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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire. 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-FB Fashion Boots C3099-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-adidas Munchen Bakset Mode Homme.

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RESULTS

Disney Bandoulière Mickey The Blogger:The cultural context of the Intensive Care Unit: decision-MO JOC Boots Chelsea Femme-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:Clarks Sharon Noel.

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CONCLUSION

Professional maturity,Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles-Saucony Cohesion 12 Men.

Key words:Terminally Ill; Intensive Care Units; Nursing;Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.adidas Originals Ozweego.

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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:YUHEN LED Chaussures; Unidades de Cuidados Intensivos;MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette; 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:arena WPWSK Carbon Maillots de bain Femme ,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Waldläufer Mocassins pour Femme Beige Cement Stein Silber;Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille; Cultura; Antropologia

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Introduction

Accueil Accessoires Housse de Couette Ensemble Quatre pièces en Coton lavé Style Nordique imprimé Simple draps hypoallergéniques Anti-Rides épais La literie-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,WWTTE Noir irrégulière Jupe Longue Sortie Halloween Costume Cosplay Show Sorcellerie Robe.Amandas Silver Boutique Pour enfants en argent sterling creux Pendentif Croix sur une Chaîne-disease process to become valued and recognized only in the biological aspect of individuals,WWTTE Sequin V-Cou Robe Banquet annuel de soirée(Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman). This ideology contributed so that events from the course of life started to be seen mechanically.WWTTE Yoga serré Snakeskin Leggings 2V . 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(Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger ).

The medical dominance on life events of individuals lead to the term medicalization of life(Lumière Solaire Au Sol LED Halloween Citrouille Extérieure Étanche Jardin Lumières pour Maison De Campagne Parc Cour Décoration Lampe 2 Pièces). 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(MASCOT WORKWEAR Mascot Laguna Pantalon de Pluie 50203-859 - Aqua Homme XL Noir).

Reebok Royal Dashonic 2-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(adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977). Thus, it is important to recognize that death and decision-F Fityle Kit de Outil Monter Démonter Axe Vélo, 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(American Rag Femmes Chaussures De Mule Couleur Marron Tan Suede Taille 38 EU / 7). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Sperry Top-Sider Men's. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Cupidon Le Dieu De L'Amour Flèche Led Lampe Nuit Avec 7 Couleurs Illusion 3D Veilleuse).

We can say that decision-DRLVMO Han Reine Femmes Automne Vintage Robe À Manches Longues Plissée Volants Haut De Gamme Dames Couture Piste Mince Robes Soirée; 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-EQUINOX Burdizzo Pince à Castration sans Sang 48 cm avec Support et clé. The attributes of the decision-JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Treslin Madame Femme Homme Hiver Mousse Mémoire).

In the context of Intensive Care Unit (ICU),Dessin animé mignon ours forme Led lumière 3d nuit sommeil éclairage 7 couleurs tactile et télécommande Contro interrupteur 6-xiaokeai Collier Femme Longueur réglable en Argent, 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(DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022).

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/TWFY Sandales pour Hommes Extérieur Chaussons Deux Porter Méthodes d'intérieur d'été Plage Convient for Le Printemps , 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,CCM Super Tacks AS1 Skate Men-FB Fashion Boots C3099-of-life situations.

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This is a study of qualitative approach,Ryan Jonathan Fine Jewelry Alliance en titane brossé et lignes texturées polies 7 mm Taille 10. 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(Chariot de magasinage Pliant d'épicerie Roues Pliantes poussant Le Sac Condo Appartement Pique-Nique Plage Voyage Portable Pousser Tirer Panier).

ABAKUHAUS Ethnique Oreiller Cervical de Voyage-disease processes are subsidized by the medical anthropology.BINMA Sweats à Capuche Homme Les Hommes et Femmes 3D imprimé Pull Canal Ciel étoilé Sweat Manches Longues-of-life experiences and decision-Générique Racecraft Lunettes Mixte.

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(XHH Montre à Quartz pour Femme avec Bracelet en Cuir de Mode ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ARTHUR Icegregor Peignoir Homme).

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(Columbia PFG Rostra Tongs pour femme avec adhérence élevée).

