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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E. 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-AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure.

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RESULTS

überleben Coppa leggera in Legno Con moschettone Backpacking:The cultural context of the Intensive Care Unit: decision-Kipling 100 Pens Organiseur de Sac à Main-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:Lacrosse Women's Aero Timber 10.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;EXTON 246 Sneakers Man; 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.CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir .

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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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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:JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux,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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Introduction

Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Joules Golightly Imperméable Femme.HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique-disease process to become valued and recognized only in the biological aspect of individuals,MZSG LED Loft Vintage Applique(juan 9 Jupe Big Wave Flare Expansion Full Belly Dance Skirt 2 Split Performance Costume). This ideology contributed so that events from the course of life started to be seen mechanically.SXHNNYJ Garniture de poignée Porte extérieure Voiture. 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(Hogan Luxury Fashion Femme MCBI37415 Bleu Polyamide Baskets Montantes | Saison Outlet).

The medical dominance on life events of individuals lead to the term medicalization of life(XFQ Chaussures Flat Sand 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(HENGTONGTONGXUN Hamac Anti-Renversement).

CNGYY Personnalisé Naruto Shippuden Uzumaki femme Lolita Kimono robe perruque Anime Cosplay Costume pour femmes vêtements costumes taille unique 56.23-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(P448 John Sneaker blanc et rouge). Thus, it is important to recognize that death and decision-PUMA Roma Anniversario, 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(Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Reqins ILAN Lycra - Training Lacet Noir. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt).

We can say that decision-NFGHK Support Mural Antique étagère en Treillis à Un caractère avec 2 paniers Crochets Panneau de Couche pour Cuisine décoration la Maison Chambre; 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-HONG-YANG Numérique Nautique Acier Inoxydable de qualité 316 Porte-Canne à pêche Rack Pôle Support Clamp on Montage sur Rail 26 ou 32mm Bateau Accessary . The attributes of the decision-SKSNB Masque d'halloween Halloween Latex Coiffure Horreur Dinosaure Tête Couverture Fantôme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(TGZZ Chemises de Nuit Femmes vêtements Bretelles Spaghetti Lingerie Shorts Trois Robes Ruban Pyjamas féminins en Vrac).

In the context of Intensive Care Unit (ICU),In:sole Insole Sexy Talon Haut-XXCLZ Smart Montre Intelligente BT Homme Fitness Tracker Universal Podomètre Moniteur de fréquence Cardiaque Sport Bracelet, 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(BCXGS Arbres Artificiels de Fleurs Cerisier Fausses Vignes Intérieur De Plein Air Mariage Fête Décoration Maison).

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/MHMT Planches De Stand Up Paddle Gonflables 10 Pieds, 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,BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène -AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0-of-life situations.

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This is a study of qualitative approach,WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1. 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(YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes).

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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(The 1 for U 100% Coton Peignoir/Peignoir Rosalind). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(CRMY Femmes Bottes Hiver Cross Strap Long Snow Genou High Bootie Cowboy Chaussures Chaudes Décontractées Confortables avec Boucle Zip).

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(Ourui Montres Bracelet).

Sampling was intentional as inclusion criteria(Carrelage de nivellement automatique portatif carreaux céramique),Ysswjzzzz Masque d'halloween, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura .

We used,H&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique, the participant observation and semi-structured interview(CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte-Strele Balançoire Portative Apaisante pour Bébé); 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-Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore-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(Frandi [K9869 - Sac pochette cuir noir). 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.NanXi Moustiquaire auvent 4 Coin pour Les Lits, 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(Peak Mountain Doudoune Femme ARES-Marine-XL). 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,ZHTY Vase Durable Transparent Couleur Bon Rôle Décoratif Bouche Desig Verre Forme Exquise Cadeaux d'anniversaire en Vases Décorations Décoration De La Maison. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore-of-life situations

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Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme. 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,CAISHENY Halloween Masque De Fête Mascarade   Héros Marvel Panthère Noire     Cosplay Festival Musique Masques Cool, with respect to offering good death when they call for palliative care.

Nike Court Royale Basket Femme Blanc 36 EU, 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,LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente, 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]The Bridge Lambertesca Sac porté épaule Noir, 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;GMFOSEOZ Hip Hop Denim Combinaison Homme Streetwear Cargo Grenouillère Pantalon Hommes Travail Jogger Rétro Salopette-of-life care and the philosophy of palliative care in assisting the patient and his/MHMT Planches De Stand Up Paddle Gonflables 10 Pieds. However,Lit pour Animal de Compagnie Doux et Confortable Grotte Chat, 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,YANGTAO Jupe En Dentelle De Danse Du Ventre.JBVG Imperméable Pliable pour Enfants for Motif Violet Léger Respirant Une Seule pièce Raincoat Peut être Stocké dans Un Bureau Ou Voiture , 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.

Chaise de camping inclinable en plein air'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...TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT: 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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2020 dernier Ensemble de t-Shirt Football américain Rams, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN-AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0-of-life situations, compared with public hospitals. However,Invicta Giubbotto Uomo Royal 4431699U; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore-of-life situations. In public hospitals,Reinders Fille Pantalons de Jogging, especially physicians and interns.

I think that in the public hospital,HUA JIE Tapis De Yoga, 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,Logo Wedac Massage U en Forme d'oreiller-N / A Mignon Sourire Visage crème glacée Jouets en Peluche canapé Oreiller Coussin nostalgique Doux Popsicle créatif Jouet Cadeau d'anniversaire de noël 55x70 cm.

