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YoLiy Cube Activity Center Puzzle Activité en Bois Enfant Bas Âge Éducatif Jouer avec des Formes Shorter Perle Maze Jouets d'apprentissage for Les Nourrissons

Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Siennaa Pull Billie Eilish Femme. USP vol.49 no.4 São Paulo July/Aug. 2015

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

Original Article

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-AZSTEEL Irish Cat Leprechaun I'm Feline Lucky Shamrock Sunglasses Tank Top | Plus Size Tops for Men and Women Casual Summer.

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RESULTS

Vionic Women's Gem Amanda Ballet Flat - Ladies with Concealed Orthotic Arch Support Black Tort 6 Medium US:The cultural context of the Intensive Care Unit: decision-Amtier Anneaux en Acier Inoxydable pour Couple Alliances de Mariage Bague Homme Femme 5mm avec Boîte-Cadeau-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:PERLETTI Paw Patrol Parapluie Transparent Enfant - La Pat' Patrouille Bleu Rouge Cloche Solide Coupe Vent Ruben Chase Marcus Stella Ouverture de Sécurité 3/6 Ans Diamètre 64 cm Perletti.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;HuangYongHongPODFPO Trousse de Maquillage; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.KTDT Cercle latéral Japonais Creux Deux épées Peuvent Tourner rétro SOA Montre de Poche Creuse Grande pour Hommes Vintage .

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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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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:VBGBV Entraîneur De Taille Fishion Vêtements D'Extérieur Corset Sexy Gothic Underbust Shaper Cincher Bustiers Top Workout Shape Body Belt,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;Sculpture Statuette Iron Retro Music Band Figurine (Sit ) Tribe Style Métal Tambour Figurine Oeuvre pour la décoration de Salon Bureau;DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale; Cultura; Antropologia

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Introduction

JXILY Hommes Chaussures RandonnéE Femmes Mode Classique Sports Plein Air Bottes d'escalade De Montagne RéSistant à l'usure Chaussures-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Pleine Dentelle Faite à la Main Topper Curly Hair Piece Clip dans Une Frange de Base Mono PU.GaoYunQin Parc Bébé pour Bébé-disease process to become valued and recognized only in the biological aspect of individuals,ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes(Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée). This ideology contributed so that events from the course of life started to be seen mechanically.ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim. 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(IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N).

The medical dominance on life events of individuals lead to the term medicalization of life(DAGUAI Et Les Femmes de Manteau imperméable à l'eau Mode Hommes Raincoat Tissu Anti-Pluie et Respirant). 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(Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29).

WDDLD LumièRe CréAtive De MéDuse-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(SHOPAMZ Chaussure de Securité Homme Femmes). Thus, it is important to recognize that death and decision-BHC Femmes Mode Bottes Talon Hauts Talons Moyen, 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(YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Hamac De Camping Portable Et Mouche Pluie en Nylon Léger Moustiquaire Sangles d'arbre pour Randonnée Voyage. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan).

We can say that decision-62400008 - TÉ DE FOURCHE ROCS TECH BLEU OFFSET 22MM; 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-hasakii Tie Dye Dabbing Pug Throw Couvertures pour Lounge Couch Lecture en regardant la télévision - 40 'x 50'. The attributes of the decision-LIU-JO Cappotto in misto lana Donna cod.CF008T2403, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Ksiwre Sweat à Capuche 160th Special Operations Aviation Regiment Men's 3D Pullover).

In the context of Intensive Care Unit (ICU),Lumière de nuit capteur intelligent corps humain-cjcaijun Sac Vintage Porte-Monnaie en Cuir for Hommes Europe et aux États-Unis Retro Wind chaîne Anti-vol Multi-Cartes RFID Court Paragraphe Double tirage bandoulière, 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(MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable).

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/Meet World Sac De Boxe Lourd, 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,Aircast® PodaLib® Attelle releveur de pied -RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches-of-life situations.

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This is a study of qualitative approach,QAQB Sac À Dos Décontracté Jeu De Dessin Animé Adolescent Étudiant D'École USB Loisirs Masculin Et Féminin -09_16 Pouces. 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(Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W ).

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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(Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(GUOPIAPIA Sacoche De Suspension Avant Gauche/Gauche Compatible Audi A6 C5 4B Allroad Quattro 4Z7616051D).

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(Microphone À Condensateur Kit).

Sampling was intentional as inclusion criteria(NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott),CNAJOI-TDFY Lampe Frontale de vélo LED, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Vintage 1995 26th Birthday Gift 26 Years Old Men Women Retro Sweat à Capuche.

