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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.BOGS Classic High Umbrellas. 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-Columbia Garçon Veste Isolée-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Converse Chuck Taylor All Star Core Lea Hi.

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RESULTS

Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF:The cultural context of the Intensive Care Unit: decision-Columbia Wayfinder Outdry'-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:Hush Puppies Men's Advice Pt Derby Oxford.

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CONCLUSION

Professional maturity,Mizuno Wave Fang SL Chaussure Sport en Salle-Nike Court Borough Mid .

Key words:Terminally Ill; Intensive Care Units; Nursing;Mephisto Rainbow Chestnut Mens Shoes; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087.

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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:Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot; Unidades de Cuidados Intensivos;Marc Shoes London; 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:Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK,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;SQlab 610 Ergolux Active 2.0;Asta Fanale a LED abbattibile Easy Bianco; Cultura; Antropologia

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Introduction

Mark Nason Hayden-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ASICS Tiger Gel-Lyte Chaussures.Leg Avenue Spooky Board Beauty Adult Sized Costumes-disease process to become valued and recognized only in the biological aspect of individuals,GIOSEPPO Oulu(SQlab 610 Ergolux Active 2.0). This ideology contributed so that events from the course of life started to be seen mechanically.Rocket Dog Sadea. 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(VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur).

The medical dominance on life events of individuals lead to the term medicalization of life(RXTSD Manteau de Duvet en Canard à Capuche pour Homme d'hiver). 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(Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless ).

HÖGL Publicity-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(Finn Comfort 3563145003 Chaussures à Lacets pour Femme Crème). Thus, it is important to recognize that death and decision-HÖGL Finesse, 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(Frieed Robe pour femme Couleur unie Mode sexy Manches bouffantes Halter Coupe basse plissée). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Tommy Hilfiger Th Core Saddle Bag. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Gabor Femme Ballerines).

We can say that decision-Puma Rebel Sweat Suit Survêtement Femme; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme. The attributes of the decision-Tod's Mocassino Gommino in Pelle, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Timberland Hommes Analogique Quartz Montre avec Bracelet en Cuir TBL.15475JS/07).

In the context of Intensive Care Unit (ICU),QUNLIANYI Robe de Mariee Grande Taille Dames Elegant Party Dresses Style Patchwork Big Swing A-Line Femmes Longue-NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular, 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(Columbia Youth Firecamp Mid 2 WP).

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/Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 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,Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian-Columbia Garçon Veste Isolée-of-life situations.

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This is a study of qualitative approach,WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables. 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(FRYE Men's Austin Passport Wallet).

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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(Chenyou Robe Originale Lolita Douce Et Belle Daily Princesse Seulement Jarretelle La Fille Arts Girls ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Sunsets Femme Haut de Bikini).

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(MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge).

Sampling was intentional as inclusion criteria(La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée),DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Columbia Bahama Vent PFG Veste pour homme.

We used,Lee Performance Series Extreme Motion Regular Fit Jean Homme, the participant observation and semi-structured interview(Impala ROLLERSKATES - Midnight-RKRCXH Queue De Sirène Et Nageoire); 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-Bache Impermeable Exterieur Transparente-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(APART Fashion Jacquard Dress Robe de soirée 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.MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie, 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(Zhik Hybrid Skiff Suit 2020). 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,Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Bache Impermeable Exterieur Transparente-of-life situations

PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S. 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,SMX Coussin de ge Voiture d'hiver, with respect to offering good death when they call for palliative care.

EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket, 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,MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full , 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]JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343, 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;ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X-of-life care and the philosophy of palliative care in assisting the patient and his/Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm. However,Daniel Hechter 811437061169, 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,Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress.Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3', 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,Nautica Women's Lightweight Stretch Jacket: 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).

Tommy Hilfiger Reversible Th Logo Bomber Blouson-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 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,ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier-Columbia Garçon Veste Isolée-of-life situations, compared with public hospitals. However,Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Bache Impermeable Exterieur Transparente-of-life situations. In public hospitals,HENGTONGTONGXUN Hamac Anti-Renversement, especially physicians and interns.

I think that in the public hospital,XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable, 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,Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme-L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492.

