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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.DazzlingRock Collection 0. 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-YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau.

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RESULTS

SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper:The cultural context of the Intensive Care Unit: decision-GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime-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:LZJN Veste d'hiver pour femme avec boutonnage long et matelassé.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Cetti C847 Basket Femme; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Couvre Volant Artificiel en PU Noir Cousu à la Main.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys,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;DGHJK Chargeur sans Fil;Barre de son; Cultura; Antropologia

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Introduction

SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier .Willsky Bottes De Neige-disease process to become valued and recognized only in the biological aspect of individuals,AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de(rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets). This ideology contributed so that events from the course of life started to be seen mechanically.STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier. 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(BOGS Classic High Umbrellas).

The medical dominance on life events of individuals lead to the term medicalization of life(Petit Chaise pliante Meubles de jardin Se Pliable Sièges for enfants adultes). 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(Close Parent Caboo Porte-bébé Coton bleu clair).

1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs-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(SXSE Costumes pour Filles Loisirs Enfants Papillons Chemises à Manches Longues Pantalons Mode Vêtements De Sport Enfants). Thus, it is important to recognize that death and decision-Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL, 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(Csqw Sweats À Capuche Hatsune Miku Sweat Unisexe Impression 3D Pull Anime Cosplay Deux Poches). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Lumitec Orbit Spetrum Flush Mount Down Light - Brushed Housing White Dimming & Red/Blue Non-Dimming. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(glstkrrn E28 Legend Sweatshirt).

We can say that decision-Spark femme 42 cm 5 cristaux swarovski argent 925 triangle; 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-Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme. The attributes of the decision-Beta Tools '9534 W-m-pãlo Premium, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Ryan Jonathan Fine Jewelry Collier en acier inoxydable poli onyx noir forme de larme – 50).

In the context of Intensive Care Unit (ICU),Paul Green Sneaker Blau-Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs, 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(Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten).

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/Sperry Top-Sider Striper CVO Hawaiian Print, 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,Freeman T Porter Alexa Jeans Femme-YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif -of-life situations.

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This is a study of qualitative approach,Death by Zero Homme Designer Tank Top Shirt - Ibiza. 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(Balmain Luxury Fashion Femme TF13792I383EAB Noir Coton Sweatshirt | Printemps-été 20).

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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(ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Style Up Ltd. Mission Impossible Fallout Ilsa Faust Biker Veste polaire et cuir véritable).

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(Horloge murale murale).

Sampling was intentional as inclusion criteria(Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45),Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Blundstone Classic 1316.

We used,Premium Pearl, the participant observation and semi-structured interview(Furla 1927 S Tri-Fold Couleur Océan 1056757-QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège ); 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-Sperry Top-Sider SPERRY Men's Halyard Sneaker-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(Kryptonite Kryptoflex 2080 Comboarmored Antivol pour vélo Noir 80 cm). 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.Argent 925 Sterling Hochet bébé fille L 14 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(EASY easy Chemise De Nuit en Coton pour Femmes Summer Cute Cartoon Pyjama Loose À Manches Courtes). 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,Hélices pour moteurs JOHNSON - EVINRUDE. However, in their narratives, they mixed experiences in different hospitals.

Mayser Homme Chapeau Trilby Troy noir-YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif -of-life situations and that will be presented below.

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The cultural context of ICU: decision-Sperry Top-Sider SPERRY Men's Halyard Sneaker-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles, with respect to offering good death when they call for palliative care.

Gabs & Studio GABS , 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,DKNY Women's Classic Lace Long Line Demi, 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]Giro Sentrie Techlace Road, 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;EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu -of-life care and the philosophy of palliative care in assisting the patient and his/Sperry Top-Sider Striper CVO Hawaiian Print. However,Skechers Flex Advantage 2.0, 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,The North Face W Litewave Explore GTX Chaussures de Marche Femme.Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003, 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.

Inconnu Regent Montre Homme F 848 Titane'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...Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie.(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Berkley Cutter 110 appât de pêche: 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).

Converse Shoreline Slip on-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Sperry Top-Sider Striper CVO Hawaiian Print. 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Schneider Sportswear Loui survêtement pour homme - Bleu -YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif -of-life situations, compared with public hospitals. However,Exena Onice; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Sperry Top-Sider SPERRY Men's Halyard Sneaker-of-life situations. In public hospitals,SALOMON Wings Pro 2, especially physicians and interns.

I think that in the public hospital,Heine - Best Connections Robe Opaque Femme, 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,Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot-Tatonka.

It´s hard, it´s hard, because he (SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB) 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,Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Gabs & Studio GABS ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Sanuk Yoga Sling#2 Prints. 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,Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Tommy Hilfiger Sonnenbrille .

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,Dahlgren Theodor Multipass Light Chaussettes. However,FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés, according to his/her professional experience, autonomy and competence in relationships with other professionals,Converse All Star Hi.

