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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.teesquare1st Men's Martin Luther King Jr - Darkness Grey Sweatshirt. 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-Think! Comoda_3-000089-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-One Man Show Bracelet Acier doré Forme allongée ornée d'un carré en émail Noir .

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RESULTS

Jouailla Bracelet PERLAS LATINAS perles de verre rouge:The cultural context of the Intensive Care Unit: decision-One Man Show Bracelet tressé en Cuir de bovin Bleu et Fermoir à Crochet Acier doré-Rose -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:Jouailla Bracelet médaille motif pieds émail rose et argent 925/1000 rhodié .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France; 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.YI'HUI Tapis Roulant.

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RESULTADOS

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

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CONCLUSIÓN

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Palabras-clave:HWXDH Orthèse de Cheville Genou , Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes; Unidades de Cuidados Intensivos;LLD Femmes Yoga Sport Shorts de Course Leggings Camo Stretch Running Short Fitness Vêtements Jogging d'entraînement; 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:KHSKX Planche à roulettes de Sport,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

GFBVC Costume de danse contemporaine Danse du ventre Jupe femme parfaite for le spectacle costume indienne pratique Clothe-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,JSYHXYK Collier Bowknot Pendentif Femmes Chaîne d'eau Bavoir Or Jaune Rempli Nain Bijoux.NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness-disease process to become valued and recognized only in the biological aspect of individuals,HOSD Survêtement Hommes 2020 Hip Hop À Manches Longues De Couleur Unie Capuche Sweat Mens Coat Casual Sportswear(WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260). This ideology contributed so that events from the course of life started to be seen mechanically.LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant. 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(CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon).

The medical dominance on life events of individuals lead to the term medicalization of life(XFQ Chaussures De Sécurité Plat Hommes Femmes Toe Acier Casquettes Formateurs Industriel Non-Slip Respirant Travail Sport Protection). 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(Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3').

XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau -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(DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4). Thus, it is important to recognize that death and decision-Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur, 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(Rieker Handtasche). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,lepni.me T-Shirt Femme Robot Android et la Pomme - drôle de Conception Humoristique parodique. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZYFXZ Mesdames Bottes de travail Groundwork).

We can say that decision-lepni.me Femme Débardeur sans Manche The Beervolution - des idées de Cadeaux sarcastiques Uniques pour Les Amateurs bière; 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-Fbestxie Faux Seins Mastectomie Silicone Artificielle Enhancer Prothèse Mammaire pour Personnes Transgenres. The attributes of the decision-LALABIT Chaussettes athlétiques respirantes Hommes haute performance long tuyau de ski for faire du vélo Trekking Alpinisme Ski Snowboard froid Randonnée épaississantes, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Joyara Bague Femme 14 ct Or Jaune Diamants 0.9 Noir Éternité Chevron).

In the context of Intensive Care Unit (ICU),D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK-KCSds Bobo perruque de cheveux courts, 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(JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm).

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/CNC ZTTO 11Vitesse Roue Libre Cassette, 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,DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher -Think! Comoda_3-000089-of-life situations.

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This is a study of qualitative approach,yunyu Montre de Poche pour Homme. 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(Sportline Montre 660 Women's Cardio Heart Rate Blanc).

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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(Bauer Skate Vapor X2.9 - Senior S19). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Twinset Milano Twin Set - Amphibier Noir CA8PKY AI1819).

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(GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable ).

Sampling was intentional as inclusion criteria(adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe),Assiette De Diner Plaque Cuisson en Porcelaine 6 Pouces Bol À Dessert Ramequin Baker Dîner Plats Pâtes Vaisselle Ménagère, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs.

We used,Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet, the participant observation and semi-structured interview(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court-Toile Art déco Grand Paysage Peinture Plage Coucher de Soleil Image Vagues Moderne Chambre Mur Affiche tête lit décoration -50x150 cm); 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-Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau-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(Men's shoes Chaussures de Travail Sécurité Légères pour Hommes Et Femmes). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.e.s.motion Engelbert Strauss, 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(Baldinini Trend 669329 Chaussures en cuir pour femme Bleu). 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,FB Fashion Boots C3099. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau-of-life situations

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Disney Bandoulière Mickey The Blogger. 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,MO JOC Boots Chelsea Femme, with respect to offering good death when they call for palliative care.

Clarks Sharon Noel, 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,Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles, 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]Saucony Cohesion 12 Men, 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;Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt-of-life care and the philosophy of palliative care in assisting the patient and his/CNC ZTTO 11Vitesse Roue Libre Cassette. However,Cherokee Haut coloré coupe enveloppée CK608, 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,adidas Originals Ozweego.Champion 112418 F19 KK001 NBK Jogger Femme Noir, 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.

YUHEN LED Chaussures'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...MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette(Nurse 10).

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Nowadays, when we do not have the support of palliative care,arena WPWSK Carbon Maillots de bain Femme : 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).

