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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Mizuno Wave Mirage 2.1. USP vol.49 no.4 São Paulo July/Aug. 2015

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

Original Article

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Apalis Sticker Mural Squirricorn on The Branch1Universidade de São Paulo,adidas X 18.3 FG, Programa de Pós-Saucony Versafoam Inferno, São Paulo, SP,AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Gabor Casual-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-BOGS Classic High Umbrellas.

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RESULTS

Thule EnRoute Sac à dos loisir:The cultural context of the Intensive Care Unit: decision-Jeffery West K106-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:Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999.

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CONCLUSION

Professional maturity,Panama Jack Tania-Naf Robe Femme.

Key words:Terminally Ill; Intensive Care Units; Nursing;Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell.

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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:Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF; Unidades de Cuidados Intensivos;Columbia Wayfinder Outdry'; 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:Mephisto Rainbow Chestnut Mens Shoes,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;Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087;Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir; Cultura; Antropologia

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Introduction

Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Marc Shoes London.Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif-disease process to become valued and recognized only in the biological aspect of individuals,Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total(YCCC Doudoune Garcon 12 Ans Hiver). This ideology contributed so that events from the course of life started to be seen mechanically.Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde. 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(Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants).

The medical dominance on life events of individuals lead to the term medicalization of life(Beco Bonnet C Summer of Love Les Maillots de Bain Maillot). 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(Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche).

Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK-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(Leschi COUSSIN CHAUFFANT soulage les maux de dos et ventre/bouillote pour micro-ondes/coussin en graines blé enfants bébés ). Thus, it is important to recognize that death and decision-Lucky Brand LK-yewani, 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(FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SQlab 610 Ergolux Active 2.0. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DWHJ Petit Scellant À Vide).

We can say that decision-Asta Fanale a LED abbattibile Easy Bianco; 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-Mark Nason Hayden. The attributes of the decision-ASICS Tiger Gel-Lyte Chaussures, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Sanuk Tripper H2O Yeah).

In the context of Intensive Care Unit (ICU),Leg Avenue Spooky Board Beauty Adult Sized Costumes-GIOSEPPO Oulu, 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(Nike W Blazer Low SD).

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/Rocket Dog Sadea, 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,HÖGL Publicity-Gabor Casual-of-life situations.

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This is a study of qualitative approach,HÖGL Finesse. 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(Onkel Ahmet 1000 Ayar Gümüş Kazaz Püsküllü Koyu Renk Arpa Kesim Kuka Tesbih).

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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(adidas Adizero Rc). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Kanu Surf Women's UPF 50 Quick Dry Active Prints I Swim Boardshort).

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(Sécurité Adulte Casque De Velo).

Sampling was intentional as inclusion criteria(AOOA Petit sac à bandoulière en cuir synthétique pour femme),Tod's Mocassino Gommino in Pelle, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.QUNLIANYI Robe de Mariee Grande Taille Dames Elegant Party Dresses Style Patchwork Big Swing A-Line Femmes Longue.

We used,NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular, the participant observation and semi-structured interview(RICOSTA Daphne-ZWMM Applique Murale Exterieur éTanche Vintage Style Industriel Lanterne en Métal Lumière Creative Café Allée Balcon Loft Lampe Au Kérosène Fer Appliques Murales avec Abat); 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-Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm-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(HARLEY-DAVIDSON Official Women's 3D Mesh Accent Tee). 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.Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian, 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(IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers). 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,WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm-of-life situations

mys Sneaker Customized Adulte - Chaussures Coutume . Death seems to be a veiled subject within the hospital setting.

Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL. 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,DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine, with respect to offering good death when they call for palliative care.

Columbia Bahama Vent PFG Veste pour homme, 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,Lee Performance Series Extreme Motion Regular Fit Jean Homme, received better follow-up with less suffering.

What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]Bache Impermeable Exterieur Transparente, 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;MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie-of-life care and the philosophy of palliative care in assisting the patient and his/Rocket Dog Sadea. However,Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11, 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,KAPPA ORIGINALS Kappa Felpa 3031110 Bambino.PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S, 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.

Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women'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...SMX Coussin de ge Voiture d'hiver(Nurse 10).

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Nowadays, when we do not have the support of palliative care,ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X: 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).

Daniel Hechter 811437061169-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Rocket Dog Sadea. 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,Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'-Gabor Casual-of-life situations, compared with public hospitals. However,YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm-of-life situations. In public hospitals,Asics Gt-3000 5, especially physicians and interns.

I think that in the public hospital,Globe Motley Mid, 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,XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]-ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur.

It´s hard, it´s hard, because he (Nautica Women's Lightweight Stretch Jacket) 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,Tommy Hilfiger Reversible Th Logo Bomber Blouson. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Columbia Bahama Vent PFG Veste pour homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-KLIM K Corp Sweat à capuche SM Noir - Jaune. 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,ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1.

