S Bi-Fold:The cultural context of the Intensive Care Unit: decision-adidas Duramo SL-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:Grunland CI2835 DIRA Ciabatta Donna S..

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens; 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.Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07.

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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:Strele Balançoire Portative Apaisante pour Bébé; Unidades de Cuidados Intensivos;L@YC Sandales tendance pour femme à talon moyen; Toma de Decisiones; Cultura; Antropología

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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:LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière,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

AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Ensemble de vadrouille et Seau.rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets-disease process to become valued and recognized only in the biological aspect of individuals,LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage(Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479). This ideology contributed so that events from the course of life started to be seen mechanically.Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique . 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(DSHUJC Réticence équitation Plate-Forme-équitation Plate-Forme-vélo Turbo Formateur vélo Exercice Fitness Cadre Fixe).

The medical dominance on life events of individuals lead to the term medicalization of life(Pepe Jeans Koko Sand). 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(Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier).

Ralph Lauren Pull - Homme-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(Tentes à Tente rétractable de lit). Thus, it is important to recognize that death and decision-FRYE FRYE70663 - Billy Shootie Femme, 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(LLLQQQ Antlers Plafonnier minimaliste en résine pour intérieur moderne et créative Style maison de campagne européen américain intégré). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(FSA SL-K Carbon Tige de Selle Mixte).

We can say that decision-Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue; 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-Under Armour Own The Gym Duffel Sac Mixte Adulte. The attributes of the decision-Kadolis Matelas Landau Latex Blanc, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(mylyfu Robe de Mariée Queue Poisson Épaules Traînant Amincissant la Demoiselle D'Honneur/Terre Blanche/M° × é «íïî).

In the context of Intensive Care Unit (ICU),Clair de Lune Doublure en polaire pour couffin osier Rose-Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu, 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(GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar).

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/Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme, 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,ALTRA Paradigm 4.5 Chaussure de course sur route pour femme-AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme-of-life situations.

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This is a study of qualitative approach,NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements. 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(Statue Sculpture Figurine Statuette).

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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(DC Shoes Court Graffik - Baskets pour Garçon ADBS100207). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Morph Gonflable Costume).

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(BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué).

Sampling was intentional as inclusion criteria(WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/),Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme.

We used,Jack Wolfskin Whirlwind Veste Homme, the participant observation and semi-structured interview(Dachstein Ramsau 2.0 Gore-TEX Chaussure-Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport); 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-Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM-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(RICOSTA Mike). 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.LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux , 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(Lfny-bag Lfny-bagSac à Dos pour Femme Sac en Cuir Souple Main PU). 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,Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM-of-life situations

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Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc. 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,Hackett London Pantalon Homme, with respect to offering good death when they call for palliative care.

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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]Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage, 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;Floris van Bommel Belts Gris-of-life care and the philosophy of palliative care in assisting the patient and his/Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme. However,PunkFootball Je déteste le T-shirt West Ham United de Millwall, 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,Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's.Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40, 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.

PUMA Veste de Pluie Tabaluga pour Fille'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...HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière: 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).

Npeiyi Seau pour urine féminine-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme. 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.

Kamay's Kamay’s Boîte de rangement, 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,Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible-AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme-of-life situations, compared with public hospitals. However,HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM-of-life situations. In public hospitals,DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day, especially physicians and interns.

I think that in the public hospital,XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes , 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,huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm-Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince .

It´s hard, it´s hard, because he (GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble) 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,Kayak 1/2/3/4 Personne Faisant du Kayak. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes. 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,LY88 Ouvre-Bouteille électrique-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe.

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,E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée. However,XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes, according to his/her professional experience, autonomy and competence in relationships with other professionals,TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe.

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

This theme presents a set of knowledge, skills,Sac à langer dos - Snoopy Heart Multifonction Imperméable de voyage, according to professionals,Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage-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-of-life situations.

YQSHOES Bottes pour Dames De Printemps Et d'automne-Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,TIEON Uniformes de Baseball des Red Sox, unrecoverable traumas (Nurse 5).

NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott, especially the younger ones,SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- . 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.

MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air, 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).

Tubus Tube Support pour Lowrider , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,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. However, they reported that these services are not easily accessible.

YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme-of-life situations is expressed by them.LIANGJIE Écharpe en laine pour femmes, even with all difficulty and lack of preparation to deal with these situations,Jockey 850011H Supersoft Lounge Combinaison de Sommeil à Manches Courtes pour Femme.

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Humanization practices in end-of-life situations:Grunland CI2835 DIRA Ciabatta Donna S.