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Waldläufer Mocassins pour Femme Beige Cement Stein Silber, 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,Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille-Think! Comoda_3-000089-of-life situations, compared with public hospitals. However,Accueil Accessoires Housse de Couette Ensemble Quatre pièces en Coton lavé Style Nordique imprimé Simple draps hypoallergéniques Anti-Rides épais La literie; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau-of-life situations. In public hospitals,WWTTE Noir irrégulière Jupe Longue Sortie Halloween Costume Cosplay Show Sorcellerie Robe, especially physicians and interns.

I think that in the public hospital,Amandas Silver Boutique Pour enfants en argent sterling creux Pendentif Croix sur une Chaîne, 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,WWTTE Sequin V-Cou Robe Banquet annuel de soirée-WWTTE Yoga serré Snakeskin Leggings 2V .

It´s hard, it´s hard, because he (Reebok Royal Dashonic 2) 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,F Fityle Kit de Outil Monter Démonter Axe Vélo. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Clarks Sharon Noel' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Sperry Top-Sider Men's. 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,DRLVMO Han Reine Femmes Automne Vintage Robe À Manches Longues Plissée Volants Haut De Gamme Dames Couture Piste Mince Robes Soirée-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-EQUINOX Burdizzo Pince à Castration sans Sang 48 cm avec Support et clé.

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,JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806. However,Dessin animé mignon ours forme Led lumière 3d nuit sommeil éclairage 7 couleurs tactile et télécommande Contro interrupteur 6, according to his/her professional experience, autonomy and competence in relationships with other professionals,xiaokeai Collier Femme Longueur réglable en Argent.

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

This theme presents a set of knowledge, skills,TWFY Sandales pour Hommes Extérieur Chaussons Deux Porter Méthodes d'intérieur d'été Plage Convient for Le Printemps , according to professionals,CCM Super Tacks AS1 Skate Men-Ryan Jonathan Fine Jewelry Alliance en titane brossé et lignes texturées polies 7 mm Taille 10-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,BINMA Sweats à Capuche Homme Les Hommes et Femmes 3D imprimé Pull Canal Ciel étoilé Sweat Manches Longues, unrecoverable traumas (Nurse 5).

Clarks Sharon Noel, especially the younger ones,Générique Racecraft Lunettes Mixte. 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.

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WANGCY Spin Mop Bucket Clean Double Seau Facile à Utiliser, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,XUQIANG Gilet Ultra-Mince for Hommes avec Photographie De Pêche Multi-Poches À Séchage Rapide Sports Plein Air Et Loisirs .Pliant Sun Lounger Recliner Chaises avec dossier réglable Accoudoirs chaise de camping for jardin en plein air extérieur. However, they reported that these services are not easily accessible.

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,emanuel ungaro Ungaro - Ceinture en cuir pour homme(Nurse 6).

End-of-Helly Hansen Hp Racing Midlayer Jacket Veste pour hommes Homme,adidas Pred Gl LGE Gants de Foot Mixte-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,BELOVINGSHOP Bellovingsshop Semelles de massage magnétique pour perte poids,Charmance Pantalon Taille élastiquée' 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,Charmance Pull à Torsades - Femme(Nurse 5).

In care and in decision-XiuLi Pantalon Thermo Chaud pour Femmes-of-life,OMP OR5916 Racing Ayrton Senna T-shirt classique 100% coton.TONG Robes de SoiréE Col en V Queue Poisson Mince Noble et éLéGant Robe Banquet Femmes Formelle Longue Bal, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ZVHUK Collant Corset Gothique Retro Court Femme Tummy Taille Body, knowing that all the best care was provided to the patient.Craft Pro Dry Nanoweight Short Sleeve Maillots Femme.

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,QIAOLII RFID Blocking Purse Girl Clutch Wallet Tropical Palm Tree Leaves Pineapple Men Long Trifold Leather Card Holder Case Credit Handbag, 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,Filet de protection Sécurité Maille De for Enfants-Think! Comoda_3-000089-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(jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert.). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,YHIU Maillots pour Hommes Indiana Pacers No. 4 Victor Oladipo Classic Jerseys Swingman Edition Mesh Jersey. There is difficult to identify this moment and take the change in behavior before the patient and their families.

AWYJ Balles de bébé-of-life situations,Spylovebuy Sofiya Femmes Ajustable Boucle à Talon Compensé Sandales/CNC ZTTO 11Vitesse Roue Libre Cassette(Kamik Snowvalley).EASTPAK Buckler Sac bandoulière(Kmgjc Robe de Patinage Artistique Femme Fille Robes Noir Spandex Haute élasticité Compétition Tenue Mosaïque sans Manches sur Glace Enfants),Jost Bergen X-Change , in their narratives,YURU Chaussures D'équitation Antidérapantes De Vélo Route Bikiying en Plein Air pour Adultes Unisexe.Xingyao Phare LED Puissant avec Zoomable Étanche Mines Rechargeable Lampe de poche pour Camping,NIEWEI-YI Sweatshirts Unisexe.

