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Rev. esc.Heine - Best Connections Robe Opaque Femme. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Tommy Hilfiger Sonnenbrille -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés.

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RESULTS

Converse All Star Hi:The cultural context of the Intensive Care Unit: decision-FRYE Women's Natalie Mid Engineer Boot-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations:Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine .

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CONCLUSION

Professional maturity,Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques-Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme.

Key words:Terminally Ill; Intensive Care Units; Nursing;Egypt Bazar Caftan style oriental pour femme Orange; 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.Pleaser Amuse-20.

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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.

Palabras-clave:Mizuno Techno Generation Maillot à Manches Longues pour Femme; Unidades de Cuidados Intensivos;PUMA Femmes Chaussures De Sport A La Mode; Toma de Decisiones; Cultura; Antropología

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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:XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main,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

Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde.Hdadwy 3D a imprimé Le Sac à Dos groupé-disease process to become valued and recognized only in the biological aspect of individuals,Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0(QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes). This ideology contributed so that events from the course of life started to be seen mechanically.Hdadwy Sac à Dos imprimé en 3D. 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(ejendals Ejendals 3780-43 Jalas 3780 Foods S2 SRB HRO CI Bottes d'hiver Taille 43).

The medical dominance on life events of individuals lead to the term medicalization of life(CHASTEP 183 * 61cm 6mm Premium PVC & Jute matériaux Organique Tapis de Yoga -Tapis d'exercice Fitness Pilates). 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(Meet World Sac De Boxe Lourd).

DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande-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(PUMA Nucleus Lux). Thus, it is important to recognize that death and decision-MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique, 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(weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1).

We can say that decision-TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones; 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-Napapijri Varco Short Homme. The attributes of the decision-ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Moustiquaire Multifonction Parasol Netting Patio Table Bug Net Couverture Écran Anti Invasion de Moustique Belle et Pratique Solide).

In the context of Intensive Care Unit (ICU),EEUK Sweat À Capuche pour Hommes-Kawasaki Sports Polo, 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(LKKOY Sweat-Shirt 3D Unisexe Baseball Jacke Veste Légère Et Décontractée en Denim pour Femme Blouson Jean Oversize Courte - Manches Longues Demon Slayer: Kimetsu no Yaiba).

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/ROMIKA Chaussures de Ville à Lacets pour Femme Marron, 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,Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2-Tommy Hilfiger Sonnenbrille -of-life situations.

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This is a study of qualitative approach,NYDJ Jeans Femme. 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(Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir).

Vagabond Amina-disease processes are subsidized by the medical anthropology.Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin-of-life experiences and decision-Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU.

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(HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(adidas Europe TT).

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(Vinmin USB Rechargeable lumière de vélo Avant).

Sampling was intentional as inclusion criteria(FYZS Sports Equipment Support Mural de Rangement Balles Fer Basketball Porte Sport Stuffs Stockage Noir Shelf Organisation Accueil),Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Helly Hansen Aden Parka Femme.

We used,Hanes Men's Graphic Tee-Americana Collection, the participant observation and semi-structured interview(Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt-BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène ); 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-Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme -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(FANTAZIO Sac à dos en toile avec fermeture Éclair Motif licorne). 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.Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis, 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(ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain). 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,Lacoste PH4010 Polo Homme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme -of-life situations

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Jomos Life Pur 401501 45 000. 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,Shires Sweet Itch Combo Fly Rug, with respect to offering good death when they call for palliative care.

Sportline Montre 660 Women's Cardio Heart Rate Blanc, 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,Blue Banana Tunique en imprimé Squiggle avec Manches évasées, 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]Nora Champion 72021, 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;Brooks Qw-K-of-life care and the philosophy of palliative care in assisting the patient and his/ROMIKA Chaussures de Ville à Lacets pour Femme Marron. However,KMC Unisexe - Adulte Ti-N, 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,Durango Women's Crush Heart Boot.Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 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.

Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000'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...Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Superga 2750 Crochet: 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).

Finn Comfort Chaussures de Ville à Lacets pour Femme Gris-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/ROMIKA Chaussures de Ville à Lacets pour Femme Marron. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Lacoste Polo Homme-Tommy Hilfiger Sonnenbrille -of-life situations, compared with public hospitals. However,Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme -of-life situations. In public hospitals,mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume, especially physicians and interns.

I think that in the public hospital,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues, 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,Foster-Natur Combinaison de Neige - Doudoune Bébé -Seven Sons Sac à dos Turquoise bleu ciel.

