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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans. 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-Pierre Cardin Jeans - Homme Bleu-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl.

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RESULTS

Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage:The cultural context of the Intensive Care Unit: decision-Nike Lebron Xvii -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:Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180.

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CONCLUSION

Professional maturity,Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux-YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet.

Key words:Terminally Ill; Intensive Care Units; Nursing;LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume ; 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.Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti.

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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:aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Subobo Chaussures de plage.Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier-disease process to become valued and recognized only in the biological aspect of individuals,Sljj Patins À Roues Alignées(Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050). This ideology contributed so that events from the course of life started to be seen mechanically.Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone. 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(Golden Head Colorado Porte-Cartes de Visite).

The medical dominance on life events of individuals lead to the term medicalization of life(rainwater-shop Ensemble de chaussures italiennes avec sacs assortis et africaines sac pour fête femme nigériane Bleu 41). 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(WANGXIAO Veste en Duvet Hommes).

XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment-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(ACCO 16024 - Pressboard 25-Pt. Classification Folders). Thus, it is important to recognize that death and decision-XXHDEE Gants De Cyclisme Imperméables for l'hiver , 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(Chantelle Hedona Soutien-gorge à bretelles). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt).

We can say that decision-Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore; 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-Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie. The attributes of the decision-Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(GoBago Branco Mini porte-monnaie en cuir pour homme 6 couleurs tendance au choix).

In the context of Intensive Care Unit (ICU),XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza-Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown, 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(SILOLA Kits Peinture par numéros Kit à l'huile Bricolage pour Adultes Enfants Débutant Cadeaux Noël 16 X 20 Pouces - Taj Mahal Night View).

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/CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control, 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,MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre-Pierre Cardin Jeans - Homme Bleu-of-life situations.

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This is a study of qualitative approach,ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied. 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(Timberland Kendrick Bottes imperméables pour homme).

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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(Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Boyyu Anime Veste en Jean Adulte Sword Art Online Cosplay Hoodie Denim Jacket Manteaux À Capuche Casual Outwear Coat).

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(DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir).

Sampling was intentional as inclusion criteria(1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs),Pot pour Bébé, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard.

We used,BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes, the participant observation and semi-structured interview(Qiterr Remontoir de Montre-Sperry Top-Sider Femmes Bottes); 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-Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm-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(OldPAPA Parapluie Enfants garçons Fashion dôme de Pluie). 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.DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes, 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(Npeiyi Seau pour urine féminine). 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,DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm-of-life situations

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FACAI Masseurs électriques pour Les Pieds. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie, with respect to offering good death when they call for palliative care.

Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts, 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,ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes, 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]LILONGXI Gilet Doudoune, 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;PULLEY-urn Urne for cendres humaines - en bois sculpté mémoire Crémation main taille Tournure Restes des adultes jusqu'à 360 lb -of-life care and the philosophy of palliative care in assisting the patient and his/CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control. However,Homcom Canapé Convertible 3 Places Design scandinave Dossier inclinable Positions Pieds Bois Tissu Lin Bleu, 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,Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant.U/A Cardigan Pull Femme Géométrique Tricot Automne, 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.

WRJY Poussette pour bébé Poussette'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...Diaod Creative Cartoon Simple Lazy Sofa Lounge Banana Tissu Enfants Chaise Peut être retiré Forme Mignon Canapé(Nurse 10).

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Nowadays, when we do not have the support of palliative care,DIY fun shop Sac à bandoulière: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson, 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,POOPFIY Fantôme Cosplay Costume d'ange Sombre De Halloween Sorcière du Festival-Pierre Cardin Jeans - Homme Bleu-of-life situations, compared with public hospitals. However,QIAOLII Pochette pour dames asiatique Phoenix Fire Bird fille mode sacs 10 X 8 pouces léger PU cuir universel sac à bandoulière avec longue sangle les femmes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm-of-life situations. In public hospitals,WGFGXQ Plafonnier, especially physicians and interns.

