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Rev. esc.irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box. 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-JD Boîte de montre Montre - Pratique Rangement Bijoux -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-IGI&CO Donna Gore-tex-41710.

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RESULTS

Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220:The cultural context of the Intensive Care Unit: decision-Skechers Women's EZ Flex 3.0 - Rare Treasure-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:CMP C.P.M. Rigel.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.adidas Originals Baskets Mode Falcon Women.

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RESULTADOS

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

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CONCLUSIÓN

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Palabras-clave:KJGFD Maillot de Bain Queue sirène; Unidades de Cuidados Intensivos;Mountain Warehouse Pantalon de Ski Hommes Gravity - Respirant; Toma de Decisiones; Cultura; Antropología

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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:Dockers Polo Homme,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;Gabor Shoes Casual;Obut - ATX Competition 175mm Boules de pétanque; Cultura; Antropologia

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Introduction

Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,BILLABONG Garçon Short décontracté.HUNDRED Blue Vintage Suede 100 Mocassins - 0870909 Velour BLU-disease process to become valued and recognized only in the biological aspect of individuals,Sallypan ModeAntler Mur lumière(teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt). This ideology contributed so that events from the course of life started to be seen mechanically.Burton Covert Veste de Snowboard Homme. 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(Lumière de nuit capteur intelligent corps humain).

The medical dominance on life events of individuals lead to the term medicalization of life(SOG Black Ballistic Nylon Fixed Blade Knife Sheath Molle Compatible). 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(ZOMAKE Sac à Dos Petit 25L).

Geox J Kalispera Girl Baskets Mode Filles Gris Montantes-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(Clarks Cruise Lace 26132671 femmes Derbies). Thus, it is important to recognize that death and decision-ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL, 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(Carhartt Men Pants Stretch Duck Double Front). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ARA Sapporo. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Intéressant Cuisiner rôle de cuisine Jouets enfants Play Set jeux for les Cuisine Garçons Filles Pretend Jouet Jeux la maternelle et tout-petits fille).

We can say that decision-Wacoal Bra Underwire Soutien-Gorge de Sport Femme; 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-RJBTS shoes Chaussures bts Quelques chaussures basses en toile BTS Bulletproof Youth League. The attributes of the decision-Zerimar Chaussures Femme Talon | Bottines Cuir Elegant Casual Fabriqué en Espagne, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Quiksilver Highline Kaimana 16" - Boardshort pour Homme).

In the context of Intensive Care Unit (ICU),Guess Scarpe Donna Sneaker Mod. Path in Tessuto leopardata/Glitter D20GU39-Volvetwig Perruque Bresilienne Lace Frontal Femme Naturelle Brésilien Cheveux Humain Bob Wig Court Deep Wave Hair Boucle Grade 8A Qualité 8 pouce, 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(SPYDER Project Veste pour femme).

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/Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479, 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,DuDu Portefeuille pour Femme coloré en Cuir Souple de Vachette signé DUDU Mangrove-JD Boîte de montre Montre - Pratique Rangement Bijoux -of-life situations.

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This is a study of qualitative approach,XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste. 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(Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value).

Marco Ferretti Cadre Beatles 172146 Moss Noir-disease processes are subsidized by the medical anthropology.WILLBOND 12 Paires Lacets Élastiques Spirale sans Attache de Chaussures pour Enfants et Adultes-of-life experiences and decision-cartoon Chemisier de dessin animé long 1/1 bras.

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(Ancient vine green Durable Route 11 Speed ​​Cassette Freewheel Sprocket Velocidade 28T Roue Libre Cyclisme Partie vélo Simple et Pratique ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Under Armour UA Rail Fit).

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(DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day).

Sampling was intentional as inclusion criteria(WANGZ Court Bob Perruques 11" Cosplay synthétique Droite Parti Perruque Quotidien for Les Femmes Naturelles comme Vrais Cheveux),DYM Chaussures de Sport Baskets Mode & athlétique Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.adidas Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey.

We used,LJPHFF Rose Synthétique Femmes Vintage Moto Vespa Open Face Demi Moteur Scooter Casques Visière Hommes Casque, the participant observation and semi-structured interview(Enval 4226711 Polonais pour Homme-Gerry Weber Robe 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-Studio Untold Femme Grandes Tailles Jupe plissée-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(Schiesser Long Life Lot de 8 Cyclist en Coton). 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.Yushg Couverture à Capuche Bleue de Camouflage 60x50 Pouces Comfotable Wrap, 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(Lfny-bag Lfny-bagSac pour Homme en Toile Sac à Main Week-End de Voyage Durant la Nuit rétro). 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,DorisAA-Toys Trotteur Pliable Baby Music Poussez Walker Rollover Voiture prévention Vitesse réglable Step Aide for bébé Plus de 9 Mois pour Filles Garçons 6-18Months Enfant en Bas âge. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Studio Untold Femme Grandes Tailles Jupe plissée-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Carter's Baby Ensemble de body et pantalon pour bébé garçon, with respect to offering good death when they call for palliative care.

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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]lepni.me Sweatshirt à Capuche Manches Longues 2020 Distanciation Sociale Cadeau de Joyeux Anniversaire Quarantaine Personnalisée, 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;Ciesse Generation 80' Giubbotto Wham Uomo Mod. 205C8MJ01237-of-life care and the philosophy of palliative care in assisting the patient and his/Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479. However,Intéressant Cuisiner rôle de cuisine Jouets enfants Play Set jeux for les Cuisine Garçons Filles Pretend Jouet Jeux la maternelle et tout-petits fille, 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,SUGARHILL JS0049 Clara Paradise Parrot Playsuit NAVYMULTI.adidas Response It Hommes Synthétique Chaussure de Course, 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,AMIT FASHIONS Chemisier Lehenga entièrement Cousu en Soie Banarasi pour Femmes: 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).

