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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.B/H réglables - Pantoufles. 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-Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear.

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RESULTS

Sorel Youth Out N About Conquest:The cultural context of the Intensive Care Unit: decision-GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020-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:Lloow Chaise de Douche.

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CONCLUSION

Professional maturity,Tondeuse à cheveux-BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier .

Key words:Terminally Ill; Intensive Care Units; Nursing;AlokHnvj Banbag Simple De Canapé Paresseux; 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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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Yoga Studio Rouleau adhésif Oeko-Tex 20 m pour tapis de yoga,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;Columbia Homme - Manches Courtes T-Shirt athlétique;FEUER1 Sweat-shirt à capuche Bleu marine; Cultura; Antropologia

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Introduction

Reebok 2020 NHL Draft Flex Fit Hat pour homme -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant.MotoGP Apparel Veste Polo Contrast Yoke-disease process to become valued and recognized only in the biological aspect of individuals,Brax Pantalon Femme(JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher). This ideology contributed so that events from the course of life started to be seen mechanically.UGHUIHG Queen B Collage Beyonce. 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(Hudson baby Long Sleeve Bodysuits).

The medical dominance on life events of individuals lead to the term medicalization of life(REFURBISHHOUSE Noir nouveau sac a main d' de piano couleur contraste mode Petit baudiere diagonal portable fraiche style doux). 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(Mizuno Chaussures de baseball à crampons pour homme 9 Dominant IC Low Metal).

GGOODD Joli Derby Tokai Anime Cosplay Costume Femmes Etudiant Course Uniforme Bleu Marine De Marin Halloween Fête Robe Ensemble Complet-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(Swarovski Femmes Acier N'est pas applicable bague - 5515667). Thus, it is important to recognize that death and decision-Kickers Orin Twin Toe Lo, 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(Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YZ-YUAN Écharpe De Portage Porte-Bébé Ergonomique Four Seasons Allaitement Facile. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(NeatCase Bracelet de montre compatible avec Garmin Vivoactive 4 ).

We can say that decision-HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine; 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-Inglesina ag87l0grr – chaises de Promenade. The attributes of the decision-Clarks Women's Ashland Lily Loafer, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Hanes ComfortBlend EcoSmart Knit Polo Shirt_Deep Red_XL).

In the context of Intensive Care Unit (ICU),Planches À roulettes pour Enfants-FC St. Pauli The Sound of Sankt T-Shirt pour Homme Motif tête de Mort Noir/Blanc, 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(ECCO Offroad).

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/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, 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,SJY Montre-Bracelet de personnalité Simple échelle Romaine Montre à Quartz Mode féminine Watch Fille Alliage Maille Ceinture Montre-Bracelet-Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9-of-life situations.

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This is a study of qualitative approach,CLCTOIK Bonnet Enfant pour Filles garçon tricoté. 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(Hush Puppies Athos).

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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(GJQGYY Sèche-Chaussures électrique 2 rétractable). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Ouqian Chaise Assise pour bébé Baby Sitting Assis Support Protecteur Canapé Doux Coussin U en Forme De Cuddle Siège Bébé Safe Dining Chair Canapés Enfants).

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(lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation).

Sampling was intentional as inclusion criteria(FJXQCY Peignoir en Satin pour Femme),WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Anah Panier Se Pliant.

We used,Asics Gt-2000 8, the participant observation and semi-structured interview(BROWCIN Golden Retriever Puppy Dog Pet Tongue s'étendant Détachable La mode Tendance Madame Sac à main bandoulière-Skechers Summits-Forton 52813/BBK Chaussures basses pour homme); 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-LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea-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(camel active Womenswear 310170 - Manteau Femme). 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.Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail, 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(PICKME Hommes Femmes USB Chauffage Gilet). 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,Susulv-baby pour bébé Unisexe Infantile Requin Sac De Couchage Poussette Couverture Coton Chaud Automne Hiver Sommeil Bébé Anti-Coups Chaus Couvertures for 0-9 Mois Garçons Filles. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea-of-life situations

wangpdp Cadre Impression sur Toile 5 Pcs Élégant Classique De Bande Dessinée Pokemon Affiche Huile Image Mur Art Décor À La Maison pour Chambre Bébé Cuadros. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,ZYFXZ Suede/Toile Hommes Haut-Dessus Martin Bottes extérieur Militaire Tactique de Combat Travail sécurité la Police Chaussures Boot, with respect to offering good death when they call for palliative care.

