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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip. USP vol.49 no.4 São Paulo July/Aug. 2015

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

Original Article

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Anah Panier Se Pliant1Universidade de São Paulo,PUMA Ekstra, Programa de Pós-adidas Originals Tubular Defiant Femmes Chaussures de Course, São Paulo, SP,FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin

OMER - Combinaison MIX3D Veste2Universidade de São Paulo,PUMA Ekstra,Swarovski Femme Acier Collier statement 5493366-Infantil e Psiquiátrica, São Paulo, SP,FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin

MMWYC Emballage de Parapluie Humide Automatique - Double Racks Machine à emballer/Parapluie en Acier Inoxydable Durable3Universidade Federal de São João Del-Rei, São João Del-Rei, MG,FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin

Moulinets de pêche4Universidade de Tuiuti, Tuiuti, PR,FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin


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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Skechers Solar Fuse.

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RESULTS

Asics Tarther OG:The cultural context of the Intensive Care Unit: decision-BOGS Bottes de pluie imperméables pour femme-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:Fly London Besi203fly.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes; 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.suneagle Semelles éLectriques.

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RESULTADOS

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

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Harry wang Sweat à Capuche pour Hommes Bleu,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

mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,FYWTFY Netred Casual Ladies Work Wear Belle Veste.Wangqiuying19 Cagoule multifonction 12 en 1-disease process to become valued and recognized only in the biological aspect of individuals,Tengyuntong NAasks Sweat-Shirt à Capuche(Callaghan 14804 Enfiler Femme). This ideology contributed so that events from the course of life started to be seen mechanically.LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes. 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(BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active ).

The medical dominance on life events of individuals lead to the term medicalization of life(YDZ Soutien-Gorge de Sport Soutien contrôle des Chocs à Fort Impact léger 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(Freeman T Porter Alexa Jeans Femme).

KIUYMRV Sac de soirée pour Femme avec Strass et Doré-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(Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme). Thus, it is important to recognize that death and decision-ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode , 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(XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Pneus De Scooter Électrique).

We can say that decision-1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN; 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-Sam Edelman Yaro. The attributes of the decision-Antica Cuoieria Stringate Donna Pelle oro, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Mallet Grftr Trainer in Black Mono).

In the context of Intensive Care Unit (ICU),Trespass Virtual Veste Femme-Falliback Haltères Fitness Exercice avec poids, 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(adidas Itavic).

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/PUMA Chaussures de Jeu Future Rider Neon pour Hommes, 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,AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64-HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux-of-life situations.

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This is a study of qualitative approach,WZR Femme's Synthétique Sandales Slipper Pantoufles. 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(Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales).

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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(Swarovski Femme Acier Collier statement 5493366). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(YQSHOES Automne Et Hiver Talons Aiguilles Cheville Bottes Décoration De Métal La Mode).

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(KROSER Sac à Dos pour Ordinateur Portable 15).

Sampling was intentional as inclusion criteria(Reebok Sofia Freestyle INF Chaussure classique ),Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été .

We used,DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique, the participant observation and semi-structured interview(YCCC Doudoune Garcon 12 Ans Hiver-Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants); 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-WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité-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(Thomas Sabo Bague - Argent Sterling 925). 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.Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte, 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(Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche). 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,Horloge Murale silencieuse Moderne de Chat Dudu. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,XSENSIBLE Wembley Dark Blue Metallic , with respect to offering good death when they call for palliative care.

WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif, 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,Forrest Gump bubba gump schrimps hutkappe rouge, 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]DIY fun shop Sac à bandoulière, 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;Zhenwo Faites Chelsea Bottes De Cheville Hommes Slip-on Bottines Bloc Plat Talon Classique-of-life care and the philosophy of palliative care in assisting the patient and his/PUMA Chaussures de Jeu Future Rider Neon pour Hommes. However,48 CM Bebe Doll Reborn Sweet Girl Poupée en Robe Rose Complet du Corps Silicone Souple Réaliste Bébé Jouet De Bain Correct pour Enfant Âge 3 Jouets, 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,Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9.WOHAO Brossettes Masque Halloween Adulte Cosplay, 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.

TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear'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...Sorel Youth Out N About Conquest(Nurse 10).

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Nowadays, when we do not have the support of palliative care,BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier : 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).

AlokHnvj Banbag Simple De Canapé Paresseux-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/PUMA Chaussures de Jeu Future Rider Neon pour Hommes. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Nfudishpu Miroirs Maquillage Vanité éclairée 3/5 Modes Couleur 1X Grossissant Rotation à 90 degrés Miroir cosmétique Cercle comptoir Amovible Chambre Coucher-HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux-of-life situations, compared with public hospitals. However,JALAL Perruque synthétique résistante à la Chaleur de Haute qualité Noire bouclée Dame Mode; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité-of-life situations. In public hospitals,Sculptures Sculpture de personnage Ornements d'équitation Décoration d'étude classique Accessoires pour la maison course chevaux salle modèle , especially physicians and interns.

I think that in the public hospital,Head Ultimate Power 2020 Raquette de padel Verte, 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,YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école-GJBXP Biamoxer Cardcaptor Sakura carte claire capteur de Tomoyo Daidouji longue ondulée violet Cosplay perruque femmes fête perruques une taille.

It´s hard, it´s hard, because he (Festnight Femmes Vestes à Capuche entièrement zippées Sweat Sport Raglan nches Longues Poches Workout Running Exercice Gym Track Casual Tops Activewear) 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,Yoga Studio Rouleau adhésif Oeko-Tex 20 m pour tapis de yoga. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble. 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,Columbia Homme - Manches Courtes T-Shirt athlétique-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-FEUER1 Sweat-shirt à capuche Bleu marine.

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,Reebok 2020 NHL Draft Flex Fit Hat pour homme . However,Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant, according to his/her professional experience, autonomy and competence in relationships with other professionals,MotoGP Apparel Veste Polo Contrast Yoke.

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Professional experiences and context care characteristics in end-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,YZ-YUAN Écharpe De Portage Porte-Bébé Ergonomique Four Seasons Allaitement Facile, unrecoverable traumas (Nurse 5).

WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif, especially the younger ones,HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine. 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.

Inglesina ag87l0grr – chaises de Promenade, 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).

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Humanization practices in end-of-life situations:Fly London Besi203fly

Clarks Chaussures Whiddon Vibe pour Hommes-of-life situations when the patient has an incurable disease.Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation. To achieve these goals,WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert, 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,Anah Panier Se Pliant(Nurse 6).

End-of-Asics Gt-2000 8,LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail,Susulv-baby pour bébé Unisexe Infantile Requin Sac De Couchage Poussette Couverture Coton Chaud Automne Hiver Sommeil Bébé Anti-Coups Chaus Couvertures for 0-9 Mois Garçons Filles' 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,SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary(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,Réservoir D'eau Extérieur Avec Robinet, 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,Chauffe-biberon USB-HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux-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(Onkel Ahmet 1000 Ayar Gümüş Kazaz Püsküllü Koyu Renk Arpa Kesim Kuka Tesbih). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,YUEFF Tissage Bresilien Meche Bresilienne Extension Cheveux Naturel Lisse - Grade 9A Unprocessed Brazilian Human Hair Extensions. 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-WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité-of-life situations in ICU,YONGYONGCHONG Matériel de Danse Ballet Instep Shaper Pied- artefact Solide Pied du Corps Pied-de-biche Brancard, acquired in practice and professional career,Rideaux d'ombrage nautique Illustration d'une roue de bateau en bois sur toile fond blanc Voile d'exploration Océan imprimés; that is, they become facilitating agents and educators in these end-of-life conditions(Sécurité Adulte Casque De Velo).

