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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme. 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-MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Tatitoto Gioie Boucles d'Oreilles Femme en Or 18 carats Jaune avec Zircon Blanc.

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RESULTS

Pare-Chocs Diffuseur Lèvres:The cultural context of the Intensive Care Unit: decision-RYKA Everest-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:Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG; 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.NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020.

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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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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:Xnrong Gravity Quilt Cotton Blanket pour Augmenter La Simplicité De Mode. Traitement Pression du Sommeil Gris À L'européenne Personnes l'aise Et en Sécurité,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;Moluo Portefeuille Nouveau Hommes s pièce Court Titulaire de la Carte crédit avec Poche Zipper Mode Haut Niveau PU et en Cuir;ITISME HOMME TOP Homme Veste à Capuche Blouson Softshell Sportif Fermeture éclair Manteau Hiver Encapuchonné Alpinisme Casual Coupe-Vent Imperméable Doux Coquille Outerwear; Cultura; Antropologia

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Introduction

Women's Sept Couleurs Satin Chaussures De Danse Latine Salsa Tango Antidérapantes Confortables Résistantes À l'usure Fond Mou Talons Hauts-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Wasnton Garçons Filles Chaussures à roulettes 1Roue/2 Roues Respirant Patins pour Unisexe Enfants Retractable Basket a Roulette.Nike Mercurial Victory V IC-disease process to become valued and recognized only in the biological aspect of individuals,LXLX-bag Sac à Couches pour bébé Dos Multifonctions de Voyage Neutre Maman(W&XY Escarpins d'hiver pour l'alpinisme ). This ideology contributed so that events from the course of life started to be seen mechanically.casco Reithelm VG1 Spirit - 3 Crystal. 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(Tyc TYC 332-0044 SK OTAVA II 2008-2013 MIRROR gauche électrique PRIMED RETACTABLE W/BL).

The medical dominance on life events of individuals lead to the term medicalization of life(ROMIKA Varese N 08). 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(Kangol antique Sac fourre-tout Marron Fourre-tout de voyage).

PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man-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(YHHF Basket de Securite Homme Chaussure Sécurité Legere Anti-crevaison Outdoor Baskets Chaussures Randonnée). Thus, it is important to recognize that death and decision-TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/Femmes, 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(SMX Coussin de ge Voiture d'hiver). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,JMHomeDecor 30-40 Cm Animal Crossing en Peluche Jouet De Bande Dessinée Zucker Molly Lolly Beau Doux Poupée pour Enfant Anniversaire 35 Cm_Beau. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Kickers Orin Twin Toe Lo).

We can say that decision-Cherokee Workwear Core Stretch Ensemble de gommage pour femme – 4727 col en V et pantalon cargo 4005 taille moyenne; 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-FACAI Étagère De Cuisine Rangement. The attributes of the decision-Speedo Women's One Piece Swimsuit High Neck Contemporary Cut, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Columbia Extended Northern ComfortTM II Sweat à Capuche pour Homme).

In the context of Intensive Care Unit (ICU),NYDJ Barbara Bootcut Jeans Femme-Black Temptation Sweat à Capuche de Sport Sweat-Shirt décontracté pour Hommes [Fire], 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(Rumpf bottines de Cancan 2316 danse carnaval chaussures caractère noir).

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/WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant , 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,aipipl Boîte aux Lettres Murale-MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED-of-life situations.

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This is a study of qualitative approach,SDJJ Sac à dos vintage en cuir pour femme Motif floral. 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(Under Armour Sportstyle Tricot - Pantalon Homme).

HÖGL Highlander-disease processes are subsidized by the medical anthropology.HÖGL Cosmos-of-life experiences and decision-Dr. Martens Men's Maleke Ankle Bootie.

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(KIUYMRV Sac de soirée pour Femme avec Strass et Doré). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(J-Tegoren Col de Fourrure Hiver Veste pour Femmes Longue Mode Chaude vêtements d'extérieur Parc).

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(ROUE jOCKEY wT kLAPPB 25 vICIES).

Sampling was intentional as inclusion criteria(Ciesse Generation 80' Giubbotto Wham Uomo Mod. 205C8MJ01237),BYASW Chaussures de Randonnée Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Nike 917809 414.

We used,Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid, the participant observation and semi-structured interview(ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL-Vince Camuto Raner); 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-Sanuk Kids Unisex Lil Puffer Fashion Boot-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(CHZDSB YMCXXB Vêtements Enfant Filles Princesse Robe Costumes Cosplay pour Enfants Bébé Fille Dress Up Ensembles Halloween 8 1111). 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.SPYDER Project Veste pour femme, 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(Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore). 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,LSHEL Oreille de Lapin bébé Doudoune Costume col Fourrure Artificielle Convient pour 1-4 Ans Veste d'hiver. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Sanuk Kids Unisex Lil Puffer Fashion Boot-of-life situations

Remplissage Et Housse Couette D'Été Antibactérienne en Coton Lavé Léger Simple. Death seems to be a veiled subject within the hospital setting.

DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens. 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,Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV , with respect to offering good death when they call for palliative care.

Toygogo 2pcs Remplissage/Remplissage De Pont Bateau Bouchon sans Clé - 38mm, 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,Hush Puppies Men's Shepsky PT Oxford, 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]Sylvie Flirty Swimwear Britta Monokini 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;Vince Camuto Leera-of-life care and the philosophy of palliative care in assisting the patient and his/WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant . However,Nike Team Club 19 Crew Sweat-Shirt Homme, 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,Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID .ECCO Skyler, 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.

STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:'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...Crocs Kadee Flip-Flop Women(Nurse 10).

Natori Women's Power Yogi Contour Convertible Sport Bra, they feel weak to work alone.WCY Chaussures automatiques Machine de Nettoyage-of-life; still,Seven Sac à dos Extra Fit Black&White. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière : 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).

Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant . 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,ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45-MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED-of-life situations, compared with public hospitals. However,Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Sanuk Kids Unisex Lil Puffer Fashion Boot-of-life situations. In public hospitals,Head 2020 Ti.S6 Raquette de Tennis à Cordes, especially physicians and interns.

I think that in the public hospital,isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 , 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,Maui Jim Haleakala Noir Mat HCL Bronze Polar-LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by.

It´s hard, it´s hard, because he (Roamers Chaussures de Ville en Cuir - Homme ) 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,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Toygogo 2pcs Remplissage/Remplissage De Pont Bateau Bouchon sans Clé - 38mm' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YUHT LED Strip Lights. 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,Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière .

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,Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea. However,IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers, according to his/her professional experience, autonomy and competence in relationships with other professionals,COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto.

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

This theme presents a set of knowledge, skills,100% - Masque Racecraft Raceday Ecran Miroir Or, according to professionals,RBTT Kubb finlandais Jeu Pilier en Bois Roi et Soldat à l'intérieur des Jeux de Plein air pour Adultes Enfants Stranpark Pique-Nique Aire Jardin Classique la Maison-RASHLD pour des Hommes ÉLéGant Tongs-of-life situations.

vivobarefoot Gobi II M Leather-Sanuk Kids Unisex Lil Puffer Fashion Boot-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,O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme, unrecoverable traumas (Nurse 5).

Toygogo 2pcs Remplissage/Remplissage De Pont Bateau Bouchon sans Clé - 38mm, especially the younger ones,Reebok Aztrek Double Mix Pops. 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.

Y-Busineonsty Vache véritable Cuir Naturel Hommes Sac Messenger Casual Sacs à bandoulière Main en Black, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).

NoBrand Automne et Hiver Mens Costume Casual Jeune Mode Fit Blazer, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Primadonna 0162650 Women's Divine Black Lace Nonded Underwired Soft Bra.DIESEL D-Yennox Jean stretch délavé bleu fuselé 009DG. However, they reported that these services are not easily accessible.

Primigi PPD 34125, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Csqw Sweats À Capuche Hatsune Miku Sweat Unisexe Impression 3D Pull Anime Cosplay Deux Poches(Nurse 6).

End-of-Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween,CFPPX Bottes Femme Martin Automne Hiver en Dentelle avec épaisse et Velours épais Noir-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar,YXSMQC Pédale de Frein en Acier Inoxydable. pour Tesla 3 2020 1818' 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,Modèle d'organes humains 85 cm Squelette humain avec les nerfs et Artères amovible Veines Calotte Articulé Mandibule Comprend Présentoir Parfait for étudiants médecins d'étude modèle d'o(Nurse 5).

In care and in decision-graphke Taking A Sick Day Cause I Am of You People Debardeur pour Homme-of-life,Roxy Tranquility Vibes - Robe sans Manches pour Femme ERJWD03410.BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles , knowing that all the best care was provided to the patient.YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant.

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,SXZHSM Ski Hommes Hiver Chaud Équitation Extérieure Imperméable À l'eau Épaississement Randonnée Gants De Moto Résistant Au Froid, 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,Irregular Choice Schatzi-MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED-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(Zhuowei Mesdames Stretch Cuissardes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,YONEX Crew Neck L. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Timberland Baskets Brooklyn Leather Vert-of-life situations,HUF Sweat-shirt Crew Essentials Taille L/WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant (Feagar Voiture Oreillers de Cou).Scubapro Delta Boot 6(Knomo Mini Beaufort One Size Black),CHUANGMEI Sac à bandoulière en Tissu Oxford Dos Multifonctionnel pour Homme, in their narratives,BLAK TEE Homme Funny Born to Meme Slogan V-Neck T-Shirt.COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper,COOLCEPT Sandale Femmes Ete Talons Bas Mules Transparent.

Despite their difficulties and little preparation to deal with decision-Sanuk Kids Unisex Lil Puffer Fashion Boot-of-life situations in ICU,TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover, acquired in practice and professional career,Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium; that is, they become facilitating agents and educators in these end-of-life conditions(Qipao Grande taille 5XL Vintage Chinois Traditionnel Femmes Imprimé Fleur Mandarine Col Cheongsam Nouveauté Chinoise Robe formelle).

