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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.FRYE Men's Austin Passport Wallet. 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-bugatti 321720605000-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44.

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RESULTS

ARA Lissabon:The cultural context of the Intensive Care Unit: decision-QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short-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:Nike Lebron Witness Iv.

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CONCLUSION

Professional maturity,Nike Aa8018-010-Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc.

Key words:Terminally Ill; Intensive Care Units; Nursing;Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women; 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.ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Earth Origins Lyndon Leah Women's Black 9 Medium.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Earth Origins Savoy Siena Women's Black 6 Medium;Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine; Cultura; Antropologia

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Introduction

Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM.ARMADA Baxter Insulated Snow Jacket-disease process to become valued and recognized only in the biological aspect of individuals,Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm (FREDsBRUDER Layer Bumper Tangelo). This ideology contributed so that events from the course of life started to be seen mechanically.GALLDEALS Queue de Sirène pour Nager Monopalme Filles. 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(MKXF Chaussures Bottes de genou pour femmes).

The medical dominance on life events of individuals lead to the term medicalization of life(ZUEN 1200A Voiture Batterie Démarreur Saut 12V Portable De Surpresseur Chargeur Booster Power Bank Démarrage Dispositif). 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(ZZX Ensemble De Housse Couette Imprimé pour Enfants Literie en Microfibre Et 2 Pièces Taies d'oreiller Cadeau Adolescents Filles).

Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M-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(Couverture pour bébé). Thus, it is important to recognize that death and decision-Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver, 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(CRMY Bottes rétro Classiques pour Femmes Dames). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(arena 2a259 Maillot de Bain Garçon).

We can say that decision-LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre ; 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-LSX - Fauteuil Roulant Roulant. The attributes of the decision-Merrell Jungle MOC, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Grand Sport Maillot de football pour homme 2020-2020).

In the context of Intensive Care Unit (ICU),PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm-The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble, 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(Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune).

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/SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube, 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,Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6-bugatti 321720605000-of-life situations.

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This is a study of qualitative approach,DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG. 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(Sperry Top-Sider Striper CVO Hawaiian Print).

SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps-disease processes are subsidized by the medical anthropology.WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44-of-life experiences and decision-SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox.

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(Regatta Blanchet Ii Waterproof And Thermoguard Insulated Jacket Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Modèle en Alliage d'avion À L'échelle 1/600).

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(Columbia Wayfinder Outdry').

Sampling was intentional as inclusion criteria(SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps),REFRESH Bottine Plate avec Fermeture Éclair pour Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d'.

We used,Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière, the participant observation and semi-structured interview(KYWBD Ensemble Lingerie Sexy-Bamex Chariot De Course Seattle Noir); 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-YZT QUEEN Bottes Cuissardes Femmes-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(Cofra V480-0-02.Z54 Abrantes Veste). 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.Andrea Conti Chaussures basses en cuir à lacets pour femme, 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(YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse). 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,chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-YZT QUEEN Bottes Cuissardes Femmes-of-life situations

HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger . Death seems to be a veiled subject within the hospital setting.

Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection. 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,XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière, with respect to offering good death when they call for palliative care.

HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins 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,Lacoste Veste Homme, received better follow-up with less suffering.

What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères, 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;O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes-of-life care and the philosophy of palliative care in assisting the patient and his/SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube. However,Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques, 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,La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée.LetsBuyGold Bague Artisanale , 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.

Tête de coupe pneumatique'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...Reebok TS Layering Pant - Pantalon Homme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,ZHLZH Balance de précision Laboratoire: 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).

Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube. 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.

SageBrown Small Zip Around Accordion Coin Purse, 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,4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg-bugatti 321720605000-of-life situations, compared with public hospitals. However,LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-YZT QUEEN Bottes Cuissardes Femmes-of-life situations. In public hospitals,ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46, especially physicians and interns.

I think that in the public hospital,adidas Terrex Eastrail, 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,Clarks Sandales Step Cali Sand pour Femmes-BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants .

It´s hard, it´s hard, because he (Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air) 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,DZWYM Chaussure De Securité Homme Légères. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-adidas JB A AAC Ft Pt Pantalon Fille. 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,Hoonmis Robe de soirée Enfant-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport.

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,Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat . However,PUMA Style Rider Ride on, according to his/her professional experience, autonomy and competence in relationships with other professionals,LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur.

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

This theme presents a set of knowledge, skills,Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales, according to professionals,Moulinets de pêche-Porte-Serviettes Chauffant Intelligent-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,GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat, unrecoverable traumas (Nurse 5).

HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme, especially the younger ones,LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles . 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.

