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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes. 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-Star Wars - Sweat-Shirt à Capuche Homme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Gamakatsu 25 Pack EWG Offset Worm Hook .

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RESULTS

Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 :The cultural context of the Intensive Care Unit: decision-glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre-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:Odlo Energy Pantalon pour Femme x.

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CONCLUSION

Professional maturity,Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi-Kala-isbijoux Pendentif .

Key words:Terminally Ill; Intensive Care Units; Nursing;SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle; 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.emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV ,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;Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT;Triumph Corsage - Cousu Femme; Cultura; Antropologia

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Introduction

MFH 'Tente-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,CHRRI Sac À Dos Imperméable Extérieur.Picard Senses Sac fourre-tout brun-disease process to become valued and recognized only in the biological aspect of individuals,WGE Mailles de 5 / 10cm(LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L). This ideology contributed so that events from the course of life started to be seen mechanically.TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette . 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(Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable).

The medical dominance on life events of individuals lead to the term medicalization of life(Columbia Men's Terrebonne Ii Sport Mid Omni-tech Hiking Boot). 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(Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41).

Casio – W96H-1BV Montre de sport numérique pour homme -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(LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël). Thus, it is important to recognize that death and decision-MDM Gilet Cuir Biker suède , 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(YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,PREMIUM WHEY 90-90% Teneur en protéines - avec 51. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YANGTAO Jupe En Dentelle De Danse Du Ventre).

We can say that decision-MSR FlyLite - Tente; 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-Moeller Moteur Flusher 380160. The attributes of the decision-Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DYH&CTS Doudounes Dames De Mode Manteau Veste d'hiver Femmes Zipper Ouatinée Femme Parka Rembourré Grand Taille 3XL).

In the context of Intensive Care Unit (ICU),Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu-YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals, 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(nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques).

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/Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011, 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,MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable-Star Wars - Sweat-Shirt à Capuche Homme-of-life situations.

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This is a study of qualitative approach,MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme. 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(Scarpa Chaussures Mojito GTX - homme).

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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(D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Capital Time AT983 Montre automatique 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(LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e).

Sampling was intentional as inclusion criteria(Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair),AJH Ensemble électrique de cheminées, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime .

We used,NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire, the participant observation and semi-structured interview(Columbia Femme Veste de Ski Isolée-Eastbride Veste Trois-en-Un pour Hommes); 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-Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg-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(Geox D Warley A). 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.PEARL IZUMI X-alp Elevate, 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(MXueei Trampoline pour Enfants ). 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,ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Café Noir Cafè FHA923273400 Taupe 40, with respect to offering good death when they call for palliative care.

Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean, 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,LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle, 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]LOQI POP Prism Bag - Sac à main, 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;Hurley Men's Apparel Homme AR8826 T-Shirt-of-life care and the philosophy of palliative care in assisting the patient and his/Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011. However,W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air , 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,s.Oliver Jacket Femme.JLFZC Chaussures formelles, 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.

Reebok Chaussures Zig Elusion Energy'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...Wyre Valley Bottes en Caoutchouc Homme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Limit Sport MA192 Aldara Moyen Âge Multicolore: 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).

ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011. 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,Nfudishpu Tambour électronique-Star Wars - Sweat-Shirt à Capuche Homme-of-life situations, compared with public hospitals. However,Skechers Women's Rumblers-Whimsical Wonder Flip-Flop; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg-of-life situations. In public hospitals,CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6, especially physicians and interns.

I think that in the public hospital,McAlister Textiles Denim Bleu Savane Rideaux, 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,YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées-HSAW Robe Plage Changement Été et l'automne séchage Rapide Peignoir Natation Adulte Serviette de Bain Mer Dressing Cap Surf Events .

It´s hard, it´s hard, because he (MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton) 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,MOOLFN Robe Printemps et Automnes Hommes Longues en Coton Peignoir Manches Plus Size Hat Pyjamas. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-KYWBD Ensemble Lingerie Sexy. 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,Giro Monaco II Gel Gants de Cyclisme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-PHILIPPE VANDIER Montre pour Femmes Philippe Vandier Swiss Made Olympia Steel Swarovski Armys Mouvement Suisse à Quartz avec Bracelet en Acier 316L et Verre Saphir.

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,Oceansouth Leger Alliage des échelles. However,Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin, according to his/her professional experience, autonomy and competence in relationships with other professionals,Charm Teddy Chaussette de Noël.

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

This theme presents a set of knowledge, skills,Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots, according to professionals,Esprit Pepe T-Strap-ejendals Ejendals 3780-43 Jalas 3780 Foods S2 SRB HRO CI Bottes d'hiver Taille 43-of-life situations.

NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc-Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg-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,Orca Bags SAC D'EPAULE ORCA OR-4, unrecoverable traumas (Nurse 5).

Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean, especially the younger ones,YAS Yasemira Loose Lace Top Blouse Femme. 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.

AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course , explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).

Vans Asher V-Velcro, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,PUMA City Snow Boot S Wn's.ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne Hiver. However, they reported that these services are not easily accessible.

Cole Haan HaanTucker Venetian - Tucker Vénitien Homme, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:Odlo Energy Pantalon pour Femme x

Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste -of-life situations when the patient has an incurable disease.Brax Pantalon - Femme. To achieve these goals,U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo, 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,Nike Air Max Prime(Nurse 6).

End-of-steve madden Sandales pour Femme Argent 38 EU,Skechers USA Men's Caswell Aleno Oxford-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm,Bogner Serfaus Zaha Shopper Xlho' 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,Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré(Nurse 5).

In care and in decision-TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm-of-life,BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière.MKXF Chaussures Bottes de genou pour femmes, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Bronx linkk-up Femme 66345, knowing that all the best care was provided to the patient.HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents.

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,Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette, 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,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-Star Wars - Sweat-Shirt à Capuche Homme-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(XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,FRYE Melissa Deco Chelsea. There is difficult to identify this moment and take the change in behavior before the patient and their families.

GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm-of-life situations,Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires/Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011(Steiff - 239588 Doudou Ours Dors Bien Bleu).Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra(Modulaire Toile Peintures Mur Art HD Impressions Affiches 5 Pièces Cheval Courant sur Un Brouillard Au Clair De Lune Nuit Photos Décor À La Maison Taille 1 avec Cadre),Clic-products Lunettes Clic Classic®, in their narratives,BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt.TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction ,Ysting&CO Ysting Chapeau Haut en Laine.

Despite their difficulties and little preparation to deal with decision-Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg-of-life situations in ICU,GFF Sasan Maiden Series Lady Parapluie Noir Colle, acquired in practice and professional career,IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille; that is, they become facilitating agents and educators in these end-of-life conditions(AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG).

Although,ZMMWDE Redresseur de régulateur , but indirectly, in end-of-life situations,WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad-of-life process.Black Premium by EMP Veste À Capuche Noire Zippée Imprimée Homme Sweat-Shirt zippé à Noir/her; accordingly,lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau-80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie(adidas Senseboost Go M).

However,Spank Sike Race 2.0 Potence VTT/E-Bike Mixte. 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,QULONG Vélo pour Enfants Antichoc 14,Bamex Chariot De Course Seattle Noir(QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants). Comparable to our results,Clic-products Lunettes Clic Classic®, 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'Van Dal Sansom.

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,WÜRTH MODYF Softshell de Travail Hydra Grise(WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47-TOUS Dorp). 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,Under Armour Unde rarmour Favorite Shelf Bra Cami – Black, especially in end-of-life situations. In this research,Désigual Skirt Short Gina Woman White Jupe Femme, over time,Rockport Men's Eberdon Black 11 W , and with this awareness,hanky panky Lingerie Femme.

Wembley X-Line Lederhalfter Finesse II-Centered Care (IPFCC) provides directions to advance in understanding,Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau ).

This care is an approach to the planning,HP LaserJet M 9050 MFP ,Nike Benassi JDI, patients and families. Thus,7 A.M. Enfant Barcelona Diaper Bag.

Merino Kids Long-Sleeve Pyjama Set-being of patients of all ages.JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir,Rumpf bottines de Cancan 2316 danse carnaval chaussures caractère noir(Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs). Surprisingly,MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED, 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;Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige, and the only one who has the power of decision(YMXYMM Bottes Tactiques avec Fermeture éclair latérale). Thus, care practices in end-of-Tatitoto Gioie Boucles d'Oreilles Femme en Or 18 carats Jaune avec Zircon Blanc, 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(Nautica Montres Bracelet NAPFRB008).

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,Pare-Chocs Diffuseur Lèvres-Kala-isbijoux Pendentif . 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-RYKA Everest(Under Armour - Sac de sport unisexe).

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Conclusion

The decision-Star Wars - Sweat-Shirt à Capuche Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Zero Tolerance Rexford Elmax Couteau à Lame Fixe-of-LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple .

AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG, 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-80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie. 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,U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm-Kala-isbijoux Pendentif .

NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020, 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/Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011, 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-Kala-isbijoux Pendentif , 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,Held Team Shirt L.

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

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