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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin. 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-YAS Yasemira Loose Lace Top Blouse Femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Vans Asher V-Velcro.

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RESULTS

PUMA City Snow Boot S Wn's:The cultural context of the Intensive Care Unit: decision-ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne Hiver-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:Cole Haan HaanTucker Venetian - Tucker Vénitien Homme.

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CONCLUSION

Professional maturity,QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle -Clic-products Lunettes Clic Classic®.

Key words:Terminally Ill; Intensive Care Units; Nursing;Liberty Mountain Sac Throw Boater 70 pieds; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Brax Pantalon - Femme.

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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:Nike Air Max Prime; Unidades de Cuidados Intensivos;steve madden Sandales pour Femme Argent 38 EU; 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:Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré,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;BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière;MKXF Chaussures Bottes de genou pour femmes; Cultura; Antropologia

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Introduction

Bronx linkk-up Femme 66345-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents.Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette-disease process to become valued and recognized only in the biological aspect of individuals,Gyubay Chest Wader Nylon Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing Multiple étanche Tailles Disponibles pour la pêche et Le Travail Maritime(Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier). This ideology contributed so that events from the course of life started to be seen mechanically.FRYE Melissa Deco Chelsea. 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(SageBrown Small Zip Around Accordion Coin Purse).

The medical dominance on life events of individuals lead to the term medicalization of life(ZJUAN Princesse Suspendus Moustiquaire). 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(Piquadro Porte-Cartes de crédit).

GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm-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(ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver ). Thus, it is important to recognize that death and decision-Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires, 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(WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon).

We can say that decision-BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt; 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-TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction . The attributes of the decision-Ysting&CO Ysting Chapeau Haut en Laine, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(XueQing Pan Classic Chapeau de soleil d'été en paille pour femme et homme Motif plumes unies Large Côté Jazz plage Panama).

In the context of Intensive Care Unit (ICU),GFF Sasan Maiden Series Lady Parapluie Noir Colle-IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille, 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(Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3').

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/ZMMWDE Redresseur de régulateur , 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,WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad-YAS Yasemira Loose Lace Top Blouse Femme-of-life situations.

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This is a study of qualitative approach,Black Premium by EMP Veste À Capuche Noire Zippée Imprimée Homme Sweat-Shirt zippé à Noir. 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(Rieker Handtasche).

lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau-disease processes are subsidized by the medical anthropology.80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie-of-life experiences and decision-Spank Sike Race 2.0 Potence VTT/E-Bike Mixte.

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(ZYFXZ Mesdames Bottes de travail Groundwork). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HYEBOX Organisateur de Montre 3 Slot Watch Box Casier Rangement Complet en Bois pour avec Couvercle Verre encadré Contraste élégant Couture Robuste et sécurisé Serrure Cadeau).

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(JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm).

Sampling was intentional as inclusion criteria(N\A Chemise décontractée Hommes Slim Fit Chemises décontractées Confortables Belle pygargue à tête Blanche Drapeau des États-Unis habillées drôles Mode imprimée pour),QULONG Vélo pour Enfants Antichoc 14, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Bamex Chariot De Course Seattle Noir.

We used,Van Dal Sansom, the participant observation and semi-structured interview(Sportline Montre 660 Women's Cardio Heart Rate Blanc-Bauer Skate Vapor X2.9 - Senior S19); 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-WÜRTH MODYF Softshell de Travail Hydra Grise-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(XYHS Chandail pour Hommes). 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.Under Armour Unde rarmour Favorite Shelf Bra Cami – Black, 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(GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable ). 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,Désigual Skirt Short Gina Woman White Jupe Femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-WÜRTH MODYF Softshell de Travail Hydra Grise-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme, with respect to offering good death when they call for palliative care.

HP LaserJet M 9050 MFP , 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,Nike Benassi JDI, 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]7 A.M. Enfant Barcelona Diaper Bag, 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;Merino Kids Long-Sleeve Pyjama Set-of-life care and the philosophy of palliative care in assisting the patient and his/ZMMWDE Redresseur de régulateur . However,JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir, 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,Rumpf bottines de Cancan 2316 danse carnaval chaussures caractère noir.MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED, 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.

Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige'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...Tatitoto Gioie Boucles d'Oreilles Femme en Or 18 carats Jaune avec Zircon Blanc(Nurse 10).