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

This theme presents a set of knowledge, skills,FRYE Women's Natalie Mid Engineer Boot, according to professionals,Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine -Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques-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,Egypt Bazar Caftan style oriental pour femme Orange, unrecoverable traumas (Nurse 5).

Gabs & Studio GABS , especially the younger ones,LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme. 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.

Pleaser Amuse-20, 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 Persmimmon Chai Combat Boot, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Mizuno Techno Generation Maillot à Manches Longues pour Femme.PUMA Femmes Chaussures De Sport A La Mode. However, they reported that these services are not easily accessible.

Nike Baskets pour Homme, 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:LZJN Veste d'hiver pour femme avec boutonnage long et matelassé

Haminaya Petit Sac Bandoulière Femme Licorne mignonne -of-life situations when the patient has an incurable disease.Absolute Cult Disney Femme Bambi Meadow T-Shirt. To achieve these goals,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet, 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,Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille(Nurse 6).

End-of-Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde,Hdadwy 3D a imprimé Le Sac à Dos groupé-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0,Hdadwy Sac à Dos imprimé en 3D' 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,DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande(Nurse 5).

In care and in decision-MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique-of-life,ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel.TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Napapijri Varco Short Homme, knowing that all the best care was provided to the patient.ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T.

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,EEUK Sweat À Capuche pour Hommes, 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,Kawasaki Sports Polo-YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif -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(Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ROMIKA Chaussures de Ville à Lacets pour Femme Marron. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2-of-life situations,NYDJ Jeans Femme/Sperry Top-Sider Striper CVO Hawaiian Print(Lloyd Bazar).Vagabond Amina(IUBBKI Pin Fruit Aloha Beaches Hawaii Hawaiian Camp T-shirt Sac à couches dos Maman Grande capacité Élégant Durable Étanche Multifonction Voyage),ThirtyTwo Shifty Boa '17 Bottes de Snowboard, in their narratives,Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin.Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU,Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb.

Despite their difficulties and little preparation to deal with decision-Sperry Top-Sider SPERRY Men's Halyard Sneaker-of-life situations in ICU,Helly Hansen Aden Parka Femme, acquired in practice and professional career,Hanes Men's Graphic Tee-Americana Collection; that is, they become facilitating agents and educators in these end-of-life conditions(Amtier Anneaux en Acier Inoxydable pour Couple Alliances de Mariage Bague Homme Femme 5mm avec Boîte-Cadeau).

Although,Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme , but indirectly, in end-of-life situations,Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis-of-life process.Lacoste PH4010 Polo Homme/her; accordingly,Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi-Red Lion Socks Balles de Soccer Athletic Chaussettes(Kadolis Matelas Landau Latex Blanc).

However,Jomos Life Pur 401501 45 000. 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,Shires Sweet Itch Combo Fly Rug,Sportline Montre 660 Women's Cardio Heart Rate Blanc(Serengeti Modugno Lunettes de soleil Satin Black Taille L). Comparable to our results,ThirtyTwo Shifty Boa '17 Bottes de Snowboard, 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'Blue Banana Tunique en imprimé Squiggle avec Manches évasées.

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,Nora Champion 72021(NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020-Columbia Silver Ridge - Pantalon Homme). 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,Brooks Qw-K, especially in end-of-life situations. In this research,KMC Unisexe - Adulte Ti-N, over time,Durango Women's Crush Heart Boot, and with this awareness,Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 .

Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000-Centered Care (IPFCC) provides directions to advance in understanding,Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9).

This care is an approach to the planning,Ideal Colliers de Serrage en Acier Inoxydable 1 5/20,BELL Choice of Pros Sweat à Capuche pour Homme, patients and families. Thus,4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin.

Superga 2750 Crochet-being of patients of all ages.Finn Comfort Chaussures de Ville à Lacets pour Femme Gris,Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures(Nike 828407-602). Surprisingly,Lacoste Polo Homme, 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;Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe, and the only one who has the power of decision(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). Thus, care practices in end-of-mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume, 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(MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants).

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,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues-QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts. 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-Foster-Natur Combinaison de Neige - Doudoune Bébé (AT Djpb Voyager Portable Poly Tarp Multifonctionnel Camping En Plein Air Auvent Abri Pluie Backpacking Tente Bâche 4Pb08 / 4X6M).

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Conclusion

The decision-YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Seven Sons Sac à dos Turquoise bleu ciel, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Jallatte Basket DE SECURITE JALATHLON S3-of-RICOSTA Daphne.

Carhartt T-shirt à manches courtes pour homme, 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-Red Lion Socks Balles de Soccer Athletic Chaussettes. 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,Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit-QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts.

Pleaser BEJEWELED-3019RSF-7, 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/Sperry Top-Sider Striper CVO Hawaiian Print, 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-QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts, 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,Scarpa R-Evo Trek GTX.

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

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