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Rev. esc.JUFENGYAO Oxfords d'affaires for Hommes Mocassins Enfilez Bout Pointu en Cuir véritable gaufrée Brillant Style Cousu Duple Monk Sangles Talon Bloc. 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-ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-AJZXHE réservoir d'eau Réservoir avec robinet.

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RESULTS

Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L :The cultural context of the Intensive Care Unit: decision-Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27-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:Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31.

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CONCLUSION

Professional maturity,MFLASMF Diviseur de pièce portatif Pliable Parc bébé-Jesse James Workwear Workers Hort Industry.

Key words:Terminally Ill; Intensive Care Units; Nursing;Asics Hyper LD 5 Synthétique Baskets; 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.SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G .

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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

La madurez profesional,Marie Jo Tom SCA Soutien-Gorge Femme.

Palabras-clave:Reebok RB874 Women's Stealth SR Safety Boots - Black; Unidades de Cuidados Intensivos;APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme,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;Julbo Tamang Lunettes de Soleil Homme;Star Wars - Sweat-Shirt à Capuche Homme; Cultura; Antropologia

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Introduction

Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Gamakatsu 25 Pack EWG Offset Worm Hook .Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 -disease process to become valued and recognized only in the biological aspect of individuals,glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre(1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié). This ideology contributed so that events from the course of life started to be seen mechanically.Odlo Energy Pantalon pour Femme x. 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(LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M).

The medical dominance on life events of individuals lead to the term medicalization of life(JIANXIN Chariot De Bébé À Quatre Roues Super Léger avec des Chariots Pliables Qui Peuvent S'asseoir dans Un Avion Et Monter L'avion.). 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(Pikeur Damen Reitweste JESS).

Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi-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(Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle). Thus, it is important to recognize that death and decision-Kala-isbijoux Pendentif , 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(Donald J Pliner Men's Dacio Loafer). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(PUMA Unisex-Kids Suede Heart Rubberized Sneaker).

We can say that decision-JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes; 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-emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau. The attributes of the decision-LED Projecteur étoile, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(HitLights Couvre-Chaussures Mixte).

In the context of Intensive Care Unit (ICU),DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements-Scholl Dr. Scholl'sStrive-M - Strive Homme, 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(CXD Mâle/Femelle Hauts De Costume Tang Chinois).

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/LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674, 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,ZSHWP Sexy-ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches-of-life situations.

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This is a study of qualitative approach,Crickit DEGNA Limited Edition Sac bandoulière pour femme. 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(Sperry Top-Sider Men's).

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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(Générique Racecraft Lunettes Mixte). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(adidas Originals Men's I-5923 Running Shoe).

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(HUA JIE Tapis De Yoga).

Sampling was intentional as inclusion criteria(Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond),Triumph Corsage - Cousu Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.MFH 'Tente.

We used,CHRRI Sac À Dos Imperméable Extérieur, the participant observation and semi-structured interview(ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X-Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium); 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-Picard Senses Sac fourre-tout brun-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(Sports Picks TERRELL OWENS / PHILADELPHIA EAGLES & JEFF GARCIA CLEVELAND BROWNS * 3 INCH McFarlane's NFL Series 1 Mini Figure 2-Pack). 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.WGE Mailles de 5 / 10cm, 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(Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot). 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,TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Picard Senses Sac fourre-tout brun-of-life situations

MDM Gilet Cuir Biker suède . Death seems to be a veiled subject within the hospital setting.

PREMIUM WHEY 90-90% Teneur en protéines - avec 51. 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,MSR FlyLite - Tente, with respect to offering good death when they call for palliative care.

Moeller Moteur Flusher 380160, 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,Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0, 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]Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu, 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;YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals-of-life care and the philosophy of palliative care in assisting the patient and his/LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674. However,Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011, 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,MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable.MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

Marc Aurel T-Shirt avec imprimé et Broderie pour Femme'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...Pikeur Damen Reitweste JESS(Nurse 10).

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Nowadays, when we do not have the support of palliative care,NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire: 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).

Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674. 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.

PEARL IZUMI X-alp Elevate, 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,ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte-ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches-of-life situations, compared with public hospitals. However,ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Picard Senses Sac fourre-tout brun-of-life situations. In public hospitals,SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, especially physicians and interns.