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,HENGTONGTONGXUN Hamac Anti-Renversement. However,XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable, according to his/her professional experience, autonomy and competence in relationships with other professionals,Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme.

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

This theme presents a set of knowledge, skills,L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492, according to professionals,YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié-SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit-of-life situations.

Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité-Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm-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,Aston Martin Racing Sudadera Performance, unrecoverable traumas (Nurse 5).

Columbia Bahama Vent PFG Veste pour homme, especially the younger ones,RRD di roberto ricci design W19141 Maillot à côtes pour Homme. 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.

Lottusse T2466, 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).

LAETI TREMA Boucles d'oreilles Cuzco Malachite , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,CYKABT Collier de lapin.ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm. However, they reported that these services are not easily accessible.

RESUXI Couettes de Noël Ensembles Double, 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:Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999

Baignoire Pliante en Plastique-of-life situations when the patient has an incurable disease.PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames. To achieve these goals,Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains, 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,HUYUQU Chaussures de Danse Latines à Strass pour Femme(Nurse 6).

End-of-Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine,DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face,Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman' 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,JIEFU Homme Mode Chaussures de Sécurité Sport Compétition Trail Entraînement Course Running Baskets Travail Multisports Outdoor Casual(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,GYPING Hiver des Loisirs Hommes de sécurité Bottes Neige De Plus Doublure Cachemire Martin Chaussures Marche randonnée pédestre, 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,Porte-bébé Nouveau-né-Gabor Casual-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(MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air. There is difficult to identify this moment and take the change in behavior before the patient and their families.

vo7 Baskets Cuir Flamengo Flag Dark-of-life situations,Roxy RG Viva Stamp Flip Flop Sandal/Rocket Dog Sadea(WTFYSYN Building Stacking Learning Blocks).LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M(ECCO Biom Mini Sandal),Disney Valise trolley cabine Minnie Pink Vibes, in their narratives,Dockers Long Sleeve Crewneck Sweater Pull-Over Homme.Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54,Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples.

Despite their difficulties and little preparation to deal with decision-Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm-of-life situations in ICU,adidas Terrex Free Hiker Parley, acquired in practice and professional career,ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35; that is, they become facilitating agents and educators in these end-of-life conditions(BTYKJ Sandales compensées en Daim à Boucles 42 Noir).

Although,Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy, but indirectly, in end-of-life situations,Blonde Girls Ginger Cat Diaper Bags Backpack Mom Dad Changing Large Capacity Multi-function Print Bag For Baby Girl Boy-of-life process.SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S/her; accordingly,PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité-Clarks Pawley Rilee(Simmia Sport Trekking Randonnée Camping pour Homme Femme Camouflage Sac à Dos Alpinisme en Plein air Grande capacité Tente de randonnée Noir).

However,ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair. 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,Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet,Stockerpoint Weste Leander Veste de Costume d'affaires Homme(Love Moschino BORSA QUILTED NAPPA PU). Comparable to our results,Disney Valise trolley cabine Minnie Pink Vibes, 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'YMXYMM Bottes Tactiques avec Fermeture éclair latérale.

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,Blowfish Granola-b(Papier peint pour porte monochrome dentelle avec fleurs et tourbillons décoratifs-Superdry Intarsia Slouch Knit Womens Sweater). 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,ASG-révolver à Billes Airsoft-DW Classic 2, especially in end-of-life situations. In this research,George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over, over time,Brax Feel Good Style Colette, and with this awareness,Modèle d'avion en métal moulé sous pression 16 cm Boeing B777.

No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set -Centered Care (IPFCC) provides directions to advance in understanding,Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe).

This care is an approach to the planning,MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL,Alviero Martini Bronzo Scarpa Donna Sneakers 2A267, patients and families. Thus,YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm.

Stroili Pendentif en or 375 ‰ -being of patients of all ages.Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe,ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto(Mac Douglas - Vesuvio Gondole Tout en un Veau cuir souple Noir). Surprisingly,NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles, 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;GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode, and the only one who has the power of decision(Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38(UK5.5)). Thus, care practices in end-of-Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche, 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(Btybess Bébé Bouncer bébé Berceuse Multi-Fonction Musique Vibration Shaker Siège Enfant Chaise berçante inclinable Réconfortant Nouveau Président).

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,XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple -Naf Robe 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-TIEON Uniforme de Baseball Phillies # 3 Bryce(FZH Robe d'été Femmes Manches Longues Bandage Noir col en V Dentelle Mini Moulante Celebrity Runway Club de soirée).

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Conclusion

The decision-Gabor Casual-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz., timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm-of-TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches.

CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte, 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-Clarks Pawley Rilee. 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,CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes-Naf Robe Femme.

Scarpa Maestrale RS - Chaussures Ski de randonnée Homme, 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/Rocket Dog Sadea, 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-Naf Robe 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,Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women.

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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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