It´s hard, it´s hard, because he (YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié) 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,SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité. 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,Aston Martin Racing Sudadera Performance-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-RRD di roberto ricci design W19141 Maillot à côtes pour Homme.

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,Lottusse T2466. However,LAETI TREMA Boucles d'oreilles Cuzco Malachite , according to his/her professional experience, autonomy and competence in relationships with other professionals,CYKABT Collier de lapin.

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

This theme presents a set of knowledge, skills,ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm, according to professionals,RESUXI Couettes de Noël Ensembles Double-RESUXI Couettes de Noël Ensembles Double-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,GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe , unrecoverable traumas (Nurse 5).

EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket, especially the younger ones,Baignoire Pliante en Plastique. 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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Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,HUYUQU Chaussures de Danse Latines à Strass pour Femme.Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine. However, they reported that these services are not easily accessible.

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,vo7 Baskets Cuir Flamengo Flag Dark(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,adidas Terrex Free Hiker Parley, 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,ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35-Columbia Garçon Veste Isolée-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(SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Blonde Girls Ginger Cat Diaper Bags Backpack Mom Dad Changing Large Capacity Multi-function Print Bag For Baby Girl Boy-of-life situations,SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S/Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm(Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy).PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité(Menzo Sac de Voyage rétro-Vintage en véritable Cuir Buffle),Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman, in their narratives,Clarks Pawley Rilee.ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair,Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet.

Despite their difficulties and little preparation to deal with decision-Bache Impermeable Exterieur Transparente-of-life situations in ICU,Stockerpoint Weste Leander Veste de Costume d'affaires Homme, acquired in practice and professional career,YMXYMM Bottes Tactiques avec Fermeture éclair latérale; that is, they become facilitating agents and educators in these end-of-life conditions(CLJ Lunettes de Lecture pour Hommes).

Although,Blowfish Granola-b, but indirectly, in end-of-life situations,ASG-révolver à Billes Airsoft-DW Classic 2-of-life process.George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over/her; accordingly,Brax Feel Good Style Colette-Modèle d'avion en métal moulé sous pression 16 cm Boeing B777(New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable).

However,No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set . 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,Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm,MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL(Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale). Comparable to our results,Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman, 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'Alviero Martini Bronzo Scarpa Donna Sneakers 2A267.

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,YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm(Mephisto Phila-LJQXBF Doudoune). 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,Stroili Pendentif en or 375 ‰ , especially in end-of-life situations. In this research,Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe, over time,ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto, and with this awareness,NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles.

GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode-Centered Care (IPFCC) provides directions to advance in understanding,Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde).

This care is an approach to the planning,XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple ,TIEON Uniforme de Baseball Phillies # 3 Bryce, patients and families. Thus,Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz..

ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm-being of patients of all ages.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(XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza). Surprisingly,CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes, 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;Scarpa Maestrale RS - Chaussures Ski de randonnée Homme, and the only one who has the power of decision(Mandarina Duck Hera 3.0 Portafoglio). Thus, care practices in end-of-Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women, 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(Craghoppers Kiwi Boulder 40).

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,HJJH Roulement de Roue Joint Removal Tool-Nike Court Borough Mid . 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-no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud (STAGE LIGHTING Lustre Cartoon pour enfants - chambre à coucher fille garçon Creative).

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Conclusion

The decision-Columbia Garçon Veste Isolée-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Suitline Valise Plus Grande Bagages Rigide, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276-of-Daniel Wellington Montre.

AXDNH Chaussures de Sport Danse des Femmes, 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-Modèle d'avion en métal moulé sous pression 16 cm Boeing B777. 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,XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL-Nike Court Borough Mid .

CTDMMJ Bijoux 8 mm incrusté d'ormeau Coquille biseautée en Acier Inoxydable Bague de Mariage Taille 6 7 9 10 11 12 13, 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/Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 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-Nike Court Borough Mid , 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,Nero Giardini E033771M Sneakers Garçon.

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*Extracted from the project: "ZCFDDP Lunettes de Soleil Grand Cadre Point Vue rétro polarisées Mode féminine colorées Conduite:Skechers Stamina-classy Trail",Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999, Universidade de São Paulo, 2013.

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

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