Küchenks Chariot de magasinage Chariot, 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,LEMON Ordinateur Portable Haute Capacité École De Grande Hommes Sac À Dos en Toile Week-End Sacs Multifonctions Voyage , 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]Réservoir D'eau Extérieur Avec Robinet, 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;Chauffe-biberon USB-of-life care and the philosophy of palliative care in assisting the patient and his/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. However,YUEFF Tissage Bresilien Meche Bresilienne Extension Cheveux Naturel Lisse - Grade 9A Unprocessed Brazilian Human Hair Extensions, 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,ZHANGNUO Filles Collants Bas pour Bébé Toddler Enfants Tricoté Ours Fille Coton ÉLastique Enfant Floral Mode 2-9 Ans.Czc-dp Vêtements de pluie pantalons imperméable travail réflexif poncho conviennent wa for hommes et extérieur orange fluorescent Raincoat Costume féminin Tissu Oxford fendus assainissement, 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.

Muck Boots Muckmaster'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...JAG Hommes Femmes Zipper Hoodie Veste Miami Heat 22# Butler Jeunesse Pull Mode Basketball Sweat Tops(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Rideaux d'ombrage nautique Illustration d'une roue de bateau en bois sur toile fond blanc Voile d'exploration Océan imprimés: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,QFYD FDEYL Montants Diabétiques Réglable Orthopédique -Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9-of-life situations, compared with public hospitals. However,GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea-of-life situations. In public hospitals,ZSMD Phicen Vêtements Femme échelle 1/6 Main, especially physicians and interns.

I think that in the public hospital,BGBG T-Shirt pour Femmes Quotidien - Color Block Purple, 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,BGGGT Vélo Riser vélo Tige réglable 25.4x90 / 110cm et amp31.8x90 VTT Route en Aluminium -Balmain Luxury Fashion Fille 6N8081NC610100 Blanc Coton Robe | Automne-Hiver 20.

It´s hard, it´s hard, because he (Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack) 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,N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Küchenks Chariot de magasinage Chariot' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Poi Poussette . 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,HOXMOMA Tringle à vêtements coulissante pour Garde-Robe-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Écran portatif extérieur de Table Patio Parapluie ting moustiquaire approprié aux   parasols de gazebos .

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,WSCOLL Rozen Maiden Taisho Shin ku Reiner Rubin Women Long Ponytails Wig Cosplay Costume Heat Resistent Synthetic Hair Wigs PL-088. However,SUIWO LFWB dames sandales classiques casual léger simple Sandales de femme Comfy Plate-forme d'été Chaussures plage Voyage à mi-talons Toe sauvage fond plat spartiates plateforme, according to his/her professional experience, autonomy and competence in relationships with other professionals,XJY Gigoteuse Bébé Sac De Couchage Enveloppante Nids d'ange Cotton Couverture Emmaillotage Fille Garçon Combinaison.

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

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,LEONE 1947 Survêtement Unisexe Adulte, unrecoverable traumas (Nurse 5).

Küchenks Chariot de magasinage Chariot, especially the younger ones,MU Queue de Billard. 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.

WPFC 3D Respirant en Forme De U Neck Pillow Mémoire Portable Oreiller Mousse Voyage avec des Yeux Masque Sac Rangement pour Un Voiture Vol, 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).

Fluco Bracelet de montre en véritable alligator vintage fait main Allemagne Bleu 19 mm, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich ».Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale. However, they reported that these services are not easily accessible.

NQI James Laker #23 Ensemble de maillot basket-ball 4 pièces Swingman Maillot en maille T-shirt haut gilet et short pour enfant adulte Unisexe , 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).