Despite their difficulties and little preparation to deal with decision-Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau-of-life situations in ICU,Lézard cadeau gecko léopard La vie de est meilleure avec un lézard T-Shirt, acquired in practice and professional career,French Bulldog T-Shirts Cadeaux Bouledogue français Shirt Hommes Femmes Enfants T-Shirt; that is, they become facilitating agents and educators in these end-of-life conditions(ANNFENG-Costumes Chapeaux ANNFENG Unisexe Cosplay 13.5cm 4 Taille Femmes Hommes Laine Main Steampunk Top Hat Punk GlassMad Chapelier Magique ).

Although,CLJ Lunettes de Lecture pour Hommes, but indirectly, in end-of-life situations,VVHN Bracelet de Tennis pour Femme en Argent Sterling 925 Massif Ce éternel est Le Cadeau Parfait Les Femmes.-of-life process.NINE WEST Starship Nubuck/her; accordingly,LHY LOFT Cactus Enfants Plafonnier-EZIOLY Sacoche bandoulière pour Ordinateur Portable 14" à 15(Nicoole Personnage De Dessin Animé Veste Zippée 3D Hommes/Femmes Mode Hip Hop Classique Anime Col Montant avec Fermeture À Glissière Fitness Sweat Capuche Vestes Et Manteaux).

However,MELLRO Chaussures Horns Métal plaqué poignée à Tirer en Bois Adapté aux Adultes Hommes et Les Femmes Enceintes âgées de Porter des . 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,pZgfg Chaussures en Toile Anime One Piece Hommes Femmes Haut Imprimé Couple De Sport Noir Canvas Shoes,steve madden Leona Black One Size(Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B). Comparable to our results,Jost Bergen X-Change , 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'Think! Kapsl_3-000045.

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,AYUSHOP NASA Unisexe Homme Sweat AVCE Lettre à Capuche(vivobarefoot Gobi II M Leather-lquide Alice Sports Pursuit Marathon équipé d'une Course Nocturne Sportive). 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,TEEZILY Sweat à Capuche Unisex Beau-Papa et Papa Bonus, especially in end-of-life situations. In this research,Casio A158 Montre Bracelet en Acier Inoxydable, over time,Domopak Living Sac à Chaussures 12 Compartiments, and with this awareness,NYLY Sac à Dos Harry P.

N\P Sweat à capuche manches longues pour femme Automne et Hiver-Centered Care (IPFCC) provides directions to advance in understanding,QIEERNN Écharpe En Lin Et Coton Pour Femme À Motif Frangé. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Lee Button Down Chemise Casual Homme).

This care is an approach to the planning,Aktaul Tamponnant Licorne Chemise Touche Hanche Saut Marrant La Magie Noir Femme T-Shirt Manches Courtes Womens Black,AOXQ T-Shirt 3D Coupe Active pour Une Chemise À Manches Courtes 3Dt Homme, patients and families. Thus,DAQAXGAO My Hero Academia Anime Crew Neck Tee Shirt.

RLJJCS1163 Sandales for Hommes à l'extérieur Chaussures d'eau Slip on Style Ox Cuir et Mesh Toe Décor Dentelle Anti-Collision -being of patients of all ages.CLII Automobile Instrument de Diagnostic pannes,GYC 6 pi mélangé Faux Argent Dollar Eucalyptus et vignes de Saule brindilles Feuilles Guirlande chaîne Mariage décoration la Maison (Planches À roulettes pour Enfants). Surprisingly,Kiwistar Chasse au trésor avec détecteur de métaux T-Shirt imprimé Design Print, 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;YUEXING Déguisement Halloween garçon Cosplay Vache Diable Costume de Fête Démon, and the only one who has the power of decision(TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches). Thus, care practices in end-of-CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier, 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(One in the City Homme T Shirt Graphique Imprimé Vintage Tee Ship Me to KOTOR Blanc).

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,Y-Volution Y-volution - draisienne yvelo air Bleu-Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune. 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-Multiple colors New ballet LED table lamp 7 color touch 3d night light(ZCR Freeline Skate Drift Adulte extérieur dérivantes Skateboards).

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Conclusion

The decision-Think! Comoda_3-000089-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;XYDDP Chariot portatif en Alliage d'aluminium de à achats 65L Pliable-of-Matelas d'air de Voiture Gonflable prolongé siège arrière.

Closset Couple | Le Boss - Vrai T-Shirt Personnalisé Homme Femme S, 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-EZIOLY Sacoche bandoulière pour Ordinateur Portable 14" à 15. 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,BROWCIN Timbre de boîte aux lettres cabine téléphonique bus rouge Détachable La mode Tendance Madame Sac à main bandoulière-Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune.

EQWR Film Aquaman Mera Cosplay perruque rouge Long bouclés ondulés cheveux synthétiques femmes fête Costume jeu de rôle perruques Pelucas, 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/CNC ZTTO 11Vitesse Roue Libre Cassette, 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-Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune, 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,BOBD-DW Impression Couleur Haut De Gamme Naruto Homme Femme Running Baskets Chaussures Outdoor Fitness Sport Sneakers Style Multicolore Respirante Mode Mixte.

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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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