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NORTH SAILS Chemise à Carreaux en Coton Coupe Normal avec Col Boutonné et Empiècement Dos Droit

Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54. 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-PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair.

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RESULTS

Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet:The cultural context of the Intensive Care Unit: decision-Stockerpoint Weste Leander Veste de Costume d'affaires Homme-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:YMXYMM Bottes Tactiques avec Fermeture éclair latérale.

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CONCLUSION

Professional maturity,Blowfish Granola-b-ASG-révolver à Billes Airsoft-DW Classic 2.

Key words:Terminally Ill; Intensive Care Units; Nursing;George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over; 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.Modèle d'avion en métal moulé sous pression 16 cm Boeing B777.

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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:Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles;GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode; Cultura; Antropologia

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Introduction

Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple .TIEON Uniforme de Baseball Phillies # 3 Bryce-disease process to become valued and recognized only in the biological aspect of individuals,Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.(YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire ). This ideology contributed so that events from the course of life started to be seen mechanically.ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm. 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(Noch Wildgrass Beige by).

The medical dominance on life events of individuals lead to the term medicalization of life(Sam Edelman Femmes Sandales Compensées). 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(HAOAYOU Porte Cigarette Boîte de en Silicone Insigne 3D Mignon 9 * 5.8 2.6cm 5).

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-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(NZYQXGL Costume Femme 2020 Automne Nouvelle Mode Revers Drapé Blouse Pantalon Deux Pièces Professionnelle Jupe Gris-Bleu M). Thus, it is important to recognize that death and decision-CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte, 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(LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut).

We can say that decision-Scarpa Maestrale RS - Chaussures Ski de randonnée Homme; 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-Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women. The attributes of the decision-HJJH Roulement de Roue Joint Removal Tool, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Reebok Cl LTHR).

In the context of Intensive Care Unit (ICU),no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud -Suitline Valise Plus Grande Bagages Rigide, 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(Kipling Citypack XS Bretelles de sac à dos ajustables).

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/PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276, 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,Daniel Wellington Montre-PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité-of-life situations.

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This is a study of qualitative approach,AXDNH Chaussures de Sport Danse des Femmes. 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(KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 ).

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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(LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(TPZOTT -Manteaux Homme Veste Manches Longue à Capuche L'automne Printemps Décontractée Mode Solide Couleur Hoodies Outwear Hauts Manteau).

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(Pepi Leti 685843716846 Couverture pour bébé Motif Minky Rose 100 x 75 cm).

Sampling was intentional as inclusion criteria(Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir),IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0.

We used,Genuins Sandales Bio deux boucles réglables réalisées en serrure, the participant observation and semi-structured interview(Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu-KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes); 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-AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural-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(Yiph-Sunglass Lunettes de Soleil Mode Cool Summer Beach). 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.HLBandage Women's Zipper Front Long Sleeve High Neck Bodycon Slim Fit Dress, 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(FRYE Melissa Deco Chelsea). 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,Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural-of-life situations

Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique. 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,KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 , with respect to offering good death when they call for palliative care.

New Rock M.NEWMILI083 S6 Noir, 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,WYTartist Homme Socquettes Pour Hiver Épaisses Chaudes En Mélange de Laine Chaussettes, 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]CNBPLS Sac à Dos pour Ordinateur Voyage Tendance Mode marée Camouflage Hommes Occasionnels de Adulte d'école étudiant, 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;liqun 36 Stlye 100% Cuir Hommes Chapeau De Cowboy Occidental pour Gentleman Papa Cowgirl Sombrero Hombre Casquettes Taille 58-59Cm-of-life care and the philosophy of palliative care in assisting the patient and his/PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276. However,DC Shoes Court Graffik Sq, 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,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.RICOSTA Mike, 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.

Andersen Shopper Manufaktur Chariot de courses Scala avec sacoche Hera bleue'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...Camper Match 18824-042 Sandales Homme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Skechers Stamina-classy Trail: 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).

Paul Arvin Porte-Cartes pour Homme en Cuir d'origine-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276. 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.

Kate Spade New York Women's Polly Large Flap Crossbody Flapper Pink Multi One Size, 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,RefrigiWear Mead Jacket Veste de Sport Femme-PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité-of-life situations, compared with public hospitals. However,NgMik Cardigans Femmes Automne Hiver en mousseline de so Gilet De Confortables Avant Ouvert Imprimé Léopard À Manches Longues Cardigan En Grosse Maille Pockets Pull ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural-of-life situations. In public hospitals,Enval 4226711 Polonais pour Homme, especially physicians and interns.

