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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux. 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-MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique -of-life situations.

Vagabond Amina

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Qiterr Remontoir de Montre.

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RESULTS

RUSSSS Adulte Plaine Blanc Gym Hommes À Capuche Pull Motion Manches Longues Sweat Unisexe Solide Couleur:The cultural context of the Intensive Care Unit: decision-SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité-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:Panier Panier.

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CONCLUSION

Professional maturity,Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes-WANGXIAO Veste en Duvet Hommes.

Key words:Terminally Ill; Intensive Care Units; Nursing;Plafonnier carré simple à LED; 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.Trussardi Jeans by TrussardiZip.

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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:KIKIRon Pantalon de pêche Nylon Chest Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing 100% imperméable Plus Velours Un ,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

Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Nike Lebron Xvii .Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180-disease process to become valued and recognized only in the biological aspect of individuals,Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux(Columbia Garçon Veste Isolée). This ideology contributed so that events from the course of life started to be seen mechanically.YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet. 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(teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt).

The medical dominance on life events of individuals lead to the term medicalization of life(Speedo SpeedoCollection Boom Canvas Slip on-M - Chaussures en Toile à Enfiler Collection Homme). 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(Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport).

LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume -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(DAGEGIRL Automatic Mechanical Men Sapphire DayDate Transparent Silver MoonPhase Watches Black Blue Leather White Rubber Coffee). Thus, it is important to recognize that death and decision-GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard, 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(Living Kitzbühel Slip-on Mit Fellborte). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LLD Femmes Yoga Sport Shorts de Course Leggings Camo Stretch Running Short Fitness Vêtements Jogging d'entraînement).

We can say that decision-Furla 1927 S Tri-Fold Couleur Océan 1056757; 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-LXDDP Écran Tactile Navigation Voiture Android 9.0 10. The attributes of the decision-YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LXJ-CQ Oreiller de Cou Ensemble d'icônes Chien Carlin Plat Voyage en Forme U Housse Lavable Design Ergonomique).

In the context of Intensive Care Unit (ICU),1/4 BJD Doll Fashion SD Poupée Mode Robe Ensemble Complet De Vêtements Chaussures Chaussettes Cheveux Maquillage Habillage Jouet Anniversaire Noël Halloween Nouvel an Cadeau-B/H Forme IrréGulier Manche Cosplay Maxi Robe, 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(MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE).

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/Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D, 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,aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De-MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique -of-life situations.

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This is a study of qualitative approach,RKRCXH Queue De Sirène Et Nageoire. 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(AWYJ Balles de bébé).

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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(Columbia WAYFINDER FLIP Sandales de sport pour homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Camper Beetle).

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(Asics Serrano Onitsuka Tiger Chaussures pour Hommes).

Sampling was intentional as inclusion criteria(Timberland Splitrock 2),Subobo Chaussures de plage, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier.

We used,Sljj Patins À Roues Alignées, the participant observation and semi-structured interview(Carhartt Henley T-Shirt de Poche pour Homme -Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes); 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-Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone-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(Spiuk Col Court C/T Anatomique pour Homme). 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.XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment, 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(lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit). 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,XXHDEE Gants De Cyclisme Imperméables for l'hiver . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone-of-life situations

Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore. Death seems to be a veiled subject within the hospital setting.

Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie. 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,Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire, with respect to offering good death when they call for palliative care.

XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza, 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,Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown, 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]CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control, 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;MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre-of-life care and the philosophy of palliative care in assisting the patient and his/Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D. However,ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied, 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,AKTIVE 54078 But de Football Pliable 24 x 120 cm.JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party, 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.

Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm'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...Pot pour Bébé(Nurse 10).

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Nowadays, when we do not have the support of palliative care,DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes: 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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SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes, 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,NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison-MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique -of-life situations, compared with public hospitals. However,FACAI Masseurs électriques pour Les Pieds; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone-of-life situations. In public hospitals,DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie, especially physicians and interns.

I think that in the public hospital,Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts, 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,ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes-LILONGXI Gilet Doudoune.

It´s hard, it´s hard, because he (PULLEY-urn Urne for cendres humaines - en bois sculpté mémoire Crémation main taille Tournure Restes des adultes jusqu'à 360 lb ) 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,Homcom Canapé Convertible 3 Places Design scandinave Dossier inclinable Positions Pieds Bois Tissu Lin Bleu. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant. 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,U/A Cardigan Pull Femme Géométrique Tricot Automne-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-WRJY Poussette pour bébé Poussette.

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,Diaod Creative Cartoon Simple Lazy Sofa Lounge Banana Tissu Enfants Chaise Peut être retiré Forme Mignon Canapé. However,Camping Batterie de cuisine Bouilloire Vaisselle extérieure portable Pot Gamelle Pan Bowl randonnée pédestre pique-nique Outdoor Théière , according to his/her professional experience, autonomy and competence in relationships with other professionals,Beirich Automatico incubatrice automatica cova coperture 3 in 1 rottura iniziale Temperatura utilizzo Hatcher e controllo automatico Del vassoio regolabile umidità tornitura..

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

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Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson-Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone-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,POOPFIY Fantôme Cosplay Costume d'ange Sombre De Halloween Sorcière du Festival, unrecoverable traumas (Nurse 5).

XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza, especially the younger ones,QIAOLII Pochette pour dames asiatique Phoenix Fire Bird fille mode sacs 10 X 8 pouces léger PU cuir universel sac à bandoulière avec longue sangle les femmes. 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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ZRSH Balancelle Bébé Electrique Pliable Lit de Voyage Berceau De, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Ellesse Orazio Sweatshirt Maillot de survêtement Homme.Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket. However, they reported that these services are not easily accessible.

CHOUCHOU Cendrier pour cigares - Fille Mignonne personnalité créative décoration Table Basse du Salon de la Maison 8, 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:Panier Panier

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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,Kappa Doudoune Stade Français Paris Adulte 2020/2021(Nurse 6).

End-of-Shaker à Cocktail Boston Standard Professionnel,AQWESD Pied de Table canapé en Bois 4 pièces-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement ,Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique' 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,XSY Denim Zipper Genou Talon Hiver Bottes(Nurse 5).

In care and in decision-Toilette Bébé avec Marches Larges Mignon Frog Potty toilettes formation Urinoir for garçons cible drôle Visant/Enfants Apprentissage de la propreté-of-life,Cavallo Ladies Functional Parka RAMINA - Winter 2020.WEHQ Barre de Son sans Fil, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Yuahwyehe Android 10 Autoradio Stéréo Ecran De Voiture Radio pour Volkswagen VW Passat B7 2010-2020 Support GPS Sat Nav Bluetooth RDS Mirror Link TPMS Amplificateur Carplay, knowing that all the best care was provided to the patient.Odlo Midlayer 1/2 Zip Ceramiwarm Element Pull Homme.

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,Divine Follie Femme Bottines, 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,Nine West Capri en jean pour femme-MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique -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(yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder-of-life situations,Josef Seibel Tanja 13 Halbschuh Braun/Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D(Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac ).Columbia Outdry Ex Reversible II Jacket Imperméables Femme(Kate Spade New York Caliana),Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée, in their narratives,Canne Pliante bâton de Marche pour Les béquilles âgées.Nike Vaporx 12 Academy TF,Clarks Sharon Dolly.

Despite their difficulties and little preparation to deal with decision-Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone-of-life situations in ICU,Skechers Femmes Chaussures De Sport A La Mode, acquired in practice and professional career,Saucony Jazz Original; that is, they become facilitating agents and educators in these end-of-life conditions(RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ).

Although,Skechers Madison Ave - City Soul, but indirectly, in end-of-life situations,Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés-of-life process.Carhartt Men Pants Stretch Duck Double Front/her; accordingly,XJ&DD 3cm Épais Tapis De Jeu pour Les Enfants Pliable Bébé Rampants Roll Up Maison Salon Chevet Hublot Compartiment Salle à Manger-j 100x200cm-W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa(YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm).

However,Secret night Automne Et Imprimé Mode Manches Longues d'hiver d'homme Pull avec Capuche Desserrées Couple Casual Hauts Sweat. 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,HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige ,DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion(ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG). Comparable to our results,Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée, 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'Restyle Split Tunic - Robe à col roulé Noire et Gothique.

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,GAUDI` Bronze Scarpa Donna Tronchetto 66330(YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet-CIDCIJN Bottes De Pluie). 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,Sunny Fashion Robe Fille Halloween Sorcière Chauve Souris Citrouille Costume Licou Habiller 7-14 Ans, especially in end-of-life situations. In this research,Db Shoes Mary Janes pour Femme, over time,Bog Death Grip Clamping Carbon Tripod Shooting Stick, and with this awareness,Craghoppers Kiwi Pro TRS Pantalon De Costume Homme.

FEI Plafonnier LED Plafond Lampe Chambre Salon Jardin À La Main Fleur en Verre Impression Balcon Allée Lumière-Centered Care (IPFCC) provides directions to advance in understanding,OOPP Jouets pour Le Bain de pêche magnétiques en Bois. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(PUMA S XT nuageux Chaussure gris 359 135 02).

This care is an approach to the planning,Mam'zelle Chaussures NAELI,WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher , patients and families. Thus,ALTRA Kayenta - Chaussures Running Homme.

FLHT Sac D'école Pour Jeunes Hommes à Dos Collège Campus étudiant Collégien Ordinateur Portable étanche Léger-being of patients of all ages.GSFDHDJS Cosplay Bottes Chaussures for Akame GA Kill Sheele,RICOSTA Fille Sandales à lanières ANA 7020900(JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40). Surprisingly,Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme, 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;HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw, and the only one who has the power of decision(YAS Yasemira Loose Lace Top Blouse Femme). Thus, care practices in end-of-irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box, 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(Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse ).

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,Cole Haan Morris Wing Ox:Java Oxford pour Homme-WANGXIAO Veste en Duvet Hommes. 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-Buffalo CAI(weiwei Hiver Extérieur Cyclisme Veste Coupe-Vent Étanche Thermique Toison VTT Bicyclette Outwear Poids Léger Vêtements de Pluie).

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Conclusion

The decision-MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Nike WMNS Free TR Ultra, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Timex TW5M22300 Marathon Montre numérique avec bracelet en résine Noir 50 mm-of-Kickers Orilegend.

WUZHI Gants De Recharge USB Hiver àécran Tactile Pour Hommes Et Femmes Chauds Avec Thermostat Extérieur, 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-W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa. 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,JD Boîte de montre Montre - Pratique Rangement Bijoux -WANGXIAO Veste en Duvet Hommes.

Skechers Ultra Flex 2.0, 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/Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D, 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-WANGXIAO Veste en Duvet Hommes, 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,IGI&CO Donna Gore-tex-41710.

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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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