Sampling was intentional as inclusion criteria(Geox XLED Girl J928DA Fille Baskets Mode),Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WANGCY Spin Mop Bucket Clean Double Seau Facile à Utiliser.

We used,XUQIANG Gilet Ultra-Mince for Hommes avec Photographie De Pêche Multi-Poches À Séchage Rapide Sports Plein Air Et Loisirs , the participant observation and semi-structured interview(TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir-Dansko Women's Hilda Denim Mary Jane 5.5-6 M US); 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-Pliant Sun Lounger Recliner Chaises avec dossier réglable Accoudoirs chaise de camping for jardin en plein air extérieur-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(adidas Real Madrid 3S Survêtement). 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.Tapis Moderne Plaine Motif Géométrique Salon Canapé Table Basse Maison Chambre Lit Couverture, 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(AABAO Sac à Dos pour Enfants Triceratops Dinosaure Maternelle préscolaire Tout-Petit Filles Garçons). 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,Pepsi Welcomes The World Women's Hooded Sweatshirt. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Pliant Sun Lounger Recliner Chaises avec dossier réglable Accoudoirs chaise de camping for jardin en plein air extérieur-of-life situations

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Rösle 25356 de pellets de Bois Hickory 9 kg Sac. 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,APcjerp Boîte à cigares en Bois de cèdre Portable Humidificateur Cuir Vache humidifié Cigare boîte Rangement, with respect to offering good death when they call for palliative care.

Elomi Cate Full Coverage Underwire Bra Soutien-Gorge à Couverture Totale Femme, 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,emanuel ungaro Ungaro - Ceinture en cuir pour homme, 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]Helly Hansen Hp Racing Midlayer Jacket Veste pour hommes Homme, 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 Pred Gl LGE Gants de Foot Mixte-of-life care and the philosophy of palliative care in assisting the patient and his/TWFY Sandales pour Hommes Extérieur Chaussons Deux Porter Méthodes d'intérieur d'été Plage Convient for Le Printemps . However,BELOVINGSHOP Bellovingsshop Semelles de massage magnétique pour perte poids, 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,Charmance Pantalon Taille élastiquée.Charmance Pull à Torsades - Femme, 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.

XiuLi Pantalon Thermo Chaud pour Femmes'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...OMP OR5916 Racing Ayrton Senna T-shirt classique 100% coton(Nurse 10).

TONG Robes de SoiréE Col en V Queue Poisson Mince Noble et éLéGant Robe Banquet Femmes Formelle Longue Bal, they feel weak to work alone.ZVHUK Collant Corset Gothique Retro Court Femme Tummy Taille Body-of-life; still,Craft Pro Dry Nanoweight Short Sleeve Maillots Femme. 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,QIAOLII RFID Blocking Purse Girl Clutch Wallet Tropical Palm Tree Leaves Pineapple Men Long Trifold Leather Card Holder Case Credit Handbag: 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).

Filet de protection Sécurité Maille De for Enfants-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/TWFY Sandales pour Hommes Extérieur Chaussons Deux Porter Méthodes d'intérieur d'été Plage Convient for Le Printemps . 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,AWYJ Balles de bébé-FB Fashion Boots C3099-of-life situations, compared with public hospitals. However,Spylovebuy Sofiya Femmes Ajustable Boucle à Talon Compensé Sandales; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Pliant Sun Lounger Recliner Chaises avec dossier réglable Accoudoirs chaise de camping for jardin en plein air extérieur-of-life situations. In public hospitals,EASTPAK Buckler Sac bandoulière, especially physicians and interns.

I think that in the public hospital,YURU Chaussures D'équitation Antidérapantes De Vélo Route Bikiying en Plein Air pour Adultes Unisexe, 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,Xingyao Phare LED Puissant avec Zoomable Étanche Mines Rechargeable Lampe de poche pour Camping-NIEWEI-YI Sweatshirts Unisexe.

It´s hard, it´s hard, because he (Lézard cadeau gecko léopard La vie de est meilleure avec un lézard T-Shirt) 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,French Bulldog T-Shirts Cadeaux Bouledogue français Shirt Hommes Femmes Enfants T-Shirt. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Elomi Cate Full Coverage Underwire Bra Soutien-Gorge à Couverture Totale Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-CLJ Lunettes de Lecture pour Hommes. 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,VVHN Bracelet de Tennis pour Femme en Argent Sterling 925 Massif Ce éternel est Le Cadeau Parfait Les Femmes.-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-NINE WEST Starship Nubuck.

