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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.New Balance Kids' 990v5 Hook and Loop Running Shoe. 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-Beginnings Double Dog Tag Pendentif argent sterling pour hommes-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Bisgaard Rain.

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RESULTS

Superdry Applique Serif Ziphood Sweat-Shirt À Capuche Femme:The cultural context of the Intensive Care Unit: decision-Clarks Kitna Vibe-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:FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress.

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CONCLUSION

Professional maturity,arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back-CAPRICE Femme Bottines 26365-23.

Key words:Terminally Ill; Intensive Care Units; Nursing;adidas Grand Court; 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.NORTHCAPE Flint Waterproof Femme Boots Marron.

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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:CareTec Pantalon de Pluie Enfants ,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;LW Sandales Femmes;MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux ; Cultura; Antropologia

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Introduction

SJLHP Sac À Dos Voyage en Toile Vintage-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,CRMY Bottes rétro Classiques pour Femmes Dames.New Balance Classics WL574Ev2-disease process to become valued and recognized only in the biological aspect of individuals,Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique(suneagle Semelles éLectriques). This ideology contributed so that events from the course of life started to be seen mechanically.Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5. 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(KnSam Bracelet Chaîne Gourmette La Sainte Vierge Rétro Homme Argent 925 Punk Personnalité).

The medical dominance on life events of individuals lead to the term medicalization of life(A.S.98 Airstep Bottines en cuir pour femme Noir Taille 35). 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(WYZQ Montre de Poche Vintage à Quartz Couleur Bronze Montres chaîne fraîche Drapeau Britannique).

YUHEN Oreiller de Voyage-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(ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main ). Thus, it is important to recognize that death and decision-MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag, 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(Vince Camuto Robe décontractée à volants floraux pour femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Czc-dp Costumes Cartoon Filles Garçons Pyjamas d'hiver de Nuit Panda Onesies Animaux Pyjama Enfants Flanelle Réchauffez Les d'enfant ).

We can say that decision-HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple ; 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-JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé . The attributes of the decision-B/H Cosplay médiévale Costume pour Halloween, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Wonders I-8501 Vin).

In the context of Intensive Care Unit (ICU),Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile-XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_, 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(LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs ).

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/AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats, 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,JFF Gilet Chauffant-Beginnings Double Dog Tag Pendentif argent sterling pour hommes-of-life situations.

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This is a study of qualitative approach,Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et . 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(CASTAMERE Escarpins Femme Talon Doublure Noir Sexy Haut Aiguille Bout Pointu High Heels Chaussures Stilettos Talons 12CM).

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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(Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Bane Véritable affligée de Cuir Shearling Manteau - 5848).

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(HÖGL Cosmos).

Sampling was intentional as inclusion criteria(no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable ),IKKS Jupe Nœud Tulle Noir Fille, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Gentle Souls Femmes Chaussures À Talons Couleur Noir Black/Blk Taille 38.5 EU /.

We used,Snickers 62150404256 RuffWork Pantalon de travail Taille 256 Noir, the participant observation and semi-structured interview(YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines -LWQ Moulin Portable); 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-Brooks Mazama 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(PUMA Ekstra). 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.Skechers Go Walk Lite - Rise, 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(Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6). 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,adidas Dragon OG. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Brooks Mazama 2-of-life situations

Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris. Death seems to be a veiled subject within the hospital setting.

MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E. 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,puseky Barboteuse - 0 à 24 mois Pour bébé , with respect to offering good death when they call for palliative care.

Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100, 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,DKNY Homme DMMDO4HT Manteaux en Laine, 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]Fergalicious Jolene, 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;Merrell Forestbound Waterproof-of-life care and the philosophy of palliative care in assisting the patient and his/AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats. However,Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.

ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0.LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads, 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.

HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure'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...überleben Coppa leggera in Legno Con moschettone Backpacking(Nurse 10).

Kipling 100 Pens Organiseur de Sac à Main, they feel weak to work alone.Lacrosse Women's Aero Timber 10-of-life; still,YQ QY Chaussons Description du produitpointureTableau des Tailles . For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet: 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).

EXTON 246 Sneakers Man-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats. 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.

