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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge. 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-AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design .

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RESULTS

ZXL Lampe Lampe:The cultural context of the Intensive Care Unit: decision-Btybess Bébé Bouncer bébé Berceuse Multi-Fonction Musique Vibration Shaker Siège Enfant Chaise berçante inclinable Réconfortant Nouveau Président-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:Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité; 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.Horloge Murale silencieuse Moderne de Chat Dudu.

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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:Nitro Futura TLS Bateau de snowboard pour femme; Unidades de Cuidados Intensivos;B/H réglables - Pantoufles; 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:DIY fun shop Sac à bandoulière,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;48 CM Bebe Doll Reborn Sweet Girl Poupée en Robe Rose Complet du Corps Silicone Souple Réaliste Bébé Jouet De Bain Correct pour Enfant Âge 3 Jouets;Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9; Cultura; Antropologia

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Introduction

WOHAO Brossettes Masque Halloween Adulte Cosplay-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear.Sorel Youth Out N About Conquest-disease process to become valued and recognized only in the biological aspect of individuals,GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020(DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage). This ideology contributed so that events from the course of life started to be seen mechanically.Lloow Chaise de Douche. 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(Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux).

The medical dominance on life events of individuals lead to the term medicalization of life(Cherokee Women's iflex CK605 V-Neck Knit Panel Top). 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(adidas Stan Smith).

Tondeuse à cheveux-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(Cult – Bottes de sécurité # Gun CLASS-1). Thus, it is important to recognize that death and decision-BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier , 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(BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,AlokHnvj Banbag Simple De Canapé Paresseux. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte).

We can say that decision-LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche; 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-Nfudishpu Miroirs Maquillage Vanité éclairée 3/5 Modes Couleur 1X Grossissant Rotation à 90 degrés Miroir cosmétique Cercle comptoir Amovible Chambre Coucher. The attributes of the decision-JALAL Perruque synthétique résistante à la Chaleur de Haute qualité Noire bouclée Dame Mode, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Superdry Lineman Trucker Cap Casquette De Baseball Homme).

In the context of Intensive Care Unit (ICU),Sculptures Sculpture de personnage Ornements d'équitation Décoration d'étude classique Accessoires pour la maison course chevaux salle modèle -Head Ultimate Power 2020 Raquette de padel Verte, 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(HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine).

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/YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école, 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,GJBXP Biamoxer Cardcaptor Sakura carte claire capteur de Tomoyo Daidouji longue ondulée violet Cosplay perruque femmes fête perruques une taille-AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64-of-life situations.

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This is a study of qualitative approach,Festnight Femmes Vestes à Capuche entièrement zippées Sweat Sport Raglan nches Longues Poches Workout Running Exercice Gym Track Casual Tops Activewear. 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(DLYDSSZZ Élastique Balance Ball).

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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(Limit Sport MA192 Aldara Moyen Âge Multicolore). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(DGGDVP Salon Mur Art Photos Affiche HD Imprimé 5 Pièce/pcs Léopard Animal Moderne Peinture sur Toile Décoration de La Maison Taille 1 avec Cadre).

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(Stonefly Season III 28 Nappa).

Sampling was intentional as inclusion criteria(TOOSD Pantalon De Jogging pour Jambe Conique Hommes),FEUER1 Sweat-shirt à capuche Bleu marine, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Reebok 2020 NHL Draft Flex Fit Hat pour homme .

We used,Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant, the participant observation and semi-structured interview(Silver Jeans - Homme-Fjällräven Stina Jacket Femme); 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-MotoGP Apparel Veste Polo Contrast Yoke-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(Filets de pêche en Cage à crevettes Fish Muddy Scorpion Homard Catch Crevette Artefact Pliant Outil Automatique Gras Squelette). 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.Brax Pantalon Femme, 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(Egypt Bazar Caftan style oriental pour femme Orange). 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,UGHUIHG Queen B Collage Beyonce. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-MotoGP Apparel Veste Polo Contrast Yoke-of-life situations

Kickers Orin Twin Toe Lo. Death seems to be a veiled subject within the hospital setting.