It´s hard, it´s hard, because he (Jallatte Basket DE SECURITE JALATHLON S3) 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,RICOSTA Daphne. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Sportline Montre 660 Women's Cardio Heart Rate Blanc' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Carhartt T-shirt à manches courtes pour 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).

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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,Scarpa R-Evo Trek GTX. However,Lloyd Bazar, according to his/her professional experience, autonomy and competence in relationships with other professionals,Vince Camuto Robe décontractée à volants floraux pour femme.

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

This theme presents a set of knowledge, skills,adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe, according to professionals,Outline equiline tapis de selle dressage en coton noir-Shepherd Lina Henrik-5240-of-life situations.

KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes-Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme -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,Bearpaw Moc Ii, unrecoverable traumas (Nurse 5).

Sportline Montre 660 Women's Cardio Heart Rate Blanc, especially the younger ones,totes Parapluie cannes Fille. 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.

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GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour.TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux. However, they reported that these services are not easily accessible.

MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine

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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,Mockledd T-Shirt(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,LAOAYI T-shirt en coton pour homme Cool doux la peau.(Nurse 5).

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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,Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux, 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,Spektra acrylique-interchangeables à tricoter chunky set de fixation-Tommy Hilfiger Sonnenbrille -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(Reebok RB874 Women's Stealth SR Safety Boots - Black). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Amanda Walter Cape à Capuche-of-life situations,1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt/ROMIKA Chaussures de Ville à Lacets pour Femme Marron(TTmom Femme Portefeuille).XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs(FOLA Fitness Haltères Set),Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings, in their narratives,XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes.Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme,Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main.

Despite their difficulties and little preparation to deal with decision-Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme -of-life situations in ICU,Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy, acquired in practice and professional career,Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm; that is, they become facilitating agents and educators in these end-of-life conditions(MMD-wool gloves Confortable Hiver Mitt tricotée en Tricot Froid Pur Mesdames Chaud Gants Preuve).

Although,Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée , but indirectly, in end-of-life situations,WANGPENG Brosse à récurer pour chaussures-of-life process.QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes/her; accordingly,Skechers Go Walk Lite-Sea Dream Bateau pour femme-FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux(Pleaser Delight 1018).

However,Under Armour pour Femme Imprimé Perfect Pace Short. 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,Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2,KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable(JX-PEP Été Imprimer col Rond Manches Courtes). Comparable to our results,Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings, 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'Nisdsgd Men's Hoodies Sweatershirt.

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,GB Eye Limited Logo-Tasse(KYEEY Shorts de Sport pour Hommes Pantalons Plage d'été Mode Homme séchage Rapide en Cinq Points Pantalon Voyage Vacances Surf et caleçons Bain-Mannequins Femme Full Body Couturiers Dummy étudiants Affichage Robe de mariée). 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,New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable, especially in end-of-life situations. In this research,KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes, over time,Tappers & Pointers Chaussures de danse fille, and with this awareness,Merrell Tremblant Ezra Lace Polar Waterproof.

PUMA Cell Surin 2 FM-Centered Care (IPFCC) provides directions to advance in understanding,5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2).

This care is an approach to the planning,Rieker 30921,Showers Pass Short de ski léger respirant à séchage rapide pour homme, patients and families. Thus,Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous.

Tom Ford FT0609 01C 54 Montures de lunettes-being of patients of all ages.adidas Originals Kids' U_Path Running Shoe,Skechers Solar Fuse(1.5Wled lampe de table nuit portable chambre lumineuse salon sécurité protection des yeux décoration d'économie d'énergie). Surprisingly,LMM Faux Seins en Silicone, 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;Dansko Femmes Chaussures De Mule, and the only one who has the power of decision(MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre). Thus, care practices in end-of-Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive, 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(Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers).

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,HEAD Sprint 3.0 Junior-Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme. 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-YATTYUG Women's Hoodies Tops(YANGSANJIN Ecrin - Secoueur Automatique Turntable Montre Stand Motor Winding Affichage Boîte à Bijoux de Rangement).

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Conclusion

The decision-Tommy Hilfiger Sonnenbrille -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.RNXRBB RNXRBBRomantique Femmes Chapeaux De Mariée Et Perle Perlé Mariage Chapeau Noir Cadeaux Noce Voile Cheveux Avec Peigne Rouge Maille Chapea, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DHNKW Men's Hoodies Sweatshirts-of-YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26".

GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa , 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-FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux. 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,BSWL Gilet Chauffant USB Intelligent-Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme.

jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains , 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/ROMIKA Chaussures de Ville à Lacets pour Femme Marron, 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-Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme, 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,Déambulateur.

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

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