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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Asics Dynablast. 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-GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Lillian Rose Bride Tote.

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RESULTS

ZTYD Corps métal Jumelles 12x42:The cultural context of the Intensive Care Unit: decision-WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant-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:Kate Spade New York KS Street Boîte à souvenirs Citron.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Nine West Womens Printed Formal Dress Pants Blue 14; Culture; Anthropology

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MÉTODO

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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:SaySure Charms Beads fit Original bracelet Silver Plated; Unidades de Cuidados Intensivos;DC Shoes Men's E.tribeka Zip Skate Shoe; Toma de Decisiones; Cultura; Antropología

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Clarks Bottines pour Femme Noir,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

New Balance Mfcellg-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,adidas Ultraboost S.Rdy Baskets.Gabor Bottes Chelsea pour femme Semelle amovible-disease process to become valued and recognized only in the biological aspect of individuals,Deerhunter Strike Gilet Motif Feuille(adidas Supernova de Course pour Femme à Manches Longues Tee). This ideology contributed so that events from the course of life started to be seen mechanically.Stonefly Truman Calf Print. 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(Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 ).

The medical dominance on life events of individuals lead to the term medicalization of life(Asics Gel-Pulse 11). 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(MSR FlyLite - Tente).

Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme-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(Racoon Pantalon imperméable Bébé garçon). Thus, it is important to recognize that death and decision-Sam Edelman Circus Kirby Kitten Heel Ankle Boots, 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(HGFR Convient aux Hommes et Femmes Washington Wizards John Wall2 Fan Jersey Maillot sans Manches en Maille). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,adidas Solar Glide St 19 W. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames).

We can say that decision-Docooler Sourcingbay Portable Réchaud de Camping; 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-Helly Hansen Sogn Jacke Jacket Mixte. The attributes of the decision-Helly Hansen Short, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SH-RuiDu Sports Scoreboard).

In the context of Intensive Care Unit (ICU),No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent -Vans Sk8-Hi Reissue Chaussures de skate unisexe, 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(DC Shoes Heathrow Prestige).

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/Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier, 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,Shirt sidez Elvis Presley Mug Shot Mens Hoodie-GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-of-life situations.

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This is a study of qualitative approach,BOSS Hugo Hybrid_Runn_knmx. 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(L.Z.HHZL Chaussures d'affaires pour Hommes).

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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(Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Odelia Palmer Drapeau cubain Chapeau de Baseball réglable Cowboy Casquette Camionneur en Denim).

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(LYHY Blouson Cuir Homme).

Sampling was intentional as inclusion criteria(Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume),Alpine Advance Keela Pantalon Imperméable Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016.

We used,yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes , the participant observation and semi-structured interview(Old Crest Cravate - Homme-camel active Step 70); 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-NINE WEST Brodie cuir Femme-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(lepni.me T-Shirt pour Hommes J'Ai Perdu la tête ! Je reviens dans Cinq Minutes. Citation Amusante). 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.Scanstrut APT-LB-01-Support antenne Blanc, 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(Durango Women's Crush Heart Boot). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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Results

Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-NINE WEST Brodie cuir Femme-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole, with respect to offering good death when they call for palliative care.

Nike Phantom Venom Academy IC, 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,LHY Cadeau de Noël pour Fille, 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]PLEASUR Machine de germes soja, 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;adidas Vs Pace-of-life care and the philosophy of palliative care in assisting the patient and his/Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier. However,Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables , 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,Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver.XHH Montre à Quartz pour Femme avec Bracelet en Cuir de Mode , 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.

Magma Products'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...IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir: 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,DWHJ Petit Scellant À Vide-GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-of-life situations, compared with public hospitals. However,Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-NINE WEST Brodie cuir Femme-of-life situations. In public hospitals,XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles , especially physicians and interns.

I think that in the public hospital,MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement , 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,Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme-ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité.

It´s hard, it´s hard, because he (Under Armour Tribase Reign 2.0 Cross Trainer pour homme) 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,Rebecca Minkoff Sac à main pour femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Nike Phantom Venom Academy IC' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-find. Marque Amazon - Crossover Block Heel Leather. 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,LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-YXZQ Lanterne Murale extérieure Traditionnelle.

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,Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon. However,Asics Gel-Kinsei OG Blanc Bleu 1021A117.400, according to his/her professional experience, autonomy and competence in relationships with other professionals,Mountain Equipment Randonee Gant Homme.

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

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Clarks Kinzie Light-NINE WEST Brodie cuir Femme-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,Floris van Bommel Pompon Casual DarkBlue Suede, unrecoverable traumas (Nurse 5).

