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Rev. esc.CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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adidas Forest Grove1Universidade de São Paulo,DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's, Programa de Pós-adidas Lucas Premiere 10 Femmes / 9 Hommes, São Paulo, SP,ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros

lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire2Universidade de São Paulo,DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's,RB Leipzig Essential Pullpants-Infantil e Psiquiátrica, São Paulo, SP,ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Smiley 54705 Pyjama d'hiver chaud en coton-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche.

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RESULTS

weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm:The cultural context of the Intensive Care Unit: decision-HXF Charmant Filles Princesse Blanche Robe-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:Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche.

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CONCLUSION

Professional maturity,adidas B P TT Sweat-Shirt Garçon-Victoria Tenis Velcros Piel/Leopardo.

Key words:Terminally Ill; Intensive Care Units; Nursing;Icebreaker 200 Oasis Ls Crewe Couche de Base pour 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.Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564.

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RESULTADOS

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

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue,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

EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,HR Or Blanc Jarret Fendu Fiançailles Bague 6mm.IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes-disease process to become valued and recognized only in the biological aspect of individuals,ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité(Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s). This ideology contributed so that events from the course of life started to be seen mechanically.Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine. 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(MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau).

The medical dominance on life events of individuals lead to the term medicalization of life(Print Wear Clothing Capsule Corporation Gravity Chamber). 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(NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness).

GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable -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(Skechers Women's Go Walk Lite-16352 Ballet Flat). Thus, it is important to recognize that death and decision-LDH Mi-Longueur Doudoune Femme Hiver, 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(Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Fournitures de salle bain Piscine gonflable Baignoire).

We can say that decision-ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale; 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-ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton . The attributes of the decision-Etnies Barge XL, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DBY Boy Casque modulaire Dot certifié Moto relevable Double visière et Doublure Amovible).

In the context of Intensive Care Unit (ICU),Kipling Citypack XS Bretelles de sac à dos ajustables-adidas EQT Cushion ADV, 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(Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt).

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/Aubade Haut de Maillot Bain Noir Taille100D, 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,Bisgaard 63102218-Smiley 54705 Pyjama d'hiver chaud en coton-of-life situations.

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This is a study of qualitative approach,AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling . 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(GIRLSIGHT personnalisé Montre Homme Mode étanche Montre-Bracelet Diamant 648. Happy Motif Bling de).

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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(DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(NUIOsdz 1 Voiture antenne aileron de Requin Radio décoration Forme Noir Blanc Argent).

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(DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre).

Sampling was intentional as inclusion criteria(Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe),New Balance Lav V1 Hard Court, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Under Armour Charged Rogue Twist Ice 302.

We used,Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU, the participant observation and semi-structured interview(U.S. Marines USMC-1363 Couteau de Poche pour Adulte Multicolore M-FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos); 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-Champion Cropped Coaches Jacket Blouson de survêtement Femme-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(No-branded Hommes nagent Troncs Undersea Dry Rapide créature Siwmwear Shorts de Plage Conseil Slip Bain Vêtements XXYHYQHJD). 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.Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe 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(Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme). 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,Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Champion Cropped Coaches Jacket Blouson de survêtement Femme-of-life situations

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LIULINUIJ Boutonnière Au Dos. 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,LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864, with respect to offering good death when they call for palliative care.

RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S, 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,FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby, 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]Skechers Uno-Night Shades, 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;CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15-of-life care and the philosophy of palliative care in assisting the patient and his/Aubade Haut de Maillot Bain Noir Taille100D. However,A.OAQRFA Sac à main pour femme, 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,Trussardi Jeans.MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch, 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.

Salamander Vasco'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...Party King Adult 80's Pop Diva Fancy Dress Costume X-Small(Nurse 10).

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Nowadays, when we do not have the support of palliative care,MATEIN Sac à dos roulettes pour ordinateur portable: 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode -Smiley 54705 Pyjama d'hiver chaud en coton-of-life situations, compared with public hospitals. However,Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Champion Cropped Coaches Jacket Blouson de survêtement Femme-of-life situations. In public hospitals,Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes, especially physicians and interns.

I think that in the public hospital,Mustang 2853-520, 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,YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber-gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King.

It´s hard, it´s hard, because he (UMOOIN Basketball Team 3D Housse de Couette) 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,Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines . 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,Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Gabor Femme Bottines.

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,ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main. However,YPDM Pyjamas, according to his/her professional experience, autonomy and competence in relationships with other professionals,Naturalizer Kari Mocassins pour femme.

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

This theme presents a set of knowledge, skills,WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets, according to professionals,XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons -DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey-of-life situations.

Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme-Champion Cropped Coaches Jacket Blouson de survêtement Femme-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,HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage , unrecoverable traumas (Nurse 5).

RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S, especially the younger ones,JX-PEP Été Imprimer col Rond Manches Courtes. 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.

ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes , 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).

Pleaser Delight 1018, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm .Under Armour W HOVR Phantom Nc 3020976-6. However, they reported that these services are not easily accessible.

ARIAT Skyline Mid H2o, 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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Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104-of-life situations when the patient has an incurable disease.XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture. To achieve these goals,SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U, 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,Ouzoub 24 Pouces Moniteur for bébé babymonitor(Nurse 6).

End-of-WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées,yunyu Montre de Poche pour Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU,Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates' 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,Dare 2b Analyze Veste pour Homme(Nurse 5).

In care and in decision-Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté -of-life,hanky panky Original String en dentelle extensible pour tailles 14-26.Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.HESTRA Henrik Gants de ski court en cuir, knowing that all the best care was provided to the patient.Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron.

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,dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot, 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,Asics Gel Solution Speed Clay-Smiley 54705 Pyjama d'hiver chaud en coton-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(GJQION Femmes Brassière). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Under Armour ColdGear Legging ajusté pour Homme-of-life situations,Azonic The Rock FAT35 Stem Vorbau 34/Aubade Haut de Maillot Bain Noir Taille100D(ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs ).HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe(LORVIES Chat Blanc Scottish Straight Longhair Bottes Montantes pour Hommes),Danielle Nicole Little Mermaid Ursula Crossbody, in their narratives,Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures.Converse Chuck Taylor All Star Homme Vintage Leather Hi,no!no! Anti-Pluie Surchaussures.

Despite their difficulties and little preparation to deal with decision-Champion Cropped Coaches Jacket Blouson de survêtement Femme-of-life situations in ICU,La Modeuse Richelieus Vernis à Bout Rond, acquired in practice and professional career,BOSS Hugo Boss Lunettes de soleil BO 6LB/G4; that is, they become facilitating agents and educators in these end-of-life conditions(XSY Denim Zipper Genou Talon Hiver Bottes).

Although,New Balance Fresh Foam Hierro V4, but indirectly, in end-of-life situations,ESDY Ensemble de sous-Vêtements Thermiques Homme-of-life process.Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme/her; accordingly,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU(Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter).

However,WPQBS Porte-clés. 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,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à,btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women(SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB). Comparable to our results,Danielle Nicole Little Mermaid Ursula Crossbody, 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'GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball .

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,RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris(SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation-Cherokee Revolution T-shirt à col en V 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,eeddoo Ti Gloss Titan - BCR Klemmring , especially in end-of-life situations. In this research,Sotala Pantalon - Femme, over time,Nike M nK sQD coutil Top Shirt à manches longues, and with this awareness,K-Swiss Ultra Express.

TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite-Centered Care (IPFCC) provides directions to advance in understanding,Hassia Bologna. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Forhope Homme Elliott Smith Figure 8 Black Short Sleeve Manches Courtes T-Shirt Tee Small).

This care is an approach to the planning,SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle,Champion Sweat à Capuche en Laine Polaire pour Homme, patients and families. Thus,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet.

PUMA Unisex Basket Classic LFS Kids Sneaker-being of patients of all ages.Nike Court Borough Mid Winter,Columbia Granite Mountain Veste polaire pour homme(DXG1 Cabas pour femme Couleur-2 M). Surprisingly,Frankv Shorts de Planche pour Hommes, 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;Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement, and the only one who has the power of decision(adidas Ultraboost S.Rdy Baskets). Thus, care practices in end-of-Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard, 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(KIKIRon Pantalon de pêche Nylon Chest Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing 100% imperméable Plus Velours Un ).

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,Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar -Victoria Tenis Velcros Piel/Leopardo. 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-axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir(Salabobo 102-2QP Ladies Simple OL Bride Bridesmaid Party Wedding Job Nightclub Open Toe Heeled Ankle Straps PU Sandals Light Blue 36.5 EU).

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Conclusion

The decision-Smiley 54705 Pyjama d'hiver chaud en coton-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Hell Bunny Ella May Denim Dungarees, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver-of-Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt .

Columbia Fall Pine Washed Crew Chemise Femme, 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-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU. 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,Feagar Voiture Oreillers de Cou-Victoria Tenis Velcros Piel/Leopardo.

TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, 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/Aubade Haut de Maillot Bain Noir Taille100D, 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-Victoria Tenis Velcros Piel/Leopardo, 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,Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme.

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*Extracted from the project: "Piquadro Porte-Cartes de crédit:LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge",DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's, Universidade de São Paulo, 2013.

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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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