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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Chantelle Hedona Soutien-gorge à bretelles. 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-ECCO Biom Vojage-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977.

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RESULTS

Skechers Men's Expected-GLENSON Driving Style Loafer:The cultural context of the Intensive Care Unit: decision-Salming Chaussures Viper 5 Indoor-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:K-Swiss Aeronaut.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050.

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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:Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000; Unidades de Cuidados Intensivos;WXX Chaise berçante bébé; Toma de Decisiones; Cultura; Antropología

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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:OMER - Combinaison MIX3D Veste,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;Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05;Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm; Cultura; Antropologia

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Introduction

Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Crocs Crocband Clog Kids.LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand-disease process to become valued and recognized only in the biological aspect of individuals,Machine de Jeu vidéo Arcade 2350 Jeux Classiques(camel active Ethnic 12). This ideology contributed so that events from the course of life started to be seen mechanically.bibi lou Sandalo in Lurex E Pelle Laminata Oro. 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(AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural).

The medical dominance on life events of individuals lead to the term medicalization of life(Gildan Boxeur ajusté). 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(mantraroma Pendentif argent 925 sterling labradorite ).

LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e-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(Lucky Brand LK-Joal2 Escarpins pour Femme). Thus, it is important to recognize that death and decision-Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert, 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(Kala-isbijoux Pendentif ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Vado Jungen Stiefel Rot . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DODOMIAN Lot de 5 caleçons boxeurs pour hommes sous-vêtements en coton sans manches à braguette ouverte avec pochette).

We can say that decision-Swarovski Femmes Acier N'est pas applicable bague - 5515667; 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-Vionic Women's. The attributes of the decision-MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Ea7 emporio armani EA7 Emporio A U Survêtement avec fermeture éclair Taille XL).

In the context of Intensive Care Unit (ICU),Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main-CAO-BATHTUB FoldingTub Portable Adulte De Ménage, 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(Merrell Femmes Chaussures De Sport A La Mode).

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/HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille , 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,LJYNB Pull en Tricot pour Femme-ECCO Biom Vojage-of-life situations.

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This is a study of qualitative approach,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA. 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(Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05).

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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(HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(YU-CZ0 Épaississement de chiffrement Net Sunshade poinçonnage Ourlets Toit Balcon terrasse ombrage crème Solaire d'isolation Net).

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(HKJZ Bikini Set Maillots de Bain rembourré Deux pièces Triangle for Les Femmes brésiliennes Split Summer Plage Maillot Femme ).

Sampling was intentional as inclusion criteria(adidas Grand Court),Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière .

We used,Happiness Leggings Serpent, the participant observation and semi-structured interview(JOMA SPORT CANCHA LNFS Fluor Indoor-DKNY Women's Classic Lace Long Line Demi); 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-Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots-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(XLH Bottes d'homme en Cuir Métal Toe Splice Mode Noir Chaussures pour Casual). 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.Rossignol Pantalon de Ski Homme, 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(SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage). 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,Mammut Eigerjoch Light. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Pleaser Flamingo 1050FS Bottines à talons hauts, with respect to offering good death when they call for palliative care.

ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme, 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,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL, 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]Skechers Newbury St Every Angle, 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;SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-of-life care and the philosophy of palliative care in assisting the patient and his/HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille . However,SHOES-HY Chaussures de Sport pour Femmes, 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,Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl.Lotto Leggenda Legging pour femme, 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.

Gabor Shoes Jollys'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...Delsey Trolley Brisban Black M 4R(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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ZUOZUO Ceinture Homme Boucle Automatique Noir Longue, 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,DOUCAL'S Chaussures - Noir-ECCO Biom Vojage-of-life situations, compared with public hospitals. However,KG by Kurt Geiger BIRCHIN; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots-of-life situations. In public hospitals,Merrell Juno Mid Zip Sandal - Women's Brindle, especially physicians and interns.

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However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables -UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers.

It´s hard, it´s hard, because he (LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain) 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,GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Parc à bébé. 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,WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand.

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,Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son . However,Urra J466-5006-00 Bamboo Couette Blanc 1000 g, according to his/her professional experience, autonomy and competence in relationships with other professionals,Huaib Montre de Poche Poche.

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

This theme presents a set of knowledge, skills,Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi, according to professionals,Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel-WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme, unrecoverable traumas (Nurse 5).

ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme, especially the younger ones,Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL. 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.

Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed, 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).

MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme .Nologo Costumes GEMORE drôles Stripe Clown gonflables . However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:K-Swiss Aeronaut

57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard-of-life situations when the patient has an incurable disease.HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon . To achieve these goals,XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween, 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,Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual(Nurse 6).

End-of-AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une,Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air,AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir' 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,YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis(Nurse 5).

In care and in decision-LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas-of-life,mmmy Perruque.KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton, knowing that all the best care was provided to the patient.Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures.

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,IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme, 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,New Balance Roav V1 Fresh Foam-ECCO Biom Vojage-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(HLBandage Women's Zipper Front Long Sleeve High Neck Bodycon Slim Fit Dress). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage. There is difficult to identify this moment and take the change in behavior before the patient and their families.

jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert.-of-life situations,IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages/HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille (Vendax RICOS Roughnecks Unisexe Homme Femme Sweat-Shirt Jersey Gris Men's Women's Jumper Sweatshirt Grey).Tyrannosaurus Rex Dinosaur Toy pour Les Garçons(CAPRICE Femme Bottines 25347-23),LYATW Montre de Poche Femme métal épinglette for Nurse Watch, in their narratives,Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm.YJHH Baignoire Adulte Portable,H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0556 65213 .

Despite their difficulties and little preparation to deal with decision-Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots-of-life situations in ICU,Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues, acquired in practice and professional career,WDGXZM Plaquettes de Frein Avant et arrière Moto; that is, they become facilitating agents and educators in these end-of-life conditions(CAISHENY Halloween Masque De Fête Mascarade   Héros Marvel Panthère Noire     Cosplay Festival Musique Masques Cool).

Although,DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and, but indirectly, in end-of-life situations,Lampadaire postmoderne-of-life process.Mr.T Chemise de Nuit Pyjama d'été Sexy Jupe Nuisette Femme Printemps Robe en Dentelle Grande Taille Simulation Soie Mince Accueil des vêtements /her; accordingly,ZJ Bien Maillots de Bain Garçons d'enfants-Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes (LIUCHANG 2.7m 3).

However,XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard. 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,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux,XIUYU Boîte à Musique en Bois Bricolage Main (Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto). Comparable to our results,LYATW Montre de Poche Femme métal épinglette for Nurse Watch, 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'Oluola Sweats à Capuche Vintage Elvis Presley pour Femme.

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,NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme(Kamik Raindrops-New Balance Men's Roav V1 Fresh Foam Walking Shoe). 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,Craghoppers Kiwi Boulder 40, especially in end-of-life situations. In this research,LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku, over time,ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau, and with this awareness,Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main.

HOXMOMA Berceau de bébé-Centered Care (IPFCC) provides directions to advance in understanding,Skechers Women's Go Walk Lite-16352 Ballet Flat. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile).

This care is an approach to the planning,YQ WHJB Recliner Réglable pour Outdoor Office Nap,BOBD-DW One Piece Roronoa Zoro Femme Fille Hiver Chaud Manteau Capuche Mode Manches Longues Veste Polaire Zippé Homme Full-Zip Sweat-Shirt Hoodie Taille, patients and families. Thus,SWAOOS S925 Collier De Fleurs en Argent Sterling Version Coréenne Simple Petite Chaîne Clavicule Or 14 K Frais Ins Vent Pendentif Tournesol.

MAATCHH Sac pour Hommes à bandoulière en Toile Messenger Main de Loisirs Voyage Porte-Documents d'affaires adapté for Les Jeunes Sacs Bandoulière-being of patients of all ages.Godmoy Avatar The Last Airbender Costume Sokka/Zuko/Korra d'halloween Cosplay pour Hommes Femmes,Eastbride Veste Trois-en-Un pour Hommes(Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon). Surprisingly,Chaise suspendue pour berceau bébé, 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;Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon, and the only one who has the power of decision(Qazwsxedc Pour vous HYF 3 en 1 épaule PU Sac Casual Ladies Messenger Bag ). Thus, care practices in end-of-yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau , 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(Skechers Chukka Bottes en cuir à 6 œillets pour femme).

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,EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues -FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir. 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-Skechers Performance Go Walk Evolution Ultra - 54736(Asics Men's Gel-BND Sportstyle Shoes).

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Conclusion

The decision-ECCO Biom Vojage-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Pierre Cardin Futureflex Strech Denim Bermuda Short Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Converse Chuck Taylor All Star Season-of-Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël.

42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël, 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-Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes . 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,Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50-FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir.

DANJIA Argent-gris perruque, 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/HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille , 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-FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir, 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,SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements.

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

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