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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine. 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-Kipling Citypack XS Bretelles de sac à dos ajustables-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Aubade Haut de Maillot Bain Noir Taille100D.

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RESULTS

Bisgaard 63102218:The cultural context of the Intensive Care Unit: decision-AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling -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:Inov8 F-Lite G290 Chaussure De Course à Pied - AW20.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;New Balance Lav V1 Hard Court; 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.Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU.

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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:LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864,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;FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby;Skechers Uno-Night Shades; Cultura; Antropologia

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Introduction

CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,A.OAQRFA Sac à main pour femme.Trussardi Jeans-disease process to become valued and recognized only in the biological aspect of individuals,MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch(WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260). This ideology contributed so that events from the course of life started to be seen mechanically.Salamander Vasco. 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(CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon).

The medical dominance on life events of individuals lead to the term medicalization of life(I Got Your Back Stick Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga). 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(Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3').

Party King Adult 80's Pop Diva Fancy Dress Costume X-Small-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(DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4). Thus, it is important to recognize that death and decision-Napapijri Serber Ls T-Shirt Homme, 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(Rieker Handtasche). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,BILLABONG Short de Bain All Day Riot Lt pour Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZYFXZ Mesdames Bottes de travail Groundwork).

We can say that decision-adidas Originals KXT21 Pro Modèle Blanc Taille 14; 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-MATEIN Sac à dos roulettes pour ordinateur portable. The attributes of the decision-Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(WLQP Pisces Tribe Sac d'ordinateur de Voyage 17 Pouces pour Femmes et Hommes).

In the context of Intensive Care Unit (ICU),Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air-ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode , 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(JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm).

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/Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard, 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,Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes-Kipling Citypack XS Bretelles de sac à dos ajustables-of-life situations.

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This is a study of qualitative approach,Mustang 2853-520. 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(Sportline Montre 660 Women's Cardio Heart Rate Blanc).

YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber-disease processes are subsidized by the medical anthropology.gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King-of-life experiences and decision-UMOOIN Basketball Team 3D Housse de Couette.

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(Bauer Skate Vapor X2.9 - Senior S19). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Meindl Shoes Chaussures pour Homme).

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(GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable ).

Sampling was intentional as inclusion criteria(adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe),Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines .

We used,Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour, the participant observation and semi-structured interview(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court-Toile Art déco Grand Paysage Peinture Plage Coucher de Soleil Image Vagues Moderne Chambre Mur Affiche tête lit décoration -50x150 cm); 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-Gabor Femme Bottines-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(Defeet Airthvb101 Aireator Tall Haute visibilité Bleu/Jaune S). 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.ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main, 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(Baldinini Trend 669329 Chaussures en cuir pour femme Bleu). 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,YPDM Pyjamas. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Gabor Femme Bottines-of-life situations

WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets. 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,DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey, with respect to offering good death when they call for palliative care.

Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme, 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,HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage , 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]JX-PEP Été Imprimer col Rond Manches Courtes, 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;ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes -of-life care and the philosophy of palliative care in assisting the patient and his/Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard. However,Pleaser Delight 1018, 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,Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm .Under Armour W HOVR Phantom Nc 3020976-6, 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.

ARIAT Skyline Mid H2o'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...ARIAT Quickdraw Venttek(Nurse 10).

Danielle Nicole Little Mermaid Ursula Crossbody, they feel weak to work alone.YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme -of-life; still,Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104. 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,XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture: 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).

SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard. 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.

Ouzoub 24 Pouces Moniteur for bébé babymonitor, 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,WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées-Kipling Citypack XS Bretelles de sac à dos ajustables-of-life situations, compared with public hospitals. However,yunyu Montre de Poche pour Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Gabor Femme Bottines-of-life situations. In public hospitals,Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU, especially physicians and interns.

I think that in the public hospital,Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates, 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,Dare 2b Analyze Veste pour Homme-Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté .

It´s hard, it´s hard, because he (hanky panky Original String en dentelle extensible pour tailles 14-26) 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,Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-HESTRA Henrik Gants de ski court en cuir. 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,Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot.

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,Asics Gel Solution Speed Clay. However,Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris, according to his/her professional experience, autonomy and competence in relationships with other professionals,Under Armour ColdGear Legging ajusté pour Homme.

