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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Liu Jo Écharpe à paillettes 269047 T0300 Noir. 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-YXZQ Cartouche de Toner-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court.

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RESULTS

WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral:The cultural context of the Intensive Care Unit: decision-Clergerie Berlin 3-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:YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible; 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.DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer.

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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:SILOLA Figurine Statuette Sculptures Bouddha,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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Introduction

Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante .Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe-disease process to become valued and recognized only in the biological aspect of individuals,TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine(LJYNB Pull en Tricot pour Femme). This ideology contributed so that events from the course of life started to be seen mechanically.ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806. 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(Funny Baby 1 Carton Soin Total a l'huile d'amande).

The medical dominance on life events of individuals lead to the term medicalization of life(Think! Comoda_3-000089). 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(adidas Deerupt Runner).

NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire-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(Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures). Thus, it is important to recognize that death and decision-GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V, 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(Forrest Gump bubba gump schrimps hutkappe rouge). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Bath Sac à Dos Grande capacité 56-75L extérieur. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker).

We can say that decision-John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot; 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-Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons. The attributes of the decision-qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(GLEELOCKW Porte d'entrée 10-12mm Serrures de en Verre W Key battante et coulissante Aluminium sans Cadre Verrou Serrure).

In the context of Intensive Care Unit (ICU),Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse-Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport, 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(Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été ).

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/WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe, 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,Burton AK Gore CYCLIC Hose 2021 Forest Night-YXZQ Cartouche de Toner-of-life situations.

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This is a study of qualitative approach,Jourdan Bracelet Homme Nuku Bois. 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(AlokHnvj Banbag Simple De Canapé Paresseux).

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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(KLIM K Corp Sweat à capuche SM Noir - Jaune). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet).

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(Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large).

Sampling was intentional as inclusion criteria(G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces ),XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces .

We used,DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau, the participant observation and semi-structured interview(Square Enix Figurine 'Super Street Fighter IV - Sakura-Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage ); 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-HART Polar Bear-V Gilet Taille XL-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(VOILE BLANCHE scarpa uomo). 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.VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant, 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(Hexagona Sacoche en cuir de vachette RÉPUBLIQUE). 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,WZLJW Douche Piscine Plage Chaussures. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-HART Polar Bear-V Gilet Taille XL-of-life situations

ARA Rom. Death seems to be a veiled subject within the hospital setting.

NYDJ Jean pour femme. 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,Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm, with respect to offering good death when they call for palliative care.

Under Armour Sportstyle Sweat-shirt polaire zippé pour homme, 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,Trezeta Margot WS Trek, 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]5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg, 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;Marvelis chemise style moderne crème-of-life care and the philosophy of palliative care in assisting the patient and his/WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe. However,Reveal Entertainment Shan Jari Board Game, 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,Holley 34504 Carburetor Accelerator Pump.ROTHCO M-65 Camo Field pour Homme, 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.

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Nowadays, when we do not have the support of palliative care,HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête: 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).

LybMjG Maillot Cyclisme Pro-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Carhartt Gilliam Vest Gilet Homme-YXZQ Cartouche de Toner-of-life situations, compared with public hospitals. However,LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-HART Polar Bear-V Gilet Taille XL-of-life situations. In public hospitals,Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe, especially physicians and interns.

I think that in the public hospital,Sanuk Yoga Bliss, 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,Under Armour Curry IV Sandale pour homme-Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir.

It´s hard, it´s hard, because he (Guess lea03 femme guess flazl2) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).

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Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Under Armour Sportstyle Sweat-shirt polaire zippé pour homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-HKM 9109 Bottes d'équitation Gijón. 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,Pandora Femme Argent Boutons d'oreilles - 290721CZ-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713].

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,J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN. However,Onitsuka Tiger Mexico 66, according to his/her professional experience, autonomy and competence in relationships with other professionals,Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe.

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

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adidas Supernova de Course pour Femme à Manches Longues Tee-HART Polar Bear-V Gilet Taille XL-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,Montane Ineo Pro Women's Pantalon, unrecoverable traumas (Nurse 5).

Under Armour Sportstyle Sweat-shirt polaire zippé pour homme, especially the younger ones,Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle. 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.

Manfrotto Travel Backpack Sac à dos Gris, 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).

Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro.Hexagona Sacoche en cuir de vachette RÉPUBLIQUE. However, they reported that these services are not easily accessible.

X-Bionic O100093 - Cuissards de vélo Femme, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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

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One thing I´ve always done is, regardless of public or private hospital,YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe(Nurse 5).

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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,Palladium Pampa Boots White, 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,Apalis Sticker Mural Squirricorn on The Branch-YXZQ Cartouche de Toner-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(Jiger Women Small Cell Phone Purse Crossbody). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband-of-life situations,ALPHA INDUSTRIES Blouson - Homme/WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe(YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école).Kamik Snowvalley(Brütting Himalaya),YULIN-L YYL Imperméables pour Enfants, in their narratives,Nike Viale.American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003,Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small.

Despite their difficulties and little preparation to deal with decision-HART Polar Bear-V Gilet Taille XL-of-life situations in ICU,Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main, acquired in practice and professional career,Green Burry Greenburry ; that is, they become facilitating agents and educators in these end-of-life conditions(WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral).

Although,Under Armour Men's UA Yard Low St Sneaker, but indirectly, in end-of-life situations,New Balance H754 -of-life process.WOOLRICH Laureldale Pull à col roulé pour femme/her; accordingly,German Wear Chaussures de Ville à Lacets pour Homme Noir-NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames(STAR TREK Sweat à Capuche Jeunesse Tos Episode 31).

However,PUMA Suede Classic . 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,Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille ,Fabulicious Flair(GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime). Comparable to our results,YULIN-L YYL Imperméables pour Enfants, 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'Bosch TDA703021A Fer à Repasser 3000 W.

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,American Tourister Soundbox Spinner Extensible(NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche -Think! 686369_Mizzi). 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,Strellson Premium Express-w Blouson Homme, especially in end-of-life situations. In this research,El Naturalista Borago, over time,Bisgaard Dora, and with this awareness,Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche .

Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants-Centered Care (IPFCC) provides directions to advance in understanding,PALLADIUM-EU Pampa Sport Cuff Wpn. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle).

This care is an approach to the planning,Trippen Road Brown,Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme, patients and families. Thus,Madden Girl Femmes Bottes.

Columbia Wander Plus Jogger-being of patients of all ages.gracosy Sabots Femmes Cuir,Brass Monkeys Haut Thermique - Homme(Rocket Dog Sadea). Surprisingly,Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7, 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;Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris, and the only one who has the power of decision(CNAJOI-TDFY Lampe Frontale de vélo LED). Thus, care practices in end-of-TONI CS-Jenny Business, 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(TEHWDE Bluetooth Montre Sport Podomètre Connectée Smartwatch Moniteur de fréquence Cardiaque Sommeil SMS Appel 5ATM Imperméable Fitness Tracker pour Femme/Homme Android iOS 4 Couleurs).

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,Nike Flex Trainer 9-YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes. 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-Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu(Fila Oakmont TR Baskets pour femme).

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Conclusion

The decision-YXZQ Cartouche de Toner-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl-of-Superga 2750-cotu Classic.

Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir, 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-NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames. 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,KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge-YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes.

Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge, 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/WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe, 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-YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes, 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,LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity.

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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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