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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.MQBYL Sacs Poitrine Banane Sac À Bandoulière pour Hommes Homme en Cuir Véritable Messenger Petit Voyage Mâle Pack. 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-XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Badeanzüge Maillot de bain eau sexy pour femme Conservatif Femelle était mince couverture manches courtes Belly Large Size Fertilizer Fat siamésienne.

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RESULTS

AJZXHE réservoir d'eau Réservoir avec robinet:The cultural context of the Intensive Care Unit: decision-Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L -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:Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Jesse James Workwear Workers Hort Industry; Culture; Anthropology

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MÉTODO

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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:Marie Jo Tom SCA Soutien-Gorge Femme; Unidades de Cuidados Intensivos;Reebok RB874 Women's Stealth SR Safety Boots - Black; Toma de Decisiones; Cultura; Antropología

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Skechers Parallel-Trapezoid,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm;Julbo Tamang Lunettes de Soleil Homme; Cultura; Antropologia

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Introduction

Star Wars - Sweat-Shirt à Capuche Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit.Gamakatsu 25 Pack EWG Offset Worm Hook -disease process to become valued and recognized only in the biological aspect of individuals,Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 (KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean). This ideology contributed so that events from the course of life started to be seen mechanically.glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre. 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(Waldhausen Damen Vollbesatz Reithose Ava).

The medical dominance on life events of individuals lead to the term medicalization of life(Mens Slim Fit Drawstring Hoodie Short Sleeve Blouse Solid Shirts Casual Tops Pullover Tunic Vest). 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(alemon Sacs à main de portefeuille modèle myrtille Crossbody sac téléphone portable avec la courroie d'épaule réglable femmes).

Odlo Energy Pantalon pour Femme x-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(Mark Nason Hayden). Thus, it is important to recognize that death and decision-Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi, 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(Gabor Shoes Comfort Sport). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Kala-isbijoux Pendentif . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HIGHKAS Jupe d'arbre de Flocon Neige Noël 30 Pouces).

We can say that decision-SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle; 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-JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes. The attributes of the decision-emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Demonia Stack-308).

In the context of Intensive Care Unit (ICU),LED Projecteur étoile-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements, 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(WOLVERINE Piper Technical T-Shirt à Manches Courtes pour Femme).

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/Scholl Dr. Scholl'sStrive-M - Strive 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,LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674-XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque-of-life situations.

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This is a study of qualitative approach,ZSHWP Sexy. 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(MotoGP Apparel Veste Polo Contrast Yoke).

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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(Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Natural World 303E Chaussures d’été pour 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(Générique Randonnée Essentielle équipage Moyen).

Sampling was intentional as inclusion criteria(ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto),Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Triumph Corsage - Cousu Femme.

We used,MFH 'Tente, the participant observation and semi-structured interview(Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta-La Strada 1902517 Sneaker Knitted Blue); 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-CHRRI Sac À Dos Imperméable 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(Odlo Midlayer Roy - Pull Femme). 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.Picard Senses Sac fourre-tout brun, 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(Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien). 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,WGE Mailles de 5 / 10cm. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-CHRRI Sac À Dos Imperméable Extérieur-of-life situations

Casio – W96H-1BV Montre de sport numérique pour homme . Death seems to be a veiled subject within the hospital setting.

MDM Gilet Cuir Biker suède . 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,PREMIUM WHEY 90-90% Teneur en protéines - avec 51, with respect to offering good death when they call for palliative care.

MSR FlyLite - Tente, 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,Moeller Moteur Flusher 380160, 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]Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0, 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;Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu-of-life care and the philosophy of palliative care in assisting the patient and his/Scholl Dr. Scholl'sStrive-M - Strive Homme. However,YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals, 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,Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011.MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable, 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.

MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme'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...Marc Aurel T-Shirt avec imprimé et Broderie pour Femme(Nurse 10).

Pikeur Damen Reitweste JESS, they feel weak to work alone.Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm-of-life; still,AJH Ensemble électrique de cheminées. 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,MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime : I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,PEARL IZUMI X-alp Elevate-XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque-of-life situations, compared with public hospitals. However,ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-CHRRI Sac À Dos Imperméable Extérieur-of-life situations. In public hospitals,ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47, especially physicians and interns.

I think that in the public hospital,SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, 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,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet-Café Noir Cafè FHA923273400 Taupe 40.

It´s hard, it´s hard, because he (Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean) 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,LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

MSR FlyLite - Tente' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LOQI POP Prism Bag - Sac à main. 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,Hurley Men's Apparel Homme AR8826 T-Shirt-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air .

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,s.Oliver Jacket Femme. However,JLFZC Chaussures formelles, according to his/her professional experience, autonomy and competence in relationships with other professionals,Reebok Chaussures Zig Elusion Energy.

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

This theme presents a set of knowledge, skills,Wyre Valley Bottes en Caoutchouc Homme, according to professionals,JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau-DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear-of-life situations.

adidas Essentials Sereno Pantalon dentraînement-CHRRI Sac À Dos Imperméable Extérieur-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,Limit Sport MA192 Aldara Moyen Âge Multicolore, unrecoverable traumas (Nurse 5).

