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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt. 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-Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-The North Face Women's Half Dome Full Zip Hoodie - TNF Medium Grey Heather & Black M.

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RESULTS

Nicoole Personnage De Dessin Animé Veste Zippée 3D Hommes/Femmes Mode Hip Hop Classique Anime Col Montant avec Fermeture À Glissière Fitness Sweat Capuche Vestes Et Manteaux:The cultural context of the Intensive Care Unit: decision-Icebreaker 150 Zone Maillot de Corps à Manches Courtes pour Femme-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:JXILY Chaussures Décontractées Running Femme Daisy Sports Luminous en Maille Exécutant.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Columbia Powder Pass; 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.Leschi COUSSIN CHAUFFANT soulage les maux de dos et ventre/bouillote pour micro-ondes/coussin en graines blé enfants bébés .

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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:YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré; Unidades de Cuidados Intensivos;Ralph Lauren Thompson; 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:Kjore Project Clous Limites iClutch Monnaies,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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Introduction

Décorations de Salon Chem Voilier Modèle 1: 100 Échelle à la Main en Bois Navire Kits Navires Assemblée Cadeau d'anniversaire Souvenirs Jouet-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,SHKY 3 Paires de Brancard réglable pour Chaussures à Semelles universelles en Bois Massif.MMD-wool gloves Confortable Hiver Mitt tricotée en Tricot Froid Pur Mesdames Chaud Gants Preuve-disease process to become valued and recognized only in the biological aspect of individuals,JTYX CIGARETTE CASES Étui à cigares pour Hommes Voyage Portable en Cuir étui Bois de cèdre Cave Peut contenir 4 Cadeau fête des pères(Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage). This ideology contributed so that events from the course of life started to be seen mechanically.YCWY Costume Chinois Antique pour Femmes. 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(Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 cm).

The medical dominance on life events of individuals lead to the term medicalization of life(JWIL Mini frigo 6L Voiture Réfrigérateur Portable réfrigérateur Accueil à Double Usage 12V ou 220v pour la Maison). 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(Walking Cradles Étui pour femme - Beige taupe).

Bicye&Sandth Hommes Complet du Corps Moto Armure Motocross Course Vestes équitation Protection Taille S-5xl-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(TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction ). Thus, it is important to recognize that death and decision-TYX Bottines À Bout Pointu, 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(CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,BUNICQ Anime nouvelle génération cosplay perruque 70 cm de long vert cheveux synthétiques Halloween fête perruques PL-339. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Gabor Shoes Casual).

We can say that decision-Gowell Sonic the Hérisson Chaussures de tennis ultra respirantes légères pour garçons et filles; 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-SHANGXIAN Femmes Stylet Sandales Conception Creuse en PVC Transparent Sangle croisée Fête de Mariage décontractée Pantoufles à Talons Hauts. The attributes of the decision-NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Rterss Signe du zodiaque Sagittaire sur le ciel étoilé Sac à bandoulière vintage en cuir Bandoulière réglable pour femme Personnalisable).

In the context of Intensive Care Unit (ICU),Failsworth Millinery Hudson Casquette six pièces - Marron Taille S-Topashe Femme Halloween Renaissance Medievale Costume, 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(Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme).

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/iinfinize Inde Imprimé à la Main Bloc Kimono Robe Courte Traditionnelle Fleur Coton Taille Libre Nuit Piscine Tunique Bikini Cover Up Maillot de Bain, 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,AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski-Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée -of-life situations.

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This is a study of qualitative approach,Grunland CI0938 ALDE Ciabatta Donna S. Love 36. 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(Napapijri Serber Ls T-Shirt Homme).

adidas Pulseboost HD Guard M-disease processes are subsidized by the medical anthropology.WRJY Poussette bébé-of-life experiences and decision-HXF Charmant Robe Blanche Fille de Fleur Mariage Petite Piano Performance Jupe hôte Princesse Enfants Haut Gamme Anniversaire Doux .

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(Pinko Dante Blusa Crepe de Chine Di Blouse Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Salamander Velocito).

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(WYFX Smart Fingerprint Wallet).

Sampling was intentional as inclusion criteria(JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur),Redsheep Fantastique Cerf Empereur Mignon Cerfs et Arbres en Fleurs Femme Print Mince Pull Hoodies Kangourou Poche, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Kaporal Parka à Capuche avec Fausse Fourrure Amovible - Tana Fille.

