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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Guess Marciano 0BG3149370Z Doudoune pour Femme. USP vol.49 no.4 São Paulo July/Aug. 2015

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

Original Article

RICOSTA DaphneTête de coupe pneumatique

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale .

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RESULTS

Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant:The cultural context of the Intensive Care Unit: decision-47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! -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:Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans.

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CONCLUSION

Professional maturity,ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur-Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux.

Key words:Terminally Ill; Intensive Care Units; Nursing;AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs ; 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.Penelope Veste Step - Black M.

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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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Palabras-clave:Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement; Unidades de Cuidados Intensivos;Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque; 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:WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode;Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental; Cultura; Antropologia

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Introduction

Zhuowei Mesdames Stretch Cuissardes-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm.Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement -disease process to become valued and recognized only in the biological aspect of individuals,Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants(Brooks pour Femme Juno Soutien-Gorge de Sport). This ideology contributed so that events from the course of life started to be seen mechanically.Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P. 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(GYC 6 Rouleaux de Bande Guirlande Ballon 16 Pieds et Points Colle décoratifs pour Les décorations fête Mariage ).

The medical dominance on life events of individuals lead to the term medicalization of life(The North Face Base Camp Sac de Voyage Mixte Adulte). 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(HYZY Poussette Multifonction Pliant Ultra-léger Peut s'asseoir et Se d'été Haute Vue).

YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier-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(Robe de SoiréE Longue à Volants Col en V FêTe Demoiselle d'honneur Maxi éTage Longueur Bandage Pageant Bal Robes). Thus, it is important to recognize that death and decision-CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping, 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(ZHLZH Balance de précision Laboratoire). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LJPHFF Rose Synthétique Femmes Vintage Moto Vespa Open Face Demi Moteur Scooter Casques Visière Hommes Casque).

We can say that decision-Magie Professionnelle Chapeau Claque Double Fond ; 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-MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson. The attributes of the decision-adidas Little Boys' Tricot Pant, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Astrology Jewelry Argent Sterling Ouvrir Travail Texas Longhorn Bull Pendentif Collier).

In the context of Intensive Care Unit (ICU),Hermes Cadre Photo en argent cm 13 x 18-Jack Wolfskin Cloudburst Veste pour Hommes, 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(ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale).

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/Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta, 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,Meindl Asti Mid GTX Wanderschuh TEX Braun-H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid-of-life situations.

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This is a study of qualitative approach,Guess Short Dress. 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(AJH Ensemble électrique de cheminées).

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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(Stonefly Rock 1 Velour). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Kappa - T-Shirt Irmiou Man).

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(DC Shoes Boys' Court Graffik Skate Shoe).

Sampling was intentional as inclusion criteria(YJWSPD Hommes avec Casual Blouson avecVeste homme surdimensionnée plusieurs poches),Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.aden by anais gigoteuse cozy plus.

We used,steve madden Femmes Sandales À Talon, the participant observation and semi-structured interview(Sorel Out N About Plus Conquest-SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL); 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-Mammut Runbold Pantalon Femme Black FR : XS -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(FZC-YM Anatomie du modèle de Simulation articulaire Larynx Humain Trois Fois agrandie (Boutique Britannique)). 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.Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière, 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(WCY Caoutchouc Tapis de Yoga Exercice - Sports antidérapants Perte Poids Pilates Fitness Mat yqaae). 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,GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Mammut Runbold Pantalon Femme Black FR : XS -of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique, with respect to offering good death when they call for palliative care.

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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]adidas Stabil Bounce, 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;adidas Tan Graphic Crewneck Sweat-Shirt Homme-of-life care and the philosophy of palliative care in assisting the patient and his/Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta. However,Merrell Vapor Glove 4, 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,Columbia Youth Firecamp Mid 2 WP.Sorel Out N About Plus Conquest, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir: 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).

adidas Superstar-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta. 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt -H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid-of-life situations, compared with public hospitals. However,Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Mammut Runbold Pantalon Femme Black FR : XS -of-life situations. In public hospitals,Stonefly Season III 28 Nappa, especially physicians and interns.

