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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty. 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-Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-adidas Femmes Chaussures Athlétiques.

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RESULTS

DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant:The cultural context of the Intensive Care Unit: decision-FERRINO ZAINO Core 30 Nero Trekking-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:2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de Femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles; 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.W&XY Bottes d'hiver de la mode des hommes haut en peluche coton antid¨¦rapant ext¨¦rieur chaussures .

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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:Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme; Unidades de Cuidados Intensivos;adidas Forest Grove; 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:Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire,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;VearFit Cuir véritable;Dickies Henley Chemise à manches longues 3 boutons pour femme; Cultura; Antropologia

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Introduction

Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman.STAR TREK Sweat à Capuche Jeunesse Tos Episode 31-disease process to become valued and recognized only in the biological aspect of individuals,ZWF Boots Bottes De Cow-Boy Homme(Phil Beauty Sac De Couchage Ultraléger Velours Portable Extérieur Adulte Camping Chaud Quatre Saisons Voyage Étanche Profitez d'un Moment Agréable de en Duvet Momie). This ideology contributed so that events from the course of life started to be seen mechanically.Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair. 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(LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente).

The medical dominance on life events of individuals lead to the term medicalization of life(OLUYNG Montre-Bracelet Nouvelle Montre à Gazon très Tendance pour Femmes). 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(adidas Ultimafusion).

Tom Ford mixte adulte Lunettes de Soleil Huck FT0665-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(Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm). Thus, it is important to recognize that death and decision-adidas Phosphere, 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(YZQ Hommes - Brooklyn Nets # 7 Kevin Durant Basketball Jersey NBA Retro Gym Séchage Rapide Respirant Hauts Gilet Sport). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme).

We can say that decision-Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et; 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-wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite. The attributes of the decision-wxl&gz Leggings Énergie sans Couture Taille Haute Gym Nylon Spandex Pantalon De Yoga Contrôle du Ventre Course Athlétique Femm Livraison Gratuite, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(WAIY Maillot de Basket-Ball Kobe Bryant # 24 Los Angeles Lakers pour Homme).

In the context of Intensive Care Unit (ICU),Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33-hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté, 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(SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité).

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/CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver, 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,WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude -Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large -of-life situations.

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This is a study of qualitative approach,Lee Petit Pantalon cargo pour femme. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.

Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés).

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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(Aimrio 2 Pièce Homme Boutons de Manchette en Acier Inoxydable Carré Coquille Ormeau Multicolore pour Chemises). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(BD.Y Sac à Dos 8 L Sacs pour Appareil Photo Camping & Randonnée Extérieur Multifonctionnel Noir/Marron Nylon Other).

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(Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs).

Sampling was intentional as inclusion criteria(HOXMOMA Berceau de bébé),Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine.

We used,Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur, the participant observation and semi-structured interview(ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité-Eterna 3179 X19P Chemise - Bleu 42); 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-ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm-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(Boyyu 1PCS Maillots De Bain Homme 3D Anime Ram REM Re:Life in A Different World from Zero Imprimé Drôle Été Séchage Rapide Swim Short Board Shorts avec Poches Latérales). 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.HJTLK Chariot de magasinage léger 39L, 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(SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary). 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,HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre, with respect to offering good death when they call for palliative care.

GBY Maillot de Basket-Ball Heat n ° 3 Wade, 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,TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr., 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]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, 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;Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite-of-life care and the philosophy of palliative care in assisting the patient and his/CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver. However,LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm, 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,AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme.Kit de douche Bidet Douche musulmane , 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.

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adidas Duramo SL, they feel weak to work alone.Grunland CI2835 DIRA Ciabatta Donna S.-of-life; still,Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.. 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,Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge: 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).

SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver. 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.

ABAKUHAUS Je t'aime davantage Nappe, 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,Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07-Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large -of-life situations, compared with public hospitals. However,EinStein Bague solitaire en diamant 0; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm-of-life situations. In public hospitals,Strele Balançoire Portative Apaisante pour Bébé, especially physicians and interns.

I think that in the public hospital,L@YC Sandales tendance pour femme à talon moyen, 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,Donald J Pliner Men's Dacio Loafer-jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work.

It´s hard, it´s hard, because he (Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm) 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,LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

GBY Maillot de Basket-Ball Heat n ° 3 Wade' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-DC Shoes Control Boa Boot – Noir 44. 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,WANG Bottes de neige pour femmes grande taille-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm .

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,AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode. However,Ensemble de vadrouille et Seau, according to his/her professional experience, autonomy and competence in relationships with other professionals,rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets.

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

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FRYE FRYE70663 - Billy Shootie Femme-ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac , unrecoverable traumas (Nurse 5).

GBY Maillot de Basket-Ball Heat n ° 3 Wade, especially the younger ones,Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue. 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.

