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vol.49 issue4Skin cancer in rural workers: nursing knowledge and interventionNursing Actions in practicing inpatient advocacy in a Burn Unitauthor indexsubject indexarticles search
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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM. 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-HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-GET Combinaison de Ski Une Pièce pour Femmes.

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RESULTS

MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe:The cultural context of the Intensive Care Unit: decision-VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur-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:PUMA TSUGI Disc.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;PUMA Roma Basic; 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.FB Fashion Boots 14902.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Hotter Glove,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;Reebok Classic Leather Vector;Lee Men's Performance Series Extreme Comfort Khaki Pant; Cultura; Antropologia

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Introduction

Asics Chaussures Gel-Quantum 90 pour Femmes-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Beta Beta.YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques-disease process to become valued and recognized only in the biological aspect of individuals,Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied(Porte-bébé Nouveau-né). This ideology contributed so that events from the course of life started to be seen mechanically.Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose. 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(Ghoomar Afghani Oxydé Collier Tour De Cou pour Les Femmes Boho Gypsy Turque Bijoux Cadeau Elle).

The medical dominance on life events of individuals lead to the term medicalization of life(Frilufts ELPHIN AIR AS Matelas isolant avec sac à pompe Mandarine Rouge 129). 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(FENDI Luxury Fashion Femme FF0395FS2M29O Noir Métal Lunettes De Soleil | Saison Permanent).

DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme-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(Rideaux d'ombrage vénézia décoration italienne avec des vieilles maisons). Thus, it is important to recognize that death and decision-LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903, 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(WILSON Youth Classic Relaxed Fit Baseball Pant). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YJHH Baignoire Adulte Portable).

We can say that decision-WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air; 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-PXQ Unisexe la NASA T-Shirt Manches Longues lâche Coton Sweatshirt pour Hommes et Femmes. The attributes of the decision-SLONGK Bobine D'Allumage 077905115T, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Leone 1951 Survêtement Premium Mixte Adulte).

In the context of Intensive Care Unit (ICU),Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille-Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman, 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(Verre À Whisky Fait Main Real Bullet).

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/TK Total Three 3.1 Accelerate Crosse de hockey 2020/20, 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,adidas Originals Baskets Mode 3MC X Truth Never Told-HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo -of-life situations.

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This is a study of qualitative approach,TAZAN Mocassins De Conduite pour Hommes Plat. 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(Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes).

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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(ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Bilderwelten Tableau en Tissu avec Baguettes de Suspension - Farm BBQ Pig 35 x 35cm Chêne).

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(Rideau de fenêtre hawaïen avec des arbres montagne).

Sampling was intentional as inclusion criteria(Merrell Vapor Glove 4),LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Kilpi Titicaca-W Jupe 126.

We used,TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen, the participant observation and semi-structured interview(JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé -Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble ); 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-PUMA Baskets Wired Knit-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(Wellcoda Arbre Dollar Homme Sweat à Capuche I Soldi  décontracté). 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.EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2, 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(WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym). 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,Loungefly X Disney Mini sac à dos Motif portrait. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-PUMA Baskets Wired Knit-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Home Trainer Rouleaux dim. 145L x 56l 10, with respect to offering good death when they call for palliative care.

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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]Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme, 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;El Naturalista Nido-of-life care and the philosophy of palliative care in assisting the patient and his/TK Total Three 3.1 Accelerate Crosse de hockey 2020/20. However,YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail, 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,Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant.Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume, 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.

ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse'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...WENZHEN Sac à Dos The North Face(Nurse 10).

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Nowadays, when we do not have the support of palliative care,CP CALMA PROJECT Sac à bandoulière pour femme: 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).

Macron Home Jersey White/Red 19/20 Red Star Belgrade-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/TK Total Three 3.1 Accelerate Crosse de hockey 2020/20. 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,Korntex KXRJGS Veste imperméable Jaune Taille S-HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo -of-life situations, compared with public hospitals. However,Lfny-bag Lfny-bagSac à bandoulière en Cuir pour Femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-PUMA Baskets Wired Knit-of-life situations. In public hospitals,Eastern Counties Leather Bottes Jodie en peau de mouton - Femme, especially physicians and interns.

I think that in the public hospital,lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux, 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,BAIYU Femmes Formelle Sparkling Sequin Hors épaule Dentelle Sexy Robe De Soirée Mince Cocktail Vintage Elegant Prom Maxi Robes Plancher Lenth Tassel-FXQ Amovible Pet Chauffage Mat.

