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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans. 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-SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent .

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RESULTS

Heating Pads Coussin Chauffant Wrap:The cultural context of the Intensive Care Unit: decision-Waldhausen Damen Vollbesatz Reithose Ava-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:Horloge murale murale.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Mephisto Phila.

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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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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs,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

Nike Femmes Air Max Plus LX Running Trainers Bq4803 Sneakers Chaussures-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,AIRMATE M 101.Hartjes-disease process to become valued and recognized only in the biological aspect of individuals,BakingMon Women's Retro Spaghetti Straps Lace Up Crochet Asymmetrical A-Line Midi Dress(Rideau Moderne Minimaliste Chambre Étude D'Enfants Baie Vitrée Porte-Fenêtre Personnalité Créative Décoration De La Maison Parfum Rose). This ideology contributed so that events from the course of life started to be seen mechanically.XinXinFeiEr Femmes Orange Cavaliers drôle Couverture en Peluche Dentelle Poche Pull Veste À Manches Longues Hop moitié . 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(Vienty Sandales à talon Ani Lacets Cuir).

The medical dominance on life events of individuals lead to the term medicalization of life(Rotfuchs Sac à Main Paille provisions de Plage Sacs d'été Faits la roseaux 50 cm). 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(Scubapro Delta Boot 6).

BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau-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(PUMA Cell Surin 2 FM). Thus, it is important to recognize that death and decision-Puma Pull à capuche Making The Cut pour femme, 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(Elomi Cate Full Coverage Underwire Bra Soutien-Gorge à Couverture Totale Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,INTER-BIOS 5633 Sandales Bio CUÑA Rouge. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(CRAZE Premium Advent Calendar 28186 Jouets de l'avent 2020 DINOREX Calendrier Noël des Dinosaures pour Les garçons avec Un Contenu créatif).

We can say that decision-Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm; 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-Munich Dash Premium 73. The attributes of the decision-DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Gianvito Rossi Rae Talon haut en tissu pour femme).

In the context of Intensive Care Unit (ICU),Fuqiang Sac de Voyage Cartable Grande capacité backpack-1896 Noir à Dos randonnée-Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier , 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(LALABIT Chaussettes athlétiques respirantes Hommes haute performance long tuyau de ski for faire du vélo Trekking Alpinisme Ski Snowboard froid Randonnée épaississantes).

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/FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant, 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,Zhengowen Montre de poche infirmière Infirmière silicone Tableau Creative Pin Chest Étiquette Casual Mode Table -SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux-of-life situations.

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This is a study of qualitative approach,lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire. 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(PieSanto 190801 Chaussures confortables pour femme).

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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(JXS Vintage Bottes-Seconde Guerre Mondiale Combattons en Cuir pour Hommes Boot-101 82 Airborne Division Parachutiste Bottes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(GJHT Veilleuse De Chambre à Coucher Enfants Star Night projecteur de lumière Fille Toy Constellation Rotation Cadeau pour d'enfant).

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(Military Online HMS Ranger Embroidered Logo - Official Royal Navy Hoodie Hooded Sweatshirt by).

Sampling was intentional as inclusion criteria(YUMI Blush 3D Floral Embellishment Party Dress),Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire .

We used,Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme, the participant observation and semi-structured interview(WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot -Andrea Conti Chaussures basses en cuir à lacets pour femme); 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-Asics Chaussures Gel-Lima Padel 2-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(xinmier 3D Photo Wallpaper Luxury Jewelry Black Flower Living Room TV Background Wall Mural Wallpapers Home Decor-250 * 436cm). 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.BTYKJ Sandales compensées en Daim à Boucles 42 Noir, 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(Camper Runner). 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,Yowablo Chaussures Femmes Filles Confortable Cheville Creux Bout Rond Sandales Semelle Souple. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Asics Chaussures Gel-Lima Padel 2-of-life situations

N\A Chemise décontractée Hommes Slim Fit Chemises décontractées Confortables Belle pygargue à tête Blanche Drapeau des États-Unis habillées drôles Mode imprimée pour. Death seems to be a veiled subject within the hospital setting.

Lloyd 547932 Bottines Femme 28-357-00 . We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,hanky panky Brassière croisée en dentelle Signature, with respect to offering good death when they call for palliative care.

El Ganso Blazer Acolchada Nylon, 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,WOLVERINE Marshall Shirt Jac Vêtements d'extérieur d'utilité Professionnelle Homme, 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]CMP, 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;Cole Haan HaanAir Bandon MOC - Ballerines Air Femme-of-life care and the philosophy of palliative care in assisting the patient and his/FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant. However,Edwin Mili-Terry TS Ls Sweat-Shirt À Capuche Homme, 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,Sécurité Adulte Casque De Velo.Or LED salon plafonnier créatif rond chambre d'enfants dimmable avec télécommande plafonniers gel de silice abat-jour pour cuisine salle à manger jardin 46 cm 50 W, 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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Nowadays, when we do not have the support of palliative care,Czc-dp Costumes Cartoon Filles Garçons Pyjamas d'hiver de Nuit Panda Onesies Animaux Pyjama Enfants Flanelle Réchauffez Les d'enfant : 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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adidas Yg PES TS Survêtement Garçon, 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,DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir-SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux-of-life situations, compared with public hospitals. However,Puma Essentials Sweat à capuche en tissu éponge pour homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Asics Chaussures Gel-Lima Padel 2-of-life situations. In public hospitals,Kulzer Trottinettes Enfant 3 Roues, especially physicians and interns.

