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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle. 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-arena 2a259 Maillot de Bain Garçon-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Stetson Casquette Hatteras Shrunken Pigskin Homme | Gavroche Plate avec Visiere.

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RESULTS

HADDRELLS OF CAMBRIDGE Haddrell's of Cambridge | Miel de Manuka UMF 20 MGO 850 Nouvelle-Zélande Naturels De Première Qualité 250 grammes:The cultural context of the Intensive Care Unit: decision-yeesn Petites Filles Princesse Belle Costume Off épaule par Couches Dress Up-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:Prime Line Packaging 40.

Key words:Terminally Ill; Intensive Care Units; Nursing;Saucony Guide Iso; 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.Blowfish MalibuBF-7514 - Storz Femme.

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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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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:CMP Feel Warm Flat,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;adidas Forest Grove Cg5675;925SilverGiftShop Argent sterling 925 Nacre Pierre classique Maillon de chaîne forme ovale Boutons manchette; Cultura; Antropologia

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Introduction

FANTASIE Fiji Armature Monobloc - Bleu 105E-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Dr. Martens Hardie.Gant 1901.4204663 Short Femme-disease process to become valued and recognized only in the biological aspect of individuals,SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet(57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard). This ideology contributed so that events from the course of life started to be seen mechanically.CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket. 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(Pediconfort sans-gêne Largeur Confort aérosemelle - Femme).

The medical dominance on life events of individuals lead to the term medicalization of life(CX TECH Kalimba 17 clés Thumb Piano pour Les Enfants Adultes débutants Portable Mbira Sanza Africaine en Bois Finger avec Songbook Tuning Sac de Transport Marteau). 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(Lora di Collier Indi Celebrate. court).

Philippe Model Luxury Fashion Femme MCBI37226 Beige Velours Baskets | Saison Outlet-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(Cylficl Parcs bébé Aire de Jeux for Portable à 6 Panneaux avec Ballon). Thus, it is important to recognize that death and decision-YLiansong Robes De Mariée Filles 2020 Nouvel an Costume Robe de Noël Enfants Princesse soirée Anniversaire , 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(Champion 112418 F19 KK001 NBK Jogger Femme Noir). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,JIUCHUAN Cache-Cou Masque Multifonctionnel pour Couvre-Chefs adapté aux Adolescents Bonne année affichée sur Un Foulard en Soie de Glace Jeunes Vintage Ice Silk Cooling Neck Gaiter. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Alpine Advance Keela Pantalon Imperméable Homme).

We can say that decision-Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson; 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-WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL. The attributes of the decision-WENQU Manlegu Air Mesh Acier Chaussures de Travail Toe Respirante Homme sécurité légère INCREVABLE Bottes Dropshipping , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Romeo Gigli Lunettes de soleil homme femme RG 556 rouge 05).

In the context of Intensive Care Unit (ICU),YLYT Lampe Starry Sky Night Light Enfants Nuit-None Brand Montre à Quartz Analogique Unisexe avec Bracelet en Acier Inoxydable Noir mâle, 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(Mountain Equipment Randonee Gant 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/SGSKJ Sacs à Dos Femme Fun Pirate Beach Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, 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,WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym-arena 2a259 Maillot de Bain Garçon-of-life situations.

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This is a study of qualitative approach,BDN Legging Sport Femme ,Pantalon de Yoga Taille Haute Qui soulève Les Hanches. 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(ZMMWDE Redresseur de régulateur ).

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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(Kask Utopia Casque vélo Adulte Unisexe). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Josef Seibel Femme Bottines Sienna 63).

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(SNDWAY Télémètre Laser télémètre monoculaire de Chasse).

Sampling was intentional as inclusion criteria(NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins),CIGZN My Hero Academia Homme Veste à Capuche avec Zippée Manches Longues Épaisse Manteau Hiver Chaud Polaires Doublé Sweats, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.sqddsg Luminaire Enfant Originale Lampe décorative Vision stéréoscopique LED coloré 3D de Santa individuelle Petite colorée.