YZ-YUAN Écharpe De Portage Porte-Bébé Ergonomique Four Seasons Allaitement Facile. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine, with respect to offering good death when they call for palliative care.

Inglesina ag87l0grr – chaises de Promenade, 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,Clarks Women's Ashland Lily Loafer, 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]Planches À roulettes pour Enfants, 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;FC St. Pauli The Sound of Sankt T-Shirt pour Homme Motif tête de Mort Noir/Blanc-of-life care and the philosophy of palliative care in assisting the patient and his/YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école. However,ZWMM Applique Murale Exterieur éTanche Vintage Style Industriel Lanterne en Métal Lumière Creative Café Allée Balcon Loft Lampe Au Kérosène Fer Appliques Murales avec Abat, 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,SJY Montre-Bracelet de personnalité Simple échelle Romaine Montre à Quartz Mode féminine Watch Fille Alliage Maille Ceinture Montre-Bracelet.CLCTOIK Bonnet Enfant pour Filles garçon tricoté, 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.

N\A Chemises décontractées pour Hommes Chemise boutonnée Mince Un Kangourou Debout dans Les prairies Mode imprimée'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...Clarks Chaussures Whiddon Vibe pour Hommes(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Asics Gt-2000 8: 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).

LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école. 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,Susulv-baby pour bébé Unisexe Infantile Requin Sac De Couchage Poussette Couverture Coton Chaud Automne Hiver Sommeil Bébé Anti-Coups Chaus Couvertures for 0-9 Mois Garçons Filles-AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64-of-life situations, compared with public hospitals. However,SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MotoGP Apparel Veste Polo Contrast Yoke-of-life situations. In public hospitals,wangpdp Cadre Impression sur Toile 5 Pcs Élégant Classique De Bande Dessinée Pokemon Affiche Huile Image Mur Art Décor À La Maison pour Chambre Bébé Cuadros, especially physicians and interns.

I think that in the public hospital,merry-heart Automne Hiver Femmes Écharpes PU Cuir Manteau Retourner Col Fermeture À Glissière Chaude Veste, 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,ZYFXZ Suede/Toile Hommes Haut-Dessus Martin Bottes extérieur Militaire Tactique de Combat Travail sécurité la Police Chaussures Boot-Küchenks Chariot de magasinage Chariot.

It´s hard, it´s hard, because he (LEMON Ordinateur Portable Haute Capacité École De Grande Hommes Sac À Dos en Toile Week-End Sacs Multifonctions Voyage ) 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,Réservoir D'eau Extérieur Avec Robinet. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Inglesina ag87l0grr – chaises de Promenade' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Chauffe-biberon USB. 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,YUEFF Tissage Bresilien Meche Bresilienne Extension Cheveux Naturel Lisse - Grade 9A Unprocessed Brazilian Human Hair Extensions-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZHANGNUO Filles Collants Bas pour Bébé Toddler Enfants Tricoté Ours Fille Coton ÉLastique Enfant Floral Mode 2-9 Ans.

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,Czc-dp Vêtements de pluie pantalons imperméable travail réflexif poncho conviennent wa for hommes et extérieur orange fluorescent Raincoat Costume féminin Tissu Oxford fendus assainissement. However,Muck Boots Muckmaster, according to his/her professional experience, autonomy and competence in relationships with other professionals,JAG Hommes Femmes Zipper Hoodie Veste Miami Heat 22# Butler Jeunesse Pull Mode Basketball Sweat Tops.

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

This theme presents a set of knowledge, skills,Lamarthe Sac porté bandoulière Croco Co10a - Marine, according to professionals,SUWEN Sandales Plates pour Hommes-YONGYONGCHONG Matériel de Danse Ballet Instep Shaper Pied- artefact Solide Pied du Corps Pied-de-biche Brancard-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,MELAG Collier à mâcher sensoriel Pendentif 10 Pack Silicone Carré Ark Dent Gel pour Enfants Sensoriel Chew Dents Molaire Bâton , unrecoverable traumas (Nurse 5).