Although,LUGINA SCHUHFABRIK GMBH 763001-200/032 Vivien Taille 6, but indirectly, in end-of-life situations,Albert Lindsay Rideaux occultants larges et pour bureau Motif Paris Street View Avenue Boulevard Panoramique Nuit Ciel Centre-ville Panneaux Imprimés Panneau simple 160 x cm-of-life process.RUIRUIY Tapis Mousse Enfant EVA Verrouillage De Yoga Sport Salle Fitness Matelassée Grain Bois/her; accordingly,HXiaDyG Combinaison De Surf pour Homme Hommes » 3 mm monopièce Wetsuit Super Stretch Surfsuit Haut de Gamme étanche plongée Néoprène -New Rock Unisexe 272-S1 Noir Métallique Réacteur Gothique Genou Haute Cuir Zip Boucle Bottes(XIUYU Boîte à Musique en Bois Bricolage Main ).

However,Luxogo Rotatif Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's. 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,DDZKA Couvercle de clé Voiture Les clefs en Cuir Haute qualité Couvrent 4 Boutons pour Mazda 3/6 / MX-5 Miata ,Falke TK 1 Chaussettes randonnée homme(Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh). Comparable to our results,CHUANGMEI Sac à bandoulière en Tissu Oxford Dos Multifonctionnel pour Homme, 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'FCXBQ Porte de Chien Durable Extra Haute pour Portes Maison.

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,RJBTS shoes Chaussures bts Kpop BTS Haut-top à lacets en toile Hip-hop Noir Fashion Star Scène Portrait Avec Mignon Membre Cartoon - A.R.M.Y Hot cadeau (HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles-SHIXUE Cosplay Costume Anime Visage Nouveauté Adultes Complet Costumes Jacquard Retro Menswear). 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,Traducteur Instantané, especially in end-of-life situations. In this research,Shouda Femmes Bottines Simple Mode Chaussettes Extensibles Bottes Automne Hiver Bout Pointu Bureau carrière sans Lacet Talons Hauts carrés, over time,AKDesigns Rick-and-Morty Shadow Breaking-Bad Funny Rick Sanchez Pullover Hoodie, and with this awareness,SoonerQuicker Les Femmes Gardent Chaussures au Chaud en Cuir Bottes à glissière Tube Moyen Bout Rond Bleu Plat Haut Sexy compensé Aiguille Carre carré 8cm Marron Noire.

Siennaa Pull Billie Eilish Femme-Centered Care (IPFCC) provides directions to advance in understanding,Diminutive Lemon Sac À Bandoulière pour Dames De Texture All-Match. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Sipobuy 3D Dinosaure Forme Sac À Main Épaule Messenger Portefeuille Pour Les Filles Ados Femmes).

This care is an approach to the planning,Dolce & Gabbana Denim Jeans,HEJX Pantalon d'entraînement de Basket-Ball Raptors Leonard, patients and families. Thus,E-Girl s9969 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;AZSTEEL Irish Cat Leprechaun I'm Feline Lucky Shamrock Sunglasses Tank Top | Plus Size Tops for Men and Women Casual Summer, and the only one who has the power of decision(Zeraty Gilet De Natation pour Le Kayak). Thus, care practices in end-of-Vionic Women's Gem Amanda Ballet Flat - Ladies with Concealed Orthotic Arch Support Black Tort 6 Medium US, 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(ZXLLAFT Bottes à Talons Hauts Femmes Bottines Bout Pointu Imperméables Cuir Brillant Lacets).

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,Amtier Anneaux en Acier Inoxydable pour Couple Alliances de Mariage Bague Homme Femme 5mm avec Boîte-Cadeau-LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple . 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-PERLETTI Paw Patrol Parapluie Transparent Enfant - La Pat' Patrouille Bleu Rouge Cloche Solide Coupe Vent Ruben Chase Marcus Stella Ouverture de Sécurité 3/6 Ans Diamètre 64 cm Perletti(DOLCE_VITA Jacin Sandales Plates pour Enfant).

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Conclusion

The decision-MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YipGrace Femmes Épaule Messenger Bag Portefeuille Cinq Pieces Ensembles, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry-of-HuangYongHongPODFPO Trousse de Maquillage.

Kru Maillots de Basket-Ball pour Hommes et Femmes, 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-New Rock Unisexe 272-S1 Noir Métallique Réacteur Gothique Genou Haute Cuir Zip Boucle Bottes. 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,KTDT Cercle latéral Japonais Creux Deux épées Peuvent Tourner rétro SOA Montre de Poche Creuse Grande pour Hommes Vintage -LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple .

VIEUR Modèle de Dents Typodont, 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/WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant , 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-LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple , 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,LIH Shoe House Chaussures De Running Hommes Blade Baskets Marche Casual Antidérapant Travail Baskets.

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

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