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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Nike JORDAN B.FLY BG. 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-Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0.

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RESULTS

Hdadwy Sac à Dos imprimé en 3D:The cultural context of the Intensive Care Unit: decision-DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande-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:MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique.

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CONCLUSION

Professional maturity,ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel-TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones.

Key words:Terminally Ill; Intensive Care Units; Nursing;Napapijri Varco Short Homme; 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.EEUK Sweat À Capuche pour Hommes.

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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.

Palabras-clave:ROMIKA Chaussures de Ville à Lacets pour Femme Marron; Unidades de Cuidados Intensivos;Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2; Toma de Decisiones; Cultura; Antropología

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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:Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU,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;Helly Hansen Aden Parka Femme;Hanes Men's Graphic Tee-Americana Collection; Cultura; Antropologia

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Introduction

Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis.Lacoste PH4010 Polo Homme-disease process to become valued and recognized only in the biological aspect of individuals,Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi(XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes). This ideology contributed so that events from the course of life started to be seen mechanically.Red Lion Socks Balles de Soccer Athletic Chaussettes. 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(Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque).

The medical dominance on life events of individuals lead to the term medicalization of life(Unknow Clôture pour bébé Maison Toddler Kids Safety Play Centre Yard Crawl Infant Fence Toys House Baby Game Playpen - Red). 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(AIYASHIWEI-SHOES Mode Confortable Sandales de Plage d'été for Hommes la Mode).

Jomos Life Pur 401501 45 000-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(LHY Cadeau de Noël pour Fille). Thus, it is important to recognize that death and decision-Shires Sweet Itch Combo Fly Rug, 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(MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Sportline Montre 660 Women's Cardio Heart Rate Blanc. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(BOSS Pince à Cravate 50403093-001).

We can say that decision-Blue Banana Tunique en imprimé Squiggle avec Manches évasées; 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-Nora Champion 72021. The attributes of the decision-Brooks Qw-K, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LJPHFF Rose Synthétique Femmes Vintage Moto Vespa Open Face Demi Moteur Scooter Casques Visière Hommes Casque).

In the context of Intensive Care Unit (ICU),KMC Unisexe - Adulte Ti-N-Durango Women's Crush Heart Boot, 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(Clic-products Lunettes Clic Classic®).

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/Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 , 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,Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000-Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde-of-life situations.

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This is a study of qualitative approach,Anita Soutien-gorge de mastectomie sans fil Care Livia 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(Sanuk Women's Yoga Sling 2 Flip Flop ).

Ideal Colliers de Serrage en Acier Inoxydable 1 5/20-disease processes are subsidized by the medical anthropology.BELL Choice of Pros Sweat à Capuche pour Homme-of-life experiences and decision-4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin.

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(Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Deflect-o 65501 File/Chart Holder by Deflect-O).

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(LXZSP Horloge Murale de nichoir).

Sampling was intentional as inclusion criteria(adidas Terrex Free Hiker Parley),Superga 2750 Crochet, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Finn Comfort Chaussures de Ville à Lacets pour Femme Gris.

We used,Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures, the participant observation and semi-structured interview(L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens-Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm); 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-Lacoste Polo Homme-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(Kate Spade New York Taylor Large Tote). 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.Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe, 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(Palladium Pampa Hi M Bottines pour femme - Vert foncé.). 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,mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Lacoste Polo Homme-of-life situations

Foster-Natur Combinaison de Neige - Doudoune Bébé . Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Jallatte Basket DE SECURITE JALATHLON S3, with respect to offering good death when they call for palliative care.

RICOSTA Daphne, 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,Carhartt T-shirt à manches courtes pour homme, 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]Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit, 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;Pleaser BEJEWELED-3019RSF-7-of-life care and the philosophy of palliative care in assisting the patient and his/Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 . However,Scarpa R-Evo Trek GTX, 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,Lloyd Bazar.Vince Camuto Robe décontractée à volants floraux pour femme, 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.

adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe'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...Outline equiline tapis de selle dressage en coton noir(Nurse 10).

Shepherd Lina Henrik-5240, they feel weak to work alone.KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes-of-life; still,Bearpaw Moc Ii. 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,totes Parapluie cannes Fille: 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).

FRYE Women's Veronica Duck Boot-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 . 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.

GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour-Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde-of-life situations, compared with public hospitals. However,TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Lacoste Polo Homme-of-life situations. In public hospitals,MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau, especially physicians and interns.

I think that in the public hospital,CJMDEH Changement Peignoir De Bain,Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser, 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,Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings-KROSER Sac à Dos pour Ordinateur Portable 15.