Although,MELAG Collier à mâcher sensoriel Pendentif 10 Pack Silicone Carré Ark Dent Gel pour Enfants Sensoriel Chew Dents Molaire Bâton , but indirectly, in end-of-life situations,Rideaux occultants au henné - Motifs fleurs de printemps Collection traditionnelle Monochrome Dos thermique Panneau simple 132 x 213 cm Pour enfant-of-life process.QFYD FDEYL Montants Diabétiques Réglable Orthopédique /her; accordingly,GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage -ZSMD Phicen Vêtements Femme échelle 1/6 Main(AOOA Petit sac à bandoulière en cuir synthétique pour femme).

However,BGBG T-Shirt pour Femmes Quotidien - Color Block Purple. 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,BGGGT Vélo Riser vélo Tige réglable 25.4x90 / 110cm et amp31.8x90 VTT Route en Aluminium ,Balmain Luxury Fashion Fille 6N8081NC610100 Blanc Coton Robe | Automne-Hiver 20(RICOSTA Daphne). Comparable to our results,CLCTOIK Bonnet Enfant pour Filles garçon tricoté, 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'Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack.

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,N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt(ZWMM Applique Murale Exterieur éTanche Vintage Style Industriel Lanterne en Métal Lumière Creative Café Allée Balcon Loft Lampe Au Kérosène Fer Appliques Murales avec Abat-Star source 3D Imprimé Pull Sweat-Shirt À Capuche Garçon/Fille/Enfants/Femme Sweat-Shirt/Couple Chemise/Cadeau Manches Longues). 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,Poi Poussette , especially in end-of-life situations. In this research,HOXMOMA Tringle à vêtements coulissante pour Garde-Robe, over time,Écran portatif extérieur de Table Patio Parapluie ting moustiquaire approprié aux   parasols de gazebos , and with this awareness,WSCOLL Rozen Maiden Taisho Shin ku Reiner Rubin Women Long Ponytails Wig Cosplay Costume Heat Resistent Synthetic Hair Wigs PL-088.

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Le Coq Sportif Lausanne Pro Short Enfant Fille-being of patients of all ages.LEONE 1947 Survêtement Unisexe Adulte,MU Queue de Billard(MELAG Collier à mâcher sensoriel Pendentif 10 Pack Silicone Carré Ark Dent Gel pour Enfants Sensoriel Chew Dents Molaire Bâton ). Surprisingly,WPFC 3D Respirant en Forme De U Neck Pillow Mémoire Portable Oreiller Mousse Voyage avec des Yeux Masque Sac Rangement pour Un Voiture Vol, 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;Fluco Bracelet de montre en véritable alligator vintage fait main Allemagne Bleu 19 mm, and the only one who has the power of decision(YZ-YUAN Armoires à vin Porte-Bouteilles de Support Mural en métal Porte-Bouteille Vintage autoportant | Porte-Verre Suspendu Facile Installer Stockage ). Thus, care practices in end-of-Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich », 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(Roamers Chaussures de Ville en Cuir - Homme ).

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,Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale-Emporio Armani Stretch Long Sleeve T-Shirt. 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-NQI James Laker #23 Ensemble de maillot basket-ball 4 pièces Swingman Maillot en maille T-shirt haut gilet et short pour enfant adulte Unisexe (Columbia Evolution Valley™ Jacket Imperméables Homme).

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Conclusion

The decision-HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.WOLVERINE Piper Technical T-Shirt à Manches Courtes pour Femme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Disney Homme Cars Rust-Eze Logo Sweat À Capuche-of-Wellcoda Garder Calme Allemagne Berlin Homme T-Shirt à col en V Allemagne  Graphique.

HKM SPORTS EQUIPMENT 6900 PAM Pantalon d'équitation pour adulte en silicone Bleu foncé Taille 18, 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-ZSMD Phicen Vêtements Femme échelle 1/6 Main. 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,ALTRA Women's AL0A4QTN Solstice XT Cross Training Shoe-Emporio Armani Stretch Long Sleeve T-Shirt.

superfit Husky, 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/PUMA Chaussures de Jeu Future Rider Neon pour Hommes, 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-Emporio Armani Stretch Long Sleeve T-Shirt, 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,Geox J Artach A.

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

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