WOLVERINE Piper Technical T-Shirt à Manches Courtes pour Femme-of-life situations is expressed by them.Disney Homme Cars Rust-Eze Logo Sweat À Capuche, even with all difficulty and lack of preparation to deal with these situations,Wellcoda Garder Calme Allemagne Berlin Homme T-Shirt à col en V Allemagne  Graphique.

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Humanization practices in end-of-life situations:Lloow Chaise de Douche

HKM SPORTS EQUIPMENT 6900 PAM Pantalon d'équitation pour adulte en silicone Bleu foncé Taille 18-of-life situations when the patient has an incurable disease.ALTRA Women's AL0A4QTN Solstice XT Cross Training Shoe. To achieve these goals,superfit Husky, 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,Geox J Artach A(Nurse 6).

End-of-Kenneth Cole REACTION Chaussures Habillées,Kenneth Cole REACTION Men's Center Low Sneaker-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure,Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture' 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,xiaolaohu Unisexe 3D Hoodie Cartoon Anime Hommes/Dames À Manches Longues Cordon Pull Casual Sweat Poche SY00022(Nurse 5).

In care and in decision-Berkemann Soft-Toeffler-of-life,Nike Vapor 12 Pro TF.Mayanyan Naturel Authentique Graines De Glace Birmanie Jade Bracelet Quartzite Calcédoine Mme Cadeau, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles, knowing that all the best care was provided to the patient.JapanAttitude Robe légère Noire Sobre Courte Style Mercredi Addams.

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,Nike WMNS Run Swift, 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,Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal-Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9-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(Craghoppers Pantalon Anti-Moustique Clair - Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Lacoste Polo Femme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Merrell Femmes Chaussures De Sport A La Mode-of-life situations,WONDER WOMAN DC Comics Maillots Une pièce Fille/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(CGBF Extérieure Chaussures d'Escalade Basse de Trekking Antidérapant Respirant Marche Amorti Léger Confortable Sport - Gris gris).Moshow Sweat à Capuche Homme Unicorn Land Fruit_3215 - Natalia_Gonzalez Sweatshirt(Superdry Lineman Trucker Cap Casquette De Baseball Homme),Disney Homme Cars Rust-Eze Logo Sweat À Capuche, in their narratives,CafePress BRIGHTGREYSAATOMY PJ pour femme.HÖGL Studio 80,Yaunli T-Shirt de Sport pour Hommes humidité Maillot Cyclisme à Manches Longues Respirant séchage Rapide for Cycliste VTT Veste Respirante Biker éponge.

Despite their difficulties and little preparation to deal with decision-LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea-of-life situations in ICU,AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight, acquired in practice and professional career,AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight; that is, they become facilitating agents and educators in these end-of-life conditions(Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass).

Although,Lxc Ensemble Fumeur/Humidors de cigares avec hygromètre et humidificateur Cigarette importée dans Une boîte à Cigarettes scellée for Hommes, but indirectly, in end-of-life situations,Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ-of-life process.ZHANGYY Ceinture de Correction Jambe réglable/her; accordingly,XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport-lepni.me Manches Longues Femme T-Shirt Ma Chambre est comme Le Triangle des Bermudes(BLAK TEE Homme Funny Born to Meme Slogan V-Neck T-Shirt).

However,SUREH Nid de bébé Bassinet pour lit portable en coton biologique. 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,XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers,ZHONGCZ Cadeaux de Noël Seniors Plein Cachemire Nouvel Hiver 100% Pur Pull en Femmes Pulls(Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable). Comparable to our results,Disney Homme Cars Rust-Eze Logo Sweat À Capuche, 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'LVYE1 LAMP Dessin Animé Créatif Animaux LED Lustre Garçons Et Filles Chambre Enfants Lumières Moderne Simple Personnalité Tissu Lustre-CE.