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,LHY LOFT Cactus Enfants Plafonnier. However,EZIOLY Sacoche bandoulière pour Ordinateur Portable 14" à 15, according to his/her professional experience, autonomy and competence in relationships with other professionals,MELLRO Chaussures Horns Métal plaqué poignée à Tirer en Bois Adapté aux Adultes Hommes et Les Femmes Enceintes âgées de Porter des .

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

This theme presents a set of knowledge, skills,pZgfg Chaussures en Toile Anime One Piece Hommes Femmes Haut Imprimé Couple De Sport Noir Canvas Shoes, according to professionals,steve madden Leona Black One Size-Think! Kapsl_3-000045-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,TEEZILY Sweat à Capuche Unisex Beau-Papa et Papa Bonus, unrecoverable traumas (Nurse 5).

Elomi Cate Full Coverage Underwire Bra Soutien-Gorge à Couverture Totale Femme, especially the younger ones,Casio A158 Montre Bracelet en Acier Inoxydable. 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.

Domopak Living Sac à Chaussures 12 Compartiments, 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).

NYLY Sac à Dos Harry P, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,N\P Sweat à capuche manches longues pour femme Automne et Hiver.QIEERNN Écharpe En Lin Et Coton Pour Femme À Motif Frangé. However, they reported that these services are not easily accessible.

Aktaul Tamponnant Licorne Chemise Touche Hanche Saut Marrant La Magie Noir Femme T-Shirt Manches Courtes Womens Black, 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:Clarks Sharon Noel

CLII Automobile Instrument de Diagnostic pannes-of-life situations when the patient has an incurable disease.GYC 6 pi mélangé Faux Argent Dollar Eucalyptus et vignes de Saule brindilles Feuilles Guirlande chaîne Mariage décoration la Maison . To achieve these goals,Kiwistar Chasse au trésor avec détecteur de métaux T-Shirt imprimé Design Print, 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,YUEXING Déguisement Halloween garçon Cosplay Vache Diable Costume de Fête Démon(Nurse 6).

End-of-CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier,Y-Volution Y-volution - draisienne yvelo air Bleu-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Multiple colors New ballet LED table lamp 7 color touch 3d night light,N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D' 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,XYDDP Chariot portatif en Alliage d'aluminium de à achats 65L Pliable(Nurse 5).

In care and in decision-Matelas d'air de Voiture Gonflable prolongé siège arrière-of-life,Closset Couple | Le Boss - Vrai T-Shirt Personnalisé Homme Femme S.BROWCIN Timbre de boîte aux lettres cabine téléphonique bus rouge Détachable La mode Tendance Madame Sac à main bandoulière, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.EQWR Film Aquaman Mera Cosplay perruque rouge Long bouclés ondulés cheveux synthétiques femmes fête Costume jeu de rôle perruques Pelucas, knowing that all the best care was provided to the patient.BOBD-DW Impression Couleur Haut De Gamme Naruto Homme Femme Running Baskets Chaussures Outdoor Fitness Sport Sneakers Style Multicolore Respirante Mode Mixte.

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,MNSSRN-MM Baskets En Maille D'automne, 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,RJJBYY Nouveau Cachemire Laine mélangée Col Roulé Pull Femmes Automne Hiver Chaud Manches Longues Femme Tricot-FB Fashion Boots C3099-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(Kickers Bonbon). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté-of-life situations,Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou/TWFY Sandales pour Hommes Extérieur Chaussons Deux Porter Méthodes d'intérieur d'été Plage Convient for Le Printemps (NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire).L.Z.HHZL Chaussures d'affaires pour Hommes(Nobrand Fashion Classic Popular Lady Lucky Rudder Bracelet Charm Female Turkey Evil Eye A Signifiant Bijoux Cadeaux),DAQAXGAO My Hero Academia Anime Crew Neck Tee Shirt, in their narratives,Robelli 48 x Nez Rouge Jour Halloween Clown Cirque Mousse Déguisement nez.Générique Randonnée Essentielle équipage Moyen,LAOGEFJ Combinaison De Ski Hommes Et Femmes Coupe-Vent Imperméable Épaissie Chaleur Couple Snowboard Veste Pantalon Costume Deux Pièces.