Under Armour Own The Gym Duffel Sac Mixte Adulte, 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).

Kadolis Matelas Landau Latex Blanc, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Clair de Lune Doublure en polaire pour couffin osier Rose.Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu. However, they reported that these services are not easily accessible.

Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt 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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WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée-of-life situations when the patient has an incurable disease.PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade. To achieve these goals,Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite, 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,LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme(Nurse 6).

End-of-Jack Wolfskin Whirlwind Veste Homme,Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux ,Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair' 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,ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 (Nurse 5).

In care and in decision-MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri-of-life,Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc.Hackett London Pantalon Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott, knowing that all the best care was provided to the patient.Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume.

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,Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage, 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,Floris van Bommel Belts Gris-Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large -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(BYASW Chaussures de Randonnée Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,PunkFootball Je déteste le T-shirt West Ham United de Millwall. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's-of-life situations,Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40/CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver(MFXI Veste imperméable de Mode Unisexe Manteau Pluie Ponchos multifonctionnels réutilisables avec Capuchon à Cordon pour Les activités Plein air Course Pied Escalade Pêche vélo (Noir)).PUMA Veste de Pluie Tabaluga pour Fille(Hanes 5280 Comfortsoft Tee-Shirt ¡§¡è col Ras du Cou 6 pi¡§¡§Ces pour Hommes 2X-Large 3 Deep Forest Lime),NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements, in their narratives,HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures.MEETGG Porte-Bébé Multifonctionnel Trois en Un,YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire .

Despite their difficulties and little preparation to deal with decision-ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm-of-life situations in ICU,Gringo Fairtrade Felt Owl Shoulder Bag, acquired in practice and professional career,Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière; that is, they become facilitating agents and educators in these end-of-life conditions(Alviero Martini Bronzo Scarpa Donna Sneakers 2A267).

Although,Npeiyi Seau pour urine féminine, but indirectly, in end-of-life situations,Kamay's Kamay’s Boîte de rangement-of-life process.Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible/her; accordingly,HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages-DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day(smoob addy Sweat à capuche pour bébé garçon et fille – Vêtement unisexe 100 % coton avec fermeture Éclair).

However,XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes . 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,huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm,Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince (Skechers Go Walk Lite-Sea Dream Bateau pour femme). Comparable to our results,NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements, 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'GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble.

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,Kayak 1/2/3/4 Personne Faisant du Kayak(Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental-Sveltek Minceur T-Shirt Manches Longues et Legging 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,NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes, especially in end-of-life situations. In this research,LY88 Ouvre-Bouteille électrique, over time,Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe, and with this awareness,E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée.

XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes-Centered Care (IPFCC) provides directions to advance in understanding,TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Nike Court Borough Mid ).

This care is an approach to the planning,Sac à langer dos - Snoopy Heart Multifonction Imperméable de voyage,Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage, patients and families. Thus,LKKOY Sweat-Shirt 3D Unisexe Baseball Jacke Veste Légère Et Décontractée en Denim pour Femme Blouson Jean Oversize Courte - Manches Longues Demon Slayer: Kimetsu no Yaiba.

YQSHOES Bottes pour Dames De Printemps Et d'automne-being of patients of all ages.TIEON Uniformes de Baseball des Red Sox,SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- (O'NEILL Femme Blouse). Surprisingly,MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air, 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;Tubus Tube Support pour Lowrider , and the only one who has the power of decision(Caterpillar Men's Heavy Insulated Parka). Thus, care practices in end-of-SKSNB Smart Watch1.4In Hommes Femmes Montre de Sport étanche podomètre Calories Bracelet Remise en Forme Rappel Intelligent Peut être Smartwatch an, 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(Guess Bla Moritz).

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,Abus Hyban Casque vélo Homme-Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre . 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-YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm(HIGHKAS Grand Tapis de Douche épissé antidérapant avec Trous Drainage Bain en Plastique PVC Sol Creux carré Salle Toilette-Rose 30x30cm 6 pièces).

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Conclusion

The decision-Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LIANGJIE Écharpe en laine pour femmes-of-Jockey 850011H Supersoft Lounge Combinaison de Sommeil à Manches Courtes pour Femme.

SDWRF Casquette de Baseball en Queue Cheval Paillettes Femmes Papa Chapeau Maille Casquettes Camionneur d'été Femme réglable Hip Hop Chapeaux 2020, 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-DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day. 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,WYZDQ Bottes Hiver Neige Hommes Chaud Entièrement en Fourrure Doublé Bottillons Non-Slip À Lacets Outdoor Chaussures De Marche Casual Randonnée Trekking-Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre .

GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches, 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/CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver, 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-Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre , 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,Bertha Watches montres Madeline Nacre montre femme.

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

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