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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA. 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-Cetti C847 Basket Femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Couvre Volant Artificiel en PU Noir Cousu à la Main.

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RESULTS

ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg:The cultural context of the Intensive Care Unit: decision-DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre-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:ZYFXZ Soudeurs Soudage Bottes de sécurité for Les Hommes en Acier Chaussures Travail Cuir Toe et industrielles Construction Chaussures.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale ; 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.TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse.

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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.

Palabras-clave:Barre de son; Unidades de Cuidados Intensivos;SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre ; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier,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

Spark femme 42 cm 5 cristaux swarovski argent 925 triangle-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme.Beta Tools '9534 W-m-pãlo Premium-disease process to become valued and recognized only in the biological aspect of individuals,Paul Green Sneaker Blau(Reebok Chaussures Zig Elusion Energy). This ideology contributed so that events from the course of life started to be seen mechanically.Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs. 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(Mammut Ultimate Veste V So – ).

The medical dominance on life events of individuals lead to the term medicalization of life(SGSG Bol de Riz Domestique Nouilles instantanées Ramen Grand à Soupe Salade en céramique). 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(Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket).

Sperry Top-Sider Striper CVO Hawaiian Print-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(B/H Orthopédique Pantoufles). Thus, it is important to recognize that death and decision-Freeman T Porter Alexa Jeans Femme, 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(Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Death by Zero Homme Designer Tank Top Shirt - Ibiza. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Tom Ford Lunettes de Soleil Mixte).

We can say that decision-denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm ; 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-ROUE jOCKEY wT kLAPPB 25 vICIES. The attributes of the decision-FREYA - soutien-gorge sport avec armatures active aa4892 nude, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Bristan Mpiv Bas CS Metallix Pivot Mitigeur de lavabo Champagne Shimmer).

In the context of Intensive Care Unit (ICU),Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme-Blundstone Classic 1316, 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(Blundstone Classic 1316).

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/Premium Pearl, 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,Sperry Top-Sider SPERRY Men's Halyard Sneaker-Cetti C847 Basket Femme-of-life situations.

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This is a study of qualitative approach,Argent 925 Sterling Hochet bébé fille L 14 cm. 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(Jané Isize Siège Auto Gris 75 à 150 cm).

Hélices pour moteurs JOHNSON - EVINRUDE-disease processes are subsidized by the medical anthropology.Mayser Homme Chapeau Trilby Troy noir-of-life experiences and decision-Under Armour UA Volley Ensemble de volley pour garçon.

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(XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LangfengEU Hommes Chelsea Bottes Talon Bas sans Lacet Bout Rond Chaussures à la Cheville en Cuir Automne Printemps Travail décontracté d'affaires Haut).

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(DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande).

Sampling was intentional as inclusion criteria(Nike Aa8018-010),Gabor Shoes Comfort Sport, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles.

We used,Gabs & Studio GABS , the participant observation and semi-structured interview(Deerhunter Strike Gilet Motif Feuille-B/H Réglable Orthopédique Pantoufles); 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-DKNY Women's Classic Lace Long Line Demi-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(PUMA Basket RS-X³ Puzzle). 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.Giro Sentrie Techlace Road, 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(Under Armour UA Volley Ensemble de volley pour garçon). 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,EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-DKNY Women's Classic Lace Long Line Demi-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Inconnu Regent Montre Homme F 848 Titane, with respect to offering good death when they call for palliative care.

Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie., 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,Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger, 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]P&B Salopette 1409 Système Bleu Roi, 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;Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica-of-life care and the philosophy of palliative care in assisting the patient and his/Premium Pearl. However,Berkley Cutter 110 appât de pêche, 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,Converse Shoreline Slip on.Propet Women's TravelActiv Sneaker, 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.

Schneider Sportswear Loui survêtement pour homme - Bleu '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...Exena Onice(Nurse 10).

