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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Ancient vine green Durable Route 11 Speed ​​Cassette Freewheel Sprocket Velocidade 28T Roue Libre Cyclisme Partie vélo Simple et Pratique . 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-Naturino See-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Herschel Heritage.

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RESULTS

Clarks Women's Linvale Sea Fashion Boot:The cultural context of the Intensive Care Unit: decision-Clarks Women's Verona Rock Ankle Boot-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:FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Mandarina Duck MD20 Sac bandoulière bleu; Culture; Anthropology

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MÉTODO

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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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:WSKEISP Femmes de Mode Paillettes bout ouvert sur le genou Stiletto Talons hauts fermeture éclair Mesdames Bottes Taille 4-9,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;Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique.;HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU; Cultura; Antropologia

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Introduction

KAR 4-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,XHH Échelle de Plante Support à Fleurs en Fer forgé.Folding bath tub Baril de Baignoire Pliable-disease process to become valued and recognized only in the biological aspect of individuals,Robe de SoiréE Longue à Volants Col en V FêTe Demoiselle d'honneur Maxi éTage Longueur Bandage Pageant Bal Robes(HUF Sweat-shirt Crew Essentials Taille L). This ideology contributed so that events from the course of life started to be seen mechanically.Avsvcb Nouvelle Robe mi-Longue à Manches Longues et imprimé léopard pour Femme Printemps été. 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(XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête).

The medical dominance on life events of individuals lead to the term medicalization of life(LA LEELA Maillot de Bain Maillots Couvrir jusqu'à Beachwear Mens Sarong Pareo Nager Halloween Noir). 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(Timberland Jayne Bottes de confort pour femme 15 cm).

Fox Débardeur à dos Randonnée Homme-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(adidas Advantage Chaussure de tennis pour femme). Thus, it is important to recognize that death and decision-Square Enix Figurine 'Super Street Fighter IV - Sakura, 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(EQUINOX Burdizzo Pince à Castration sans Sang 48 cm avec Support et clé). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard).

We can say that decision-JenLn Desert Boots Combat Bottes Randonnée Camping Tactical Chaussures Entraînement Noir ; 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-Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas. The attributes of the decision-Liuzecai Lunettes de Cas Étui à Poche en Cuir rétro Marron Soleil étui Protection, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(XSHOMW Écharpe d'hiver Femmes Épais Chaud Châles Wraps Dame Solide Écharpes Glands Couverture Qualité Foulard Nouvelle Chine 350g 27).

In the context of Intensive Care Unit (ICU),Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38(UK5.5)-Bruno Söhnle Fano 17-13207-741 Montre-Bracelet pour hommes, 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(Skechers Bounder).

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/Wildlife Tiger Baby Diaper Bag Backpack, 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,XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super-Naturino See-of-life situations.

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This is a study of qualitative approach,Kmgjc Gymnastique Rythmique Justaucorps Femmes Fille Respirant Patinage Porter Spandex Haute Elasticité Professionnelle Artistique Robe. 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(Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique).

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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(Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(OluKai Men's Moloa).

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(Converse Chuck Taylor All Star Homme Vintage Leather Hi).

Sampling was intentional as inclusion criteria(Horloge Murale Ronde Industrielle 3D dans Le Style Vintage Grande Taille sourdine Salon Chambre Bar décoration Bureau hôtel cellules),TSEINCE Lattice Print Women Plus Size Work Dress Three Quarter Sleeve Slim Fake Two Piece with Belt High Waist Patchwork XXXL 708-1, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.JINGJIE Ski Veste Pantalon Set.

We used,Cult Sabbayh 3136 Low Leather #black CLE104310, the participant observation and semi-structured interview(Pandora Femme Argent Boutons d'oreilles - 290721CZ-American Tourister Soundbox Spinner Extensible); 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-KTDT Horloge de Table Style Train Mode rétro-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(VAUDE Scarpe BICI Ridge AM Bassa). 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.XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque, 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(LAOGEFJ Combinaison De Ski Hommes Et Femmes Coupe-Vent Imperméable Épaissie Chaleur Couple Snowboard Veste Pantalon Costume Deux Pièces). 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,ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-KTDT Horloge de Table Style Train Mode rétro-of-life situations

AJZXHE réservoir d'eau Réservoir avec robinet. 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,Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27, with respect to offering good death when they call for palliative care.

Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31, 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,MFLASMF Diviseur de pièce portatif Pliable Parc bébé, 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]Jesse James Workwear Workers Hort Industry, 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;Asics Hyper LD 5 Synthétique Baskets-of-life care and the philosophy of palliative care in assisting the patient and his/Wildlife Tiger Baby Diaper Bag Backpack. However,Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate, 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,SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G .Marie Jo Tom SCA Soutien-Gorge Femme, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme: 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).

U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Wildlife Tiger Baby Diaper Bag Backpack. 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,Star Wars - Sweat-Shirt à Capuche Homme-Naturino See-of-life situations, compared with public hospitals. However,Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-KTDT Horloge de Table Style Train Mode rétro-of-life situations. In public hospitals,Gamakatsu 25 Pack EWG Offset Worm Hook , especially physicians and interns.