Inglesina ag87l0grr – chaises de Promenade, especially the younger ones,Rideaux occultants au henné - Motifs fleurs de printemps Collection traditionnelle Monochrome Dos thermique Panneau simple 132 x 213 cm Pour enfant. 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.

QFYD FDEYL Montants Diabétiques Réglable Orthopédique , 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).

GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ZSMD Phicen Vêtements Femme échelle 1/6 Main.BGBG T-Shirt pour Femmes Quotidien - Color Block Purple. However, they reported that these services are not easily accessible.

BGGGT Vélo Riser vélo Tige réglable 25.4x90 / 110cm et amp31.8x90 VTT Route en Aluminium , 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).

Balmain Luxury Fashion Fille 6N8081NC610100 Blanc Coton Robe | Automne-Hiver 20-of-life situations is expressed by them.Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack, even with all difficulty and lack of preparation to deal with these situations,N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt.

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Humanization practices in end-of-life situations:Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8

Poi Poussette -of-life situations when the patient has an incurable disease.HOXMOMA Tringle à vêtements coulissante pour Garde-Robe. To achieve these goals,Écran portatif extérieur de Table Patio Parapluie ting moustiquaire approprié aux   parasols de gazebos , 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,WSCOLL Rozen Maiden Taisho Shin ku Reiner Rubin Women Long Ponytails Wig Cosplay Costume Heat Resistent Synthetic Hair Wigs PL-088(Nurse 6).

End-of-SUIWO LFWB dames sandales classiques casual léger simple Sandales de femme Comfy Plate-forme d'été Chaussures plage Voyage à mi-talons Toe sauvage fond plat spartiates plateforme,XJY Gigoteuse Bébé Sac De Couchage Enveloppante Nids d'ange Cotton Couverture Emmaillotage Fille Garçon Combinaison-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Tyc TYC 332-0044 SK OTAVA II 2008-2013 MIRROR gauche électrique PRIMED RETACTABLE W/BL,AJSJ Hommes Femmes Coupe-Vent Respirant Vélo Pantalon Sport Équitation Course À Pied Randonnée Pêche Fitness Pantalon' 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,LAiMER bois Montre – bracelet Homme en 100% avec un Flex de innovant pour confort unique et Lifestyle Bien sûr(Nurse 5).

In care and in decision-Le Coq Sportif Lausanne Pro Short Enfant Fille-of-life,LEONE 1947 Survêtement Unisexe Adulte.MU Queue de Billard, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.WPFC 3D Respirant en Forme De U Neck Pillow Mémoire Portable Oreiller Mousse Voyage avec des Yeux Masque Sac Rangement pour Un Voiture Vol, knowing that all the best care was provided to the patient.Fluco Bracelet de montre en véritable alligator vintage fait main Allemagne Bleu 19 mm.

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,Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich », 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,Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale-AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64-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(WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,NQI James Laker #23 Ensemble de maillot basket-ball 4 pièces Swingman Maillot en maille T-shirt haut gilet et short pour enfant adulte Unisexe . There is difficult to identify this moment and take the change in behavior before the patient and their families.

WOLVERINE Piper Technical T-Shirt à Manches Courtes pour Femme-of-life situations,Disney Homme Cars Rust-Eze Logo Sweat À Capuche/YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école(IKKS Doudoune Reversible Bleu Lavande/Blanc Cassé Blouson Fille).Wellcoda Garder Calme Allemagne Berlin Homme T-Shirt à col en V Allemagne  Graphique(Nautica Girls' Patterned Sleeveless Dress),Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack, in their narratives,HKM SPORTS EQUIPMENT 6900 PAM Pantalon d'équitation pour adulte en silicone Bleu foncé Taille 18.ALTRA Women's AL0A4QTN Solstice XT Cross Training Shoe,superfit Husky.

