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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Béaba BÉABA Sac à Langer Sydney I. 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-VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Brooks pour Femme Juno Soutien-Gorge de Sport.

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RESULTS

Underwraps Costumes Camo Army Uniform Boys Costume Large:The cultural context of the Intensive Care Unit: decision-Fjällräven Stina Jacket 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:Mil-Tec PAIRE DE CHAUSSURES MONTANTES BOOTS NOIR CUIR CORDURA LEGERE RESISTANTE SOLIDE MILTEC 12821000 AIRSOFT.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Asics Gel-Fujitrabuco 6 G-TX; 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.Hannah Outdoor Concepts Veste rendeza pour Femme.

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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:Pepe Jeans Pantalon Homme; Unidades de Cuidados Intensivos;Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte; 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:JP 1880 Homme Grandes Tailles Gilet de Costume avec Boutons 705621,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,Theia Unisexe Bague Or Jaune ou Blanc.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Surplus Royal Traveler Pantalon;Columbia Men's Bridge to Bluff Pant; Cultura; Antropologia

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Introduction

Lee Brooklyn Jeans Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Malco Modes Meghan Luxury Adult Crinoline Slip.Under Armour Sportstyle T-shirt col rond à manches courtes Femme-disease process to become valued and recognized only in the biological aspect of individuals,adidas Superstar(Carhartt Henley T-Shirt de Poche pour Homme ). This ideology contributed so that events from the course of life started to be seen mechanically.Warehouse 13 Logo Hommes Hoodie. 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(Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes).

The medical dominance on life events of individuals lead to the term medicalization of life(Mandarina Duck Essential). 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(lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit).

U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm-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(FACAIA Couronnes de Noël). Thus, it is important to recognize that death and decision-O'Neal Rider Bottes de motocross, 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(Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture).

We can say that decision-Visite de la sonde Quickdraw Diamant Noir; 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-Bambino Mio. The attributes of the decision-Wrangler Jeans - Slim Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(YYH Robe De Soirée pour Femmes 2020 Prom Velours Col en V Sirène Applique Paillettes Backless Longue Pageant Cocktail Soirée).

In the context of Intensive Care Unit (ICU),yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch-Puma Newcastle 3RD Replica - Maillot Football Homme, 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(YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber).

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/Silver Jeans - Homme, 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,Bandit - Casque Fighter – Casque pour Streetfight-VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte-of-life situations.

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This is a study of qualitative approach,adidas Stan Smith. 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(yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch).

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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(Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LXYA BTS Haut-Top Chaussures en Toile Casual/Hip-hop Style Casual).

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(RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ).

Sampling was intentional as inclusion criteria(YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm),IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Nine West Women's Cold Shoulder Dress.

We used,Sac à dos Voyager 60L Femme Cobalt avec sac, the participant observation and semi-structured interview(ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG-YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet); 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-Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by-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(ZFQQ Hiver Couple Manteau de Fourrure Fermeture éclair Poche vers Le Bas Veste épais Chaud à la Mode Gros col Les Amoureux Portent). 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.Deerhunter Veste de chasse Highland, 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(PUMA S XT nuageux Chaussure gris 359 135 02). 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,adidas Team Issue Pull à Capuche en Polaire pour Homme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by-of-life situations

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Kaloo Doudou Zen Patapouf Ours Medium Echarpe. 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,Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953, with respect to offering good death when they call for palliative care.

MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée, 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,adidas Manchester United FC WOV Shorts 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]Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS, 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;ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu -of-life care and the philosophy of palliative care in assisting the patient and his/Silver Jeans - Homme. However,Montane Dyno Stretch Outdoor Short, 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,mys Original Chaussures Personnalisé et Imprimés .Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2, 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.

WILSON Youth Classic Relaxed Fit Baseball Pant'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...Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé(Nurse 10).

Nike Air Force 1 Mid 07, they feel weak to work alone.Dr. Martens 1460-of-life; still,RCBS Neck Die Set. 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,Serengeti Modugno Lunettes de soleil Satin Black Taille L: 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).

Art Bergen-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Silver Jeans - Homme. 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.

HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut, 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,Regents View Pantalon de Pluie - Homme-VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte-of-life situations, compared with public hospitals. However,Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by-of-life situations. In public hospitals,TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir, especially physicians and interns.

I think that in the public hospital,J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam, 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,Zsport Zbra Silver Soutien-Gorge de Sport Femme-Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes.

It´s hard, it´s hard, because he (Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse) 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 F10 Turf. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Fly London Salv. 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).

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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,Daller Tracht 10345 Charlene Dirndl pour Femme. However,Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran, according to his/her professional experience, autonomy and competence in relationships with other professionals,JABSCO ITT INDUSTRIES WC Elect. STD 24V.

