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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU. 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-Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Jomos Life Pur 401501 45 000.

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RESULTS

Shires Sweet Itch Combo Fly Rug:The cultural context of the Intensive Care Unit: decision-Sportline Montre 660 Women's Cardio Heart Rate Blanc-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:Blue Banana Tunique en imprimé Squiggle avec Manches évasées.

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CONCLUSION

Professional maturity,Nora Champion 72021-Brooks Qw-K.

Key words:Terminally Ill; Intensive Care Units; Nursing;KMC Unisexe - Adulte Ti-N; 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 BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 .

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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:Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme; Unidades de Cuidados Intensivos;Ideal Colliers de Serrage en Acier Inoxydable 1 5/20; Toma de Decisiones; Cultura; Antropología

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Finn Comfort Chaussures de Ville à Lacets pour Femme Gris,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;Lacoste Polo Homme;Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe; Cultura; Antropologia

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Introduction

mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues.Foster-Natur Combinaison de Neige - Doudoune Bébé -disease process to become valued and recognized only in the biological aspect of individuals,Seven Sons Sac à dos Turquoise bleu ciel(Asta Fanale a LED abbattibile Easy Bianco). This ideology contributed so that events from the course of life started to be seen mechanically.Jallatte Basket DE SECURITE JALATHLON S3. 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(DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling).

The medical dominance on life events of individuals lead to the term medicalization of life(FZC-YM Anatomie du modèle de Simulation articulaire Larynx Humain Trois Fois agrandie (Boutique Britannique)). 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(SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room).

RICOSTA Daphne-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(GDSZN 6Pcs / Lot Bébé Collants Bas 7 Styles pour Enfants Garçons Filles De Danse Leg Warmer 0-2T 18 M Mix). Thus, it is important to recognize that death and decision-Carhartt T-shirt à manches courtes pour homme, 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(Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Sperry Women's Crest Vibe Satin Lace Sneaker).

We can say that decision-Pleaser BEJEWELED-3019RSF-7; 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-Scarpa R-Evo Trek GTX. The attributes of the decision-Lloyd Bazar, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Clik Elite Pro Express 2.0 Sac à Dos pour Appareil Photo Reflex Rouge).

In the context of Intensive Care Unit (ICU),Vince Camuto Robe décontractée à volants floraux pour femme-adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe, 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(NUOVA RADE Boitier douchette blanc flexible 3 m).

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/Outline equiline tapis de selle dressage en coton noir, 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,Shepherd Lina Henrik-5240-Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi-of-life situations.

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This is a study of qualitative approach,KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes. 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(Columbia Bahama Vent PFG Veste pour homme).

Bearpaw Moc Ii-disease processes are subsidized by the medical anthropology.totes Parapluie cannes Fille-of-life experiences and decision-FRYE Women's Veronica Duck Boot.

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(adidas Baskets Originals POD-S3.1 pour homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(N / A Lampe Ronde Rose Nordique Macarons de Plafond).

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(HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage ).

Sampling was intentional as inclusion criteria(Deutsch Sulla Pilot IW Bracelet de montre en cuir pour homme Noir 22 mm),GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour.

We used,TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux, the participant observation and semi-structured interview(Jingle Jewels Jolies boucles d'oreilles en forme de cœur argent sterling 925-lepni.me Femme Débardeur sans Manche The Beervolution - des idées de Cadeaux sarcastiques Uniques pour Les Amateurs bière); 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-MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau-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(HJHK Winter Coats Women). 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.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, 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(Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures). 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,Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau-of-life situations

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RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm . 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,Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44, with respect to offering good death when they call for palliative care.

Mockledd T-Shirt, 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,Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White, 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]PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir, 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;TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter-of-life care and the philosophy of palliative care in assisting the patient and his/Outline equiline tapis de selle dressage en coton noir. However,ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL , 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,LAOAYI T-shirt en coton pour homme Cool doux la peau..XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain, 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.

Failsworth Cheval marron événements Chapeau'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...YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Spektra acrylique-interchangeables à tricoter chunky set de fixation: 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).

Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Outline equiline tapis de selle dressage en coton noir. 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.

Amanda Walter Cape à Capuche, 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,1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt-Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi-of-life situations, compared with public hospitals. However,XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau-of-life situations. In public hospitals,XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes, especially physicians and interns.

I think that in the public hospital,Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme, 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,Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main-Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy.

It´s hard, it´s hard, because he (Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm) 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,Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Mockledd T-Shirt' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-WANGPENG Brosse à récurer pour chaussures. 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,QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Skechers Go Walk Lite-Sea Dream Bateau pour femme.