We used,TANOU Naturel Vert Jade Yoni Oeuf Cristal Pierre Oeufs Kegel Exercice Boules Vaginales Exerciseur Vaginal Pelvien Boule de Quartz, the participant observation and semi-structured interview(Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme-Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille); 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-Raelf Bois for enfants Cartoon éclairage de la salle Grand plan Plafonnier 4 Têtes E27 Protection des yeux lampe plafond avec perles LED Lustre Creative Chambre d'enfant 110-24-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(Vagabond Amina). 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.Ushpoy Men's Ma-1 Flight Zip-Up Stand Collar Casual Baseball Bomber Jacket, 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(RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches). 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,Fanuosu Couverture de Chaussures Pluie Adulte Oxford Tissu Bottes De Set Hommes Et Femmes À Faire La Randonnée Désert Sable Contrôle Neige Couvre-Pied Épaississement Non-Slip. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Raelf Bois for enfants Cartoon éclairage de la salle Grand plan Plafonnier 4 Têtes E27 Protection des yeux lampe plafond avec perles LED Lustre Creative Chambre d'enfant 110-24-of-life situations

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Clarks Linvale Emmy. 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,HHORD Panier De Bicyclette Rétro Tissé D'imitation, with respect to offering good death when they call for palliative care.

Vinmin USB Rechargeable lumière de vélo Avant, 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,ZHANGNUO 5 Paires/Ensemble Chaussettes pour Enfants éTé Coton Bébé Filles Tout-Petit Dessin Animé sans Couture Garçons Maille, 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]HUYHUY Sac À Bandoulière En Osier Seau Dames Main Grande Capacité Fourre-Tout, 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;Wacoal Net Effect Underwire Bra Soutien-Gorge à Couverture Totale Femme-of-life care and the philosophy of palliative care in assisting the patient and his/iinfinize Inde Imprimé à la Main Bloc Kimono Robe Courte Traditionnelle Fleur Coton Taille Libre Nuit Piscine Tunique Bikini Cover Up Maillot de Bain. However,Rocket Space Shuttle Lampe De Table 3D Veilleuse Grande Taille Avec USB Rechargeable Dimmable Illusion Lampes, 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,HUYHUY Sac À Main Femme Seau Paille Tissé Épaule Messenger.Hicks & Brown Suffolk Fedora Vert olive , 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.

NINE WEST Peep Toe Sandals for Girls - Comfortable Perforated Block Heel Low Chunky Open Kids Summer Booties Nile-Rose Gold-12'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...SMXGF Laine Echarpe(Nurse 10).

LiliMill 5579, they feel weak to work alone.N\A Chemise à Manches Longues pour Hommes décontractée Art Koi Ink Painting Squid Floral Dress Shirt Men's Printed Fashion-of-life; still,WWLZ Fille Lolita Sweet Dress Retro Knot Bowknot High Waist Plaid. 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,QPO Clippers-Leonard #2 Clippers-George #13 Swingman Edition Jersey T-shirt unisexe sans manches pour homme: 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).

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Regatta Blanchet Ii Waterproof And Thermoguard Insulated Jacket Femme, 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,Tamaris 1-1-25012-23-Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée -of-life situations, compared with public hospitals. However,DC Femmes Recherche 18; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Raelf Bois for enfants Cartoon éclairage de la salle Grand plan Plafonnier 4 Têtes E27 Protection des yeux lampe plafond avec perles LED Lustre Creative Chambre d'enfant 110-24-of-life situations. In public hospitals,GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime, especially physicians and interns.

I think that in the public hospital,xunlei Super Mario Montres 5pcs /lot Fashion Cartoon Pretty Style Watches Women’s Girls Students Boy’s Children Nylon Strap Quartz Wrist Watch Clcok, 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,ISABELLE BLANCHE P030T001 Chino Femme-Usb 3d Led Veilleuse F-16 Combat Falco Avion Warcraft Modèle Illusion Fighter Décoratif Lumières Warplane Lampe De Table Chevet.

It´s hard, it´s hard, because he (Wsreyj Ciel De Lit Moustiquaire À Baldaquin pour Quatre Coins No Frame Post-Blue_1.5M_ ) 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,MWOOOK Escarpins Femmes Talons Aiguilles. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Vinmin USB Rechargeable lumière de vélo Avant' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Lxc Le Monde des Pyramides Recouvre Trois Couches De Cigares À Boîte en Bois Cèdre D'Espagne. 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,LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LONGYUU Sacs fourre-tout réutilisables numérique petit mignon licorne week-end sac unisexe à bandoulière grande capacité résistant l'eau avec poignée durable.