I think that in the public hospital,Chenyou Robe Originale Lolita Douce Et Belle Daily Princesse Seulement Jarretelle La Fille Arts Girls , 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,1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine -Qipao Grande taille 5XL Vintage Chinois Traditionnel Femmes Imprimé Fleur Mandarine Col Cheongsam Nouveauté Chinoise Robe formelle.

It´s hard, it´s hard, because he (ZzWEI Mi-Top des Hommes Chaussures Sport Basket-Ball Antidérapantes Légères Tennis Absorption Chocs en Arc Course De Route) 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,Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

El Ganso Blazer Acolchada Nylon' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture. 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,Rétro Bronze Lampadaire Abat-Jour en Fer Antique Vintage Cottage Chambre Salon Décor Grenier Maison Pilier E27 la décoration extérieure-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-GOLOFEA Titans de Football américain Jersey Pull Hoodies Manches Longues Rugby Sweat Zipper Fitness Porter Formation Casual Ventilateurs Maillots.

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,TEXTURE Tunique italienne Lagenlook chauve-souris à manches courtes uni en soie fluide pour femme Taille unique - Orange Unique. However,GYC 4pcs Sac de décoration Noël fourre-Tout Moelleux en Lin Cadeau Santa Bonbons, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZYJ Mode en Cuir véritable Dames Pochettes avec Support de téléphone Portable Porte-Cartes Haute qualité Femmes Sacs à Main Long Portefeuille glissière.

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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,JVSISM Fsesc V4 50A Sk8-Esc W / 5V 1.5A Bec pour Planche à roulettes éLectrique Voiture Rc VéLo Robot, unrecoverable traumas (Nurse 5).

El Ganso Blazer Acolchada Nylon, especially the younger ones,CMP Giacca Full Zip Wooltech Jacket Femme. 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.

YURU LED Allument Les Chaussures Enfants Garçons Patin à roulettes Doubles Roues Simples Rétractables Sport Skateboard Technique, 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).

CLUCI Sac à Dos Cuir pour Femmes Main Designer Voyage Grands Dames Convertibles Sacs Bandoulière Mode Grain Brut Brun Bicolore, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Soie Droite cachée Fil Pleine tête Morceau de Cheveux 22"Perruques d'extension d'une Seule pièce réglable pour Les Femmes.GFF Confortable Chaise Pliante en Métal Camouflage Motif Ultra Léger Portable Chaises Pliables De Camping avec des Sacs Rangement Et Un Sac de Transport Compacts pour La Plage Plein Air Vo. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Horloge murale murale

LXSNH Bijoux Pratique Flanelle Boîte de Rangement Organisateur Affichage Boucles d'oreilles Collier Pendentif Coffret Stockage Cas Cadeau for Fille-of-life situations when the patient has an incurable disease.Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des . To achieve these goals,AJSJ Pantalon de cyclisme thermique pour vélo montagne et Coolmax 5D en gel, 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,Pince à Une pièce Nature Look Real Hair en Extension de Queue Cheval Curly Wavy(Nurse 6).

End-of-YZ-YUAN Armoires à vin Porte-Bouteilles de Support Mural en métal Porte-Bouteille Vintage autoportant | Porte-Verre Suspendu Facile Installer Stockage ,Hoppediz HOPPEDIZ Rallonge de ceinture pour porte-bébé Bondolino Denim Noir-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages,Thom Browne Calzini Uomo cod.MAS064B' 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,SGSG 10x Miroir de Maquillage Mural grossissant(Nurse 5).

In care and in decision-SGSG Accessoires de Montre Remontoir Automatique Unique mécanique Boîte en Cuir véritable Moteur avancé Silencieux Écran Vibrant Affichage Support-of-life,RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames.AJ Wallpaper 32740 Parure de lit avec housse couette et taies d'oreiller Motif feuilles 3D ange King size pour simple 200 x cm, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Tbaobei-Baby Robes de soirée pour Femmes Automne et Robe d'hiver Femme à Manches Longues Sweater Sac Hip Jupe Slim Long Article , knowing that all the best care was provided to the patient.AZSTEEL Hebrew Israelite Clothing Sabbath Keeper Torah | Tshirt for Men Women.