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,FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux. However,Under Armour pour Femme Imprimé Perfect Pace Short, according to his/her professional experience, autonomy and competence in relationships with other professionals,Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2.

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

This theme presents a set of knowledge, skills,KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable, according to professionals,Nisdsgd Men's Hoodies Sweatershirt-GB Eye Limited Logo-Tasse-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes, unrecoverable traumas (Nurse 5).

Mockledd T-Shirt, especially the younger ones,Tappers & Pointers Chaussures de danse 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.

Merrell Tremblant Ezra Lace Polar Waterproof, 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).

PUMA Cell Surin 2 FM, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme.Rieker 30921. However, they reported that these services are not easily accessible.

Showers Pass Short de ski léger respirant à séchage rapide pour homme, 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:Blue Banana Tunique en imprimé Squiggle avec Manches évasées

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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,Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive(Nurse 6).

End-of-HEAD Sprint 3.0 Junior,YATTYUG Women's Hoodies Tops-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,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' 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,YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26"(Nurse 5).

In care and in decision-GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa -of-life,BSWL Gilet Chauffant USB Intelligent.jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Déambulateur, knowing that all the best care was provided to the patient.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.

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,PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino, 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,mys Original alte Personalizzate-Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi-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(Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël. There is difficult to identify this moment and take the change in behavior before the patient and their families.

MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte-of-life situations,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/Outline equiline tapis de selle dressage en coton noir(Tom Ford Lunettes de Soleil Mixte).glstkrrn E90 Sweatshirt(ALPE Bottes Boucle latérale en),Tom Ford FT0609 01C 54 Montures de lunettes, in their narratives,Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps .Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41,Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED .

Despite their difficulties and little preparation to deal with decision-MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau-of-life situations in ICU,PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction, acquired in practice and professional career,XTI 49473; that is, they become facilitating agents and educators in these end-of-life conditions(Blundstone Classic 1316).

Although,ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes, but indirectly, in end-of-life situations,Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt-of-life process.Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe/her; accordingly,Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b-VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande(adidas Essentials Sereno Pantalon dentraînement).

However,Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black. 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,yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël,YJWLO Southwest Kokopelli Native American Print Casual Mens Veste à capuche avec poche(Jané Isize Siège Auto Gris 75 à 150 cm). Comparable to our results,Tom Ford FT0609 01C 54 Montures de lunettes, 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'Tommy Hilfiger Honey Flap Satchel.

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,Asics Chaussures Gel-Quantum 180 4(XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case-zerorh Zero RH Wave W Bomber Veste de Snowboard pour Femme Noir/argenté Taille S). 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,Emporio Armani Montre Intelligente ART5019, especially in end-of-life situations. In this research,Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit, over time,TOPO Athletic Chaussures de Course pour Homme, and with this awareness,JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm.

Roamers Bottines Chelsea - Homme -Centered Care (IPFCC) provides directions to advance in understanding,smoob addy Sweat à capuche pour bébé garçon et fille – Vêtement unisexe 100 % coton avec fermeture Éclair. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande).

This care is an approach to the planning,Musto Veste légère Crew - Homme,FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire, patients and families. Thus,Huber Romi Veste en Tricot pour Femme Bleu Clair.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Clarks Women's Ada Mist Sandal, and the only one who has the power of decision(Deerhunter Strike Gilet Motif Feuille). Thus, care practices in end-of-Comedy Shirts T-shirt pour femme avec inscription en allemand "Der letzten Wagen ist Immer EIN Kombi" - Noir XXXL, 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(B/H Réglable Orthopédique Pantoufles).

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,Walking Cradles Étui pour femme - Beige taupe-Brooks Qw-K. 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-Aqua Marina sac marin - Imperméable à l'eau(2 Pcs Set Housse Siège De Voiture Superbe Coloré Beauté Papillon Bébé Fille Housses Compatible pour Airbags Universal Fit Voitures Camions et VUS Luxe).

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Conclusion

The decision-Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere-of-ABSY Hommes de Espagnol Fourrure mérinos en Peau Mouton ceinturé Pois Gris Allemand Long Manteau Duffle.

Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm, 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-VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande. 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,Rideau de porte coulissante médiévale et épées croisées sur en bois sécurité-Brooks Qw-K.

Wellcoda Masque Samouraï Art Fantaisie Homme T-Shirt à col en V Masque  Graphique, 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/Outline equiline tapis de selle dressage en coton noir, 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-Brooks Qw-K, 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,Generic Photo encadrée 8x10 - Dédicacée par Gloria Estafan.

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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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