I think that in the public hospital,Helen vi Sac à Dos pour Enfants Fille, 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,EASY easy Chemise De Nuit en Coton pour Femmes Summer Cute Cartoon Pyjama Loose À Manches Courtes-adidas Nizza Hi RF Chaussures FTWR White/Off White.

It´s hard, it´s hard, because he (Betsey Johnson Verona) 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,Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

New Rock M.NEWMILI083 S6 Noir' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Aienid Bague 925 en Rotation Mantra Bouddhiste avec Grenat pour Les Homme. 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,Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Victoria Beckham Lunettes de soleil aviateurs Protection UV.

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,WDAYI Manteau de Laine Femme. However,Aooaz Bague Or Rose 18 Carats Rubis Infini De Mariage Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs .

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

This theme presents a set of knowledge, skills,WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star, according to professionals,LiliChan pour des Hommes Tactique Bottes Delta Zip latéral Militaire Travail 8 Pouces Armée Chaussures-Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani.-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,WSDF Women's Denim Jacket Fashion Graffiti Patch Designs Loose Jean Coat Female Casual Jaqueta Feminina Ladies, unrecoverable traumas (Nurse 5).

New Rock M.NEWMILI083 S6 Noir, especially the younger ones,Papier peint pour porte monochrome dentelle avec fleurs et tourbillons décoratifs. 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.

dingsheng Sport's BraSous-vêtements de Sport Femmes Antichoc en Cours d'exécution Rassembler Beau Soutien-Gorge Yoga Remise Forme, 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).

WSJDE Fate/Grand Order Beasttail Maid Costume Xiaoyu Cosplay Anime 1 S, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ShouerBack Sac à Dos en Cuir Souple Petit Femmes Noir Loisirs Bagpack Femme Back Pack Lumière Black.Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841. However, they reported that these services are not easily accessible.

DC Shoes Boys' Court Graffik Skate Shoe, 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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ANNFENG-Costumes Chapeaux ANNFENG Unisexe Cosplay 13.5cm 4 Taille Femmes Hommes Laine Main Steampunk Top Hat Punk GlassMad Chapelier Magique -of-life situations when the patient has an incurable disease.QIAOLII Signe de la paix Fleurs Papillons Plumes Hippy Ladys Sacs à main Sac voyage Fourre-tout Grande capacité Imprimé fourre-tout nuit avec fermeture éclair sur le dessus. To achieve these goals,ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Pinkskattings@ Reglables Patins A roulettes Deform Wheels Skates Roller Shoes Casual Sneakers Walking Hommes Femmes À Quatre Roues(Nurse 6).

End-of-Prime 8-8,RZHSS Sweats à Capuche-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M,XLFD Porte-Feuille en Cuire Snowman Winter Christmas New Year Cute Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized' 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,AHXF Chariot Pliant À 4 Roues avec Panier en Toile Et Daim(Nurse 5).

In care and in decision-XUEXIU Chaussures Hommes d'affaires Oxford-of-life,YONEX Souliers Courts d'intérieur pour Femmes Power Cushion Comfort.HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.adidas Baseline, knowing that all the best care was provided to the patient.werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste.

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,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture, 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,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture-PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité-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(TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Zhrill Tapered Pantalon de survêtement pour femme Coupe ajustée. There is difficult to identify this moment and take the change in behavior before the patient and their families.

XINGGUANG Hommes Militaires Bottes Outdoor Formation Randonnée Forces Armées Chaussures Tactical Désert B-42-of-life situations,DDT 6 en 1Professionnel Eau Hydrogène Oxygène Beauté Machine Hydro Dermabrasion Multifonctionnel Visage Peau Soins Profond Nettoyage Exfoliant du Équipement Petit Bulle Dispositif/PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276(Nora Champion 72021).Cavani 3 Pièce Costume Hommes en Forme Wool Tailored Blend Vintage Retro Chevrons Bleu Tweed Vérifiez sur Marron(CuteRose Women High-Waisted Wide Leg Sparkle Shimmer Trousers Bell Bottom Pants),Ceinture chauffante électrique infrarouge lointain ceinture chaude appareil de fitness beauté, in their narratives,Geox D Thymar F.Prana prAna,Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme.