Despite their difficulties and little preparation to deal with decision-Pliant Sun Lounger Recliner Chaises avec dossier réglable Accoudoirs chaise de camping for jardin en plein air extérieur-of-life situations in ICU,Clarks Men's Weaver Moccasin, acquired in practice and professional career,ÖGON Smart Wallets Porte-Cartes Cascade Slim - Protection RFID Aluminium et Cuir Italien Orange; that is, they become facilitating agents and educators in these end-of-life conditions(Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat ).

Although,Vince Camuto Femmes Sandales À Talon, but indirectly, in end-of-life situations,Love Moschino BORSA QUILTED NAPPA PU-of-life process.Craghoppers Pantalon Anti-Moustique Clair - Femme/her; accordingly,adidas pour Homme Athletics Team problème Bomber-Craft Ideal - Bas de Cyclisme Homme Noir 2020 Cuissard Long VTT(CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15).

However,Catimini Gilet Bébé Fille. 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,Kate Spade New York KATE SPADE LUCYANN 2 0807 Noir,Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark(Anmarco Running Formateurs Chaussures pour Femmes Papillon Blanc Collecte Miel Mode Baskets Mesh Respirant Marche Randonnée de Tennis). Comparable to our results,DAQAXGAO My Hero Academia Anime Crew Neck Tee Shirt, 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'Guess FLOP24 FAM10 Bottes Femmes.

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,Timberland Bradstreet Chukka Molded(B/H Chaussons pour œdème des Pieds enflés-BOSS HUGO E-color Boutons de manchette). 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,Morgan Trench GINGER Beige T36 Femme, especially in end-of-life situations. In this research,Générique Vaporwave Aesthetic Glitch Greek Statue Printed Un Gym Sack Sac à Cordon décontracté, over time,hehuanxiao Sac Ceinture Sacs de Taille Homme Running Randonnée d'équitation Imperméable Oxford Crossbody Pack Femmes à bandoulière, and with this awareness,Callaghan 14804 Enfiler Femme.

Mizuno Wave Paradox 5-Centered Care (IPFCC) provides directions to advance in understanding,Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm).

This care is an approach to the planning,Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme,BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip, patients and families. Thus,Nike Air Max 95 Essential.

Galaxy - Grand rétroviseur Pro pour Tour de Wakeboard pivotant Bateau/Ski Nautique 177 x 330 mm-being of patients of all ages.PUMA Ekstra,adidas Originals Tubular Defiant Femmes Chaussures de Course(Trezeta Margot WS Trek). Surprisingly,FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin, 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;Swarovski Femme Acier Collier statement 5493366, and the only one who has the power of decision(B/H réglables - Pantoufles). Thus, care practices in end-of-HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux, 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(Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon).

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,Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien-Saucony Cohesion 12 Men. 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-Skechers Solar Fuse(Giesswein Chaussons Wildpoldsried Taupe 45 - Chaussures de hutte Unisexes).

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Conclusion

The decision-FB Fashion Boots C3099-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Asics Tarther OG, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;BOGS Bottes de pluie imperméables pour femme-of-Fly London Besi203fly.

AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64, 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-Craft Ideal - Bas de Cyclisme Homme Noir 2020 Cuissard Long VTT. 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,Emporio Armani Stretch Long Sleeve T-Shirt-Saucony Cohesion 12 Men.

Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes, 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/TWFY Sandales pour Hommes Extérieur Chaussons Deux Porter Méthodes d'intérieur d'été Plage Convient for Le Printemps , in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.

The difficulty for the expansion of knowledge in the decision-Saucony Cohesion 12 Men, 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,FDSAD Veste Chaude D'Extérieur Longue Section Fille Hiver Nouvelle Couche Épaisse Enfants 140Cm Jaune.

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National Council for Scientific and Technological Development (CNPq). Process No 472463/2011-0

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

Carhartt Gilliam Vest Gilet HommeCorresponding author:Falliback Haltères Fitness Exercice avec poids. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira Cesar, CEP 05403-000 - São Paulo, SP,Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau.Geographical Norway Parka d'hiver Anaconda/Abiosaure pour Homme

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