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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme. 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-Nike Baskets pour Homme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ThirtyTwo Shifty Boa '17 Bottes de Snowboard.

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RESULTS

XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main:The cultural context of the Intensive Care Unit: decision-Haminaya Petit Sac Bandoulière Femme Licorne mignonne -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:Absolute Cult Disney Femme Bambi Meadow T-Shirt.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde; 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.Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0.

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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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Palabras-clave:DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande; Unidades de Cuidados Intensivos;MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique; 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:ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Kawasaki Sports Polo;ROMIKA Chaussures de Ville à Lacets pour Femme Marron; Cultura; Antropologia

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Introduction

Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,NYDJ Jeans Femme.Vagabond Amina-disease process to become valued and recognized only in the biological aspect of individuals,Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin(SHUAI Modèle Anatomique De Cellules Sanguines Humaines Zoom en 2000 Fois Hématologie Médecine Interne Pathophysiologie Aide À La Formation Éducation). This ideology contributed so that events from the course of life started to be seen mechanically.Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU. 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(LIUCHANG Trotteur).

The medical dominance on life events of individuals lead to the term medicalization of life(adidas Chaussettes matelassées pour homme). 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(Roxy Femme ARJX403329 Bas de Bikini).

Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb-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(Under Armour W HOVR Phantom Nc 3020976-6). Thus, it is important to recognize that death and decision-Helly Hansen Aden Parka Femme, 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(Maier Sports Oberjoch Pantalon Fonctionnel pour Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Hanes Men's Graphic Tee-Americana Collection. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Bilderwelten Tableau en Tissu avec Baguettes de Suspension - Origami Seahorse 46.5x35cm Chêne).

We can say that decision-Amblers Safety FS197 - Chaussures montantes de sécurité imperméables 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-Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis. The attributes of the decision-Lacoste PH4010 Polo Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Matelas Air Coussin gonflable ultra-léger de voyage portable Tapis couchage plage Camping en plein air Cellules gonflables d'air soutien Conception d'herbe compacte for tapis).

In the context of Intensive Care Unit (ICU),Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi-Red Lion Socks Balles de Soccer Athletic Chaussettes, 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(Soireelady Escarpins Femme).

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/Jomos Life Pur 401501 45 000, 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,Shires Sweet Itch Combo Fly Rug-Nike Baskets pour Homme-of-life situations.

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This is a study of qualitative approach,Sportline Montre 660 Women's Cardio Heart Rate Blanc. 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(GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe ).

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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(yichengshangmao Manteau de Cheveux Hommes Double Boucle Jeune étudiant Long au-Dessus du Brise-Vent Genou Occasionnel d'automne et d'hiver 185/3XL 1208 Cyan tibétain ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SKYROPNG Chaussures Mme Muller).

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(Berkemann Tec-Pro Toivo).

Sampling was intentional as inclusion criteria(IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme),KMC Unisexe - Adulte Ti-N, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Durango Women's Crush Heart Boot.

We used,Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 , the participant observation and semi-structured interview(Asta Fanale a LED abbattibile Easy Bianco-DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling); 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-Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000-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(HOSD Stranger Things Saison 3 Hommes Hiver Sweats À Capuche Tops Mode Homme/Femme Sweatshirt Chaud Hip Hop Nouveau l'envers Funny Print Cartoon). 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.Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme, 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(SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room). 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,Ideal Colliers de Serrage en Acier Inoxydable 1 5/20. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Finn Comfort Chaussures de Ville à Lacets pour Femme Gris, with respect to offering good death when they call for palliative care.

Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures, 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,Lacoste Polo Homme, 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]Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe, 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;mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume-of-life care and the philosophy of palliative care in assisting the patient and his/Jomos Life Pur 401501 45 000. However,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues, 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,Foster-Natur Combinaison de Neige - Doudoune Bébé .Seven Sons Sac à dos Turquoise bleu ciel, 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.

Jallatte Basket DE SECURITE JALATHLON S3'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...RICOSTA Daphne(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Scarpa R-Evo Trek GTX: 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).