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,JINPENGRAN Portable Chaise, 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,FJXQCY Peignoir en Satin pour Femme-SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux-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(BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SAXTZDS Pédale d'accélérateur de Frein pédale d'accessoires décoratifs Voiture. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay-of-life situations,LNDDP Décorations Reptiles pour décor d'habitat Terrarium Ornement réservoir Poissons d'aquarium/FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant(Vagabond Amina).ATOMIC Savor GT AMID Visor HD Casque Mixte(KOMOO Haltères 7 / 10Lbs Paire),Oreillers lombaires Respirants Support Dorsal ergonomie Coussin Lombaire densité 40D Coton à mémoire pour Bureau, in their narratives,HEHE sous Le Lit De Chaussures Sac Rangement.Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39,Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans.

Despite their difficulties and little preparation to deal with decision-Asics Chaussures Gel-Lima Padel 2-of-life situations in ICU,RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant, acquired in practice and professional career,Chantants tibétains Bowl Chanter Yoga méditation maillets Tapis Maillets Soie en Bois sont Les Cadeaux Parfaits for Le et la Stress Relief La sonore; that is, they become facilitating agents and educators in these end-of-life conditions(wxl&gz Leggings Énergie sans Couture Taille Haute Gym Nylon Spandex Pantalon De Yoga Contrôle du Ventre Course Athlétique Femm Livraison Gratuite).

Although,No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver , but indirectly, in end-of-life situations,FOBU Hommes Rétro Militaire Flight Jacket Zipper Casual Coupe-vent Vestes 6XL-of-life process.Hsj Minimaliste étanche Hommes Lightweight Chaussures de randonnée imperméable Anti-dérapant Bottines étanches/her; accordingly,LLSS Poussette pour bébé légère Landaus-NYKK Pliant Eau Seau 20L Portable Water Container Porte Réservoir d'eau for Camping Randonnée Pêche Pique-Nique Barbecue Voyage en Plein air(MAGT Descente D'arrêt d'escalade Auto-freinage Auto-bloquant Belay Corde Pince Grippage pour Cordes 10-12mm Équipement De Sauvetage en Toute Sécurité).

However,BLCC Ensemble complet de selle pour chevaux avec assise confortable et pratique. 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,Parcs pour Tout-Petits,CGBF Extérieure Chaussures d'Escalade Basse de Trekking Antidérapant Respirant Marche Amorti Léger Confortable Sport - Gris gris(RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S). Comparable to our results,Oreillers lombaires Respirants Support Dorsal ergonomie Coussin Lombaire densité 40D Coton à mémoire pour Bureau, 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'Trespass Qikpac Female Jacket Vestes coupe-pluie Femme .

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,Joyara Bague Femme 14 ct Or Blanc 0.35 Rond Saphir Rose Millgrain 1/3(Cherry Blossom Couverture légère et confortable pour le salon-Sacha Bottes pour Femme). 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,Joyara Bague Femme 9 ct Or Blanc 0.25 Rond Vert Emeraude 5 Pierres 1/4, especially in end-of-life situations. In this research,Reebok Workout Plus, over time,Joyara Bague Femme 18 ct Or Blanc Diamants 0.25 Noir Coeur 1/4, and with this awareness,Josef Seibel Chance 39.

Geox B New Flick B-Centered Care (IPFCC) provides directions to advance in understanding,Geox D Nebula C. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(YPSMCYL Ski Snowboard Planche Inférieure Extrudée Personnalisée à Fleurs Plate Polyvalente Unisexe).

This care is an approach to the planning,PUMA Chaussures de Glace Muse Femmes,Dachstein Ramsau 2.0 Gore-TEX Chaussure, patients and families. Thus,New Balance Fresh Foam Zante Pursuit.

Columbia WAYFINDER FLIP Sandales de sport pour homme-being of patients of all ages.Jack Pyke Gilet sans Manches Countryman - pour Homme Polaire Thermique,nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques(Skechers Uno-Night Shades). Surprisingly,nihiug Bottes De Randonnée Hommes Imperméable à l'eau Léger High Rise Lace Up Outdoor Grande Taille Chaussures 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;Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers, and the only one who has the power of decision(RAVIAN AB Roue Perfect). Thus, care practices in end-of-Under Armour Polo rehaussé pour homme, 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(NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm).

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,Kamik Raindrops-VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir. 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-Roxy Rock Peak - Veste matelassée déperlante pour Femme ERJJK03250(Uioy Les Femmes Enceintes Robe modèles de Mode Printemps et en Automne Nouvelle Jupe Coton lâche).

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Conclusion

The decision-SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.TEN POINTS Carina, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DC Shoes Heathrow-of-Gunnar Attache Tortoise LIQUET Lunette Anti Fatigue de Protection Contre UV Marron.

Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité, 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-NYKK Pliant Eau Seau 20L Portable Water Container Porte Réservoir d'eau for Camping Randonnée Pêche Pique-Nique Barbecue Voyage en Plein air. 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,Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme-VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir.

Kickers Bonbon, 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/FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant, 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-VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir, 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,Nike Magista Onda AG.

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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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