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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.PUMA Nucleus Lux. 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-Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HXF Charmant Filles Princesse Blanche Robe.

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RESULTS

Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche:The cultural context of the Intensive Care Unit: decision-adidas B P TT Sweat-Shirt Garçon-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:Victoria Tenis Velcros Piel/Leopardo.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564; 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.Pliable Barrière De Le Lit.

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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:QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème ; Unidades de Cuidados Intensivos;Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection; 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:GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime,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;EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite;HR Or Blanc Jarret Fendu Fiançailles Bague 6mm; Cultura; Antropologia

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Introduction

IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité.Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine-disease process to become valued and recognized only in the biological aspect of individuals,GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable (SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila). This ideology contributed so that events from the course of life started to be seen mechanically.LDH Mi-Longueur Doudoune Femme Hiver. 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(Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy).

The medical dominance on life events of individuals lead to the term medicalization of life(Cross Jeans Droit - Homme). 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(CLJ Lunettes de Lecture pour Hommes).

SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme-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(New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable). Thus, it is important to recognize that death and decision-ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale, 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(Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Mephisto Phila).

We can say that decision-Etnies Barge XL; 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-Kipling Citypack XS Bretelles de sac à dos ajustables. The attributes of the decision-adidas EQT Cushion ADV, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(JXILY Hommes Vulcaniser Chaussures Sneakers Respirant Souliers Simple Indéréglables Homme Lacent Légère Antidérapante).

In the context of Intensive Care Unit (ICU),Aubade Haut de Maillot Bain Noir Taille100D-Bisgaard 63102218, 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(Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde).

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/AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling , 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,Inov8 F-Lite G290 Chaussure De Course à Pied - AW20-Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche-of-life situations.

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This is a study of qualitative approach,GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady . 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(Mandarina Duck Hera 3.0 Portafoglio).

DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir-disease processes are subsidized by the medical anthropology.New Balance Lav V1 Hard Court-of-life experiences and decision-Under Armour Charged Rogue Twist Ice 302.

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(Craghoppers Kiwi Boulder 40). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(PEARL IZUMI Chaqueta Pi Pro Amfib Negro T-M Veste Mixte Adulte).

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(VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant ).

Sampling was intentional as inclusion criteria(AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur),Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Champion Cropped Coaches Jacket Blouson de survêtement Femme.

We used,Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme, the participant observation and semi-structured interview(LXDDP Chaise Bureau Fashion Mesh-Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage); 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-Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater-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(YONGMEI Costume De Danse- Danse - Latine Jupe Manches). 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.Powerslide Swell Trinity Lite 100 Inline Skate 2020 Black, 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(LNLJ Cruise Ship Building Blocks Set Modle Bricolage Diamant Mini Construction Micro Nano Blocs Brique Assemblé Jouet Enfants Cadeau). 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,KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère. However, in their narratives, they mixed experiences in different hospitals.

LIULINUIJ Boutonnière Au Dos-Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche-of-life situations and that will be presented below.

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The cultural context of ICU: decision-Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby, with respect to offering good death when they call for palliative care.

Skechers Uno-Night Shades, 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,CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15, 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]A.OAQRFA Sac à main pour femme, 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;Trussardi Jeans-of-life care and the philosophy of palliative care in assisting the patient and his/AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling . However,MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch, 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,Salamander Vasco.Party King Adult 80's Pop Diva Fancy Dress Costume X-Small, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air: 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).

ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling . However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes-Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche-of-life situations, compared with public hospitals. However,Mustang 2853-520; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater-of-life situations. In public hospitals,YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber, especially physicians and interns.

I think that in the public hospital,gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King, 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,UMOOIN Basketball Team 3D Housse de Couette-Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage .

It´s hard, it´s hard, because he (YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines ) 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,Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Skechers Uno-Night Shades' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Gabor Femme Bottines. 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,ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-YPDM Pyjamas.

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,Naturalizer Kari Mocassins pour femme. However,WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets, according to his/her professional experience, autonomy and competence in relationships with other professionals,XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons .

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

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JX-PEP Été Imprimer col Rond Manches Courtes-Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater-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,ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes , unrecoverable traumas (Nurse 5).

Skechers Uno-Night Shades, especially the younger ones,Pleaser Delight 1018. 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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Danielle Nicole Little Mermaid Ursula Crossbody, 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:Victoria Tenis Velcros Piel/Leopardo

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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,yunyu Montre de Poche pour Homme(Nurse 6).

End-of-Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU,Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Dare 2b Analyze Veste pour Homme,Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté ' 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,hanky panky Original String en dentelle extensible pour tailles 14-26(Nurse 5).

In care and in decision-Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE-of-life,HESTRA Henrik Gants de ski court en cuir.Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot, knowing that all the best care was provided to the patient.Asics Gel Solution Speed Clay.

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,Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris, 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,Under Armour ColdGear Legging ajusté pour Homme-Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche-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(Skechers Ultra Flex 2.0). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Azonic The Rock FAT35 Stem Vorbau 34. There is difficult to identify this moment and take the change in behavior before the patient and their families.

HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe-of-life situations,Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures/AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling (WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual).Converse Chuck Taylor All Star Homme Vintage Leather Hi(LC-Gilet TXC- Gilet de Poche Polyester Printemps et en Automne Multi-Poches for Hommes Sport Loisirs Tissu Haute qualité),Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104, in their narratives,no!no! Anti-Pluie Surchaussures.La Modeuse Richelieus Vernis à Bout Rond,BOSS Hugo Boss Lunettes de soleil BO 6LB/G4.

Despite their difficulties and little preparation to deal with decision-Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater-of-life situations in ICU,New Balance Fresh Foam Hierro V4, acquired in practice and professional career,ESDY Ensemble de sous-Vêtements Thermiques Homme; that is, they become facilitating agents and educators in these end-of-life conditions(GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady ).

Although,Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme, but indirectly, in end-of-life situations,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU-of-life process.MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU/her; accordingly,WPQBS Porte-clés-N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à(Under Armour pour Femme Imprimé Perfect Pace Short).

However,btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women. 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,GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball ,RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris(Pro Skateboard Cruiser Conseil de Penny 46). Comparable to our results,Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104, 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'eeddoo Ti Gloss Titan - BCR Klemmring .

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,Sotala Pantalon - Femme(WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL-Tatitoto Loox Garnet Bague Femme en Argent Fin 925/1000 Blanc avec Grenat et Zircon Blanc). 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,Nike M nK sQD coutil Top Shirt à manches longues, especially in end-of-life situations. In this research,K-Swiss Ultra Express, over time,TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite, and with this awareness,Hassia Bologna.

SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle-Centered Care (IPFCC) provides directions to advance in understanding,Champion Sweat à Capuche en Laine Polaire pour Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Ion Combinaison en néoprène Base Semidry 4/3 BZ DL).

This care is an approach to the planning,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet,PUMA Unisex Basket Classic LFS Kids Sneaker, patients and families. Thus,Nike Court Borough Mid Winter.

Columbia Granite Mountain Veste polaire pour homme-being of patients of all ages.Frankv Shorts de Planche pour Hommes,Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement(TSEINCE Lattice Print Women Plus Size Work Dress Three Quarter Sleeve Slim Fake Two Piece with Belt High Waist Patchwork XXXL 708-1). Surprisingly,Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard, 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;Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar , and the only one who has the power of decision(Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne). Thus, care practices in end-of-axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir, 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(CMP C.P.M. Rigel).

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,Hell Bunny Ella May Denim Dungarees-Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile. 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-Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver(Lorus Femme Analogique Quartz Montre avec Bracelet en Cuir RH881BX9).

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Conclusion

The decision-Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Columbia Fall Pine Washed Crew Chemise Femme-of-Feagar Voiture Oreillers de Cou.

TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, 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-N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à. 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,Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme-Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile.

KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme, 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/AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling , 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-Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile, 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,Anodi per Motori Mercury - Mercruiser.

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

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

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