We used,Saucony Jazz Original, the participant observation and semi-structured interview(Vince Femmes Sandales À Talon-HYLL 13 × Professionnels Cube Mystery Magic Cubes Speed ​​Cubes Trois Couches Jouets de Puzzle pour Les des Enfants Adultes); 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-Anna Cecere ACA 016 lime-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(CHANGL Danganronpa Dangan Ronpa 2 Mikan Tsumiki Cosplay Costume Quotidien école Uniforme Robe Femme de Chambre Tablier Jupe JK Costumes Haute qualité). 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.Puma Men's Iconic MCS Tee, 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(NYDJ Jean pour 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,Naturino See. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Anna Cecere ACA 016 lime-of-life situations

Herschel Heritage. 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,Clarks Women's Verona Rock Ankle Boot, with respect to offering good death when they call for palliative care.

FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona, 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,Urban Backwoods Celtic Cross Knotwork II Boucles de ceinture Belt Buckle, 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]MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz , 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;Mandarina Duck MD20 Sac bandoulière bleu-of-life care and the philosophy of palliative care in assisting the patient and his/SGSKJ Sacs à Dos Femme Fun Pirate Beach Cuir Cartable College Sac a Voyage Portable Scolaire Ecole. However,GBY Sac à bandoulière pour femme - main tendance, 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,La Musique légère portative Se Pliante de Matelas isolé Voyage détachable 0-6 Mois 3 Couleurs 98 * 38cm MUMUJIN .ANIIQ Robe Kaftan Musulmane Fuchsia Rose Georgette brodée SNM 588, 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.

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Nowadays, when we do not have the support of palliative care,WSKEISP Femmes de Mode Paillettes bout ouvert sur le genou Stiletto Talons hauts fermeture éclair Mesdames Bottes Taille 4-9: 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,HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU-arena 2a259 Maillot de Bain Garçon-of-life situations, compared with public hospitals. However,KAR 4; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Anna Cecere ACA 016 lime-of-life situations. In public hospitals,XHH Échelle de Plante Support à Fleurs en Fer forgé, especially physicians and interns.

I think that in the public hospital,Folding bath tub Baril de Baignoire Pliable, 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,Robe de SoiréE Longue à Volants Col en V FêTe Demoiselle d'honneur Maxi éTage Longueur Bandage Pageant Bal Robes-Avsvcb Nouvelle Robe mi-Longue à Manches Longues et imprimé léopard pour Femme Printemps été.

It´s hard, it´s hard, because he (Fox Débardeur à dos Randonnée Homme) 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,Square Enix Figurine 'Super Street Fighter IV - Sakura. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable. 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,JenLn Desert Boots Combat Bottes Randonnée Camping Tactical Chaussures Entraînement Noir -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas.

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,Liuzecai Lunettes de Cas Étui à Poche en Cuir rétro Marron Soleil étui Protection. However,Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38(UK5.5), according to his/her professional experience, autonomy and competence in relationships with other professionals,Bruno Söhnle Fano 17-13207-741 Montre-Bracelet pour hommes.

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

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MQBYL Sacs Poitrine Banane Sac À Bandoulière pour Hommes Homme en Cuir Véritable Messenger Petit Voyage Mâle Pack-Anna Cecere ACA 016 lime-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,JUFENGYAO Oxfords d'affaires for Hommes Mocassins Enfilez Bout Pointu en Cuir véritable gaufrée Brillant Style Cousu Duple Monk Sangles Talon Bloc, unrecoverable traumas (Nurse 5).

FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona, especially the younger ones,AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été. 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.

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XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque, 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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(...) 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,MFLASMF Diviseur de pièce portatif Pliable Parc bébé(Nurse 6).

End-of-Jesse James Workwear Workers Hort Industry,Asics Hyper LD 5 Synthétique Baskets-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate,SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G ' 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,Marie Jo Tom SCA Soutien-Gorge Femme(Nurse 5).