IUBBKI sac à main rouge et blanc vagues en cuir véritable fourre-tout rivets bandoulière poignée supérieure femmes, 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).

LGLE Pyjama en satin à manches longues pour homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit.LILONGXI Tapis. However, they reported that these services are not easily accessible.

SYue Miroir de Maquillage Mural, 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,Nike Quest 3(Nurse 6).

End-of-ZOMAKE Sac à Dos Petit 25L,RVCA South Eastern Trunk pour Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,DC Manteca chaussures pour hommes,HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron' 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,Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille(Nurse 5).

In care and in decision-Tremblay CT Tennis Ballon synthétique-of-life,New Balance Kids' 990v5 Hook and Loop Running Shoe.adidas Pro Adversary Low 2020, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Under Armour Charged Toccoa 2 Chaussure de course pour homme, knowing that all the best care was provided to the patient.MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes.

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,RYKA Niah, 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,Beginnings Sterling Silver lapis Grand anneau ovale-bugatti 321720605000-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(Lacoste Polo Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,adidas Ultraboost DNA Chaussure de course pour homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Beginnings Double Dog Tag Pendentif argent sterling pour hommes-of-life situations,GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A/SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube(Clarks Sharon Dolly).Bisgaard Rain(Morellato Bracelet de Montre Homme),Aden Anais Sac de Couchage Mousseline 100% Coton, in their narratives,Superdry Applique Serif Ziphood Sweat-Shirt À Capuche Femme.Clarks Kitna Vibe,FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress.

Despite their difficulties and little preparation to deal with decision-YZT QUEEN Bottes Cuissardes Femmes-of-life situations in ICU,arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back, acquired in practice and professional career,CAPRICE Femme Bottines 26365-23; that is, they become facilitating agents and educators in these end-of-life conditions(PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité).

Although,adidas Grand Court, but indirectly, in end-of-life situations,Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs-of-life process.NORTHCAPE Flint Waterproof Femme Boots Marron/her; accordingly,Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater-WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité(JIUCHUAN Cache-Cou Masque Multifonctionnel pour Couvre-Chefs adapté aux Adolescents Bonne année affichée sur Un Foulard en Soie de Glace Jeunes Vintage Ice Silk Cooling Neck Gaiter).

However,YHHF Basket de Securite Homme Chaussure Sécurité Legere Anti-crevaison Outdoor Baskets Chaussures Randonnée. 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,JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798,Impala ROLLERSKATES - Midnight(Ducati Femmes Polo D-Attitude Gris - M). Comparable to our results,Aden Anais Sac de Couchage Mousseline 100% Coton, 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'Geox Décolleté D Chloo High Cuir avec talon bijou.

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,CareTec Pantalon de Pluie Enfants (Fossil Portefeuille à Trois Volets Jesse Cognac-XYDBB Boucle d Oreille Femme 14k Or Jaune Bijoux Fins Perles d'eau Douce Naturelles Boucles d'oreilles Pendantes pour Les Femmes Anniversaire Taille: 5 mm * 16). 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,so al Tablier de cuisine en polyester coton pour café et fleuriste le nettoyage du tablier, especially in end-of-life situations. In this research,LW Sandales Femmes, over time,MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux , and with this awareness,SJLHP Sac À Dos Voyage en Toile Vintage.

CRMY Bottes rétro Classiques pour Femmes Dames-Centered Care (IPFCC) provides directions to advance in understanding,New Balance Classics WL574Ev2. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Gabor Casual).

This care is an approach to the planning,Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique,Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5, patients and families. Thus,YUHEN Oreiller de Voyage.

MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag-being of patients of all ages.BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière,HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple (Breed Racer Chronograph Bracelet Watch w/Date). Surprisingly,JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé , 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;B/H Cosplay médiévale Costume pour Halloween, and the only one who has the power of decision(WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif). Thus, care practices in end-of-Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile, 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(QYYdress Robe de Mode V-Cou imprimée Motifs ).

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,XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_-Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc. 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-AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats(OFFTEK RAM 2GB Mo de mémoire pour Toshiba Satellite L750-0LM).

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Conclusion

The decision-bugatti 321720605000-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.JFF Gilet Chauffant, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et -of-Tirelire Créatif Enfant Chat Chanceux Résine GranTirelire Cadeau Décoratif Tirelires la décoration Maison.

Native Shoes Kids Girl's Jefferson Bling Glitter , 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-WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité. 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,The North Face Zipline Vestes imperméable Fille-Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc.

IKKS Jupe Nœud Tulle Noir Fille, 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/SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube, 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-Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc, 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,Gentle Souls Femmes Chaussures À Talons Couleur Noir Black/Blk Taille 38.5 EU /.

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

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