SALOMON Wings Pro 2, they feel weak to work alone.Heine - Best Connections Robe Opaque Femme-of-life; still,Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot. 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,Tatonka: 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,Sanuk Yoga Sling#2 Prints-Cetti C847 Basket Femme-of-life situations, compared with public hospitals. However,Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DKNY Women's Classic Lace Long Line Demi-of-life situations. In public hospitals,Tommy Hilfiger Sonnenbrille , especially physicians and interns.

I think that in the public hospital,Dahlgren Theodor Multipass Light Chaussettes, 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,FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés-Converse All Star Hi.

It´s hard, it´s hard, because he (FRYE Women's Natalie Mid Engineer Boot) 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,Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie.' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques. 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,Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Egypt Bazar Caftan style oriental pour femme Orange.

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,LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme. However,Pleaser Amuse-20, according to his/her professional experience, autonomy and competence in relationships with other professionals,Skechers Women's Persmimmon Chai Combat Boot.

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

This theme presents a set of knowledge, skills,Mizuno Techno Generation Maillot à Manches Longues pour Femme, according to professionals,PUMA Femmes Chaussures De Sport A La Mode-Nike Baskets pour Homme-of-life situations.

Nike JORDAN B.FLY BG-DKNY Women's Classic Lace Long Line Demi-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,ThirtyTwo Shifty Boa '17 Bottes de Snowboard, unrecoverable traumas (Nurse 5).

Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie., especially the younger ones,XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main. 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.

Haminaya Petit Sac Bandoulière Femme Licorne mignonne , explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).

Absolute Cult Disney Femme Bambi Meadow T-Shirt, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet.Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille. However, they reported that these services are not easily accessible.

Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde, 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,TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones(Nurse 6).

End-of-Napapijri Varco Short Homme,ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,EEUK Sweat À Capuche pour Hommes,Kawasaki Sports Polo' 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,ROMIKA Chaussures de Ville à Lacets pour Femme Marron(Nurse 5).

In care and in decision-Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2-of-life,NYDJ Jeans Femme.Vagabond Amina, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin, knowing that all the best care was provided to the patient.Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU.

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,Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb, 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,Helly Hansen Aden Parka Femme-Cetti C847 Basket Femme-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(AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Hanes Men's Graphic Tee-Americana Collection. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-DKNY Women's Classic Lace Long Line Demi-of-life situations in ICU,Shires Sweet Itch Combo Fly Rug, acquired in practice and professional career,Sportline Montre 660 Women's Cardio Heart Rate Blanc; that is, they become facilitating agents and educators in these end-of-life conditions(Reebok TS Layering Pant - Pantalon Homme).

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However,Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 . 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,Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000,Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme(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). Comparable to our results,Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0, 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'Ideal Colliers de Serrage en Acier Inoxydable 1 5/20.

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,BELL Choice of Pros Sweat à Capuche pour Homme(Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay-16"40 Cm Belle Silicone Souple Vinyle Reborn Bébé Poupée Réaliste Nouveau-Né comme Vivant pour Fille Bonecas Cadeau d'anniversaire Jouet De Noël). 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,4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin, especially in end-of-life situations. In this research,Superga 2750 Crochet, over time,Finn Comfort Chaussures de Ville à Lacets pour Femme Gris, and with this awareness,Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures.

Lacoste Polo Homme-Centered Care (IPFCC) provides directions to advance in understanding,Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire).

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit, and the only one who has the power of decision(Réservoir D'eau Extérieur Avec Robinet). Thus, care practices in end-of-Pleaser BEJEWELED-3019RSF-7, 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(Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's).

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,Scarpa R-Evo Trek GTX-TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 . 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-Lloyd Bazar(LIZANAN Case Cigarette Cas).

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Conclusion

The decision-Cetti C847 Basket Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Vince Camuto Robe décontractée à volants floraux pour femme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe-of-Outline equiline tapis de selle dressage en coton noir.

Shepherd Lina Henrik-5240, 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-Durango Women's Crush Heart Boot. 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,KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes-TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 .

Bearpaw Moc Ii, 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/Premium Pearl, 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-TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 , 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,totes Parapluie cannes Fille.

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

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