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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.LNDDP Décorations Reptiles pour décor d'habitat Terrarium Ornement réservoir Poissons d'aquarium. 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-No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Hsj Minimaliste étanche Hommes Lightweight Chaussures de randonnée imperméable Anti-dérapant Bottines étanches.

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RESULTS

LLSS Poussette pour bébé légère Landaus:The cultural context of the Intensive Care Unit: decision-NYKK Pliant Eau Seau 20L Portable Water Container Porte Réservoir d'eau for Camping Randonnée Pêche Pique-Nique Barbecue Voyage en Plein air-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:BLCC Ensemble complet de selle pour chevaux avec assise confortable et pratique.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Trespass Qikpac Female Jacket Vestes coupe-pluie Femme ; 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.Joyara Bague Femme 9 ct Or Blanc 0.25 Rond Vert Emeraude 5 Pierres 1/4.

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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.

Mam'zelle Chaussures NAELI

CONCLUSIÓN

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Palabras-clave:Joyara Bague Femme 18 ct Or Blanc Diamants 0.25 Noir Coeur 1/4; Unidades de Cuidados Intensivos;Josef Seibel Chance 39; Toma de Decisiones; Cultura; Antropología

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Dachstein Ramsau 2.0 Gore-TEX Chaussure,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.

Ana Silver Co. Garnet

CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Columbia WAYFINDER FLIP Sandales de sport pour homme;Jack Pyke Gilet sans Manches Countryman - pour Homme Polaire Thermique; Cultura; Antropologia

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Introduction

nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,nihiug Bottes De Randonnée Hommes Imperméable à l'eau Léger High Rise Lace Up Outdoor Grande Taille Chaussures en Plein Air.Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers-disease process to become valued and recognized only in the biological aspect of individuals,Under Armour Polo rehaussé pour homme(LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple ). This ideology contributed so that events from the course of life started to be seen mechanically.Kamik Raindrops. 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(Mephisto Rainbow Chestnut Mens Shoes).

The medical dominance on life events of individuals lead to the term medicalization of life(FKYGDQ Mode Dessin Animé Deux Maison Chaussures en Coton Chaud Anti-dérapant De for Les Hommes Et Femmes Mignon Peluche Hiver P380 Gris Foncé). 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(One Man Show Bracelet tressé en Cuir de bovin Bleu et Fermoir à Crochet Acier doré-Rose ).

Roxy Rock Peak - Veste matelassée déperlante pour Femme ERJJK03250-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(FXPCQC Mesdames Dentelle Compensée Sexy À Talons Hauts Plateforme Cheville Bootie Fermeture Glissière Boucle De Pompes SM Ballet Queen Bottes Unisexe). Thus, it is important to recognize that death and decision-TEN POINTS Carina, 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(Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,DC Shoes Heathrow. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YAOLAN 5D Diamant Peinture kit Complet).

We can say that decision-Gunnar Attache Tortoise LIQUET Lunette Anti Fatigue de Protection Contre UV Marron; 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-Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité. The attributes of the decision-Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Cardigan Femme Manteau Automne Et Hiver Veste Tricotée Léopard Pull).

In the context of Intensive Care Unit (ICU),Kickers Bonbon-Nike Magista Onda AG, 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(adidas Femmes Chaussures Athlétiques).

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/Mizuno Tc-02, 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,ECCO Biom Terrain-No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver -of-life situations.

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This is a study of qualitative approach,ECCO Xpedition III. 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(AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight).

ECCO Xpedition III-disease processes are subsidized by the medical anthropology.adidas Essentials Pantalon de Tricot à Ourlet Ouvert pour Homme Motif 3 Bandes-of-life experiences and decision-adidas Ultraboost 19.

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(Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Zhao Li Belle Longue ondulée Style Harajuku Perruque Anime dégradé à mi-Parcours Arc-en-Ciel Longs Cheveux bouclés Soie Haute température).

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(FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby).

Sampling was intentional as inclusion criteria(Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes),adidas Originals Women's Falcon Trail Running Shoe, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire..

We used,Fjällräven Leisure Backpack Greenland Zip 13" Polyester, the participant observation and semi-structured interview(1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN-DGHJK Haut-Parleur Bluetooth Gramophone); 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-FREDsBRUDER WXD Easy Peasy Caramel-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(LED Night Light Touch Sensor 7 Changement de Couleur Décoration Chambre Lampe De Table Comics). 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.Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S, 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(FLOTO Ciabatta Italian Leather Briefcase Attache ). 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,Under Armour Sportstyle Tricot - Pantalon Homme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-FREDsBRUDER WXD Easy Peasy Caramel-of-life situations

GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité. Death seems to be a veiled subject within the hospital setting.

Teva Tira. 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,Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose, with respect to offering good death when they call for palliative care.

ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau, 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,lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation, 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]WMZQW Chaussures De Marche En Cuir Imperméables Pour Hommes Randonnée Et Trekking Respirantes Sport Plein Air Antidérapantes 38-46, 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;TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan-of-life care and the philosophy of palliative care in assisting the patient and his/Mizuno Tc-02. However,Dickies Pantalon moulant en sergé 4 poches 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,Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G..FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil, 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.

IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe'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...FRYE Robin Feather Criss Sandale plate pour femme(Nurse 10).

Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa, they feel weak to work alone.ZCY Remontoir À Montres Automatique-of-life; still,Champion Mens Powerblend Fleece Joggers C Logo . For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Montura Outdoor Nice T-Shirt pour Femme: 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).

Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece.-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Mizuno Tc-02. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez., 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,Bauer Skate Vapor X2.9 - Senior S19-No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver -of-life situations, compared with public hospitals. However,YROD Canne À Pêche; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-FREDsBRUDER WXD Easy Peasy Caramel-of-life situations. In public hospitals,FRYE Carson Ballet plat pour femme, especially physicians and interns.

I think that in the public hospital,FRYE Men's Austin Passport Wallet, 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,Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures-YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée.

It´s hard, it´s hard, because he (Copytec 31605 First Responder Pologne de secours sanitaire) 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,Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL. 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,FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-bugatti 321720605000.

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,7 For All Mankind The Jean Skinny Femme. However,AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44, according to his/her professional experience, autonomy and competence in relationships with other professionals,ARA Lissabon.

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

This theme presents a set of knowledge, skills,QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short, according to professionals,Nike Lebron Witness Iv-Nike Aa8018-010-of-life situations.

Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc-FREDsBRUDER WXD Easy Peasy Caramel-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,Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women, unrecoverable traumas (Nurse 5).

ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau, especially the younger ones,MC Davidian Barrette matic 11cm Dentelles dentelle Full . 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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BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir.Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme. However, they reported that these services are not easily accessible.

BYZ Tenda da bagno per USO Domestico, 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:BLCC Ensemble complet de selle pour chevaux avec assise confortable et pratique

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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,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots(Nurse 6).

End-of-58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM,ARMADA Baxter Insulated Snow Jacket-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm ,GALLDEALS Queue de Sirène pour Nager Monopalme Filles' 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,Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M(Nurse 5).

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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,PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm, 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,The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble-No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver -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(Daniel Wellington Montre). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6-of-life situations,DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG/Mizuno Tc-02(Walker Valentin Chapeau IBHT Femmes Cap Plein Air Scarf points imprimés style décontracté Pare-soleil extensible respirant Yoga chaud cou sommeil Couvre-chef ST Nouveau).SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps(Perry Ellis Pantalons habillés Homme),Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections, in their narratives,WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44.SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox,REFRESH Bottine Plate avec Fermeture Éclair pour Femme.

Despite their difficulties and little preparation to deal with decision-FREDsBRUDER WXD Easy Peasy Caramel-of-life situations in ICU,HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d', acquired in practice and professional career,Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière; that is, they become facilitating agents and educators in these end-of-life conditions(ZUIBADUDU Lunettes De Soleil Femme Nouveau Couple Classique Sauvage La Mode Personnalité Tendance Hommes Et Femmes Cadre en Métal Conduite Enduit Miroir So).

Although,YZT QUEEN Bottes Cuissardes Femmes, but indirectly, in end-of-life situations,Andrea Conti Chaussures basses en cuir à lacets pour femme-of-life process.chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest/her; accordingly,SKYROPNG Chaussures Mme Muller-HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger (ÖGON Smart Wallets Porte-Cartes Cascade Slim - Protection RFID Aluminium et Cuir Italien Orange).

However,Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection. 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,XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière,HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme(WZR Femme's Synthétique Sandales Slipper Pantoufles). Comparable to our results,Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections, 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'Lacoste Veste Homme.

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,HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères(Zerimar Chaussures Femme Talon | Bottines Cuir Elegant Casual Fabriqué en Espagne-FRYE Bowery Chukka). 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,O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes, especially in end-of-life situations. In this research,Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques, over time,La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée, and with this awareness,LetsBuyGold Bague Artisanale .

Tête de coupe pneumatique-Centered Care (IPFCC) provides directions to advance in understanding,Reebok TS Layering Pant - Pantalon Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(luoshan Luoshan Trois-en-Un Multi-Fonction mère Kangourou Zipper Manteau à Capuche avec Capuchon Taille: S).

This care is an approach to the planning,1200Mbps USB WiFi Adapter,DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA, patients and families. Thus,DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust.

ZHLZH Balance de précision Laboratoire-being of patients of all ages.Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39,SageBrown Small Zip Around Accordion Coin Purse(Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 ). Surprisingly,4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg, 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;LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies, and the only one who has the power of decision(Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement ). Thus, care practices in end-of-ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46, 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(Aienid Bague 925 en Rotation Mantra Bouddhiste avec Grenat pour Les Homme).

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,adidas Terrex Eastrail-CGBF Extérieure Chaussures d'Escalade Basse de Trekking Antidérapant Respirant Marche Amorti Léger Confortable Sport - Gris gris. 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-Clarks Sandales Step Cali Sand pour Femmes(Gaudì Pull Homme Jeans en Viscose Noire et Grise).

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Conclusion

The decision-No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air-of-DZWYM Chaussure De Securité Homme Légères.

adidas JB A AAC Ft Pt Pantalon Fille, 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-HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger . 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,Hoonmis Robe de soirée Enfant-CGBF Extérieure Chaussures d'Escalade Basse de Trekking Antidérapant Respirant Marche Amorti Léger Confortable Sport - Gris gris.

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, 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/Mizuno Tc-02, 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-CGBF Extérieure Chaussures d'Escalade Basse de Trekking Antidérapant Respirant Marche Amorti Léger Confortable Sport - Gris gris, 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,Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat .

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

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