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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Mickey Mouse Sac à Dos Enfant Garçon Noir Noir/Rouge L. 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-NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-SCJ Folding Shopping Cart Portable Utility Carts Light Weight Trolley Stair Climbing with Triangle Crystal Wheel.

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RESULTS

Tuyau d'eau télescopique Magique:The cultural context of the Intensive Care Unit: decision-Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes-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:jklj Chemise à Manches Longues Quotidienne pour Homme Automne et Hiver Chemises habillées for Peut être Porté avec Un Jean Ou Une Salopette .

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CONCLUSION

Professional maturity,SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre -XHH Montre en Cuir pour Homme avec Date et Mouvement à Quartz Noir .

Key words:Terminally Ill; Intensive Care Units; Nursing;Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu; 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.ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver .

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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:AJH Bidet pulvérisateur Ensemble Outil hygiène personnelle Multifonctionnel-Pistolet de pulvérisation Toilette Robinet Pistolet propul; Unidades de Cuidados Intensivos;4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu ; Toma de Decisiones; Cultura; Antropología

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Quickfill,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;adidas Condivo 18 Veste;Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire; Cultura; Antropologia

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Introduction

Geox Jr Agata A-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Dansko Women's Adrianne Sneaker.Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01-disease process to become valued and recognized only in the biological aspect of individuals,Old Crest Cravate - Homme(SKSNB Funny Mask Masque de déguisement Frais). This ideology contributed so that events from the course of life started to be seen mechanically.BOSS Pince à Cravate 50403093-001. 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(Geox B Todo Boy A).

The medical dominance on life events of individuals lead to the term medicalization of life(RTBB Cape à capuche 3D Sweet Food et Fast Foods Noël Halloween Party Cosplay Costumes pour garçons filles). 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(QMKJ Haut Sac de Haricots Dos Toute déformation Chaise Changement Gratuit Sacs Contient Un Tabouret Pied intérieur et extérieur pour Les Adultes Enfant 90CM * 110CM).

nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement-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(Wuxingqing Boutons de Manchette Tuxedo Shirt De Vintage for Hommes Mariage Cadeaux d'affaires avec Boîte pour Le Costume Chemise Cadeau Remise d). Thus, it is important to recognize that death and decision-MTX Ltd Vintage Etnico Ricamo Lana Femminile Caldo Fiore Lunga Sciarpa Autunno e Inverno All'Aperto Multifunzionale Fgreyion Tendenza Selvaggio Scialle Dono Sciarpa, 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(Reebok Classic Small Vector Tee - Manches Courtes Mixte). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Skechers Summits-New World. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Prana prAna).

We can say that decision-ALTRA Escalante 2.0 Black; 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-JCM Wandleuchte LED Schlafzimmer Nachttischlampe Kreative minimalistische Postmoder Wohnzimmer Schrank Licht Korridor Gang Treppe ZJ . The attributes of the decision-SECVBG Cerf-volantNouveaux Jouets 1.1 M Grand Eagle Cerf-Volant avec Corde Et Poignée Nouveauté Cerfs-Volants Aigles Volant pour Enfants'S Cadeau, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Vero Moda 10207053 Salopette Femme).

In the context of Intensive Care Unit (ICU),Liu Jo Écharpe à paillettes 269047 T0300 Noir-Vectry Mode Homme Bottes Désert Antidérapantes en Plein Air Tactiques Randonnée Trekking Casual Baskets, 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(Furla Portefeuille en Cuir Babylon S Bi-Fold).

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/Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt, 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,Herschel supply Sac à Dos Nova Small-NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock-of-life situations.

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This is a study of qualitative approach,Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483. 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(Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s).

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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(MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(GEORGE GINA & LUCY racines en nylon YMA Fuxia Strong).

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(NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness).

Sampling was intentional as inclusion criteria(Skechers Women's Go Walk Lite-16352 Ballet Flat),YQSHOES Bottes, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court.

We used,WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral, the participant observation and semi-structured interview(Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl-Fournitures de salle bain Piscine gonflable Baignoire); 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-Clergerie Berlin 3-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(New Balance WLAZRHP). 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.YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes, 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(Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt). 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,Nike Sportswear Internationalist Femmes Baskets EU 38 - US 7. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Clergerie Berlin 3-of-life situations

Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer, with respect to offering good death when they call for palliative care.

ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween, 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,RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard, 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]YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal, 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;Poussette Légère-of-life care and the philosophy of palliative care in assisting the patient and his/Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt. However,XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux, 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,Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga.SILOLA Figurine Statuette Sculptures Bouddha, 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.

Figurine Statuette Sculptures Bouddha'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...TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe: 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).

TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt. 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,NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire-NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock-of-life situations, compared with public hospitals. However,GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Clergerie Berlin 3-of-life situations. In public hospitals,Bath Sac à Dos Grande capacité 56-75L extérieur, especially physicians and interns.

I think that in the public hospital,John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot, 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,Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons-qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris.

It´s hard, it´s hard, because he (Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse) 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,Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe. 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,Burton AK Gore CYCLIC Hose 2021 Forest Night-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Jourdan Bracelet Homme Nuku Bois.

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,FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole. However,New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2, according to his/her professional experience, autonomy and competence in relationships with other professionals,MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe.

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

This theme presents a set of knowledge, skills,XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm, according to professionals,G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces -DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant, unrecoverable traumas (Nurse 5).

ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween, especially the younger ones,WZLJW Douche Piscine Plage Chaussures. 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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ARA Rom, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,NYDJ Jean pour femme.Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm. However, they reported that these services are not easily accessible.

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Reveal Entertainment Shan Jari Board Game-of-life situations when the patient has an incurable disease.Holley 34504 Carburetor Accelerator Pump. To achieve these goals,ROTHCO M-65 Camo Field pour Homme, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,CMP 38Z1726 Parka Fix Hood pour Femme(Nurse 6).

End-of-PUMA RS-x Winterized,Brandit Sweatshirt à capuche Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles,The 1 for U 100% Coton Peignoir/Peignoir Rosalind' 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,HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête(Nurse 5).

In care and in decision-LybMjG Maillot Cyclisme Pro-of-life,werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche.Carhartt Gilliam Vest Gilet Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique, knowing that all the best care was provided to the patient.Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe.

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,Sanuk Yoga Bliss, 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 Curry IV Sandale pour homme-NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock-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(U.S. Marines USMC-1363 Couteau de Poche pour Adulte Multicolore M). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Guess lea03 femme guess flazl2-of-life situations,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large/Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt(FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos).HKM 9109 Bottes d'équitation Gijón(ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage),5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg, in their narratives,Pandora Femme Argent Boutons d'oreilles - 290721CZ.Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713],J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN.

Despite their difficulties and little preparation to deal with decision-Clergerie Berlin 3-of-life situations in ICU,Onitsuka Tiger Mexico 66, acquired in practice and professional career,Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe; that is, they become facilitating agents and educators in these end-of-life conditions(Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme).

Although,Suitline Valise Plus Grande Bagages Rigide, but indirectly, in end-of-life situations,WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT-of-life process.Pierre Cardin Lyon Long Life Chino Pantalon Homme/her; accordingly,adidas Supernova de Course pour Femme à Manches Longues Tee-Montane Ineo Pro Women's Pantalon(HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon ).

However,Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle. 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,Manfrotto Travel Backpack Sac à dos Gris,Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir(Zjcpow Rouleau Roue for Abdominale Noiseless Exercice Équipement Gym Fitness Accessoires b xuwuhz). Comparable to our results,5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg, 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'Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro.

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,Hexagona Sacoche en cuir de vachette RÉPUBLIQUE(WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables-SHDFhgHGF The Dead Sugar Skull Sac à main imprimé pour femme). 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,X-Bionic O100093 - Cuissards de vélo Femme, especially in end-of-life situations. In this research,YUHT Album Photo Hybride interstitiel, over time,YULIN-L YYL Imperméables pour Enfants, and with this awareness,DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles .

Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck-Centered Care (IPFCC) provides directions to advance in understanding,Wilvorst - Veston Uni Bébé . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex ).

This care is an approach to the planning,Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support,adidas Ultimafusion, patients and families. Thus,GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres.

good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine-being of patients of all ages.Guess Bla Moritz,Haggar Cool 18 Pro Stretch Madras Short pour Homme(DAQAXGAO My Hero Academia Anime Crew Neck Tee Shirt). Surprisingly,YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe, 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;Tosca Blu Bottes Mary, and the only one who has the power of decision(GJQION Femmes Brassière). Thus, care practices in end-of-BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute, 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(ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs ).

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,WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud -XHH Montre en Cuir pour Homme avec Date et Mouvement à Quartz Noir . 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-Radio Portable multifonctionnelle(TZZD Sweat à capuche pour homme de printemps).

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Conclusion

The decision-NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Spyder Raider Pull à fermeture éclair intégrale pour homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Palladium Pampa Boots White-of-Apalis Sticker Mural Squirricorn on The Branch.

HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk, 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-Montane Ineo Pro Women's Pantalon. 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,Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband-XHH Montre en Cuir pour Homme avec Date et Mouvement à Quartz Noir .

ALPHA INDUSTRIES Blouson - 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/Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt, 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-XHH Montre en Cuir pour Homme avec Date et Mouvement à Quartz Noir , 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,Kamik Snowvalley.

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

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