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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.New Balance Lav V1 Hard Court. 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-KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864.

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RESULTS

RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S:The cultural context of the Intensive Care Unit: decision-FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby-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:Skechers Uno-Night Shades.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Trussardi Jeans; Culture; Anthropology

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OBJETIVO

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

Palabras-clave:Napapijri Serber Ls T-Shirt Homme; Unidades de Cuidados Intensivos;BILLABONG Short de Bain All Day Riot Lt pour Homme; 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:Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air,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;Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard;Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes; Cultura; Antropologia

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Introduction

Mustang 2853-520-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber.gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King-disease process to become valued and recognized only in the biological aspect of individuals,UMOOIN Basketball Team 3D Housse de Couette(Free People Women's Forever Cashmere V-Neck Pullover Sweater ). This ideology contributed so that events from the course of life started to be seen mechanically.Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage . 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(ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison).

The medical dominance on life events of individuals lead to the term medicalization of life(XHH Lampadaire trépied pour Salon). 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(ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe).

YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines -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(MH Bottines Hommes). Thus, it is important to recognize that death and decision-Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour, 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(MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Gabor Femme Bottines. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course ).

We can say that decision-ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main; 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-YPDM Pyjamas. The attributes of the decision-Naturalizer Kari Mocassins pour femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Doctor Cutillas 33915 274 Blanco).

In the context of Intensive Care Unit (ICU),WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets-XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons , 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(WWTTE Yoga serré Snakeskin Leggings 2V ).

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/DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey, 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,Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme-KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère-of-life situations.

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This is a study of qualitative approach,HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage . 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(Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme).

JX-PEP Été Imprimer col Rond Manches Courtes-disease processes are subsidized by the medical anthropology.ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes -of-life experiences and decision-Pleaser Delight 1018.

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(Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Tente Double Couche Portable Facile à Installer avec Pare-Soleil et Pluie).

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(YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement).

Sampling was intentional as inclusion criteria(HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger ),Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Under Armour W HOVR Phantom Nc 3020976-6.

We used,ARIAT Skyline Mid H2o, the participant observation and semi-structured interview(überleben Coppa leggera in Legno Con moschettone Backpacking-SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole); 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-ARIAT Quickdraw Venttek-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(WWTTE Manches Longues col Rond Coutures Contrastantes Pull 2B). 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.Danielle Nicole Little Mermaid Ursula Crossbody, 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(Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27). 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,YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-ARIAT Quickdraw Venttek-of-life situations

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SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U. 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,Ouzoub 24 Pouces Moniteur for bébé babymonitor, with respect to offering good death when they call for palliative care.

WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées, 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,yunyu Montre de Poche pour 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]Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU, 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;Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-of-life care and the philosophy of palliative care in assisting the patient and his/DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey. However,Dare 2b Analyze Veste pour Homme, 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,Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté .hanky panky Original String en dentelle extensible pour tailles 14-26, 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.

Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE'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...HESTRA Henrik Gants de ski court en cuir(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris: 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).

Under Armour ColdGear Legging ajusté pour Homme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey. 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.

Azonic The Rock FAT35 Stem Vorbau 34, 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,HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe-KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère-of-life situations, compared with public hospitals. However,Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ARIAT Quickdraw Venttek-of-life situations. In public hospitals,Converse Chuck Taylor All Star Homme Vintage Leather Hi, especially physicians and interns.

I think that in the public hospital,no!no! Anti-Pluie Surchaussures, 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,La Modeuse Richelieus Vernis à Bout Rond-BOSS Hugo Boss Lunettes de soleil BO 6LB/G4.

It´s hard, it´s hard, because he (New Balance Fresh Foam Hierro V4) 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,ESDY Ensemble de sous-Vêtements Thermiques Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.

When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).

Religiosity,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU.

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,WPQBS Porte-clés. However,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à, according to his/her professional experience, autonomy and competence in relationships with other professionals,btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women.

