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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.SILOLA Figurine Statuette Sculptures Bouddha. 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-TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire.

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RESULTS

GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V:The cultural context of the Intensive Care Unit: decision-Bath Sac à Dos Grande capacité 56-75L extérieur-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:John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse; 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.WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe.

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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:Jourdan Bracelet Homme Nuku Bois; Unidades de Cuidados Intensivos;FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole; 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:G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces ,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,DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;HART Polar Bear-V Gilet Taille XL;VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant; Cultura; Antropologia

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Introduction

WZLJW Douche Piscine Plage Chaussures-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,TPHJRM Coussin d'accoudoir de Console Centrale Voiture.ARA Rom-disease process to become valued and recognized only in the biological aspect of individuals,NYDJ Jean pour femme(Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8). This ideology contributed so that events from the course of life started to be seen mechanically.Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm. 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(Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica).

The medical dominance on life events of individuals lead to the term medicalization of life(DYecHenG Chausse-Pied Longue poignée Shoe Rack Creative marqueté en Bois Chausse Convient for Les Femmes âgées Idéal pour Une Utilisation Personnelle). 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(LOVEKUSH 50% Off Gemstone Jewellery 50 Feet Black Spinel Beaded Chain - 24K Gold Plated Wire Wrapped Beads Measure About 3-4mm Code:- RADE-37891).

Under Armour Sportstyle Sweat-shirt polaire zippé pour homme-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(Marc New York by Andrew Men's Bergen Ultra Stretch Packable Jacket). Thus, it is important to recognize that death and decision-Trezeta Margot WS Trek, 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(CHRRI Sac À Dos Imperméable Extérieur). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Julbo Tamang Lunettes de Soleil Homme).

We can say that decision-Marvelis chemise style moderne crème; 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-Reveal Entertainment Shan Jari Board Game. The attributes of the decision-Holley 34504 Carburetor Accelerator Pump, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(MZNSQB Marque en Cuir Véritable Hommes Portefeuille Petits Portefeuilles Double Fermeture Éclair & Pincée Mâle Court Porte-Monnaie).

In the context of Intensive Care Unit (ICU),ROTHCO M-65 Camo Field pour Homme-CMP 38Z1726 Parka Fix Hood pour Femme, 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(xiaokeai Collier Femme Longueur réglable en Argent).

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/PUMA RS-x Winterized, 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,Brandit Sweatshirt à capuche Homme-TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine-of-life situations.

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This is a study of qualitative approach,Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles. 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(NLRHH Lot de 12 décorations bouteille vin Noël pour décoration vin).

The 1 for U 100% Coton Peignoir/Peignoir Rosalind-disease processes are subsidized by the medical anthropology.HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête-of-life experiences and decision-LybMjG Maillot Cyclisme Pro.

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(Inconnu Regent Montre Homme F 848 Titane). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Amody Boutons de Manchette pour Homme Style Élégant Cuivre l'horloge Classiques d'affaires Mariage Argent).

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(MIBKLPG Femmes Chic Oversize Robe Longue Col en V Droite Chandail Femme Casual Lâche Tricot Une Taille Gruau).

Sampling was intentional as inclusion criteria(RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris),werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Carhartt Gilliam Vest Gilet Homme.

We used,LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique, the participant observation and semi-structured interview(WSKEISP Femmes de Mode Paillettes bout ouvert sur le genou Stiletto Talons hauts fermeture éclair Mesdames Bottes Taille 4-9-Smilice Bottes d'hiver pour Femme); 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-Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe-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(Daesar Anneaux Tungstène Acier Homme Incrustation de Coquille D'Ormeau Bague Gothique Argent Taille 64). 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.Sanuk Yoga Bliss, 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(Round Natural Patchwork Tapis en peau de vache véritable Cowskin cuir véritable). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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Results

Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,Under Armour Curry IV Sandale pour homme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe-of-life situations

Guess lea03 femme guess flazl2. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,HKM 9109 Bottes d'équitation Gijón, with respect to offering good death when they call for palliative care.

Pandora Femme Argent Boutons d'oreilles - 290721CZ, 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,Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713], 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]J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN, 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;Onitsuka Tiger Mexico 66-of-life care and the philosophy of palliative care in assisting the patient and his/PUMA RS-x Winterized. However,Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe, 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,Suitline Valise Plus Grande Bagages Rigide.WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT, 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.

Pierre Cardin Lyon Long Life Chino Pantalon Homme'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...adidas Supernova de Course pour Femme à Manches Longues Tee(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini 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).

Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/PUMA RS-x Winterized. 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.

Hexagona Sacoche en cuir de vachette RÉPUBLIQUE, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,X-Bionic O100093 - Cuissards de vélo Femme-TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine-of-life situations, compared with public hospitals. However,YUHT Album Photo Hybride interstitiel; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe-of-life situations. In public hospitals,YULIN-L YYL Imperméables pour Enfants, especially physicians and interns.

I think that in the public hospital,DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles , 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,Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck-Wilvorst - Veston Uni Bébé .

It´s hard, it´s hard, because he (Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support) 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,adidas Ultimafusion. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Pandora Femme Argent Boutons d'oreilles - 290721CZ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres. 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,good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Guess Bla Moritz.

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,Haggar Cool 18 Pro Stretch Madras Short pour Homme. However,YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe, according to his/her professional experience, autonomy and competence in relationships with other professionals,Tosca Blu Bottes Mary.