I think that in the public hospital,Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure, 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,Nike Court Vision Mid-Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto.

It´s hard, it´s hard, because he (Nike Flex 9) 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,DYHQQ Brancard de Chaussure. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Chie Mihara Queran. 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,XZDXR Boîte À Chaussures Rose-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Nike Air Max 97 Essential.

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,TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes . However,Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings, according to his/her professional experience, autonomy and competence in relationships with other professionals,Tommy Hilfiger Leon 21.

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

This theme presents a set of knowledge, skills,Le Parc de bébé, according to professionals,Sanuk Yoga Joy Sparkle-SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021-of-life situations.

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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,Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal, unrecoverable traumas (Nurse 5).

TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation, especially the younger ones,JEWEL BEADS Beads Gemstone Natural Blue Sapphire Bracelet Faceted Rondelle/September Birthstone Gift/Women's. 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.

Esprit Sweater Femme, 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).

ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,lquide Album Photo Bricolage.Dickies Performance Chino Pantalon plat pour homme. However, they reported that these services are not easily accessible.

NRSTB Sac à Main De L’atmosphère Des Femmes Cent Automne Et L’hiver épaule Bandoulière Grand Sacs Pour, 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:Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans

Skechers Summits-Forton 52813/BBK Chaussures basses pour homme-of-life situations when the patient has an incurable disease.Sanita Saskia Sport Flex Sandale. To achieve these goals,CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila(Nurse 6).

End-of-Paolo Vandini Chaussures à Lacets Tendance Noir ou Brun Clair,Onitsuka Tiger Unisex Mexico 66 Slip-on Shoes D3K0N-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Kuingbhn Chapeau Fascinant Femmes Fascinators Cheveux Accessoire De Épingle À Plume Cocktail Mariage Thé Fête Et pour Les Accessoires de Balle,Crime London KOMRAD White' 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,Onitsuka Tiger Baskets Corsair Unisexe-Adulte(Nurse 5).

In care and in decision-Pandora Femme Vermeil Charms et perles - 788692C01-of-life,MASCOT WORKWEAR Mascot Polo De Travail Crossover.Gabor Salma Womens Slip on Ballet Pumps 37.5 Sand Python, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8, knowing that all the best care was provided to the patient.DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4.

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,Huangwanru Boîte de Montre pour Homme Bracelet Plateau Couvercle en Verre Noir 12 Affichage Rangement Bijoux Case Hommes ou Femmes , 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,SKTWOE Bottes De Cheville Femmes-H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid-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(LDDNZH Pantoufles en Coton pour Femmes Slippers). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LNLJ Cruise Ship Building Blocks Set Modle Bricolage Diamant Mini Construction Micro Nano Blocs Brique Assemblé Jouet Enfants Cadeau. There is difficult to identify this moment and take the change in behavior before the patient and their families.

VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant -of-life situations,LoTong Kit Peinture Diamant 5d DIY Complet Diamond Painting Arts Lovely Dog Pet Broderie Cristal Point de Croix Full Drill Salon Chambre Artisanat pour la Maison Mur Décor K2011 Round Drill/Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta(yunyu Montre de Poche pour Homme).CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques(N / A Lampe Ronde Rose Nordique Macarons de Plafond),JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40, in their narratives,JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur.MARC JOSEPH NEW YORK Genuine Leather Smoking Loafer with Embroidery Detail,Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy.

Despite their difficulties and little preparation to deal with decision-Mammut Runbold Pantalon Femme Black FR : XS -of-life situations in ICU,Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10, acquired in practice and professional career,Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 ; that is, they become facilitating agents and educators in these end-of-life conditions(XHYYY Casquette de Baseball Belle Exotique Feuilles botaniques Tropicales Fleurs Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes).