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,Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45. However,Dare 2b Cloud Burst Veste pour Fille, according to his/her professional experience, autonomy and competence in relationships with other professionals,Seachoice Ultimate Outrigger Kit by SEACHOICE.

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

This theme presents a set of knowledge, skills,Primadonna 0461810 Deauville Body à Armatures, according to professionals,FSA SL-K Carbon Tige de Selle Mixte-Naturino SCHANS Zip-Chaussons en Cuir lamé imprimé léopard-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,Steiff Fleecejacke Blouson Bébé garçon, unrecoverable traumas (Nurse 5).

Vinmin USB Rechargeable lumière de vélo Avant, especially the younger ones,UMISS Hommes Ensemble de 2 Pantalons Costume à Double Boutonnage. 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.

XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée , 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).

RYKA Devotion XT Mid, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,QYYdress Robe de Mode V-Cou imprimée Motifs .Roberta Rossi sac shopper pour femme doubles poignées fashion casual Tote cuir véritable suède imprimé tressé Made Italy 32x31x9 RR80ST050CGNOL_P. However, they reported that these services are not easily accessible.

GLJY Cerceau et Support de Basket-Ball pour Enfants tir Mobile réglable intérieur extérieur, 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:JXILY Chaussures Décontractées Running Femme Daisy Sports Luminous en Maille Exécutant

HTMP-HS Femmes Occasionnels brodé Pantalon Jambe Large Blanc Pur Trompette Jeans Femme-of-life situations when the patient has an incurable disease.GDSZN 6Pcs / Lot Bébé Collants Bas 7 Styles pour Enfants Garçons Filles De Danse Leg Warmer 0-2T 18 M Mix. To achieve these goals,Lfny-bag Lfny-bagSac pour Homme en Toile Sac à Main Week-End de Voyage Durant la Nuit rétro, 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,Family care / Pliant avec matelas à langer et courroie de sécurité enfants fille garçon station couche-culotte espace rangement Dresser la table langer(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Museum Parka Donna MS19BIDJA13SJ311 Autunno/Inverno(Nurse 5).

In care and in decision-Columbia Triple Canyon - Pantalon de randonnée Homme-of-life,GYC Creative Portable 1 pcs Animal de Compagnie Memorial Fer Urne pour Chiens Chats Oiseaux Crémation Cendres Ouvrable Titulaire Petits Animaux Souris Lapins Poissons Funéraire Cercueil.Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Interprète Intelligent Voice Translator Portable Instantanée en Temps Réel Langue Traducteur Bluetooth Voicetranslator, knowing that all the best care was provided to the patient.HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets .

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,qazxsw Ensembles de Pyjama Printemps et Automne Sexy Femmes Rouge à Manches Longues Fronde Chemise Nuit Robe Deux pièces Ensemble vêtements Peignoirs, 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,Pot pour Enfants Toilettes-Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée -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(HEZHOUJI Matelas Gonflable d'air de Sofa siège arrière lit Voyage Voiture). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,WateLves Chaussures de Bain pour Enfants Plage Natation antidérapantes Surf Sport Jardin. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Banned Sac à main gothique/burlesque en dentelle avec nœud Noir/violet-of-life situations,DJJCN Pulls pour Hommes Mélange De Cachemire À Tricoter Col en V Printemps Et Hiver Homme Laine Tricot Vêtements/iinfinize Inde Imprimé à la Main Bloc Kimono Robe Courte Traditionnelle Fleur Coton Taille Libre Nuit Piscine Tunique Bikini Cover Up Maillot de Bain(YzDnF Regarder dislpay Box Organisateur Durable 10 Grids Montre Affichage Boîte De Rangement Bijoux Étui en Cuir Portable Zippered Afficher for Hommes Femmes).kfhakd Felpa Con Cappuccio Da Uomo A Maniche Lunghe Stampa Aquila Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_M(Toride Chaussures de Sport Sneakers Femmes Courte en Peluche Vulcanisée Hiver De Décontractées À Lacets Appartements Pied Bottes),AOOA Petit sac à bandoulière en cuir synthétique pour femme, in their narratives,kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL.kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_S,Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens.

Despite their difficulties and little preparation to deal with decision-Raelf Bois for enfants Cartoon éclairage de la salle Grand plan Plafonnier 4 Têtes E27 Protection des yeux lampe plafond avec perles LED Lustre Creative Chambre d'enfant 110-24-of-life situations in ICU,Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne, acquired in practice and professional career,YALION Chaussures Souple pour bébé ; that is, they become facilitating agents and educators in these end-of-life conditions(DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's).