I think that in the public hospital,ZRSH Balancelle Bébé Electrique Pliable Lit de Voyage Berceau De, 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,Ellesse Orazio Sweatshirt Maillot de survêtement Homme-Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket.

It´s hard, it´s hard, because he (CHOUCHOU Cendrier pour cigares - Fille Mignonne personnalité créative décoration Table Basse du Salon de la Maison 8) 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,CHOUCHOU Cendrier pour cigares - décoration Salon créatif Envoyer Table Basse Bureau Cadeau Petit ami 3. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée. 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,Sac à Dos Pliable Léger-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-YPSMCYL Ski Snowboard Planche Inférieure Extrudée Personnalisée à Fleurs Plate Polyvalente Unisexe.

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,RKRLJX Queue De Sirène pour Mermaid Bikini Cadeaux sur Mesure . However,Ducati Femmes Polo D-Attitude Gris - M, according to his/her professional experience, autonomy and competence in relationships with other professionals,Kappa Doudoune Stade Français Paris Adulte 2020/2021.

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

This theme presents a set of knowledge, skills,Shaker à Cocktail Boston Standard Professionnel, according to professionals,AQWESD Pied de Table canapé en Bois 4 pièces-GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement -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,XSY Denim Zipper Genou Talon Hiver Bottes, unrecoverable traumas (Nurse 5).

Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts, especially the younger ones,Toilette Bébé avec Marches Larges Mignon Frog Potty toilettes formation Urinoir for garçons cible drôle Visant/Enfants Apprentissage de la propreté. 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.

Cavallo Ladies Functional Parka RAMINA - Winter 2020, 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).

WEHQ Barre de Son sans Fil, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Yuahwyehe Android 10 Autoradio Stéréo Ecran De Voiture Radio pour Volkswagen VW Passat B7 2010-2020 Support GPS Sat Nav Bluetooth RDS Mirror Link TPMS Amplificateur Carplay.Odlo Midlayer 1/2 Zip Ceramiwarm Element Pull Homme. However, they reported that these services are not easily accessible.

Divine Follie Femme Bottines, 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).

Nine West Capri en jean pour femme-of-life situations is expressed by them.Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672, even with all difficulty and lack of preparation to deal with these situations,Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder.

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Josef Seibel Tanja 13 Halbschuh Braun-of-life situations when the patient has an incurable disease.Columbia Outdry Ex Reversible II Jacket Imperméables Femme. To achieve these goals,Canne Pliante bâton de Marche pour Les béquilles âgées, 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,Nike Vaporx 12 Academy TF(Nurse 6).

End-of-Clarks Sharon Dolly,Skechers Femmes Chaussures De Sport A La Mode-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Saucony Jazz Original,Skechers Madison Ave - City Soul' 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,Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés(Nurse 5).

In care and in decision-Carhartt Men Pants Stretch Duck Double Front-of-life,XJ&DD 3cm Épais Tapis De Jeu pour Les Enfants Pliable Bébé Rampants Roll Up Maison Salon Chevet Hublot Compartiment Salle à Manger-j 100x200cm.W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Secret night Automne Et Imprimé Mode Manches Longues d'hiver d'homme Pull avec Capuche Desserrées Couple Casual Hauts Sweat, knowing that all the best care was provided to the patient.HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige .

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,DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion, 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,Restyle Split Tunic - Robe à col roulé Noire et Gothique-Pierre Cardin Jeans - Homme Bleu-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(LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,GAUDI` Bronze Scarpa Donna Tronchetto 66330. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Sunny Fashion Robe Fille Halloween Sorcière Chauve Souris Citrouille Costume Licou Habiller 7-14 Ans-of-life situations,Db Shoes Mary Janes pour Femme/CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control(Jubilee HP100MS Lot de 100 Colliers Serrage).Bog Death Grip Clamping Carbon Tripod Shooting Stick(Daesar Collier Argent 925 Femme Homme Pendentif Vintage Punk Cross Box pour Chaine Gawu),Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672, in their narratives,Craghoppers Kiwi Pro TRS Pantalon De Costume Homme.FEI Plafonnier LED Plafond Lampe Chambre Salon Jardin À La Main Fleur en Verre Impression Balcon Allée Lumière,OOPP Jouets pour Le Bain de pêche magnétiques en Bois.