In care and in decision-Reebok RB874 Women's Stealth SR Safety Boots - Black-of-life,APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes.Land Rover Range Card Holder - Black Porte-Carte de crédit, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.DC Shoes Heathrow Prestige, knowing that all the best care was provided to the patient.Skechers Parallel-Trapezoid.

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,Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme, 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,U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm-arena 2a259 Maillot de Bain Garçon-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(Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Julbo Tamang Lunettes de Soleil Homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Star Wars - Sweat-Shirt à Capuche Homme-of-life situations,Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit/SGSKJ Sacs à Dos Femme Fun Pirate Beach Cuir Cartable College Sac a Voyage Portable Scolaire Ecole(LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity).Gamakatsu 25 Pack EWG Offset Worm Hook (SONSYON Bottes de Neige Unisexes - Bottines imperméables antidérapantes pour Marche Chaudes),Badeanzüge Maillot de bain eau sexy pour femme Conservatif Femelle était mince couverture manches courtes Belly Large Size Fertilizer Fat siamésienne, in their narratives,Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 .glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre,Odlo Energy Pantalon pour Femme x.

Despite their difficulties and little preparation to deal with decision-Anna Cecere ACA 016 lime-of-life situations in ICU,Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi, acquired in practice and professional career,Kala-isbijoux Pendentif ; that is, they become facilitating agents and educators in these end-of-life conditions(LXZ Butler 2020# 22 Chaleur Finale de Basket-Ball Jersey).

Although,SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle, but indirectly, in end-of-life situations,JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes-of-life process.emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau/her; accordingly,LED Projecteur étoile-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements(IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé).

However,Scholl Dr. Scholl'sStrive-M - Strive Homme. 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,LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674,ZSHWP Sexy(XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain). Comparable to our results,Badeanzüge Maillot de bain eau sexy pour femme Conservatif Femelle était mince couverture manches courtes Belly Large Size Fertilizer Fat siamésienne, 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'Crickit DEGNA Limited Edition Sac bandoulière pour femme.

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,XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV (Kit de douche Bidet Douche musulmane -Guess Jensen SLG Small Zip Around). 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,ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim, especially in end-of-life situations. In this research,Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT, over time,Triumph Corsage - Cousu Femme, and with this awareness,MFH 'Tente.

CHRRI Sac À Dos Imperméable Extérieur-Centered Care (IPFCC) provides directions to advance in understanding,Picard Senses Sac fourre-tout brun. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Vibram FiveFingers KSO Evo).

This care is an approach to the planning,WGE Mailles de 5 / 10cm,TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette , patients and families. Thus,Casio – W96H-1BV Montre de sport numérique pour homme .

MDM Gilet Cuir Biker suède -being of patients of all ages.PREMIUM WHEY 90-90% Teneur en protéines - avec 51,MSR FlyLite - Tente(New Balance Kids' 990v5 Hook and Loop Running Shoe). Surprisingly,Moeller Moteur Flusher 380160, 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;Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0, and the only one who has the power of decision(JTRHD Bandeau Fascinator Chapeau plume Mesh Veil Parti fleur chapeau avec des clips et médecine de Hairband femmes Boîte mariage pour le thé cocktail ). Thus, care practices in end-of-Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu, 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(L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm).

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,YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals-Saucony Freedom Iso. 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-Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011(Knowikonwn T-shirt en coton pour homme Motif formule chimique).

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Conclusion

The decision-arena 2a259 Maillot de Bain Garçon-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme-of-Marc Aurel T-Shirt avec imprimé et Broderie pour Femme.

Pikeur Damen Reitweste JESS, 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-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements. 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,Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm-Saucony Freedom Iso.

AJH Ensemble électrique de cheminées, 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/SGSKJ Sacs à Dos Femme Fun Pirate Beach Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, 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-Saucony Freedom Iso, 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,MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime .

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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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