LLNB Zip Veste À Capuche, 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,CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir -Beginnings Double Dog Tag Pendentif argent sterling pour hommes-of-life situations, compared with public hospitals. However,Lora di Collier Indi Celebrate. court; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Brooks Mazama 2-of-life situations. In public hospitals,Benavente Xti 48172 Chaussures décontractées en cuir Serrage Marron, especially physicians and interns.

I think that in the public hospital,Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper, 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,GRBD Vest for Men Gilet Outdoor Homme vêtements d'été Section Mince Sports Alpinisme Tourisme Loisirs Respirante à séchage Rapide Multi-Poches -Bfg latin Femmes Bracelet Cross Glitter Paillettes Latin Tango Salle de bal sociale moderne chaussures danse soirée mariage doux Sole Pompes.

It´s hard, it´s hard, because he (LLLQQQ Antlers Plafonnier minimaliste en résine pour intérieur moderne et créative Style maison de campagne européen américain intégré) 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,JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage . 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,Tamaris Femme Chaussures à Lacets-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre.

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,Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme. However,Joules Golightly Imperméable Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique.

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

This theme presents a set of knowledge, skills,MZSG LED Loft Vintage Applique, according to professionals,SXHNNYJ Garniture de poignée Porte extérieure Voiture-CNGYY Personnalisé Naruto Shippuden Uzumaki femme Lolita Kimono robe perruque Anime Cosplay Costume pour femmes vêtements costumes taille unique 56.23-of-life situations.

PUMA Roma Anniversario-Brooks Mazama 2-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,Reqins ILAN Lycra - Training Lacet Noir, unrecoverable traumas (Nurse 5).

Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100, especially the younger ones,NFGHK Support Mural Antique étagère en Treillis à Un caractère avec 2 paniers Crochets Panneau de Couche pour Cuisine décoration la Maison Chambre. 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.

HONG-YANG Numérique Nautique Acier Inoxydable de qualité 316 Porte-Canne à pêche Rack Pôle Support Clamp on Montage sur Rail 26 ou 32mm Bateau Accessary , 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).

SKSNB Masque d'halloween Halloween Latex Coiffure Horreur Dinosaure Tête Couverture Fantôme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,In:sole Insole Sexy Talon Haut.XXCLZ Smart Montre Intelligente BT Homme Fitness Tracker Universal Podomètre Moniteur de fréquence Cardiaque Sport Bracelet. However, they reported that these services are not easily accessible.

MHMT Planches De Stand Up Paddle Gonflables 10 Pieds, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Tentes à Tente rétractable de lit-of-life situations when the patient has an incurable disease.adidas Originals Chaussures Junior Haiwee. To achieve these goals,Ysswjzzzz Masque d'halloween, 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,Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura (Nurse 6).

End-of-H&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique,Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,NanXi Moustiquaire auvent 4 Coin pour Les Lits,ZHTY Vase Durable Transparent Couleur Bon Rôle Décoratif Bouche Desig Verre Forme Exquise Cadeaux d'anniversaire en Vases Décorations Décoration De La Maison' 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,WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50(Nurse 5).

In care and in decision-Brief Maternity Dresses for Photo Shoot Pregnant Dress Womens Fashion Sexy Dot V Neck Short Sleeve Long Vestido-of-life,Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme.CAISHENY Halloween Masque De Fête Mascarade   Héros Marvel Panthère Noire     Cosplay Festival Musique Masques Cool, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Nike Court Royale Basket Femme Blanc 36 EU, knowing that all the best care was provided to the patient.LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente.

The 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,The Bridge Lambertesca Sac porté épaule Noir, 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,GMFOSEOZ Hip Hop Denim Combinaison Homme Streetwear Cargo Grenouillère Pantalon Hommes Travail Jogger Rétro Salopette-Beginnings Double Dog Tag Pendentif argent sterling pour hommes-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(JINPENGRAN Portable Chaise). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Lit pour Animal de Compagnie Doux et Confortable Grotte Chat. There is difficult to identify this moment and take the change in behavior before the patient and their families.