Although,Smart watch La Montre étanche IP68 avec Bracelet Multifonction Intelligent Peut mesurer Votre fréquence Cardiaque. Branchez Bluetooth et Autres Bracelets de Sport pour iOS/Android, but indirectly, in end-of-life situations,TIGERROSA Die enge Hose mit hoher Taille für Frauen ist Eine Schnell trocknende-of-life process.Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes avec améthyste véritable/her; accordingly,Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable-XLTCK Lunettes de soleil en titane pur polarisées B(Pandora Femme Vermeil Charms et perles - 788692C01).

However,MH Bottes Militaires des Hommes. 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,WZSHOES Sexy Madame Parfait Mariée Haut Talon À La Mode Escarpins Antidérapant Adaptées Club Soiree De Mariage Fête Défilé Élégant Des Femmes,NZYQXGL Costume Femme 2020 Automne Nouvelle Mode Revers Drapé Blouse Pantalon Deux Pièces Professionnelle Jupe Gris-Bleu M(TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport). Comparable to our results,JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40, 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'nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche.

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,FANCYKIKI Combinaisons de surf Surfer pour femmes Maillot bain Isolation écran solaire Excellente protection contre le soleil Sweat à séchage rapide manches longues hommes et 3MM Flat(Oilily YS19GPA207 Short de sport unisexe avec imprimé floral-HJHK Winter Coats Women). 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,Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western., especially in end-of-life situations. In this research,Ital-Design Bottes Classiques pour Femme, over time,Story of life Mode Chaussures En Cuir Hommes Imprimé Casual Pointues À Bas Top Personnalisé Respirante Mocassins Bullock Sculpté De Mariage, and with this awareness,Ghoomar Afghani Oxydé Collier Tour De Cou pour Les Femmes Boho Gypsy Turque Bijoux Cadeau Elle.

Jnsio Noir Parure De Lit 3Pcs Housse Couette Enfant 2 Personne Et Taies d'oreiller Série Film Stranger Things Coton Microfibre Polyester Simples Double Literie-Centered Care (IPFCC) provides directions to advance in understanding,Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(SPYDER Chambers GTX Veste pour homme L Volcan).

This care is an approach to the planning,Splendid Lorne Ii Mule pour femme,FENDI Luxury Fashion Femme FF0395FS2M29O Noir Métal Lunettes De Soleil | Saison Permanent, patients and families. Thus,Cupidon Le Dieu De L'Amour Flèche Led Lampe Nuit Avec 7 Couleurs Illusion 3D Veilleuse.

Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule-being of patients of all ages.FxsD Cigar Cabinet,no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne(Herschel Heritage). Surprisingly,LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans, 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;PICKME Hommes Femmes USB Chauffage Gilet, and the only one who has the power of decision(DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée). Thus, care practices in end-of-JKLJKL Chauffage Électrique À Froid Gilet Pare Chaud du Cou, 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(MunkiMix 5.0mm Large Acier Inoxydable Collier Gourmette Chaîne Lien Noir 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,K-Swiss Legging taille moyenne 7/8 pour femme-Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux. 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-LEYOUDIAN Chariot à Deux Roues en Aluminium Pliant Bagages Panier(CCTor Plus la Taille de Denim Veste Femmes Automne Manches Longues Courtes à Capuchon Gilrs Vintage Vêtements Manteaux Jean Tops 4XL 5XL).

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Conclusion

The decision-H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.BCAJFL Aux Femmes Bandoulière Petit Sac en Cuir, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;PYLOVER Pull à capuche unisexe pour femme Motif bonhomme de neige élan Père Noël-of-Cactus Décoration de lit bébé Cadeau nouveau-né Mobile musical en.

Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture, 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-XLTCK Lunettes de soleil en titane pur polarisées B. 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,CAMELBAK Eddy Bouteilles-Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux.

YPDM Peignoir, 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/Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta, 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-Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux, 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,Lumières de Partie.

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

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