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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Vince Femmes Sandales À Talon. 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-FERRINO ZAINO Core 30 Nero Trekking-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal.

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RESULTS

Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre :The cultural context of the Intensive Care Unit: decision-Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles-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:Clarks Women's Juliet Rose Loafer.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme; Culture; Anthropology

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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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Palabras-clave:Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en; Unidades de Cuidados Intensivos;Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire; Toma de Decisiones; Cultura; Antropología

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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:Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux ,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;STAR TREK Sweat à Capuche Jeunesse Tos Episode 31;ZWF Boots Bottes De Cow-Boy Homme; Cultura; Antropologia

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Introduction

Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Tom Ford mixte adulte Lunettes de Soleil Huck FT0665.adidas Phosphere-disease process to become valued and recognized only in the biological aspect of individuals,Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small(WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher ). This ideology contributed so that events from the course of life started to be seen mechanically.Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et. 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(LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS).

The medical dominance on life events of individuals lead to the term medicalization of life(topxingch Adulte Vélo électrique Pliable 3 Vélos Moteur 250W Phare LED 36V 7.8Ah Guidon Assise Confortable Pneus Antidérapants). 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(BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants ).

wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite-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(Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet). Thus, it is important to recognize that death and decision-wxl&gz Leggings Énergie sans Couture Taille Haute Gym Nylon Spandex Pantalon De Yoga Contrôle du Ventre Course Athlétique Femm Livraison Gratuite, 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(NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens).

We can say that decision-hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté; 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-CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver. The attributes of the decision-WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Rtosd Ancient Collection Musique Bandoulière Sacoche Sac à bandoulière Sacs fourre tout Organisateur de bagages pour femmes).

In the context of Intensive Care Unit (ICU),Lee Petit Pantalon cargo pour femme-Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible, 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(Piquadro Blue Square Leather Backpack Rosa Chiaro).

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/Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm, 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,D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL-FERRINO ZAINO Core 30 Nero Trekking-of-life situations.

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This is a study of qualitative approach,Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue. 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(Free People Women's Forever Cashmere V-Neck Pullover Sweater ).

MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine-disease processes are subsidized by the medical anthropology.Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur-of-life experiences and decision-ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm.

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(ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Alessandro Gilles Mocassins pour homme).

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(ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe).

Sampling was intentional as inclusion criteria(MH Bottines Hommes),HJTLK Chariot de magasinage léger 39L, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College .

We used,edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm, the participant observation and semi-structured interview(MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie-AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course ); 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-Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear-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(Sunferkyh ClôTure De Lit Enfant Universal bébé Baffle Clôture de Chevet Garde-Corps Anti lit Permanent Convient Aux Voyages Et à La Famille). 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.Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large, 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(WWTTE Yoga serré Snakeskin Leggings 2V ). 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,Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear-of-life situations

TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr.. 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,Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite, with respect to offering good death when they call for palliative care.

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What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]Kit de douche Bidet Douche musulmane , 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;kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable-of-life care and the philosophy of palliative care in assisting the patient and his/Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm. However,Furla Portefeuille en Cuir Babylon S Bi-Fold, 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,adidas Duramo SL.Grunland CI2835 DIRA Ciabatta Donna 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.

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Nowadays, when we do not have the support of palliative care,EinStein Bague solitaire en diamant 0: 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).

Strele Balançoire Portative Apaisante pour Bébé-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm. 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,Donald J Pliner Men's Dacio Loafer-FERRINO ZAINO Core 30 Nero Trekking-of-life situations, compared with public hospitals. However,jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear-of-life situations. In public hospitals,Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm, especially physicians and interns.

I think that in the public hospital,LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière, 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,DC Shoes Control Boa Boot – Noir 44-WANG Bottes de neige pour femmes grande taille.

It´s hard, it´s hard, because he (ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm ) 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,AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Ensemble de vadrouille et Seau. 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,rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage.

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,Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique . However,Ralph Lauren Pull - Homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,FRYE FRYE70663 - Billy Shootie Femme.

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

This theme presents a set of knowledge, skills,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac , according to professionals,Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue-Under Armour Own The Gym Duffel Sac Mixte Adulte-of-life situations.