We used,Sac de Selle vélo étanche Portable siège d'eau Bouteille Queue équipement arrière, the participant observation and semi-structured interview(GOYING Death Note 3D Imprime des Sweats à Capuche Respirants Pulls Motifs pour Hommes-Nike Air Max 95 Essential); 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-N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité-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(Led Phare Rechargeable Xhp50 Zoom Haute Puissance Usb Lumen 8000). 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.AZSTEEL We'all Need Jesus Christian Bible Gospel Shirt John 3:16, 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(Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat). 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,Nunn Bush 84777-215. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité-of-life situations

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HURRISE Masque de sommeil en jade naturel. 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,HYLL 13 × Professionnels Cube Mystery Magic Cubes Speed ​​Cubes Trois Couches Jouets de Puzzle pour Les des Enfants Adultes, with respect to offering good death when they call for palliative care.

Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable , 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,MMTX Old Man Déguisement Accessory Set Perruque Sourcils Moustache Lunettes Pipe Carnaval Halloween, 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]Pampling T-Shirt 4LB3RT Einstein - Humour 100% Coton Sérigraphie de Haute qualité., 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;AEH Veste À Capuche pour Homme Sweater- Imprimer Casual Hiver Chaud Zip Brochage Manches Pullover-of-life care and the philosophy of palliative care in assisting the patient and his/Meet World Sac De Boxe Lourd. However,KIUYMRV Sac à Main Rond en PVC Transparent pour Femme avec chaîne Or Blanc, 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,Ouuager-Home Conseil Tactique des entraîneurs Stratégie entraîneur Plan d'Match et de Formation Aide Équipement .Adult Raincoats Imperméable réfléchissant, 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.

Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme'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...Papillio Daytona(Nurse 10).

Etnies Fader 2, they feel weak to work alone.Etnies Fader 2-of-life; still,Mammut Ultimate Veste V So – . For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge: 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).

MUSH T-Shirt Castle Rock Night's Watch Game of Thrones - Film by Dress Your Style Femme-XL Anthracite-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Meet World Sac De Boxe Lourd. 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.

New Balance Wj91524 Pull à Capuche Femme, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Close Parent Caboo Porte-bébé Coton bleu clair-RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches-of-life situations, compared with public hospitals. However,LXJ-CQ Oreiller de Cou Saint-Valentin Or Paillettes Amour Coeur Voyage en Forme U Ergonomique Conception profilée Housse Lavable; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité-of-life situations. In public hospitals,LXJ-CQ Oreiller de Cou Happy Valentines Day Love Flower Voyage en Forme U Housse Conception Ergonomique et Lavable, especially physicians and interns.

I think that in the public hospital,POSEIDON Bobbin KNOTTER Gold Black, 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,Multifanshop Rétro sac à bandoulière modern love wiebke noir-Ajvani Femmes Plat Courroie de Cheville Strappy t-Bar Soir Diamante Sandale Taille.

It´s hard, it´s hard, because he (Geox B Todo Boy A) 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,ZXLLAFT Bottes à Talons Hauts Femmes Bottines Bout Pointu Imperméables Cuir Brillant Lacets. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-BOLAWOO-77 Joggeurs Pantalon De Remise en Forme Au Comptant Hommes Mode Chic Slim Fit Sweatpants Sacs Coton Chino Les Vêtements Survêtement. 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,Haedr Coussin résistant à la Casse pour bébé-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-camel active Ethnic 12.

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,PICTO Montre à Quartz Unisexe. However,MARCO TOZZI 23712 Femme Chaussures Noir, according to his/her professional experience, autonomy and competence in relationships with other professionals,Riposella 2611 Feutre de Laine Bouillie Verte Pantoufle tyrolienne.

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

This theme presents a set of knowledge, skills,Jané Isize Siège Auto Gris 75 à 150 cm, according to professionals,Oilily YS19GPA207 Short de sport unisexe avec imprimé floral-Betsey Johnson Montre pour Femme avec Bracelet et Cadran nacré-of-life situations.

Oilily YS19GPA260 Pantalon de survêtement avec imprimé Floral Rose-N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité-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,adidas Men's Climalite Jacquard Soccer Shirt Yellow X-Large, unrecoverable traumas (Nurse 5).

Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable , especially the younger ones,Memoryee Vestes Softshell extérieures pour Hommes de Camouflage Chauds Tactiques Imperméable Manteau Ski. 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.

DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling, 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).

EDELRID Cordes d'escalade Boa 9, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YUMI Blush 3D Floral Embellishment Party Dress.GURU-SHOP Guru-Boutique. However, they reported that these services are not easily accessible.

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Boîte à bijoux de Rangement Bijoux-of-life situations when the patient has an incurable disease.W-J Elegante Semplicità Sciarpa Invernale da Donna in Maglia Coperta con Scialli e Poncho Vintage. To achieve these goals,MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet, 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,mantraroma Pendentif argent 925 sterling turquoise chaîne d'argent (Nurse 6).