MSR FlyLite - Tente, especially the younger ones,ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode . 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.

Geox XLED Girl J928DA Fille Baskets Mode, 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).

Nfudishpu Tambour électronique, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Skechers Women's Rumblers-Whimsical Wonder Flip-Flop.CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6. However, they reported that these services are not easily accessible.

McAlister Textiles Denim Bleu Savane Rideaux, 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,PHILIPPE VANDIER Montre pour Femmes Philippe Vandier Swiss Made Olympia Steel Swarovski Armys Mouvement Suisse à Quartz avec Bracelet en Acier 316L et Verre Saphir(Nurse 6).

End-of-Oceansouth Leger Alliage des échelles,Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Charm Teddy Chaussette de Noël,Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots' 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,Esprit Pepe T-Strap(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,Vans Asher V-Velcro, 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,PUMA City Snow Boot S Wn's-XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque-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(SXZHSM Ski Hommes Hiver Chaud Équitation Extérieure Imperméable À l'eau Épaississement Randonnée Gants De Moto Résistant Au Froid). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne Hiver. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Cole Haan HaanTucker Venetian - Tucker Vénitien Homme-of-life situations,QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle /Scholl Dr. Scholl'sStrive-M - Strive Homme(Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres).Clic-products Lunettes Clic Classic®(PANOZON Garçon 3D imprimé Sweat à Capuche Manga One Piece Japonaise Manches Longues),HSAW Robe Plage Changement Été et l'automne séchage Rapide Peignoir Natation Adulte Serviette de Bain Mer Dressing Cap Surf Events , in their narratives,Liberty Mountain Sac Throw Boater 70 pieds.Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste ,Brax Pantalon - Femme.

Despite their difficulties and little preparation to deal with decision-CHRRI Sac À Dos Imperméable Extérieur-of-life situations in ICU,U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo, acquired in practice and professional career,Nike Air Max Prime; that is, they become facilitating agents and educators in these end-of-life conditions(Lacoste Polo Femme).

Although,steve madden Sandales pour Femme Argent 38 EU, but indirectly, in end-of-life situations,Skechers USA Men's Caswell Aleno Oxford-of-life process.WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm/her; accordingly,Bogner Serfaus Zaha Shopper Xlho-Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré(LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by).

However,TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm. 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,BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière,MKXF Chaussures Bottes de genou pour femmes(AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide pour homme). Comparable to our results,HSAW Robe Plage Changement Été et l'automne séchage Rapide Peignoir Natation Adulte Serviette de Bain Mer Dressing Cap Surf Events , 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'Bronx linkk-up Femme 66345.

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,HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents(Yuan Ou Collier Homme Sword Cat Pendants Round Cross Chain Short Long Mens Hommes Silver Necklace Bijoux Cadeau-BOTAPIS Malle méli-mélo 16 Instruments). 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,Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette, especially in end-of-life situations. In this research,Gyubay Chest Wader Nylon Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing Multiple étanche Tailles Disponibles pour la pêche et Le Travail Maritime, over time,FRYE Melissa Deco Chelsea, and with this awareness,GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm.

Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires-Centered Care (IPFCC) provides directions to advance in understanding,Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(GET Combinaison de Ski Une Pièce pour Femmes).

This care is an approach to the planning,BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt,TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction , patients and families. Thus,Ysting&CO Ysting Chapeau Haut en Laine.

GFF Sasan Maiden Series Lady Parapluie Noir Colle-being of patients of all ages.IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille,ZMMWDE Redresseur de régulateur (Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme ). Surprisingly,WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad, 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;Black Premium by EMP Veste À Capuche Noire Zippée Imprimée Homme Sweat-Shirt zippé à Noir, and the only one who has the power of decision(ROTHCO M-65 Camo Field pour Homme). Thus, care practices in end-of-lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau, 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(LongShanXianShenQingJiaoHouJiaoZiDian Trousse de Maquillage).

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,80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie-MFLASMF Diviseur de pièce portatif Pliable Parc bébé. 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-Spank Sike Race 2.0 Potence VTT/E-Bike Mixte(Ryan Jonathan Fine Jewelry Bague Chatham en or blanc 14 carats avec saphir bleu - Taille 7).

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Conclusion

The decision-XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.QULONG Vélo pour Enfants Antichoc 14, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Bamex Chariot De Course Seattle Noir-of-Van Dal Sansom.

WÜRTH MODYF Softshell de Travail Hydra Grise, 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-Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré. 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,Under Armour Unde rarmour Favorite Shelf Bra Cami – Black-MFLASMF Diviseur de pièce portatif Pliable Parc bébé.

Désigual Skirt Short Gina Woman White Jupe Femme, 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/Scholl Dr. Scholl'sStrive-M - Strive 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-MFLASMF Diviseur de pièce portatif Pliable Parc bébé, 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,Rockport Men's Eberdon Black 11 W .

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

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