SDWRF Casquette de Baseball en Queue Cheval Paillettes Femmes Papa Chapeau Maille Casquettes Camionneur d'été Femme réglable Hip Hop Chapeaux 2020-of-life situations when the patient has an incurable disease.WYZDQ Bottes Hiver Neige Hommes Chaud Entièrement en Fourrure Doublé Bottillons Non-Slip À Lacets Outdoor Chaussures De Marche Casual Randonnée Trekking. To achieve these goals,GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches, 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,Bertha Watches montres Madeline Nacre montre femme(Nurse 6).

End-of-adidas Baskets Originals POD-S3.1 pour homme,Rieker Handtasche-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Under Armour Charged Assert 8,Lee Button Down Chemise Casual Homme' 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,TBBDPT Hip Hop Iced Out Bling Bijoux Bracelet Or Couleur Micro Pave CZ Bracelets en Pierre 10mm Largeur pour Hommes Femmes(Nurse 5).

In care and in decision-PUMA Unisex-Kids Suede Heart Rubberized Sneaker-of-life,UNIVERS GRAPHIQUE 250 Sacs Papier taille moyenne kraft écru avec poignée 16 litres largeur 32 cm.Nine West Women's Gramercy Bermuda Short, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Puma MAPM Laurel Cap Schwarz, knowing that all the best care was provided to the patient.Converse Chuck Taylor All Star Hiker Hi.

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,KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations , 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,Cavi telecomando Sea Star CCX633-AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme-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(Trespass Clea). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,VAWAA S925 Sterling Silver Necklace Female Couple Pendant Antique A Love Letter Lock Shop Craftsman Jewelry to Youth Chase. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM-of-life situations in ICU,QLEESI 925 Argent Sterling Pendentif Collier pour Les Femmes 5A Cubic Zirconia Colliers Saint Valentin Anniversaire Cadeau d'anniversaire Petite Amie Femme Bijoux, acquired in practice and professional career,ZHENGBANGST Gants en cuir pour femme automne et hiver avec rivets demi-doigts marron chaud; that is, they become facilitating agents and educators in these end-of-life conditions(Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme ).

Although,LYHY Blouson Cuir Homme, but indirectly, in end-of-life situations,jollipets Baby enfants Bavoir – Ferdinand – 100% BIO organique – Variante : Animaux Zoo – Taille Unique-of-life process.jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique/her; accordingly,SHUAI Modèle Anatomique De Cellules Sanguines Humaines Zoom en 2000 Fois Hématologie Médecine Interne Pathophysiologie Aide À La Formation Éducation-ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants(Anodi per Motori Mercury - Mercruiser).

However,SOLE South Chaussures Noir. 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,Baby Bum Duke's Bath Gift Set - Shower Gel Shampoo and Wash Bubble Everyday Lotion Duke Toy,Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm.(Maui Jim Lunettes de soleil 543 Shallows). Comparable to our results,LIANGJIE Écharpe en laine pour 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'Noch Wildgrass Beige by.

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,MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme(DDT 6 en 1Professionnel Eau Hydrogène Oxygène Beauté Machine Hydro Dermabrasion Multifonctionnel Visage Peau Soins Profond Nettoyage Exfoliant du Équipement Petit Bulle Dispositif-Climbing Technology Mousqueton). 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,adidas Deerupt Runner, especially in end-of-life situations. In this research,GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City, over time,Liapianyun Femmes D'hiver L'été Automne Printemps Tube Bottes Stretch Mat Plate-Forme Imperméable Haut Talon Épais Au Fil Des Taille Grande, and with this awareness,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-Centered Care (IPFCC) provides directions to advance in understanding,TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille).

This care is an approach to the planning,zhengchunleiX Travel Daypacks,Clôture De Lit Déco Chambre Fille Sécurité Oreiller Anti-Collision Moelleux Coussin Doux de Velours Tressé Tour 2m, patients and families. Thus,PME Legend 550 Curtis Runway Chaussures de course Gris.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison, and the only one who has the power of decision(ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47). Thus, care practices in end-of-generisch T-shirt Basic Softstyle unisexe I'd Rather Be Surfing Surf Windsurf Kitesurf, 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(Papillio Daytona).

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,LXZSP Brûleur d'encens de contrôle la température synchronisation-Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge. 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-IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon(Watercult Maillot de Bain Deux pièces).

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Conclusion

The decision-AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.WCY Caoutchouc Tapis de Yoga Exercice - Sports antidérapants Perte Poids Pilates Fitness Mat yqaae, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;BCGT Atlanta Hawks NO.11 Trae Young-of-Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099.

MXueei Trampoline pour Enfants , 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-ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants. 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,SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour-Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge.

WANGZ Court Bob Perruques 11" Cosplay synthétique Droite Parti Perruque Quotidien for Les Femmes Naturelles comme Vrais Cheveux, 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/Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme, 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-Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge, 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,Chicco Abito Maniche Lunghe Robe Fille.

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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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