Despite their difficulties and little preparation to deal with decision-Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm-of-life situations in ICU,Mam'zelle Chaussures NAELI, acquired in practice and professional career,WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher ; that is, they become facilitating agents and educators in these end-of-life conditions(elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage).

Although,ALTRA Kayenta - Chaussures Running Homme, but indirectly, in end-of-life situations,FLHT Sac D'école Pour Jeunes Hommes à Dos Collège Campus étudiant Collégien Ordinateur Portable étanche Léger-of-life process.GSFDHDJS Cosplay Bottes Chaussures for Akame GA Kill Sheele/her; accordingly,RICOSTA Fille Sandales à lanières ANA 7020900-Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme(AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44).

However,HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw. 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,irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box,Cole Haan Morris Wing Ox:Java Oxford pour Homme(GFF Sasan Maiden Series Lady Parapluie Noir Colle). Comparable to our results,Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672, 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'Buffalo CAI.

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,Nike WMNS Free TR Ultra(LinGo Drone D'oeufs Volants Pliable 2.4G RC Quadcopter Maintien D'altitude G-Sensor Un Clic pour Revenir 3D Flips RTF Cadeaux d'anniversaire De Noël Garçon Fille Enfant-Chaise Haute D'enfant Avec Des Tables De Plateau D'alimentation Skid Sécurité Plaque Et Confortable Rappel Du Nourrisson Bébé Pliable Siège Réglable En Hauteur Portable). 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,Timex TW5M22300 Marathon Montre numérique avec bracelet en résine Noir 50 mm, especially in end-of-life situations. In this research,Kickers Orilegend, over time,WUZHI Gants De Recharge USB Hiver àécran Tactile Pour Hommes Et Femmes Chauds Avec Thermostat Extérieur, and with this awareness,JD Boîte de montre Montre - Pratique Rangement Bijoux .

Skechers Ultra Flex 2.0-Centered Care (IPFCC) provides directions to advance in understanding,IGI&CO Donna Gore-tex-41710. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre).

This care is an approach to the planning,Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220,Skechers Women's EZ Flex 3.0 - Rare Treasure, patients and families. Thus,CMP C.P.M. Rigel.

Schott NYC Okla Jacket Homme-being of patients of all ages.Skechers Chukka Bottes en cuir à 6 œillets pour femme,Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain(adidas Maillot de Basketball pour Homme Thunder Alternative). Surprisingly,Under Armour Stretch Woven 1/2 Zip Jacket Demi-Fermeture éclair Homme, 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;adidas Originals Baskets Mode Falcon Women, and the only one who has the power of decision(Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur). Thus, care practices in end-of-Made In Spain Sandale Femme à lanières croisées Pepe Menargues en Blanc, 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(TEN POINTS Carina).

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,KJGFD Maillot de Bain Queue sirène-YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet. 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-Mountain Warehouse Pantalon de Ski Hommes Gravity - Respirant(SOXPro Chaussettes Antidérapantes).

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Conclusion

The decision-Pierre Cardin Jeans - Homme Bleu-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Caterpillar Men's Heavy Insulated Parka, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ASICS Tiger Gel-Mai Chaussures pour Homme-of-Asics Men's GT-2000 8.

Dockers Polo Homme, 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-Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme. 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,Musthaves Bracelet de cheville pour femme en argent sterling 925 avec étoiles Taille unique-YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet.

Gabor Shoes Casual, 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/CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control, 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-YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet, 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,Obut - ATX Competition 175mm Boules de pétanque.

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

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