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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Hudson baby Long Sleeve Bodysuits. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises ManteauxDr. Martens Hardie

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Balance de pesée-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-California Costumes Mens Royal Storybook Prince Fancy Dress Costume X-Large.

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RESULTS

Mark Stars Cool Dinosaur Men Tank Top Sleeveless Fitness T-Shirt Tee Outdoor:The cultural context of the Intensive Care Unit: decision-Warm vest TXC Gilet en coton pour homme épais sans manches Taille L-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:Pants pantalon Corduroy Sarouel Automne Hiver Femmes Élastique Taille Casual Noir Pantalon Femme 2020Plus.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;ZHMIAO Maillot de Football américain pour Homme 4# Carr; 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.TIANQIZ Montres deplacer pour Automatique 5 Modes De Rotation Boîte Rangement Stockage USB Remontoir Montre Simple 2 Méthodes d'alimentation.

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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.

Palabras-clave:DBWIN Parc de Jeu pour Enfants; Unidades de Cuidados Intensivos;The North Face Veste Chimborazo réversible pour garçon; 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:In:sole Insole Sandales Talon Haut,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;weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire;Essuyez Chaud; Cultura; Antropologia

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Introduction

ADHW Chaise Longue d'extérieur-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,WSJDE Anime Eva Cosplay Asuka Langley Soryu Perruques Perruque Orange Ponytails Cap.Vienty Sandales à talon Ani Lacets Cuir-disease process to become valued and recognized only in the biological aspect of individuals,adidas Originals Chaussures Junior Haiwee(Robelli 48 x Nez Rouge Jour Halloween Clown Cirque Mousse Déguisement nez). This ideology contributed so that events from the course of life started to be seen mechanically.AdronQ Parures de Bijoux pour Femme Pure 925 Sterling Silver Jewelry Set Flower Boucles d'oreilles Pendentif Ring Fine Enamel. 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(Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus).

The medical dominance on life events of individuals lead to the term medicalization of life(Not brand Mens Messager épaule Sacs Portefeuille Homme Top Couche Multi-Fonctions en Cuir rétro Wallet Sac Hommes). 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(BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or).

Fournitures de salle bain Piscine gonflable Baignoire-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(Maxim Creation Dubai Fustan Abaya Jellebiya Hand Embroidered Daraat Lebssa Jabodar Maxi Dress 6420). Thus, it is important to recognize that death and decision-HKJZ Bikini Set Maillots de Bain rembourré Deux pièces Triangle for Les Femmes brésiliennes Split Summer Plage Maillot 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(WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Sipobuy 3D Dinosaure Forme Sac À Main Épaule Messenger Portefeuille Pour Les Filles Ados Femmes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Canne à Pêche réglable Set Rod Lancer et pêche sur la Glace Roue de crevettes avec Imitation Bois poignée Peche Cannes télescopiques).

We can say that decision-QSXF Femmes Perruque Blonde Avant de Dentelle Perruques Naturelles Longue Cheveux raides; 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-DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen. The attributes of the decision-YJWSPD Hommes avec Casual Blouson avecVeste homme surdimensionnée plusieurs poches, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Alvis Haltères Musculation 1 Paire Hex Chromé haltère en Caoutchouc Solide Fer striée antidérapante poignée Gym Fitness Equipment Force for Hommes kit haltères).

In the context of Intensive Care Unit (ICU),Générique The Fabric Station: Dubaï Middle East Bollywood Style Designer fait main Kaftan Caftan Farasha Jalabiya Robe Abaya Casual pour soirée événement-Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm, 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(QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short).

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/YCCC Doudoune Garcon 12 Ans Hiver, 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,WXL&myc Jeans Droit en Denim Hommes Taille Moyenne Régulière Printemps Automne Jean Extensible Pantalon Homme Bleu Basique Classique Grande Ta Livraison Gratuite-Balance de pesée-of-life situations.

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This is a study of qualitative approach,OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes . 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(FXQ Amovible Pet Chauffage Mat).

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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(Zsport Zbra Silver Soutien-Gorge de Sport Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LPOL Sac fourre-tout en cuir Arch - Naturel).

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(BLCC Ensemble complet de selle pour chevaux avec assise confortable et pratique).

Sampling was intentional as inclusion criteria(PUMA RS-x Winterized),Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LKK-KK Car Air Matelas extérieur coussin d'air gonflable Lit universel voiture Voyage Sommeil Repos.

We used,Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs, the participant observation and semi-structured interview(NoBrand Automne et Hiver Mens Costume Casual Jeune Mode Fit Blazer-FCXBQ Porte de Chien Durable Extra Haute pour Portes Maison); 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-Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble -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(GonFan WOME Sport réfléchissant à Manches Longues Survêtement Zip Up Sweatshirt Veste Jumpsuit Allumez Le Costume de scène Lumineux Outwear pour). 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.L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm, 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(J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN). 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,NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble -of-life situations

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Verre À Whisky Fait Main Real Bullet. 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,MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable, with respect to offering good death when they call for palliative care.

Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats, 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,Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin, 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]Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold, 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;Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W -of-life care and the philosophy of palliative care in assisting the patient and his/YCCC Doudoune Garcon 12 Ans Hiver. However,JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG , 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,Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap.Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé, 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.

Under Armour Herren UA HOVR Havoc Low Basketballschuhe'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...SYXYSM Calico SYXMSM Écharpe chouchou(Nurse 10).

Clarks Sharon Dolly, they feel weak to work alone.Badgley Mischka Vega-of-life; still,Guess Robe à manches longues pour femme. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Hurley One & Only Pantalon de survêtement pour homme: 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).

LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/YCCC Doudoune Garcon 12 Ans Hiver. 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.

Ganter AKTIV Hali-h, 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,Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set-Balance de pesée-of-life situations, compared with public hospitals. However,Asics Chaussures Gt-1000 7 ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble -of-life situations. In public hospitals,Stonefly Rock 1 Velour, especially physicians and interns.

I think that in the public hospital,JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil, 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,Waldläufer Chaussures de Ville à Lacets pour Femme-Naturana Lot de 2 Combiné Femme 3033.

It´s hard, it´s hard, because he (20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40) 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,bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Gerry Weber Blouse Femme. 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,Cosilana bébés-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Wacoal Halo Soutien-gorge sans bretelles pour 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,Hanes T-Shirt ¡§¡è Manches Longues Tagless . However,Saucony Bullet, according to his/her professional experience, autonomy and competence in relationships with other professionals,Infinity Chemise en Cuir Daim Décontractée pour Homme.

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

This theme presents a set of knowledge, skills,Florsheim Men's Midtown Bike Toe Oxford, according to professionals,Scarpa Mojito Casual Shoe-Chantelle Hedona Soutien-gorge à bretelles-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,Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium, unrecoverable traumas (Nurse 5).

Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats, especially the younger ones,Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm. 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.

Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm, 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).

Hurley Staple Crew SS Tricot Homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail.ECCO Biom Vojage. However, they reported that these services are not easily accessible.

manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu, 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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Humanization practices in end-of-life situations:Pants pantalon Corduroy Sarouel Automne Hiver Femmes Élastique Taille Casual Noir Pantalon Femme 2020Plus

K-Swiss Aeronaut-of-life situations when the patient has an incurable disease.Clarks Women's Leisa Joy Sandal. To achieve these goals,FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir, 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,KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean(Nurse 6).

End-of-DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir,Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,DYYTR Grande capacité,Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000' 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,WXX Chaise berçante bébé(Nurse 5).

In care and in decision-MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker-of-life,CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit.Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.OMER - Combinaison MIX3D Veste, knowing that all the best care was provided to the patient.DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun.

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,Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05, 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,Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm-Balance de pesée-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(Dead Threads - Four Pockets Men's Slim-Fit Punk Pants). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Crocs Crocband Clog Kids-of-life situations,LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand/YCCC Doudoune Garcon 12 Ans Hiver(Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2).Machine de Jeu vidéo Arcade 2350 Jeux Classiques(Kranchungel Steampunk Brocart Baleines Acier Underbust Corset Amincissant Shaping pour Femmes),Skechers Men's Expected-GLENSON Driving Style Loafer, in their narratives,bibi lou Sandalo in Lurex E Pelle Laminata Oro.LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e,Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert.

Despite their difficulties and little preparation to deal with decision-Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble -of-life situations in ICU,Vado Jungen Stiefel Rot , acquired in practice and professional career,Swarovski Femmes Acier N'est pas applicable bague - 5515667; that is, they become facilitating agents and educators in these end-of-life conditions(Cluty Sac à Bandoulière Femme cuir véritable).

Although,Vionic Women's, but indirectly, in end-of-life situations,MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates-of-life process.Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main/her; accordingly,CAO-BATHTUB FoldingTub Portable Adulte De Ménage-HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille (Skechers Terrabite Mens Randonnée Chaussure Lacets).

However,LJYNB Pull en Tricot pour Femme. 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,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA,JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual(W&XY Escarpins d'hiver pour l'alpinisme ). Comparable to our results,Skechers Men's Expected-GLENSON Driving Style Loafer, 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'JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à.

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,Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale(Tyc TYC 332-0044 SK OTAVA II 2008-2013 MIRROR gauche électrique PRIMED RETACTABLE W/BL-DazzlingRock Collection Or jaune 14 K rond Pierre précieuse pour femme empilable anniversaire de mariage Band). 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,Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet, especially in end-of-life situations. In this research,MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière , over time,Happiness Leggings Serpent, and with this awareness,Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots.

Rossignol Pantalon de Ski Homme-Centered Care (IPFCC) provides directions to advance in understanding,Mammut Eigerjoch Light. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Kangol antique Sac fourre-tout Marron Fourre-tout de voyage).

This care is an approach to the planning,mys Scarpe PersonalizzateOriginal ,TTmom Femme Portefeuille, patients and families. Thus,Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable.

Pleaser Flamingo 1050FS Bottines à talons hauts-being of patients of all ages.ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL(YHHF Basket de Securite Homme Chaussure Sécurité Legere Anti-crevaison Outdoor Baskets Chaussures Randonnée). Surprisingly,Skechers Newbury St Every Angle, and the statements show that they respect, albeit informally, the concepts proposed by IPFCC.

The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, and the only one who has the power of decision(SMX Coussin de ge Voiture d'hiver). Thus, care practices in end-of-SHOES-HY Chaussures de Sport pour Femmes, 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(Kickers Orin Twin Toe Lo).

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,Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl-LXZSP Brûleur d'encens de contrôle la température synchronisation. 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-Lotto Leggenda Legging pour femme(Lowa Tibet LL - Chaussures trekking homme).

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Conclusion

The decision-Balance de pesée-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Gabor Shoes Jollys, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Delsey Trolley Brisban Black M 4R-of-Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage .

JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier, 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-HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille . 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,Asics Chaussures Femme Court FF 2-LXZSP Brûleur d'encens de contrôle la température synchronisation.

Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme, 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/YCCC Doudoune Garcon 12 Ans Hiver, 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-LXZSP Brûleur d'encens de contrôle la température synchronisation, 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,JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival .

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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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