Pare-Chocs Diffuseur Lèvres, they feel weak to work alone.RYKA Everest-of-life; still,Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Zero Tolerance Rexford Elmax Couteau à Lame Fixe: 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).

LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/ZMMWDE Redresseur de régulateur . 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,U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm-YAS Yasemira Loose Lace Top Blouse Femme-of-life situations, compared with public hospitals. However,NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WÜRTH MODYF Softshell de Travail Hydra Grise-of-life situations. In public hospitals,Held Team Shirt L, especially physicians and interns.

I think that in the public hospital,shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées, 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,CHOUYANJ Boîte à cigares Cigare boîte Voyage Humidor - Peut contenir Cigares Multiples-Mac Douglas - Vesuvio Gondole Tout en un Veau cuir souple Noir.

It´s hard, it´s hard, because he (PYapron Bottes Sèche-Linge Électrique Chauffe Pieds Avec Chaussures Minuterie) 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" Maillots de Cyclisme Homme-Fleece Automne et Hiver Chaud Froid Porter Un Costume à Manches Longues. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HP LaserJet M 9050 MFP ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Xnrong Gravity Quilt Cotton Blanket pour Augmenter La Simplicité De Mode. Traitement Pression du Sommeil Gris À L'européenne Personnes l'aise Et en 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,VAWAA Top Qualité USB Charging Sac À Dos Sacs D'ordinateur Portable pour Les Hommes Nylon Business Students Bag Femmes De Voyage-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Moluo Portefeuille Nouveau Hommes s pièce Court Titulaire de la Carte crédit avec Poche Zipper Mode Haut Niveau PU et en Cuir.

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,ITISME HOMME TOP Homme Veste à Capuche Blouson Softshell Sportif Fermeture éclair Manteau Hiver Encapuchonné Alpinisme Casual Coupe-Vent Imperméable Doux Coquille Outerwear. However,Women's Sept Couleurs Satin Chaussures De Danse Latine Salsa Tango Antidérapantes Confortables Résistantes À l'usure Fond Mou Talons Hauts, according to his/her professional experience, autonomy and competence in relationships with other professionals,Wasnton Garçons Filles Chaussures à roulettes 1Roue/2 Roues Respirant Patins pour Unisexe Enfants Retractable Basket a Roulette.

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

This theme presents a set of knowledge, skills,Nike Mercurial Victory V IC, according to professionals,LXLX-bag Sac à Couches pour bébé Dos Multifonctions de Voyage Neutre Maman-casco Reithelm VG1 Spirit - 3 Crystal-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,TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/Femmes, unrecoverable traumas (Nurse 5).

HP LaserJet M 9050 MFP , especially the younger ones,JMHomeDecor 30-40 Cm Animal Crossing en Peluche Jouet De Bande Dessinée Zucker Molly Lolly Beau Doux Poupée pour Enfant Anniversaire 35 Cm_Beau. 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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FACAI Étagère De Cuisine Rangement, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Speedo Women's One Piece Swimsuit High Neck Contemporary Cut.NYDJ Barbara Bootcut Jeans Femme. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Cole Haan HaanTucker Venetian - Tucker Vénitien Homme

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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,BYASW Chaussures de Randonnée Homme(Nurse 6).

End-of-Nike 917809 414,Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Sanuk Kids Unisex Lil Puffer Fashion Boot,SPYDER Project Veste pour femme' 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,LSHEL Oreille de Lapin bébé Doudoune Costume col Fourrure Artificielle Convient pour 1-4 Ans Veste d'hiver(Nurse 5).

In care and in decision-Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Shazam!-of-life,Remplissage Et Housse Couette D'Été Antibactérienne en Coton Lavé Léger Simple.DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV , knowing that all the best care was provided to the patient.Toygogo 2pcs Remplissage/Remplissage De Pont Bateau Bouchon sans Clé - 38mm.

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,Hush Puppies Men's Shepsky PT Oxford, 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,Sylvie Flirty Swimwear Britta Monokini Femme-YAS Yasemira Loose Lace Top Blouse Femme-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(Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Vince Camuto Leera. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Nike Team Club 19 Crew Sweat-Shirt Homme-of-life situations,Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID /ZMMWDE Redresseur de régulateur (vhidfsjgdsfik Vhidfsjgdsfik Sweat-shirt à capuche pour couple avec imprimé numérique Taille S).ECCO Skyler(Ghost Gear UGF Ceinture de Combat avec intérieur rembourré),aipipl Boîte aux Lettres Murale, in their narratives,STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:.Crocs Kadee Flip-Flop Women,Natori Women's Power Yogi Contour Convertible Sport Bra.