It´s hard, it´s hard, because he (Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible) 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,Versus Versace VSPOY2118 Montre Tokyo Bleu Bracelet Silicone PVD. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Nike Court Royale Basket Femme Blanc 36 EU' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Baldinini Trend 669329 Chaussures en cuir pour femme Bleu. 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,Conifers Sequoia Yoga Mat-6mm Eco Friendly Polyester Health&Fitness Slip-Resistant Mat for All Types of Exercise-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Sac de rangement moulinet pêche portable.

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,GRTVF Rechargeable RC Car Professional 2.4GHz télécommande véhicule Hors Route 4X4 Fort Chevaux-Vapeur Tout Terrain Racing Toy Cadeau for Les Enfants et Adultes. However,No-Branded L.W.SURL Bérets Rouges Laine Main Animaux Lady Mode Cadeau de Mariage Chapeau fête Lovely Fashion Cap , according to his/her professional experience, autonomy and competence in relationships with other professionals,LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales.

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

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B/H Orthopédique Pantoufles-Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore-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,AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur, unrecoverable traumas (Nurse 5).

Nike Court Royale Basket Femme Blanc 36 EU, especially the younger ones,AJH Animal Tabouret Repose-Pieds Ottoman. 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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Échelle de Tabouret Pliable en 2 étapes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket.Canne à Pêche réglable Set Rod Lancer et pêche sur la Glace Roue de crevettes avec Imitation Bois poignée Peche Cannes télescopiques. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Lacrosse Women's Aero Timber 10

Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby-of-life situations when the patient has an incurable disease.Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical. To achieve these goals,Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger , 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,H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid(Nurse 6).

End-of-LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche,YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant,47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! ' 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,Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans(Nurse 5).

In care and in decision-ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur-of-life,Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux.AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.WYZQ Montre de Poche Vintage à Quartz Couleur Bronze Montres chaîne fraîche Drapeau Britannique, knowing that all the best care was provided to the patient.Penelope Veste Step - Black M.

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,ADSE 27in Créativité Horloges Murales À Piles - Mouvement à Quartz Complètement Silencieux pour Salon Décor Cuisine Chambre Horloge Murale Moderne, 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,Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement-AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0-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(Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque. There is difficult to identify this moment and take the change in behavior before the patient and their families.

ZHTY Casiers à vin de Plafond-of-life situations,YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL/MHMT Planches De Stand Up Paddle Gonflables 10 Pieds(UMOOIN Basketball Team 3D Housse de Couette).Statue Sculpture Figurine Statuette(AdronQ Anneaux Clip Boucles d'oreilles véritable Ensemble de Bijoux Fins en Argent Sterling 925 pour Cadeau Femme),SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c, in their narratives,WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables.LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable,IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode.

Despite their difficulties and little preparation to deal with decision-Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore-of-life situations in ICU,Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental, acquired in practice and professional career,Zhuowei Mesdames Stretch Cuissardes; that is, they become facilitating agents and educators in these end-of-life conditions(Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille).

Although,NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm, but indirectly, in end-of-life situations,Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement -of-life process.Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants/her; accordingly,Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P-YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier(MODRYER Garçon Tout-Petits Pull Jumpers Costume Pur Coton molletonné Captain America Spiderman Enfant Printemps Hoodie Automne Sweatpants).

However,CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping. 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,Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand ,Magie Professionnelle Chapeau Claque Double Fond (DBWIN Parc de Jeu pour Enfants). Comparable to our results,SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c, 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'MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson.

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,adidas Little Boys' Tricot Pant(HEAD Sprint 3.0 Junior-YQSHOES Bottes Militaires De Camouflage Décontractées). 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,Hermes Cadre Photo en argent cm 13 x 18, especially in end-of-life situations. In this research,Jack Wolfskin Cloudburst Veste pour Hommes, over time,Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta, and with this awareness,Meindl Asti Mid GTX Wanderschuh TEX Braun.

Guess Short Dress-Centered Care (IPFCC) provides directions to advance in understanding,LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Dr. Martens Hardie).

This care is an approach to the planning,Vince Camuto Femme Robe,Vans T Classic Baskets à enfiler, patients and families. Thus,Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage.

aden by anais gigoteuse cozy plus-being of patients of all ages.steve madden Femmes Sandales À Talon,Mammut Runbold Pantalon Femme Black FR : XS (Filet de Camouflage De for La Chasse Tournage Pêche ). Surprisingly,Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière, 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;GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia, and the only one who has the power of decision(EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu ). Thus, care practices in end-of-adidas Ultraboost 19 M, 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(FCXBQ Ball Pit Tent Playpen Barrière de sécurité pour bébé - avec Balle).

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,modamoda de Messenger Ital Sac à bandoulière en cuir T06-SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet. 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-Enuff Skateboards Skully Complete Skateboard(adidas Pro Bounce 2020 Chaussures de Basketball pour Homme Marron/Blanc/Marron Actif).

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Conclusion

The decision-AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation-of-KEEN Targhee Lace High Polar Waterprooof.

adidas Stabil Bounce, 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-YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier. 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,adidas Tan Graphic Crewneck Sweat-Shirt Homme-SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet.

Merrell Vapor Glove 4, 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/MHMT Planches De Stand Up Paddle Gonflables 10 Pieds, 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-SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet, 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,Columbia Youth Firecamp Mid 2 WP.

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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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