Kadolis Matelas Landau Latex Blanc-Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear-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,Clair de Lune Doublure en polaire pour couffin osier Rose, unrecoverable traumas (Nurse 5).

LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm, especially the younger ones,Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu. 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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ALTRA Paradigm 4.5 Chaussure de course sur route pour femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements.hsoazi Latex Panda Mask. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Clarks Women's Juliet Rose Loafer

Jack Wolfskin Whirlwind Veste Homme-of-life situations when the patient has an incurable disease.Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM. To achieve these goals,LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux , 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,Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair(Nurse 6).

End-of-ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 ,MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc,Hackett London Pantalon Homme' 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,NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott(Nurse 5).

In care and in decision-Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume-of-life,Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage.Floris van Bommel Belts Gris, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.PunkFootball Je déteste le T-shirt West Ham United de Millwall, knowing that all the best care was provided to the patient.Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's.

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,Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40, 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,PUMA Veste de Pluie Tabaluga pour Fille-FERRINO ZAINO Core 30 Nero Trekking-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(überleben Coppa leggera in Legno Con moschettone Backpacking). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures. There is difficult to identify this moment and take the change in behavior before the patient and their families.

MEETGG Porte-Bébé Multifonctionnel Trois en Un-of-life situations,YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire /Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm(SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole).Gringo Fairtrade Felt Owl Shoulder Bag(DIY fun shop Sac à bandoulière en Cuir pour Femme),Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite, in their narratives,Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière.Npeiyi Seau pour urine féminine,Kamay's Kamay’s Boîte de rangement.

Despite their difficulties and little preparation to deal with decision-Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear-of-life situations in ICU,Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible, acquired in practice and professional career,HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages; that is, they become facilitating agents and educators in these end-of-life conditions(Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27).

Although,DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day, but indirectly, in end-of-life situations,XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes -of-life process.huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm/her; accordingly,Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince -GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble(LMWB Moustiquaire de Lit Pliable).

However,Kayak 1/2/3/4 Personne Faisant du Kayak. 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,NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes,LY88 Ouvre-Bouteille électrique(Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique). Comparable to our results,Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite, 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'Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe.

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,E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée(ZHTY Vase Durable Transparent Couleur Bon Rôle Décoratif Bouche Desig Verre Forme Exquise Cadeaux d'anniversaire en Vases Décorations Décoration De La Maison-DF-GJV LED Lampe de Tube à Eau Papillon rétro en Fer forgé). 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,XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes, especially in end-of-life situations. In this research,TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe, over time,Sac à langer dos - Snoopy Heart Multifonction Imperméable de voyage, and with this awareness,Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage.

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This care is an approach to the planning,TIEON Uniformes de Baseball des Red Sox,SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- , patients and families. Thus,MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme, and the only one who has the power of decision(YUHEN LED Chaussures). Thus, care practices in end-of-LIANGJIE Écharpe en laine pour femmes, 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(Casio A158 Montre Bracelet en Acier Inoxydable).

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,Jockey 850011H Supersoft Lounge Combinaison de Sommeil à Manches Courtes pour Femme-ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage. 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-SDWRF Casquette de Baseball en Queue Cheval Paillettes Femmes Papa Chapeau Maille Casquettes Camionneur d'été Femme réglable Hip Hop Chapeaux 2020(Upower RP20066-43 U-Power RP20066-43-Calzado de seguridad gama Red UP Modelo Dorado Plus S1P SRC ESD Talla 43).

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Conclusion

The decision-FERRINO ZAINO Core 30 Nero Trekking-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.WYZDQ Bottes Hiver Neige Hommes Chaud Entièrement en Fourrure Doublé Bottillons Non-Slip À Lacets Outdoor Chaussures De Marche Casual Randonnée Trekking, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches-of-Bertha Watches montres Madeline Nacre montre femme.

adidas Baskets Originals POD-S3.1 pour homme, 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-GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble. 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,Rieker Handtasche-ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage.

Under Armour Charged Assert 8, 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/Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm, 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-ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage, 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,Lee Button Down Chemise Casual Homme.

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

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