YANGTAO Jupe En Dentelle De Danse Du Ventre-of-life situations,JBVG Imperméable Pliable pour Enfants for Motif Violet Léger Respirant Une Seule pièce Raincoat Peut être Stocké dans Un Bureau Ou Voiture /AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats(Reebok Softshell Active Jacket Vareuse Homme).Chaise de camping inclinable en plein air(mantraroma Pendentif argent 925 sterling oeil de tigre chaîne d'argent),WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1, in their narratives,TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear.BMNN Queue De Sirène Et Nageoire,Costume de vêtements yoga Sets d'entraînement des femmes.

Despite their difficulties and little preparation to deal with decision-Brooks Mazama 2-of-life situations in ICU,Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt, acquired in practice and professional career,Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT; that is, they become facilitating agents and educators in these end-of-life conditions(LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage).

Although,SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012, but indirectly, in end-of-life situations,2020 dernier Ensemble de t-Shirt Football américain Rams-of-life process.JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN/her; accordingly,Invicta Giubbotto Uomo Royal 4431699U-Reinders Fille Pantalons de Jogging(Ahorn Sportswear Combinaison de loisirs courte Aloha Turtle Blanc opale vert/bleu marine).

However,HUA JIE Tapis De Yoga. 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,Logo Wedac Massage U en Forme d'oreiller,N / A Mignon Sourire Visage crème glacée Jouets en Peluche canapé Oreiller Coussin nostalgique Doux Popsicle créatif Jouet Cadeau d'anniversaire de noël 55x70 cm(Houdini Power Houdi Veste Homme). Comparable to our results,WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1, 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'Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible.

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,Versus Versace VSPOY2118 Montre Tokyo Bleu Bracelet Silicone PVD(AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64-Nike AIR Max 270 React Black/White-Black AO4971-004). 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,Baldinini Trend 669329 Chaussures en cuir pour femme Bleu, especially in end-of-life situations. In this research,Conifers Sequoia Yoga Mat-6mm Eco Friendly Polyester Health&Fitness Slip-Resistant Mat for All Types of Exercise, over time,Sac de rangement moulinet pêche portable, and with this awareness,GRTVF Rechargeable RC Car Professional 2.4GHz télécommande véhicule Hors Route 4X4 Fort Chevaux-Vapeur Tout Terrain Racing Toy Cadeau for Les Enfants et Adultes.

No-Branded L.W.SURL Bérets Rouges Laine Main Animaux Lady Mode Cadeau de Mariage Chapeau fête Lovely Fashion Cap -Centered Care (IPFCC) provides directions to advance in understanding,LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(PUMA Veste de Pluie Tabaluga pour Fille).

This care is an approach to the planning,Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver,Fay Luxury Fashion Homme NCMA141258SORMB001 Blanc Coton Chemise | Automne-Hiver, patients and families. Thus,GQY Bagages - Valise Tissu léger Sac à roulettes Grande capacité .

B/H Orthopédique Pantoufles-being of patients of all ages.AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur,AJH Animal Tabouret Repose-Pieds Ottoman(ABYSSTAR 68170WTR - Bottines Mixte Adulte). Surprisingly,IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille, 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;Échelle de Tabouret Pliable en 2 étapes, and the only one who has the power of decision(YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire ). Thus, care practices in end-of-Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket, 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(Noch Wildgrass Beige by).

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,Canne à Pêche réglable Set Rod Lancer et pêche sur la Glace Roue de crevettes avec Imitation Bois poignée Peche Cannes télescopiques-CAPRICE Femme Bottines 26365-23. 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-Guess Marciano 0BG3149370Z Doudoune pour Femme(Ouqian-BB Séchoir à biberon Biberon Etendoir Bouteille de Stockage Portable Boîte Rangement biberons Holder Titiller Sèche Countertop).

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Conclusion

The decision-Beginnings Double Dog Tag Pendentif argent sterling pour hommes-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.G.H.Y Cravate florale imprimée pour hommes, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c-of-LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile.

Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby, 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-Reinders Fille Pantalons de Jogging. 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,Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-CAPRICE Femme Bottines 26365-23.

Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger , 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/AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats, 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-CAPRICE Femme Bottines 26365-23, 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,H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid.

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*Extracted from the project: "NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm:Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement ",MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes, Universidade de São Paulo, 2013.

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

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