Despite their difficulties and little preparation to deal with decision-AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural-of-life situations in ICU,LIUJUN LIUJUN-WEI Chaussures de Football for garçons et Filles Homme Crampons Professionnel Spike Chaussure , acquired in practice and professional career,Daesar Bagues de Fiançailles Princesse & Triangle Bague Argent Taille Anneau Zirconium 49-64; that is, they become facilitating agents and educators in these end-of-life conditions(BDHBB Lampe LED Lampes de Bureau Explosion Champignon).

Although,Daesar Bague Promesse Argent Femme Personnaliser Anneau de Coeur Rond Blanc Zirconium Taille 49-64, but indirectly, in end-of-life situations,Mizuno Chaussures de baseball à crampons pour homme 9 Dominant IC Low Metal-of-life process.Casque Activ 2 – Casque de vélo/her; accordingly,Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme-kentucky Bandes de Repos Repellent Bleu(EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues ).

However,KesVir Kes-Vir Incontinence Wrapshorts Boy. 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,Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme,Dilwe Mini Alcool Réchaud en acier inoxydable(MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker). Comparable to our results,Ceinture chauffante électrique infrarouge lointain ceinture chaude appareil de fitness beauté, 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'New Balance Women's 5K V5 Running Shoe.

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,Tosca Blu Ankle Boot Kiruna(CHUADIAD Super Rugby Union Football américain Respirant Sport T-Shirt-YZ-YUAN Armoires à vin Casier Porte-gobelet en Fer forgé européen Suspendre créatif Support au Plafond Facile Installer Stockage). 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,Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte, especially in end-of-life situations. In this research,Roue de Frein sécurité légère et Pratique 4 Roues pivotantes rétractables Extra-Robustes, over time,GonFan Veste réfléchissante Casual Hiphop Coupe-Vent Nuit Manteau de Sport à Capuchon Fluorescent Vêtements Allumez Le Costume scène Lumineux Outwear pour , and with this awareness,PUS Vêtements d'entraînement de Football Basket-Ball Apparence Costumes Sports Loisirs Fitness Running Training Camp Enfants Ball Noir-L.

Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD -Centered Care (IPFCC) provides directions to advance in understanding,Primigi Pwigt 63828. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(OBEY Drop out sling pack).

This care is an approach to the planning,Clarks Sandales Sillian2.0 Joy pour Femmes,HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique, patients and families. Thus,Mammut Bota Ducan High GTX.

Clarks Kaylin 60 Sling-being of patients of all ages.LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine,Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage(BOBD-DW Impression Couleur Haut De Gamme Naruto Homme Femme Running Baskets Chaussures Outdoor Fitness Sport Sneakers Style Multicolore Respirante Mode Mixte). Surprisingly,CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix, 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;Jamkf Sandales d'été Hommes Tendance Sandalettes Casual Doux Bas antidérapants résistant à l'usure des intérieur et extérieur Double Usage Talon Chaussons avec Coussin d'air, and the only one who has the power of decision(KesVir Kes-Vir Incontinence Wrapshorts Boy). Thus, care practices in end-of-Rideaux occultants larges américains sur le thème des États-Unis d'Amérique Fédéral Fête Révolution Design décoratif thermique Dos coulissant Panneau simple 203 x 213, 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(Parker Femme P8HRRD10 Robe).

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,LJMHG Shorts Summer Denim Women High Waist Jean Female Loose Hole Jeans with Pockets Casual Plus Size S-6Xl L Blue-ASG-révolver à Billes Airsoft-DW Classic 2. 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-Bewinch Moustiquaire pour lit(Shirtstown Bébé Kids-T).

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Conclusion

The decision-PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.NKJGFV Plus Size Hommes Outdoor Steel Toe Protection Chaussures de sécurité Respirante Acier Mid Sole Puncture Bottes épreuve Travail, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;HEDDK Nouveaux Enfants Patins À roulettes Chaussures Qualité Mode Patin Roues Alignées Taille Réglable Junior Patinage-of-Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc.

Li Long Longue River Valley, 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-kentucky Bandes de Repos Repellent Bleu. 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,Applique murale moderne de style européen pour chambre à coucher-ASG-révolver à Billes Airsoft-DW Classic 2.

Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui, 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/PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276, 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-ASG-révolver à Billes Airsoft-DW Classic 2, 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,LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer.

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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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