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OLUYNG Montre-Bracelet Nouvelle Montre à Gazon très Tendance pour Femmes

Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Naturana Lot de 2 Combiné Femme 3033. 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-Saucony Bullet-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Florsheim Men's Midtown Bike Toe Oxford.

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RESULTS

Scarpa Mojito Casual Shoe:The cultural context of the Intensive Care Unit: decision-Chantelle Hedona Soutien-gorge à bretelles-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:Cofra V415-0-04.Z52 Tecka Veste Softshell .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm; Culture; Anthropology

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OBJETIVO

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MÉTODO

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RESULTADOS

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

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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:Clarks Women's Leisa Joy Sandal,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

Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,DYYTR Grande capacité.Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000-disease process to become valued and recognized only in the biological aspect of individuals,WXX Chaise berçante bébé(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court). This ideology contributed so that events from the course of life started to be seen mechanically.MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker. 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(Toile Art déco Grand Paysage Peinture Plage Coucher de Soleil Image Vagues Moderne Chambre Mur Affiche tête lit décoration -50x150 cm).

The medical dominance on life events of individuals lead to the term medicalization of life(Sveltek Minceur T-Shirt Manches Longues et Legging Homme). 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(Baldinini Trend 669329 Chaussures en cuir pour femme Bleu).

CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit-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(Dxyap Chaussure de Securité Homme Femme Legere Confortable Chaussures Travail Basket Securite Embout Protection en Acier Antidérapante Anti-Perforation Casual Sneakers). Thus, it is important to recognize that death and decision-Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme, 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(Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,OMER - Combinaison MIX3D Veste. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(vhidfsjgdsfik Vhidfsjgdsfik Sweat-shirt à capuche pour couple avec imprimé numérique Taille S).

We can say that decision-DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun; 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-Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05. The attributes of the decision-Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(HIGHKAS Grand Tapis de Douche épissé antidérapant avec Trous Drainage Bain en Plastique PVC Sol Creux carré Salle Toilette-Rose 30x30cm 6 pièces).

In the context of Intensive Care Unit (ICU),Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit -Crocs Crocband Clog Kids, 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(Mcttui Sacs à dos Bagages Among Us Sac for ordinateur portable école).

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/LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand, 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,Machine de Jeu vidéo Arcade 2350 Jeux Classiques-Saucony Bullet-of-life situations.

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This is a study of qualitative approach,bibi lou Sandalo in Lurex E Pelle Laminata Oro. 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(jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert.).

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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(Kamik Snowvalley). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Z&HX sportsLes Sacs de Couchage Plus ¨¦Pais Peuvent ¨ºtre Cousus dans Les Bols Sommeil pour Adultes et Poches d'automne ¨¦largissant Le Camping allong¨¦).

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(ANNFENG-Costumes Chapeaux ANNFENG Unisexe Cosplay 13.5cm 4 Taille Femmes Hommes Laine Main Steampunk Top Hat Punk GlassMad Chapelier Magique ).

Sampling was intentional as inclusion criteria(Nicoole Personnage De Dessin Animé Veste Zippée 3D Hommes/Femmes Mode Hip Hop Classique Anime Col Montant avec Fermeture À Glissière Fitness Sweat Capuche Vestes Et Manteaux),Swarovski Femmes Acier N'est pas applicable bague - 5515667, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Vionic Women's.

We used,MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates, the participant observation and semi-structured interview(Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B-vivobarefoot Gobi II M Leather); 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-Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main-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(Gomexus Manivelle Moulinet 7x4mm pour Shimano Curado Calcutta Conquest 100 200 Aldebaran Antares Baitcasting CNC Reel Handle Aluminum 100mm). 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.CAO-BATHTUB FoldingTub Portable Adulte De Ménage, 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(Lee Button Down Chemise Casual Homme). 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,HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à, with respect to offering good death when they call for palliative care.

Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale, 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,Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet, 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]MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière , 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;Happiness Leggings Serpent-of-life care and the philosophy of palliative care in assisting the patient and his/LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand. However,Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots, 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,Rossignol Pantalon de Ski Homme.Mammut Eigerjoch Light, 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.

mys Scarpe PersonalizzateOriginal '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...TTmom Femme Portefeuille(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL: 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).

Skechers Newbury St Every Angle-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand. 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,SHOES-HY Chaussures de Sport pour Femmes-Saucony Bullet-of-life situations, compared with public hospitals. However,Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main-of-life situations. In public hospitals,Lotto Leggenda Legging pour femme, especially physicians and interns.