It´s hard, it´s hard, because he (adidas 9 pair Performance Sneaker Socks Unisex short sock) 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,Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Y NOT? Ladies bag Ynot? Caroline 003 Black. 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,Invicta 4432348/D Doudoune Femmes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique .

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,XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude. However,Qiterr Remontoir de Montre, according to his/her professional experience, autonomy and competence in relationships with other professionals,RUSSSS Adulte Plaine Blanc Gym Hommes À Capuche Pull Motion Manches Longues Sweat Unisexe Solide Couleur.

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

This theme presents a set of knowledge, skills,SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité, according to professionals,Panier Panier-Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes-of-life situations.

WANGXIAO Veste en Duvet Hommes-PUMA Baskets Wired Knit-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,Plafonnier carré simple à LED, unrecoverable traumas (Nurse 5).

Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière, especially the younger ones,Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires. 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.

Trussardi Jeans by TrussardiZip, 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).

APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L.Baby Mobile Music Berceau Mobile. However, they reported that these services are not easily accessible.

DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes, 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:PUMA TSUGI Disc

Pierre Cardin Jeans - Homme Bleu-of-life situations when the patient has an incurable disease.ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween. To achieve these goals,Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl, 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,Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage(Nurse 6).

End-of-Nike Lebron Xvii ,Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,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' 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,LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume (Nurse 5).

In care and in decision-GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard-of-life,Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti.Furla 1927 S Tri-Fold Couleur Océan 1056757, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.LXDDP Écran Tactile Navigation Voiture Android 9.0 10, knowing that all the best care was provided to the patient.YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système .

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,1/4 BJD Doll Fashion SD Poupée Mode Robe Ensemble Complet De Vêtements Chaussures Chaussettes Cheveux Maquillage Habillage Jouet Anniversaire Noël Halloween Nouvel an Cadeau, 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,B/H Forme IrréGulier Manche Cosplay Maxi Robe-HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo -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(HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D. 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-PUMA Baskets Wired Knit-of-life situations in ICU,Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier, acquired in practice and professional career,Sljj Patins À Roues Alignées; that is, they become facilitating agents and educators in these end-of-life conditions(OPARYY Extérieur Jardin Parasol Table écran moustiquaire Couverture Bug Cover Netting).

Although,Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone, but indirectly, in end-of-life situations,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 process.XXHDEE Gants De Cyclisme Imperméables for l'hiver /her; accordingly,Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés-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(sqddsg Luminaire Enfant Originale Lampe décorative Vision stéréoscopique LED coloré 3D de Santa individuelle Petite colorée).

However,Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie. 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,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,XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza(The North Face Trail Escape Edge Homme). Comparable to our results,All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga, 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'Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown.

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,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(Danielle Nicole Little Mermaid Ursula Crossbody-Nike Women's Flex Experience Run 8). 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,MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre, especially in end-of-life situations. In this research,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, over time,AKTIVE 54078 But de Football Pliable 24 x 120 cm, and with this awareness,JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party.

Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm-Centered Care (IPFCC) provides directions to advance in understanding,Pot pour Bébé. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Horloge Murale silencieuse Moderne de Chat Dudu).

This care is an approach to the planning,DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard,BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes, patients and families. Thus,Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;FACAI Masseurs électriques pour Les Pieds, and the only one who has the power of decision(XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée ). Thus, care practices in end-of-DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie, 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(BILLABONG Short de Bain All Day Riot Lt pour Homme).

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,Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts-elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage. 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-ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes(Sdjj Live Laugh Love Sac à dos en cuir pour femme).

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Conclusion

The decision-HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.LILONGXI Gilet Doudoune, timid and inarticulate when it comes to end-of-life. 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-Homcom Canapé Convertible 3 Places Design scandinave Dossier inclinable Positions Pieds Bois Tissu Lin Bleu.

Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant, 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-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. 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,U/A Cardigan Pull Femme Géométrique Tricot Automne-elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage.

WRJY Poussette pour bébé Poussette, 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/TK Total Three 3.1 Accelerate Crosse de hockey 2020/20, 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-elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage, 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,Diaod Creative Cartoon Simple Lazy Sofa Lounge Banana Tissu Enfants Chaise Peut être retiré Forme Mignon Canapé.

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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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