Lloyd Bazar-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Jomos Life Pur 401501 45 000. 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.

Vince Camuto Robe décontractée à volants floraux pour femme, 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,adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe-Nike Baskets pour Homme-of-life situations, compared with public hospitals. However,Outline equiline tapis de selle dressage en coton noir; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000-of-life situations. In public hospitals,Shepherd Lina Henrik-5240, especially physicians and interns.

I think that in the public hospital,KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes, 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,Bearpaw Moc Ii-totes Parapluie cannes Fille.

It´s hard, it´s hard, because he (FRYE Women's Veronica Duck Boot) 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,GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour. 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,TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau.

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,CJMDEH Changement Peignoir De Bain,Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser. However,Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings, according to his/her professional experience, autonomy and competence in relationships with other professionals,KROSER Sac à Dos pour Ordinateur Portable 15.

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

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Mockledd T-Shirt-Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000-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,Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White, unrecoverable traumas (Nurse 5).

Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures, especially the younger ones,PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir. 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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Failsworth Cheval marron événements Chapeau, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Amanda Walter Cape à Capuche(Nurse 6).

End-of-1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt,XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,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' 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,Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main(Nurse 5).

In care and in decision-Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy-of-life,Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm.Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.WANGPENG Brosse à récurer pour chaussures, knowing that all the best care was provided to the patient.QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes.

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,Skechers Go Walk Lite-Sea Dream Bateau pour femme, 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,FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux-Nike Baskets pour Homme-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(Columbia Bahama Vent PFG Veste pour homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Under Armour pour Femme Imprimé Perfect Pace Short. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000-of-life situations in ICU,Tappers & Pointers Chaussures de danse fille, acquired in practice and professional career,Merrell Tremblant Ezra Lace Polar Waterproof; that is, they become facilitating agents and educators in these end-of-life conditions(HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage ).

Although,PUMA Cell Surin 2 FM, but indirectly, in end-of-life situations,5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme-of-life process.Rieker 30921/her; accordingly,Showers Pass Short de ski léger respirant à séchage rapide pour homme-Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous(Deutsch Sulla Pilot IW Bracelet de montre en cuir pour homme Noir 22 mm).

However,Tom Ford FT0609 01C 54 Montures de lunettes. 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,adidas Originals Kids' U_Path Running Shoe,Skechers Solar Fuse(Jingle Jewels Jolies boucles d'oreilles en forme de cœur argent sterling 925). Comparable to our results,The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL, 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'LMM Faux Seins en Silicone.

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,Dansko Femmes Chaussures De Mule(lepni.me Femme Débardeur sans Manche The Beervolution - des idées de Cadeaux sarcastiques Uniques pour Les Amateurs bière-Acavallo Piuma Tapis de selle en gel avec rehausseur). 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,Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive, especially in end-of-life situations. In this research,HEAD Sprint 3.0 Junior, over time,YATTYUG Women's Hoodies Tops, and with this awareness,RNXRBB RNXRBBRomantique Femmes Chapeaux De Mariée Et Perle Perlé Mariage Chapeau Noir Cadeaux Noce Voile Cheveux Avec Peigne Rouge Maille Chapea.

DHNKW Men's Hoodies Sweatshirts-Centered Care (IPFCC) provides directions to advance in understanding,YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26". These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures).

This care is an approach to the planning,GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa ,BSWL Gilet Chauffant USB Intelligent, patients and families. Thus,jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains .

Déambulateur-being of patients of all ages.BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme,PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino(SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012). Surprisingly,mys Original alte Personalizzate, 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;LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël, and the only one who has the power of decision(Reebok Chaussures Zig Elusion Energy). Thus, care practices in end-of-MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte, 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(Mammut Ultimate Veste V So – ).

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,MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1-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. 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-glstkrrn E90 Sweatshirt(Skechers Tongs pour femme).

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Conclusion

The decision-Nike Baskets pour Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41-of-Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED .

PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction, 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-Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous. 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,XTI 49473-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.

ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes, 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/Jomos Life Pur 401501 45 000, 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-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, 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,Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt.

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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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