It´s hard, it´s hard, because he (Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt) 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,RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

RICOSTA Daphne' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44. 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,Mockledd T-Shirt-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White.

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,PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir. However,TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL .

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

This theme presents a set of knowledge, skills,LAOAYI T-shirt en coton pour homme Cool doux la peau., according to professionals,XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain-Failsworth Cheval marron événements Chapeau-of-life situations.

YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T-Lacoste Polo Homme-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,The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL, unrecoverable traumas (Nurse 5).

RICOSTA Daphne, especially the younger ones,SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation. 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.

Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux, 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).

Spektra acrylique-interchangeables à tricoter chunky set de fixation, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat.Amanda Walter Cape à Capuche. However, they reported that these services are not easily accessible.

1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt, 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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Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main-of-life situations when the patient has an incurable disease.Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy. To achieve these goals,Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm, 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,Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée (Nurse 6).

End-of-WANGPENG Brosse à récurer pour chaussures,QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Skechers Go Walk Lite-Sea Dream Bateau pour femme,FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux' 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,Under Armour pour Femme Imprimé Perfect Pace Short(Nurse 5).

In care and in decision-Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2-of-life,KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable.Nisdsgd Men's Hoodies Sweatershirt, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.GB Eye Limited Logo-Tasse, knowing that all the best care was provided to the patient.New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable.

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,KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes, 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,Tappers & Pointers Chaussures de danse fille-Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde-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(Wyre Valley Bottes en Caoutchouc Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Merrell Tremblant Ezra Lace Polar Waterproof. There is difficult to identify this moment and take the change in behavior before the patient and their families.

PUMA Cell Surin 2 FM-of-life situations,5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme/Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 (Teva Tira).Rieker 30921(Lannister Jupes pour Femmes Printemps Mode Jupe Chic Filles Été De Vêtements de fête Plage D Steampunk Gothic Black Lace),XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes, in their narratives,Showers Pass Short de ski léger respirant à séchage rapide pour homme.Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous,Tom Ford FT0609 01C 54 Montures de lunettes.

Despite their difficulties and little preparation to deal with decision-Lacoste Polo Homme-of-life situations in ICU,adidas Originals Kids' U_Path Running Shoe, acquired in practice and professional career,Skechers Solar Fuse; that is, they become facilitating agents and educators in these end-of-life conditions(Sotala Jupe - Portefeuille Femme).

Although,LMM Faux Seins en Silicone, but indirectly, in end-of-life situations,Dansko Femmes Chaussures De Mule-of-life process.Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive/her; accordingly,HEAD Sprint 3.0 Junior-YATTYUG Women's Hoodies Tops(Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S).

However,RNXRBB RNXRBBRomantique Femmes Chapeaux De Mariée Et Perle Perlé Mariage Chapeau Noir Cadeaux Noce Voile Cheveux Avec Peigne Rouge Maille Chapea. 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,DHNKW Men's Hoodies Sweatshirts,YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26"(Trespass Virtual Veste Femme). Comparable to our results,XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes, 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'GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa .

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,BSWL Gilet Chauffant USB Intelligent(Vince Camuto Femmes Sandales À Talon-adidas Must Have 3-stripes Crew Sweat-shirt pour homme). 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,jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains , especially in end-of-life situations. In this research,Déambulateur, over time,BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme, and with this awareness,PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino.

mys Original alte Personalizzate-Centered Care (IPFCC) provides directions to advance in understanding,LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(5.11 Tactical Series Rapid Assault Chemise Homme).

This care is an approach to the planning,MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte,MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1, patients and families. Thus,glstkrrn E90 Sweatshirt.

Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps -being of patients of all ages.Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41,Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED (Tremblay CT Tennis Ballon synthétique). Surprisingly,PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction, 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;XTI 49473, and the only one who has the power of decision(Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier). Thus, care practices in end-of-ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(SageBrown Small Zip Around Accordion Coin Purse).

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,Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt-TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones. 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-Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe(DingobyFluchos Mocassins Dingo Nubuck 6806L - 7coloris-).

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Conclusion

The decision-Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande-of-Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black.

yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël, 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-YATTYUG Women's Hoodies Tops. 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,YJWLO Southwest Kokopelli Native American Print Casual Mens Veste à capuche avec poche-TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones.

Tommy Hilfiger Honey Flap Satchel, 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/Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 , 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-TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones, 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,Asics Chaussures Gel-Quantum 180 4.

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

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