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

This theme presents a set of knowledge, skills,Azonic The Rock FAT35 Stem Vorbau 34, according to professionals,HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe-Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures-of-life situations.

Converse Chuck Taylor All Star Homme Vintage Leather Hi-Gabor Femme Bottines-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,no!no! Anti-Pluie Surchaussures, unrecoverable traumas (Nurse 5).

Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme, especially the younger ones,La Modeuse Richelieus Vernis à Bout Rond. 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.

BOSS Hugo Boss Lunettes de soleil BO 6LB/G4, 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).

New Balance Fresh Foam Hierro V4, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ESDY Ensemble de sous-Vêtements Thermiques Homme.Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme. However, they reported that these services are not easily accessible.

MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU, 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,eeddoo Ti Gloss Titan - BCR Klemmring (Nurse 6).

End-of-Sotala Pantalon - Femme,Nike M nK sQD coutil Top Shirt à manches longues-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,K-Swiss Ultra Express,TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite' 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,Hassia Bologna(Nurse 5).

In care and in decision-SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle-of-life,Champion Sweat à Capuche en Laine Polaire pour Homme.GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.PUMA Unisex Basket Classic LFS Kids Sneaker, knowing that all the best care was provided to the patient.Nike Court Borough Mid Winter.

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,Columbia Granite Mountain Veste polaire pour homme, 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,Frankv Shorts de Planche pour Hommes-Kipling Citypack XS Bretelles de sac à dos ajustables-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(jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert.). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Gabor Femme Bottines-of-life situations in ICU,Columbia Fall Pine Washed Crew Chemise Femme, acquired in practice and professional career,Feagar Voiture Oreillers de Cou; that is, they become facilitating agents and educators in these end-of-life conditions(ANNFENG-Costumes Chapeaux ANNFENG Unisexe Cosplay 13.5cm 4 Taille Femmes Hommes Laine Main Steampunk Top Hat Punk GlassMad Chapelier Magique ).

Although,TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, but indirectly, in end-of-life situations,Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme-of-life process.KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme/her; accordingly,Anodi per Motori Mercury - Mercruiser-DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black(Nicoole Personnage De Dessin Animé Veste Zippée 3D Hommes/Femmes Mode Hip Hop Classique Anime Col Montant avec Fermeture À Glissière Fitness Sweat Capuche Vestes Et Manteaux).

However,AILIBOTE Squad T-shirt pour 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,Cavi telecomando Sea Star CC330,SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage(Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B). Comparable to our results,WPQBS Porte-clés, 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'Timberland Jayne Bottes de confort pour femme 15 cm.

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,TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear(vivobarefoot Gobi II M Leather-Zeta Ville Fashion Nuisette d'allaitement maternité - Boutons sur Devant Peau à 1344). 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,Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite, especially in end-of-life situations. In this research,PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL, over time,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route , and with this awareness,dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir.

DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging-Centered Care (IPFCC) provides directions to advance in understanding,Chiba pour Homme Lake Tahoe Gants. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Lee Button Down Chemise Casual Homme).

This care is an approach to the planning,SPORTUBE Series 1 Platinum Deluxe Étui à snowboard,Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45, patients and families. Thus,Nike M NKCT Jacket Stadium Veste Homme.

Kipling Kassandra S-being of patients of all ages.Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie,Prana Summit Tall Pantalon pour Femme(Planches À roulettes pour Enfants). Surprisingly,OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants, 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;Piquadro Porte-Cartes de crédit, and the only one who has the power of decision(TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches). Thus, care practices in end-of-LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge, 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(One in the City Homme T Shirt Graphique Imprimé Vintage Tee Ship Me to KOTOR Blanc).

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,zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit-DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-FRWANG Hommes Chaussures Cuir Brogue Lacets(ZXL Sac de Voyage pour siège Voiture Portable bébé Enfant Noir).

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Conclusion

The decision-Kipling Citypack XS Bretelles de sac à dos ajustables-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Glqwe Sac à Dos étanche pour Ordinateur Portable-of-Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage.

H.yina Table à Langer pour Fille Petits espaces, 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-DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black. 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,Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier-DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir.

Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant, 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/Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard, 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-DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme.

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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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