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

This theme presents a set of knowledge, skills,BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute, according to professionals,WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud -Radio Portable multifonctionnelle-of-life situations.

Spyder Raider Pull à fermeture éclair intégrale pour homme-Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe-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,Palladium Pampa Boots White, unrecoverable traumas (Nurse 5).

Pandora Femme Argent Boutons d'oreilles - 290721CZ, especially the younger ones,Apalis Sticker Mural Squirricorn on The Branch. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ALPHA INDUSTRIES Blouson - Homme.Kamik Snowvalley. However, they reported that these services are not easily accessible.

Nike Viale, 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:John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot

Green Burry Greenburry -of-life situations when the patient has an incurable disease.Under Armour Men's UA Yard Low St Sneaker. To achieve these goals,New Balance H754 , 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,WOOLRICH Laureldale Pull à col roulé pour femme(Nurse 6).

End-of-German Wear Chaussures de Ville à Lacets pour Homme Noir,NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,PUMA Suede Classic ,Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille ' 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,Fabulicious Flair(Nurse 5).

In care and in decision-Bosch TDA703021A Fer à Repasser 3000 W-of-life,American Tourister Soundbox Spinner Extensible.Strellson Premium Express-w Blouson Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.El Naturalista Borago, knowing that all the best care was provided to the patient.Bisgaard Dora.

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,Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche , 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,Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants-TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine-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(Sebago Men's Black Winhall Slip on 8 D). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,PALLADIUM-EU Pampa Sport Cuff Wpn. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Trippen Road Brown-of-life situations,Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme/PUMA RS-x Winterized(Lee Short Homme).Madden Girl Femmes Bottes(CHANGRAN Rugby Jersey Los Angeles Rams Manches Longues à Capuche épaissie Plus Velours Sport Sweat-Shirt Équipement d'impression pour Les Hommes et Femmes S-3XL),Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small, in their narratives,Columbia Wander Plus Jogger.gracosy Sabots Femmes Cuir,Brass Monkeys Haut Thermique - Homme.

Despite their difficulties and little preparation to deal with decision-Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe-of-life situations in ICU,Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7, acquired in practice and professional career,Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris; that is, they become facilitating agents and educators in these end-of-life conditions(Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock).

Although,TONI CS-Jenny Business, but indirectly, in end-of-life situations,Nike Flex Trainer 9-of-life process.Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu/her; accordingly,XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise-HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl(TROUSSELIER - DISNEY Minnie Boîte à Bijoux Musicale Idéal Cadeau Jeune Fille Musique Lullaby de Mozart Colori Rose).

However,Superga 2750-cotu Classic. 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,Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir,KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge(YunNR Robe de Patinage Artistique Professionnelle pour Femmes Élastique Respirant Costume Compétition à roulettes La Glace Vêtements Gymnastique Performance avec Strass). Comparable to our results,Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small, 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'Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge.

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,LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity(Beirich Automatico incubatrice automatica cova coperture 3 in 1 rottura iniziale Temperatura utilizzo Hatcher e controllo automatico Del vassoio regolabile umidità tornitura.-Diminutive Lemon Sac À Bandoulière Unique pour Femmes De Style Occidental Rétro). 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,Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value, especially in end-of-life situations. In this research,Coccinelle Metallic Soft Mini Purse, over time,Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine, and with this awareness,Fizik R1B Uomo - Chaussures Homme noir 2020 chaussures vtt shimano.

Craghoppers Cr165 Sport Homme-Centered Care (IPFCC) provides directions to advance in understanding,Adidas Condivo d'entraînement pour homme Pantalon . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(FRYE Women's Natalie Mid Engineer Boot).

This care is an approach to the planning,Oliver Peoples BERNARDO OV 5189/S,WFQGZ Chaussures De Sport pour Hommes Bas, patients and families. Thus,Aura Cacia Ginger/Mint Mist aromathérapie.

Hush Puppies H18800-being of patients of all ages.IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents,Chariot de magasinage Pliant d'épicerie Roues Pliantes poussant Le Sac Condo Appartement Pique-Nique Plage Voyage Portable Pousser Tirer Panier(Ryan Jonathan Fine Jewelry Pendentif en forme d'hélice 3 lames or blanc 14 carats). Surprisingly,Speedo - City NY Pbck AF Maillot de Bain pour Adulte, 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;Thrasher Skate And Destroy' Pullover Hood. Black., and the only one who has the power of decision(FACAI Étagère De Cuisine Rangement). Thus, care practices in end-of-Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47, 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(Marc Cain Collections Dress Robe Femme).

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,Maier Sports Oberjoch Pantalon Fonctionnel pour Homme-qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-QFYD FDEYL Chaussures pour Femmes diabétiques(Puma Fd Athl Sweat-shirt à capuche Femme).

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Conclusion

The decision-TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.T-JMGP Maillot De Cyclisme d'hiver pour Hommes, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Ventro Pro Turbo VT01 Patins à roulettes 4 roues-of-Sebago Men's Black Winhall Slip on 8 D.

RYKA Dévotion pour femme, 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-HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl. 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,YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled-qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris.

Divers NOW chaussures de sécurité eN 20345 s1P hRO, 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/PUMA RS-x Winterized, 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-qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,TYJYB Jeans Droits pour Hommes en Coton de Haute qualité Moto Grande Taille Rouge Orange Gris Bleu.

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

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