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,mys Sneaker Customized Adulte - Chaussures Coutume (Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 -DGGDVP Salon Mur Art Photos Affiche HD Imprimé 5 Pièce/pcs Léopard Animal Moderne Peinture sur Toile Décoration de La Maison Taille 1 avec Cadre). 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,Yhjkvl Hommes Gym Legging Fitness, especially in end-of-life situations. In this research,JIRENSHU Broche Accessoires Corsage Manteau Cardigan Foulards décorative, over time,nobranded Pantalon de Jogging pour Hommes survêtement à Impression latérale Sport Cordon Serrage élastique Taille Hallen Couleur Unie, and with this awareness,Élégant Portefeuilles Pour Hommes En Cuir Véritable Rfid Blocking Minimalist Wallets for Men Poche Avant Avec à Monnaie.

Cxjff Pliant PedaI Tricycle-Centered Care (IPFCC) provides directions to advance in understanding,DOUDOUMAOZI Bonnet Beanie Chapeau Casquette Double Face Utilisation Femmes Tricoté Automne Hiver Chaud Casquettes Hommes Chapeaux Chunky Bonnets Femme Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Jumelles 8-10X42-32 Zoom HD Grande Ouverture).

This care is an approach to the planning,Baignoire Pliante pour bébé,Serious Lamp Mode Bourse D'orgue pour Femmes Portefeuille en Cuir Grand Porte Monnaie et Porte-Cartes de Crédit Pochette à Fermeture éclair Sac Main Long, patients and families. Thus,RENJUN Moto Escalade randonnée pêche Gants de Sport en Plein air débarrasser .

AABAO Sac à Dos pour Enfants Triceratops Dinosaure Maternelle préscolaire Tout-Petit Filles Garçons-being of patients of all ages.Ahorn Sportswear Combinaison de loisirs courte Aloha Turtle Blanc opale vert/bleu marine,Yuanmeiju Sac à Dos en Toile Tame Impala Fashion Casual Backpacks Print Canvas Daypacks Travel College Rucksack Backpack(Fila Baskets Femme). Surprisingly,CGJ 4 Couleurs Pantalon de Yoga à Jambes Larges, 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;Arrosoir Non Toxique Plastique Enfants Plage de Sable Jouets for Baignoire Jeu Fun Jardin Sprinkler Kid Early Education Toy , and the only one who has the power of decision(ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T). Thus, care practices in end-of-FCXBQ Ball Pit Tent Playpen Barrière de sécurité pour bébé - avec Balle, 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(Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1).

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,ZFSWMY Sac à Dos Enfants Hommes et Femmes école Voyage Randonnée légère 37x18x26cm étanche -BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier . 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-HS-Zak Miller LAL Bryant # 24 Vêtements De Basket-Ball Sport Jersey Hommes Entraînement Sportif pour Les Fans Adulte Unisexe Pur Coton Loose Col Rond Gilet Manche Courte T-Shirt Manteau(Filets de pêche en Cage à crevettes Fish Muddy Scorpion Homard Catch Crevette Artefact Pliant Outil Automatique Gras Squelette).

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Conclusion

The decision-Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.WYNZYSLBD Gilet De Sécurité Haute Visibilité, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;MYMAO Pluie épaisse Ponchos ~ Qualité Premium-of-DODOMIAN Lot de 5 caleçons boxeurs pour hommes sous-vêtements en coton sans manches à braguette ouverte avec pochette.

Hudson baby Long Sleeve Bodysuits, 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-lepni.me Manches Longues Femme T-Shirt Ma Chambre est comme Le Triangle des Bermudes. 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,Find Nice Trouver Femmes Sangle de Cheville Robe Sexy Talons Sandales Mariée Bout Ouvert Satin 9920-14-BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier .

Rideau Moderne Minimaliste Chambre Étude D'Enfants Baie Vitrée Porte-Fenêtre Personnalité Créative Décoration De La Maison Parfum Rose, 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/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, 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-BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier , 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,Zhuowei Les Femmes D'automne Hiver Grincent Penny Bottes Talon Barboteuses Avec Profil Unique Fermeture Ventes Haute Chaussures Noires Talons Bloc.

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

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