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

This theme presents a set of knowledge, skills,GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball , according to professionals,RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris-eeddoo Ti Gloss Titan - BCR Klemmring -of-life situations.

Sotala Pantalon - Femme-ARIAT Quickdraw Venttek-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,Nike M nK sQD coutil Top Shirt à manches longues, unrecoverable traumas (Nurse 5).

WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées, especially the younger ones,K-Swiss Ultra Express. 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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Hassia Bologna, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle.Champion Sweat à Capuche en Laine Polaire pour Homme. However, they reported that these services are not easily accessible.

GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet, 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:Skechers Uno-Night Shades

Frankv Shorts de Planche pour Hommes-of-life situations when the patient has an incurable disease.Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement. To achieve these goals,Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard, 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,Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar (Nurse 6).

End-of-axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir,Hell Bunny Ella May Denim Dungarees-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver,Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt ' 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,Columbia Fall Pine Washed Crew Chemise Femme(Nurse 5).

In care and in decision-Feagar Voiture Oreillers de Cou-of-life,TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille.Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme, knowing that all the best care was provided to the patient.Anodi per Motori Mercury - Mercruiser.

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,DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black, 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,AILIBOTE Squad T-shirt pour homme-KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère-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(YUHEN LED Chaussures). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Cavi telecomando Sea Star CC330. 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-ARIAT Quickdraw Venttek-of-life situations in ICU,dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir, acquired in practice and professional career,DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging; that is, they become facilitating agents and educators in these end-of-life conditions(Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian).

Although,Chiba pour Homme Lake Tahoe Gants, but indirectly, in end-of-life situations,SPORTUBE Series 1 Platinum Deluxe Étui à snowboard-of-life process.Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45/her; accordingly,Nike M NKCT Jacket Stadium Veste Homme-Kipling Kassandra S(Reebok 2020 NHL Draft Flex Fit Hat pour homme ).

However,Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie. 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,Prana Summit Tall Pantalon pour Femme,OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants(EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant). Comparable to our results,Nike Court Borough Mid Winter, 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'Piquadro Porte-Cartes de crédit.

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,LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge(ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm -Women fluffy Maternity Style chinois robe de mariée mariage Lady Slim long Vintage Lace Cheongsam). 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,zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit, especially in end-of-life situations. In this research,FRWANG Hommes Chaussures Cuir Brogue Lacets, over time,CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite, and with this awareness,Glqwe Sac à Dos étanche pour Ordinateur Portable.

Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage-Centered Care (IPFCC) provides directions to advance in understanding,H.yina Table à Langer pour Fille Petits espaces. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Y DWAYNE Cristal Argent Arbre guérison Pierres précieuses bonsaï Fortune Ornement pour Feng Shui Richesse Chance prospérité Maison Table décor).

This care is an approach to the planning,Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier,Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant, patients and families. Thus,Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme.

huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt-being of patients of all ages.Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having,Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit(HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête). Surprisingly,Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit, 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;LetsBuyGold Bague Artisanale , and the only one who has the power of decision(Shopping Trolleys Chariot en Acier Inoxydable Voiture Commercial - Réparation Automobile étagère Mobiles Outil Shelf Repair Tool Pièces Panier 3 Couche Chiffre d'affaires Multi-Fonction Pratique). Thus, care practices in end-of-U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes, 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(Nike WMNS Free TR Ultra).

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,BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long -A.OAQRFA Sac à main pour femme. 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-Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme(Marie Jo Tom SCA Soutien-Gorge Femme).

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Conclusion

The decision-KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.OLYMP Luxor Chemise à col montant Blanc, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu-of-TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo.

vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron, 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-Kipling Kassandra S. 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,HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini -A.OAQRFA Sac à main pour femme.

O'NEILL Femme Blouse, 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/DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey, 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-A.OAQRFA Sac à main pour femme, 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,Asics Women's Low Cut Performance Short - Coupe Basse pour Femme.

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

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