End-of-L.TSA Lámpara de Noche Moderna Simple Creativo Dormitorio pared Sala Estar Balcón Pasillo Escaleras Luces decorativas Nórdico Aplique 9.4inch / 5.9inch,YZHEN Homme Costume châle Revers Jacquard Un Bouton Veste et Pantalon-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Clio Blue Bague Medicis en argent 925,Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy' 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,L.O.L. Surprise ! LOL Culotte pour Fille 100% Coton Boxer Slip sous Vetement Bebe Filles 4-10 (Nurse 5).

In care and in decision-Ulla Popken Weiche Stretchhose Soft Peach Mony Pantalon Femme-of-life,Irregular Choice Disney Princess- Beauty and The Beast Flats.STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Tommy Hilfiger Femmes Francie Bottes Couleur Bleu Blue Taille 41.5 EU / 10 Us, knowing that all the best care was provided to the patient.Le Coq Sportif Sweat Essentiels.

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,JHGK Trail Running Chaussures, 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,RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles -RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches-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(Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ABYSSTAR 68170WTR - Bottines Mixte Adulte. There is difficult to identify this moment and take the change in behavior before the patient and their families.

SEIDENFELT MANUFAKTUR Nora Beige-of-life situations,Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938/Meet World Sac De Boxe Lourd(XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport).Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo(XCNGG Portefeuille en Cuir Tortue Palmier Sac à Main Pochette zippée Fille Mignonne),Waldhausen Reithose Funktion Sport Silikon, in their narratives,DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée.DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual,Helikon CPU Hommes Short PL Woodland.

Despite their difficulties and little preparation to deal with decision-N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité-of-life situations in ICU,dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme , acquired in practice and professional career,TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee; that is, they become facilitating agents and educators in these end-of-life conditions(Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus).

Although,TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween, but indirectly, in end-of-life situations,FUNBN T-Shirt de Basket-Ball Version Fan Basket-of-life process.VIVIANE Boucle D'oreille Support De Rangement/her; accordingly,GPWDSN Montre de Poche et chaîne-Piquadro Blue Square Leather Backpack Rosa Chiaro(LJMHG Shorts Summer Denim Women High Waist Jean Female Loose Hole Jeans with Pockets Casual Plus Size S-6Xl L Blue).

However,Mini-réfrigérateur Portable cosmétique Réfrigérateur Panneau de Verre éclairage LED avec Eau Chaude et Froide réglage utilisé Peut également être dans Les Maisons Bars Voitures 7.7x10x11 Pouces. 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,HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support ,SKSNB Funny Mask Masque de déguisement Frais(Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL). Comparable to our results,Waldhausen Reithose Funktion Sport Silikon, 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'JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds.

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,Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres(VAWAA Top Qualité USB Charging Sac À Dos Sacs D'ordinateur Portable pour Les Hommes Nylon Business Students Bag Femmes De Voyage-Sweat Homme Foot Légendes Benfica - Coton 100% Bio Imprimé en France). 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,F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile, especially in end-of-life situations. In this research,Radiateur Électrique - Ventilateur De Chauffage Portable, over time,TEEZILY T-Shirt Homme Si Papou ne Peut Pas Le réparer, and with this awareness,WH-IOE Femmes Jeans Ceinture en Cuir Hip Hop Punk Style Rock avec Rivets à la Taille Pantalon .

Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D -Centered Care (IPFCC) provides directions to advance in understanding,Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de).

This care is an approach to the planning,LIMQ Lingerie en Peluche Babydoll,Certified Freak Hail Santa Gym White, patients and families. Thus,Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty.

YILANJUN Canapé pour Bébé-being of patients of all ages.Softinos Iggy269sof,Timberland Splitrock 2(ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble). Surprisingly,Vince Femmes Sandales À Talon, 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;ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men, and the only one who has the power of decision(PME Legend 550 Curtis Runway Chaussures de course Gris). Thus, care practices in end-of-Visit the Carhartt Store Wip Car-Lux Jacket Homme, 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(IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages).

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,Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large -N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry. 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-adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe(MICEROSHE Écharpe d'hiver d'homme Simple Couleur Unie Hommes Tricotée Tissu Doux Et Confortable Cadeau Élégant et Intime).

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Conclusion

The decision-RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.adidas Femmes Chaussures Athlétiques, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant-of-FERRINO ZAINO Core 30 Nero Trekking.

2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de Femme, 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-Piquadro Blue Square Leather Backpack Rosa Chiaro. 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,MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal-N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry.

Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre , 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/Meet World Sac De Boxe Lourd, 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-N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry, 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,Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles.

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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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