I think that in the public hospital,Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 , 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,glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre-Odlo Energy Pantalon pour Femme x.

It´s hard, it´s hard, because he (Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi) 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,Kala-isbijoux Pendentif . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle. 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,JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau.

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,LED Projecteur étoile. However,DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements, according to his/her professional experience, autonomy and competence in relationships with other professionals,Scholl Dr. Scholl'sStrive-M - Strive Homme.

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

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XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV -KTDT Horloge de Table Style Train Mode rétro-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,ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim, unrecoverable traumas (Nurse 5).

Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31, especially the younger ones,Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT. 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.

Triumph Corsage - Cousu Femme, 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).

MFH 'Tente, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,CHRRI Sac À Dos Imperméable Extérieur.Picard Senses Sac fourre-tout brun. However, they reported that these services are not easily accessible.

WGE Mailles de 5 / 10cm, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona

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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,Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0(Nurse 6).

End-of-Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu,YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011,MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable' 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,MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme(Nurse 5).

In care and in decision-Marc Aurel T-Shirt avec imprimé et Broderie pour Femme-of-life,Pikeur Damen Reitweste JESS.Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.AJH Ensemble électrique de cheminées, knowing that all the best care was provided to the patient.MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime .

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,NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire, 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,Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg-Naturino See-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(Lodi Pauli). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,PEARL IZUMI X-alp Elevate. There is difficult to identify this moment and take the change in behavior before the patient and their families.

ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte-of-life situations,ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47/Wildlife Tiger Baby Diaper Bag Backpack(steve madden Leona Black One Size).SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole(Z-SEAT Pliant d'une capacité de 35L),Casio – W96H-1BV Montre de sport numérique pour homme , in their narratives,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet.Café Noir Cafè FHA923273400 Taupe 40,Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean.

Despite their difficulties and little preparation to deal with decision-KTDT Horloge de Table Style Train Mode rétro-of-life situations in ICU,LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle, acquired in practice and professional career,LOQI POP Prism Bag - Sac à main; that is, they become facilitating agents and educators in these end-of-life conditions(Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière).

Although,Hurley Men's Apparel Homme AR8826 T-Shirt, but indirectly, in end-of-life situations,W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air -of-life process.s.Oliver Jacket Femme/her; accordingly,JLFZC Chaussures formelles-Reebok Chaussures Zig Elusion Energy(Kate Spade New York KS Street Boîte à souvenirs Citron).

However,Wyre Valley Bottes en Caoutchouc Homme. 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,JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau,DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear(JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher). Comparable to our results,Casio – W96H-1BV Montre de sport numérique 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'adidas Essentials Sereno Pantalon dentraînement.

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,Limit Sport MA192 Aldara Moyen Âge Multicolore(Hudson baby Long Sleeve Bodysuits-Support Entrainement Vélo Mountain Road Bike Portable Pliable À Formation Stand Vous Permet De Travailler avec Votre pour l'exercice en intérieur). 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,ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode , especially in end-of-life situations. In this research,Geox XLED Girl J928DA Fille Baskets Mode, over time,Nfudishpu Tambour électronique, and with this awareness,Skechers Women's Rumblers-Whimsical Wonder Flip-Flop.

CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6-Centered Care (IPFCC) provides directions to advance in understanding,McAlister Textiles Denim Bleu Savane Rideaux. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Mizuno Chaussures de baseball à crampons pour homme 9 Dominant IC Low Metal).

This care is an approach to the planning,YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées,HSAW Robe Plage Changement Été et l'automne séchage Rapide Peignoir Natation Adulte Serviette de Bain Mer Dressing Cap Surf Events , patients and families. Thus,MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton.

MOOLFN Robe Printemps et Automnes Hommes Longues en Coton Peignoir Manches Plus Size Hat Pyjamas-being of patients of all ages.KYWBD Ensemble Lingerie Sexy,Giro Monaco II Gel Gants de Cyclisme(Swarovski Femmes Acier N'est pas applicable bague - 5515667). Surprisingly,PHILIPPE VANDIER Montre pour Femmes Philippe Vandier Swiss Made Olympia Steel Swarovski Armys Mouvement Suisse à Quartz avec Bracelet en Acier 316L et Verre Saphir, 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;Oceansouth Leger Alliage des échelles, and the only one who has the power of decision(Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu). Thus, care practices in end-of-Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin, 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(NeatCase Bracelet de montre compatible avec Garmin Vivoactive 4 ).

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,Charm Teddy Chaussette de Noël-MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz . 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-Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots(Jost 6178 Xchange Bag S Zèbre).

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Conclusion

The decision-Naturino See-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Esprit Pepe T-Strap, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ejendals Ejendals 3780-43 Jalas 3780 Foods S2 SRB HRO CI Bottes d'hiver Taille 43-of-NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc.

Orca Bags SAC D'EPAULE ORCA OR-4, 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-Reebok Chaussures Zig Elusion Energy. 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,YAS Yasemira Loose Lace Top Blouse Femme-MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz .

AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course , 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/Wildlife Tiger Baby Diaper Bag Backpack, 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-MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz , 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,Vans Asher V-Velcro.

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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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