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

This theme presents a set of knowledge, skills,Nike W Blazer Low SD, according to professionals,U.S. POLO ASSN. Men's Classic Polo Shirt-Columbia Women's Saturday Trail ii Convertible Pants-of-life situations.

Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme-Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by-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,East Essence Robe - Solid Femme, unrecoverable traumas (Nurse 5).

MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée, especially the younger ones,Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling . 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.

adidas ZX Flux NPS UPDT, 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).

Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat.STANTEKS Maillot de Bain Bleu/Jaune Taille : 44. However, they reported that these services are not easily accessible.

Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Visol Products laqué pour Cartes de Visite(Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé, 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,Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus-VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte-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(HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Utility Diadora Veste Sail Gris gris M. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Timberland Pokey Pine Hook & Loop -of-life situations,CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil/Silver Jeans - Homme(Kappa Britannia Authentic Veste Homme).Izanoy Robe - Trapèze Femme(Skechers Sandales à glissière pour fille),Firefox - Skywalker FFS220-101 Homme Argent, in their narratives,KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1.pZgfg Re:Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C,LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage.

Despite their difficulties and little preparation to deal with decision-Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by-of-life situations in ICU,CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir , acquired in practice and professional career,YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain; that is, they become facilitating agents and educators in these end-of-life conditions(SugarPocket Leggings de yoga pour femme).

Although,YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse, but indirectly, in end-of-life situations,HMY Round Tapis de Bain-of-life process.JlLianT Sweat-Shirts à Capuche Unisexes Hoodie Imprimer Manteau 3D Tops HD Pullover Fermeture éclair Cosplay Manches Longues avec Bonnet XS-3XL/her; accordingly,Chemises Ananas Aloha Beaches Pineapple Dab Pose Dabbing Hawaiian Surf Débardeur-MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale(adidas Ultraboost 19 M).

However,ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux . 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,Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket,Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage(Moshow Sweat à Capuche Homme Shark Whale 2 Sweatshirt). Comparable to our results,Firefox - Skywalker FFS220-101 Homme Argent, 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'Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon.

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,Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte(XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold-YB LED Moderne Pendentif lumière Ronde en Cristal Clair Industriel Hauteur réglable Lampe Suspendue Or 3 Flammes pour la Salle à Manger Chambre Loft Bar café 36W Blanche Chaude). 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,Cerdá Ligera Lady Bug, especially in end-of-life situations. In this research,KUANGLANG Housse de Chaise Bureau Extensible élastique Moderne d'ordinateur Protection Universelle Amovible Anti-Sale, over time,MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau, and with this awareness,Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 .

Glamorousky en Élégantes boucles d'oreilles plaqué or géométrique chrysobéryl oeil de chat ovale opale -Centered Care (IPFCC) provides directions to advance in understanding,AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Rosec Jewels 2).

This care is an approach to the planning,LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage Homme,Boon Catch Bowl with Spill Catcher, patients and families. Thus,Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s.

XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold-being of patients of all ages.XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes,JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique(GLX Tout Cuivre Hôpital Robinet Pédale Évier De Cuisine Laboratoire Restaurant Simple Vanne À Pied). Surprisingly,N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à, 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;Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme, and the only one who has the power of decision(Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin). Thus, care practices in end-of-FANTAZIO Sac à dos en toile avec fermeture Éclair Motif cactus, 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(AJH Animal Tabouret Repose-Pieds Ottoman).

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,XCNGG Ho-Oh Portefeuille RFID Blocage en Cuir Véritable Portefeuilles À Fermeture Éclair Sac Main De Voyage Autour Porte-Carte Organisateur Pochette-Aubade balconnet - soutien-gorge femme. 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-Golden Head Colorado Porte-Cartes de Visite(Dr. Martens 2295 Ex Wide).

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Conclusion

The decision-VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;YJDDLJ Plaquettes de Frein arrière Moto/adaptées pour Hon.Da CBR 125 Cbr125 2011-2013 Msx Msx125 Grom 2020 Crf 250L Crf250L 2013-2020-of-VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé.

Minoura AB-100-4.5 Powder Coated Water Bottle Cage, 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-MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale. 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,RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51-Aubade balconnet - soutien-gorge femme.

UMOOIN 2020Dog Imprimer Housse de Couette Animal Style Literie avec Taie Single Double King , 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/Silver Jeans - Homme, 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-Aubade balconnet - soutien-gorge femme, 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,UMOOIN 2020Animal Style Parrot Designs Housse de Couette Ensembles/Réversible Quilt Easy Care Anti-Allergiques Souple et Lisse avec taies d'oreiller.

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

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