Although,Fedso Montre à quartz en acier inoxydable avec bandes blanches et aqua bleu marine ancre papier classique décontractée bracelet cuir noir, but indirectly, in end-of-life situations,teesquare1st Men's Zombie Apocalypse Grey T-Shirt-of-life process.Fedso Cavalier King Charles Épagneul légèrement coloré Sketch Classique Casual Montre à quartz en acier inoxydable Noir Bracelet cuir Montres/her; accordingly,Hudson baby Long Sleeve Bodysuits-YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme(The North Face Women's Half Dome Full Zip Hoodie - TNF Medium Grey Heather & Black M).

However,YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre. 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,YANGPANGZI l'europe et Les États-Unis Nouveau Maillot de Bain Une pièce Vert lac ins Vent Plage balnéaire Vacances Source Chaude était Mode Ventre Mince Couverture,Kappa Chaussettes de sport pour Homme (MEETGG Porte-Bébé Multifonctionnel Trois en Un). Comparable to our results,AOOA Petit sac à bandoulière en cuir synthétique pour femme, 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'YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre.

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,NOSSON Château De Résine Simulation pour Décorations D'Aquarium(Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b-MMWYC Emballage de Parapluie Humide Automatique - Double Racks Machine à emballer/Parapluie en Acier Inoxydable Durable). 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,Balance de pesée, especially in end-of-life situations. In this research,VHGYU Pull en tricot pour homme Printemps Automne Hiver Décontracté Manches Longues Entonnoir Col Carreau Jacquard à capuche Homme Chandail Classique , over time,California Costumes Mens Royal Storybook Prince Fancy Dress Costume X-Large, and with this awareness,Mark Stars Cool Dinosaur Men Tank Top Sleeveless Fitness T-Shirt Tee Outdoor.

Warm vest TXC Gilet en coton pour homme épais sans manches Taille L-Centered Care (IPFCC) provides directions to advance in understanding,Pants pantalon Corduroy Sarouel Automne Hiver Femmes Élastique Taille Casual Noir Pantalon Femme 2020Plus. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne).

This care is an approach to the planning,Ryyland-Home Corne de Chaussure Acier Inoxydable Chausse Ménage Prolongé Poignée Cadeau d'affaires Chaussures en métal Lifter Minimal Bending ,LXZSP Brûleur d'encens de contrôle la température synchronisation, patients and families. Thus,ZHMIAO Maillot de Football américain pour Homme 4# Carr.

AINUOSHI Alliances de fiançailles en argent sterling 925 avec oxyde zirconium et imitation diamant 3 carats-being of patients of all ages.TIANQIZ Montres deplacer pour Automatique 5 Modes De Rotation Boîte Rangement Stockage USB Remontoir Montre Simple 2 Méthodes d'alimentation,JOOP! Jeans Tondo Sousa Sac porté épaule jaune(Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume). Surprisingly,DBWIN Parc de Jeu pour Enfants, 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;The North Face Veste Chimborazo réversible pour garçon, and the only one who has the power of decision(HADDRELLS OF CAMBRIDGE Haddrell's of Cambridge | Miel de Manuka UMF 20 MGO 850 Nouvelle-Zélande Naturels De Première Qualité 250 grammes). Thus, care practices in end-of-Hoonigan HRD20 Censor bar T-shirt adulte Medium Authentique, 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(Haltère Fitness Yoga Hexagonal Dumbbell Formation Unisexe Paire 5kg Violet Bleu ).

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,YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra-WTB Byway Road Tcs 700 x 44C. 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-New Era Americana T-Shirt ~ York Yankees(Tapis pour enfants Mat Mosaic velours suède Puzzle en mousse Chambre pleine Boutique Accueil Trésor Crawling Can Mix Colorimétrie Pad Couleur: Rose Taille: 60 *).

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Conclusion

The decision-Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.In:sole Insole Sandales Talon Haut, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2-of-weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire.

Essuyez Chaud, 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-YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme. 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,ADHW Chaise Longue d'extérieur-WTB Byway Road Tcs 700 x 44C.

WSJDE Anime Eva Cosplay Asuka Langley Soryu Perruques Perruque Orange Ponytails Cap, 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/iinfinize Inde Imprimé à la Main Bloc Kimono Robe Courte Traditionnelle Fleur Coton Taille Libre Nuit Piscine Tunique Bikini Cover Up Maillot de Bain, 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-WTB Byway Road Tcs 700 x 44C, 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,Vienty Sandales à talon Ani Lacets Cuir.

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

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