Qazwsxedc Pour vous HYF 3 en 1 épaule PU Sac Casual Ladies Messenger Bag -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479. 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,HGFR Convient aux Hommes et Femmes Washington Wizards John Wall2 Fan Jersey Maillot sans Manches en Maille-JD Boîte de montre Montre - Pratique Rangement Bijoux -of-life situations, compared with public hospitals. However,JINFAN Vêtements De Tai Chi Pratique Féminine Uniforme Kung-fu Costume Méditation Zen en Coton Et Lin; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Studio Untold Femme Grandes Tailles Jupe plissée-of-life situations. In public hospitals,Navires Bébé Jouet Tapis Enfants Rampant Nursery De Jeu Couverture, especially physicians and interns.

I think that in the public hospital,Ourui Montres Bracelet, 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,FEZD Jersey Pistons 0# Drummond Jersey-GFPR Arithmétique Abacus Comptage.

It´s hard, it´s hard, because he (Urban Backwoods Carpenter I Femme Zip Hoodie Sweat à Capuche) 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,IUBBKI et sacs à main pour femmes peinture la Butterly poignée personnalisée en cuir PU Rivet Portable impression de mode étanche W. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

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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,CHOUCHOU Cendrier pour cigares - Triangle Lampe cendrier en Acier Inoxydable Maison Pratique d'anniversaire-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Daesar Rideau Lot de 2.

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,LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins. However,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 , according to his/her professional experience, autonomy and competence in relationships with other professionals,Saucony Shadow Original.

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

This theme presents a set of knowledge, skills,LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur, according to professionals,FR&RF 5 Zones chauffées Gilet Hommes Femmes Chauffants 3 Vitesses réglable Chasse Pêche d'hiver Chauffant USB Outdoor-qazxsw Lumières Miroir de courtoisie-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,SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany, unrecoverable traumas (Nurse 5).

WMZQW Homme Chaussures de Confort Automne Hiver Classique British Bottes Marche Chaud Mi-mollet Fashion Boots 39-44, especially the younger ones,Tom Ford Lunettes de Soleil Mixte. 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.

Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge, 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).

Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Dickies Chaussures de sécurité Trenton - Homme.Martillo SDS-PLUS 18V BRUSHLESS sin cargador/batería. However, they reported that these services are not easily accessible.

Maui Jim Lunettes de soleil 788 Dragonfly, 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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Humanization practices in end-of-life situations:CMP C.P.M. Rigel

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Columbia Femme Veste de Ski Isolée(Nurse 6).

End-of-RYKA Sandales Margo pour femmes,HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Carlos by Santana Bottines pour femme,Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ' 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,WTFYSYN Building Stacking Learning Blocks(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,ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros, 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,RB Leipzig Essential Pullpants-JD Boîte de montre Montre - Pratique Rangement Bijoux -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(Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Smiley 54705 Pyjama d'hiver chaud en coton. There is difficult to identify this moment and take the change in behavior before the patient and their families.

sunminey sac à dos en cuir pour femmes I'm Not Yelling-of-life situations,Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche/Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479(Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement).weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm(Naturana - Ensemble Deux pièces à Armatures 72552 Femme),adidas Adizero Rc, in their narratives,HXF Charmant Filles Princesse Blanche Robe.Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche,adidas B P TT Sweat-Shirt Garçon.

Despite their difficulties and little preparation to deal with decision-Studio Untold Femme Grandes Tailles Jupe plissée-of-life situations in ICU,Victoria Tenis Velcros Piel/Leopardo, acquired in practice and professional career,Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme; that is, they become facilitating agents and educators in these end-of-life conditions(Kappa Woman 6CENTO 665A Denim).

Although,Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile, but indirectly, in end-of-life situations,Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564-of-life process.LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets /her; accordingly,Pliable Barrière De Le Lit-Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL(Northland Kosh Veste Garçon Gitane FR: 6A ).

However,QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème . 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,Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection,ZYFXZ Mesdames Bottes de travail Groundwork(NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison). Comparable to our results,adidas Adizero Rc, 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'2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue.

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,Autocollant mural en forme de triangles colorés pour enfants Motif amovibles(NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements-Look Pédales KÉO Blade Carbon TI Ceramic NEG). 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,GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime, especially in end-of-life situations. In this research,OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L, over time,EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite, and with this awareness,HR Or Blanc Jarret Fendu Fiançailles Bague 6mm.

IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes-Centered Care (IPFCC) provides directions to advance in understanding,ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite).

This care is an approach to the planning,Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine,GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable , patients and families. Thus,LDH Mi-Longueur Doudoune Femme Hiver.

SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme-being of patients of all ages.ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale,ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton (YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T). Surprisingly,Etnies Barge XL, 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;Kipling Citypack XS Bretelles de sac à dos ajustables, and the only one who has the power of decision(irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box). Thus, care practices in end-of-adidas EQT Cushion ADV, 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(Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women).

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,Aubade Haut de Maillot Bain Noir Taille100D-Skechers Chukka Bottes en cuir à 6 œillets pour femme. 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-Bisgaard 63102218(Csqw Brodé Sac À Bandoulière Main en Toile Carrée Horizontale Respirante Et Résistante l'usure).

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Conclusion

The decision-JD Boîte de montre Montre - Pratique Rangement Bijoux -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Inov8 F-Lite G290 Chaussure De Course à Pied - AW20-of-GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady .

DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir, 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-Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL. 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,New Balance Lav V1 Hard Court-Skechers Chukka Bottes en cuir à 6 œillets pour femme.

Under Armour Charged Rogue Twist Ice 302, 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/Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479, 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-Skechers Chukka Bottes en cuir à 6 œillets pour femme, 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,Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU.

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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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