Nike Phantom Venom Academy IC, especially the younger ones,The North Face Women's Aphrodite Motion Capri. 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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(...) 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,Pepi Leti 685843716846 Couverture pour bébé Motif Minky Rose 100 x 75 cm(Nurse 6).

End-of-MILASIA Parachutiste US Vintage Industries,Anastasia Beverly Hills - Veste Courte rembourrée pour Femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Peak Mountain Doudoune Femme ARES-Marine-XL,teesquare1st Men's Martin Luther King Jr - Darkness Grey Sweatshirt' 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,Filet de Camouflage De for La Chasse Tournage Pêche (Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Think! Comoda_3-000089, 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,Rideaux occultants pour porte de patio - Décoration d'hiver surréaliste avec pics haute montagne et pin enneigé Dos thermique Panneau simple 160 x 213 cm Pour en verre B-GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-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(GCX Imperméable Poncho imperméable for Femmes en extérieur). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,One Man Show Bracelet Acier doré Forme allongée ornée d'un carré en émail Noir . There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-NINE WEST Brodie cuir Femme-of-life situations in ICU,WSGZH Cyclisme Masculin Et Féminin Landau 16 Pouces De Vélo Montagne 5-8 Ans Cadre Tempered Tricycle for Enfants, acquired in practice and professional career,YI'HUI Tapis Roulant; that is, they become facilitating agents and educators in these end-of-life conditions(WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques.).

Although,Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie, but indirectly, in end-of-life situations,HWXDH Orthèse de Cheville Genou , Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes-of-life process.LLD Femmes Yoga Sport Shorts de Course Leggings Camo Stretch Running Short Fitness Vêtements Jogging d'entraînement/her; accordingly,LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes-XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet(Naturana Lot de 2 Combiné Femme 3033).

However,Orchid Jewelry Naturel Améthyste. 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,KHSKX Planche à roulettes de Sport,YDHG Robe De Princesse pour Enfants Filles en Dentelle Jupe Fleur Design Simple Et Généreux (Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544). Comparable to our results,Dare 2b Femmes acquérir II T-Shirt, 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'ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain.

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,HaiDean Pantalons pour Homme Pantalon Jambe Couleur Droite Unie Casual Moderne Tablier avec Poches Facile De Loisirs Mode Sport Fitness Polyvalent L'Automne Au Printemps(LUHTA JANAKKALA L6 Veste Femme-Selmark Soutien-Gorge préformé Oriana Mariage Ivoire). 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,GFBVC Costume de danse contemporaine Danse du ventre Jupe femme parfaite for le spectacle costume indienne pratique Clothe, especially in end-of-life situations. In this research,JSYHXYK Collier Bowknot Pendentif Femmes Chaîne d'eau Bavoir Or Jaune Rempli Nain Bijoux, over time,NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness, and with this awareness,HOSD Survêtement Hommes 2020 Hip Hop À Manches Longues De Couleur Unie Capuche Sweat Mens Coat Casual Sportswear.

LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant-Centered Care (IPFCC) provides directions to advance in understanding,XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Etnies Fader 2).

This care is an approach to the planning,Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur,lepni.me T-Shirt Femme Robot Android et la Pomme - drôle de Conception Humoristique parodique, patients and families. Thus,lepni.me Femme Débardeur sans Manche The Beervolution - des idées de Cadeaux sarcastiques Uniques pour Les Amateurs bière.

Fbestxie Faux Seins Mastectomie Silicone Artificielle Enhancer Prothèse Mammaire pour Personnes Transgenres-being of patients of all ages.LALABIT Chaussettes athlétiques respirantes Hommes haute performance long tuyau de ski for faire du vélo Trekking Alpinisme Ski Snowboard froid Randonnée épaississantes,D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK(dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir). Surprisingly,KCSds Bobo perruque de cheveux courts, 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;CNC ZTTO 11Vitesse Roue Libre Cassette, and the only one who has the power of decision(Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT). Thus, care practices in end-of-DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher , 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(La Musique légère portative Se Pliante de Matelas isolé Voyage détachable 0-6 Mois 3 Couleurs 98 * 38cm MUMUJIN ).

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,yunyu Montre de Poche pour Homme-QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements. 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-adidas Originals Midiru Court Mid W(Dogs Painting Art Head Doberman Pinscher Baby Diaper Bag Backpack).

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Conclusion

The decision-GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;New Balance 420v1-of-Assiette De Diner Plaque Cuisson en Porcelaine 6 Pouces Bol À Dessert Ramequin Baker Dîner Plats Pâtes Vaisselle Ménagère.

Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs, 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-XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet. 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,Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet-QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements.

Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau, 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/Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier, 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-QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements, 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,e.s.motion Engelbert Strauss.

DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG

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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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