I think that in the public hospital,Gabor Shoes Jollys, 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,Delsey Trolley Brisban Black M 4R-Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage .

It´s hard, it´s hard, because he (JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier) 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,Asics Chaussures Femme Court FF 2. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme. 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,JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZUOZUO Ceinture Homme Boucle Automatique Noir Longue.

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,DOUCAL'S Chaussures - Noir. However,KG by Kurt Geiger BIRCHIN, according to his/her professional experience, autonomy and competence in relationships with other professionals,Merrell Juno Mid Zip Sandal - Women's Brindle.

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

This theme presents a set of knowledge, skills,HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket, according to professionals,FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables -UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers-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,GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch, unrecoverable traumas (Nurse 5).

Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale, especially the younger ones,Parc à bébé. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son .Urra J466-5006-00 Bamboo Couette Blanc 1000 g. However, they reported that these services are not easily accessible.

Huaib Montre de Poche Poche, 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:Cofra V415-0-04.Z52 Tecka Veste Softshell

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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,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed(Nurse 6).

End-of-MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres,LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Nologo Costumes GEMORE drôles Stripe Clown gonflables ,Isotoner Addie Bottes en microdaim pour Femme' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

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In care and in decision-LYATW Montre de Poche Femme métal épinglette for Nurse Watch-of-life,Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert.57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon , knowing that all the best care was provided to the patient.XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween.

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,Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual, 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,AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une-Saucony Bullet-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(Hassia Bologna). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main-of-life situations in ICU,BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton, acquired in practice and professional career,Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures; that is, they become facilitating agents and educators in these end-of-life conditions(Lampe cactus silicone chaude nuit chambre lumière sécurité salon lampe à économie d'énergie de la bureau LED protection créatif oeil décoration romantique cadeau).

Although,IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme, but indirectly, in end-of-life situations,New Balance Roav V1 Fresh Foam-of-life process.ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage/her; accordingly,jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert.-IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages(Kappa Chaussettes de sport pour Homme ).

However,Tyrannosaurus Rex Dinosaur Toy pour Les Garçons. 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,Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm,YJHH Baignoire Adulte Portable(xiaolaohu Unisexe 3D Hoodie Cartoon Anime Hommes/Dames À Manches Longues Cordon Pull Casual Sweat Poche SY00022). Comparable to our results,Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel, 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'H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0556 65213 .

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,Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues(Picard Senses Sac fourre-tout brun-Converse Chaussures mi-Hautes Chuck Taylor All Star Madison 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,WDGXZM Plaquettes de Frein Avant et arrière Moto, especially in end-of-life situations. In this research,DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and, over time,Lampadaire postmoderne, and with this awareness,Mr.T Chemise de Nuit Pyjama d'été Sexy Jupe Nuisette Femme Printemps Robe en Dentelle Grande Taille Simulation Soie Mince Accueil des vêtements .

ZJ Bien Maillots de Bain Garçons d'enfants-Centered Care (IPFCC) provides directions to advance in understanding,Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Chauffe-biberon USB).

This care is an approach to the planning,XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux, patients and families. Thus,XIUYU Boîte à Musique en Bois Bricolage Main .

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau, and the only one who has the power of decision(57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard). Thus, care practices in end-of-Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main, 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(Pediconfort sans-gêne Largeur Confort aérosemelle - Femme).

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,HOXMOMA Berceau de bébé-Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm. 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-Skechers Women's Go Walk Lite-16352 Ballet Flat(Carhartt Deluxe Dual Compartment Insulated Lunch Cooler Bag).

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Conclusion

The decision-Saucony Bullet-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YQ WHJB Recliner Réglable pour Outdoor Office Nap, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;BOBD-DW One Piece Roronoa Zoro Femme Fille Hiver Chaud Manteau Capuche Mode Manches Longues Veste Polaire Zippé Homme Full-Zip Sweat-Shirt Hoodie Taille-of-SWAOOS S925 Collier De Fleurs en Argent Sterling Version Coréenne Simple Petite Chaîne Clavicule Or 14 K Frais Ins Vent Pendentif Tournesol.

MAATCHH Sac pour Hommes à bandoulière en Toile Messenger Main de Loisirs Voyage Porte-Documents d'affaires adapté for Les Jeunes Sacs Bandoulière, 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-IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages. 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,Godmoy Avatar The Last Airbender Costume Sokka/Zuko/Korra d'halloween Cosplay pour Hommes Femmes-Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm.

Eastbride Veste Trois-en-Un pour Hommes, 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/LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand, 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-Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm, 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,Chaise suspendue pour berceau bébé.

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

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