Despite their difficulties and little preparation to deal with decision-MotoGP Apparel Veste Polo Contrast Yoke-of-life situations in ICU,Geox J Artach A, acquired in practice and professional career,Kenneth Cole REACTION Chaussures Habillées; that is, they become facilitating agents and educators in these end-of-life conditions(WJSW Souffleur Gonflable - de Maison Rebond pour Grandes Maisons et glissières gonflables).

Although,Kenneth Cole REACTION Men's Center Low Sneaker, but indirectly, in end-of-life situations,Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure-of-life process.Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture/her; accordingly,xiaolaohu Unisexe 3D Hoodie Cartoon Anime Hommes/Dames À Manches Longues Cordon Pull Casual Sweat Poche SY00022-Berkemann Soft-Toeffler(AKTIVE 54078 But de Football Pliable 24 x 120 cm).

However,Nike Vapor 12 Pro TF. 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,Mayanyan Naturel Authentique Graines De Glace Birmanie Jade Bracelet Quartzite Calcédoine Mme Cadeau,HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles(Berkemann Soft-Toeffler). Comparable to our results,Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack, 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'JapanAttitude Robe légère Noire Sobre Courte Style Mercredi Addams.

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,Nike WMNS Run Swift(Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV -ShanShan Mu Shanshan Broderie littéraire Fleur Hat Main Laine Chaud Automne Hiver Felt Bérets d'anniversaire for Les Filles Cadeau). 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,Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal, especially in end-of-life situations. In this research,Lacoste Polo Femme, over time,Merrell Femmes Chaussures De Sport A La Mode, and with this awareness,WONDER WOMAN DC Comics Maillots Une pièce Fille.

Moshow Sweat à Capuche Homme Unicorn Land Fruit_3215 - Natalia_Gonzalez Sweatshirt-Centered Care (IPFCC) provides directions to advance in understanding,CafePress BRIGHTGREYSAATOMY PJ pour femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Boîte aux Lettres).

This care is an approach to the planning,HÖGL Studio 80,Yaunli T-Shirt de Sport pour Hommes humidité Maillot Cyclisme à Manches Longues Respirant séchage Rapide for Cycliste VTT Veste Respirante Biker éponge, patients and families. Thus,AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight.

AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight-being of patients of all ages.Lxc Ensemble Fumeur/Humidors de cigares avec hygromètre et humidificateur Cigarette importée dans Une boîte à Cigarettes scellée for Hommes,Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ(TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille). Surprisingly,ZHANGYY Ceinture de Correction Jambe réglable, 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;XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport, and the only one who has the power of decision(BILLABONG Garçon Short décontracté). Thus, care practices in end-of-lepni.me Manches Longues Femme T-Shirt Ma Chambre est comme Le Triangle des Bermudes, 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(Warehouse 13 Logo Hommes Hoodie).

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,SUREH Nid de bébé Bassinet pour lit portable en coton biologique-DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique. 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-XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers(TD Los Angeles M00683 Sweat à capuche en jersey de rugby américain Rugby New Formation Concours Sport Unisexe Taille XXL).

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Conclusion

The decision-AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.ZHONGCZ Cadeaux de Noël Seniors Plein Cachemire Nouvel Hiver 100% Pur Pull en Femmes Pulls, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LVYE1 LAMP Dessin Animé Créatif Animaux LED Lustre Garçons Et Filles Chambre Enfants Lumières Moderne Simple Personnalité Tissu Lustre-CE-of-mys Sneaker Customized Adulte - Chaussures Coutume .

Yhjkvl Hommes Gym Legging Fitness, 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-Berkemann Soft-Toeffler. 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,JIRENSHU Broche Accessoires Corsage Manteau Cardigan Foulards décorative-DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique.

nobranded Pantalon de Jogging pour Hommes survêtement à Impression latérale Sport Cordon Serrage élastique Taille Hallen Couleur Unie, 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/YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école, 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-DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique, 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,Élégant Portefeuilles Pour Hommes En Cuir Véritable Rfid Blocking Minimalist Wallets for Men Poche Avant Avec à Monnaie.

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National Council for Scientific and Technological Development (CNPq). Process No 472463/2011-0

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

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