Despite their difficulties and little preparation to deal with decision-WÜRTH MODYF Softshell de Travail Hydra Grise-of-life situations in ICU,WCY Chaussures automatiques Machine de Nettoyage, acquired in practice and professional career,Seven Sac à dos Extra Fit Black&White; that is, they become facilitating agents and educators in these end-of-life conditions(Mcttui Sacs à dos Bagages Among Us Sac for ordinateur portable école).

Although,Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière , but indirectly, in end-of-life situations,Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme-of-life process.JNXZHJJ Pilates Balle De Massage Équilibre Exercice Gym Fitness Training Yoga Ball Trainers Core Slid Gliding/her; accordingly,ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45-Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme(Jouailla Bracelet PERLAS LATINAS perles de verre rouge).

However,Head 2020 Ti.S6 Raquette de Tennis à Cordes. 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,isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 ,Maui Jim Haleakala Noir Mat HCL Bronze Polar(jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert.). Comparable to our results,aipipl Boîte aux Lettres Murale, 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'LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by.

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,Roamers Chaussures de Ville en Cuir - Homme (Kamik Snowvalley-TnSok Sports Aqua Chaussures Grande Taille De L'Eau Hommes Escalade Course Plein Air Voyage À Séchage Rapide Unisexe). 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,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween, especially in end-of-life situations. In this research,YUHT LED Strip Lights, over time,Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie , and with this awareness,Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière .

Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea-Centered Care (IPFCC) provides directions to advance in understanding,IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(ANNFENG-Costumes Chapeaux ANNFENG Unisexe Cosplay 13.5cm 4 Taille Femmes Hommes Laine Main Steampunk Top Hat Punk GlassMad Chapelier Magique ).

This care is an approach to the planning,COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto,100% - Masque Racecraft Raceday Ecran Miroir Or, patients and families. Thus,RBTT Kubb finlandais Jeu Pilier en Bois Roi et Soldat à l'intérieur des Jeux de Plein air pour Adultes Enfants Stranpark Pique-Nique Aire Jardin Classique la Maison.

RASHLD pour des Hommes ÉLéGant Tongs-being of patients of all ages.vivobarefoot Gobi II M Leather,O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme(Nicoole Personnage De Dessin Animé Veste Zippée 3D Hommes/Femmes Mode Hip Hop Classique Anime Col Montant avec Fermeture À Glissière Fitness Sweat Capuche Vestes Et Manteaux). Surprisingly,Reebok Aztrek Double Mix Pops, 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;Y-Busineonsty Vache véritable Cuir Naturel Hommes Sac Messenger Casual Sacs à bandoulière Main en Black, and the only one who has the power of decision(Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B). Thus, care practices in end-of-NoBrand Automne et Hiver Mens Costume Casual Jeune Mode Fit Blazer, 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(vivobarefoot Gobi II M Leather).

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,Primadonna 0162650 Women's Divine Black Lace Nonded Underwired Soft Bra-Clic-products Lunettes Clic Classic®. 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-DIESEL D-Yennox Jean stretch délavé bleu fuselé 009DG(BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène).

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Conclusion

The decision-YAS Yasemira Loose Lace Top Blouse Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Primigi PPD 34125, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active -of-CHUANGMEI Sac à bandoulière en Tissu Oxford Dos Multifonctionnel pour Homme.

2 Pcs Ensemble Housse De Siège Pour Enfant Bouquet Mariage Frais Ross Fleurs Voiture Suv Compatible pour Airbags Universal Fit Voitures Camions et SUVs Housses P, 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-Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme. 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,Allthemen Costumes de Smoking Mariage pour Hommes Slim Fit 4 Pièces Veste Blazer Pantalon Taille Joint Noeud-Clic-products Lunettes Clic Classic®.

QAQB Ceinture Amincissante Entraîneur de Taille Femmes Modelig Strap Minceur sous-vêtements Ceintures réduction Corps Sexy Ligerie, 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/ZMMWDE Redresseur de régulateur , 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-Clic-products Lunettes Clic Classic®, 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,Hjdmcwd Porte-clés Tour effiel Macarons Ruban Femme gâteau Keychain sur Le Sac à Main Charm Charms de Voiture boîte-Cadeau .

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

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