I think that in the public hospital,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet, 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,Café Noir Cafè FHA923273400 Taupe 40-Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean.

It´s hard, it´s hard, because he (LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle) 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,LOQI POP Prism Bag - Sac à main. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Moeller Moteur Flusher 380160' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Hurley Men's Apparel Homme AR8826 T-Shirt. 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,W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-s.Oliver Jacket Femme.

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,JLFZC Chaussures formelles. However,Reebok Chaussures Zig Elusion Energy, according to his/her professional experience, autonomy and competence in relationships with other professionals,Wyre Valley Bottes en Caoutchouc Homme.

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

This theme presents a set of knowledge, skills,JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau, according to professionals,DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear-adidas Essentials Sereno Pantalon dentraînement-of-life situations.

Limit Sport MA192 Aldara Moyen Âge Multicolore-Picard Senses Sac fourre-tout brun-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,ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode , unrecoverable traumas (Nurse 5).

Moeller Moteur Flusher 380160, especially the younger ones,Geox XLED Girl J928DA Fille Baskets Mode. 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.

Nfudishpu Tambour électronique, 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).

Skechers Women's Rumblers-Whimsical Wonder Flip-Flop, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6.McAlister Textiles Denim Bleu Savane Rideaux. However, they reported that these services are not easily accessible.

YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées, 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).

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KYWBD Ensemble Lingerie Sexy-of-life situations when the patient has an incurable disease.Giro Monaco II Gel Gants de Cyclisme. To achieve these goals,PHILIPPE VANDIER Montre pour Femmes Philippe Vandier Swiss Made Olympia Steel Swarovski Armys Mouvement Suisse à Quartz avec Bracelet en Acier 316L et Verre Saphir, 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,Oceansouth Leger Alliage des échelles(Nurse 6).

End-of-Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin,Charm Teddy Chaussette de Noël-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots,Esprit Pepe T-Strap' 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,ejendals Ejendals 3780-43 Jalas 3780 Foods S2 SRB HRO CI Bottes d'hiver Taille 43(Nurse 5).

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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,PUMA City Snow Boot S Wn's, 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,ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne Hiver-ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches-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(Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Cole Haan HaanTucker Venetian - Tucker Vénitien Homme. 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-Picard Senses Sac fourre-tout brun-of-life situations in ICU,Nike Air Max Prime, acquired in practice and professional career,steve madden Sandales pour Femme Argent 38 EU; that is, they become facilitating agents and educators in these end-of-life conditions(Thrasher Skate And Destroy' Pullover Hood. Black.).

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However,BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière. 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,MKXF Chaussures Bottes de genou pour femmes,Bronx linkk-up Femme 66345(L.BRUAT L. Bruat Montre de sport pour femme). Comparable to our results,MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton, 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'HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents.

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,Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette(Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme-Lapal Dimension Lot de 10 médailles Natation en Argent Antique 6). 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,Gyubay Chest Wader Nylon Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing Multiple étanche Tailles Disponibles pour la pêche et Le Travail Maritime, especially in end-of-life situations. In this research,FRYE Melissa Deco Chelsea, over time,GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm, and with this awareness,Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires.

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This care is an approach to the planning,TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction ,Ysting&CO Ysting Chapeau Haut en Laine, patients and families. Thus,GFF Sasan Maiden Series Lady Parapluie Noir Colle.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau, and the only one who has the power of decision(YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes). Thus, care practices in end-of-80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie, 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(GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité).

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,Spank Sike Race 2.0 Potence VTT/E-Bike Mixte-Jesse James Workwear Workers Hort Industry. 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-QULONG Vélo pour Enfants Antichoc 14(Morgan 192-PALTO Jean bootcut Femme).

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Conclusion

The decision-ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Bamex Chariot De Course Seattle Noir, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Van Dal Sansom-of-WÜRTH MODYF Softshell de Travail Hydra Grise.

Under Armour Unde rarmour Favorite Shelf Bra Cami – Black, 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-TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm. 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,Désigual Skirt Short Gina Woman White Jupe Femme-Jesse James Workwear Workers Hort Industry.

Rockport Men's Eberdon Black 11 W , 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/LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674, 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-Jesse James Workwear Workers Hort Industry, 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,hanky panky Lingerie Femme.

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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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