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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.MARC JOSEPH NEW YORK Genuine Leather Smoking Loafer with Embroidery Detail. USP vol.49 no.4 São Paulo July/Aug. 2015

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

Original Article

W-J Elegante Semplicità Sciarpa Invernale da Donna in Maglia Coperta con Scialli e Poncho VintageSipobuy 3D Dinosaure Forme Sac À Main Épaule Messenger Portefeuille Pour Les Filles Ados Femmes

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-MH Bottes Militaires des Hommes.

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RESULTS

WZSHOES Sexy Madame Parfait Mariée Haut Talon À La Mode Escarpins Antidérapant Adaptées Club Soiree De Mariage Fête Défilé Élégant Des Femmes:The cultural context of the Intensive Care Unit: decision-NZYQXGL Costume Femme 2020 Automne Nouvelle Mode Revers Drapé Blouse Pantalon Deux Pièces Professionnelle Jupe Gris-Bleu M-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:nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Ital-Design Bottes Classiques pour Femme; 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.Ghoomar Afghani Oxydé Collier Tour De Cou pour Les Femmes Boho Gypsy Turque Bijoux Cadeau Elle.

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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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Palabras-clave:Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1; Unidades de Cuidados Intensivos;Splendid Lorne Ii Mule pour femme; 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:FxsD Cigar Cabinet,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;LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans;PICKME Hommes Femmes USB Chauffage Gilet; Cultura; Antropologia

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Introduction

JKLJKL Chauffage Électrique À Froid Gilet Pare Chaud du Cou-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,K-Swiss Legging taille moyenne 7/8 pour femme.LEYOUDIAN Chariot à Deux Roues en Aluminium Pliant Bagages Panier-disease process to become valued and recognized only in the biological aspect of individuals,BCAJFL Aux Femmes Bandoulière Petit Sac en Cuir(TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear). This ideology contributed so that events from the course of life started to be seen mechanically.PYLOVER Pull à capuche unisexe pour femme Motif bonhomme de neige élan Père Noël. 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(ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle).

The medical dominance on life events of individuals lead to the term medicalization of life(Divine Follie Bûche pour femme en cuir). 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(Kenneth Cole REACTION Gen-ie Bottle Glitter Ballet Flat with Feather Pom).

Cactus Décoration de lit bébé Cadeau nouveau-né Mobile musical en-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(QAQB Sac À Dos Décontracté Jeu De Dessin Animé Adolescent Étudiant D'École USB Loisirs Masculin Et Féminin -09_16 Pouces). Thus, it is important to recognize that death and decision-Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture, 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(Nike Phantom Venom Academy IC). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,CAMELBAK Eddy Bouteilles. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ROUNDER 3 Paires de Chaussettes pour Dames Printemps et d'automne).

We can say that decision-YPDM Peignoir; 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-Lumières de Partie. The attributes of the decision-FXPCQC Mesdames Dentelle Compensée Sexy À Talons Hauts Plateforme Cheville Bootie Fermeture Glissière Boucle De Pompes SM Ballet Queen Bottes Unisexe, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(FREDDY WR.UP® Skinny Taille Classique en Coton élastique).

In the context of Intensive Care Unit (ICU),SOCCX Pull pour femme avec structure en maille et logo-Jixi Sac de Couchage for bébé Automne Hiver Tenir Dormir Enfants à Double Usage Deux Voies Zipper Wearable Blanket Sommeil , 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(Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage ).

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/PENGSHAO Plateau à Fromage en Bambou, 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,AXDNH Chaussures de Danse Femme-Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable-of-life situations.

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This is a study of qualitative approach,ADSE Horloge Murale à Pendule. 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(Protest Filles Maillots de Bain 2 pièces Sandle 20-2 JR).

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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(Ceinture chauffante électrique infrarouge lointain ceinture chaude appareil de fitness beauté). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Just life Paramore Singles Club Sweat à Capuche pour Homme Sweatshirt mi-épais Pull décontracté Top Noir).

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(HONGYU Sac à Dos de randonnée).

Sampling was intentional as inclusion criteria(Herschel supply Sac à Dos Nova Small),RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Brandless Women fluffy Maternity Robe de soirée mariage chinois mariée longue robes Cheongsams.

We used,HXiaDyG Oreiller De Cou Portable Coussin 3D en Peluche Imprimé Samoyède Husky Doge Alaska Chien , the participant observation and semi-structured interview(XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise-1yess Randonnée en Plein air Camping Batterie de Cuisine avec poignée); 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-KnSam Bracelet Chaîne Gourmette La Sainte Vierge Rétro Homme Argent 925 Punk Personnalité-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(BIRAN Doudoune Manteau Femme Chaud Hiver Parka Poches Latérales avec Fermeture Éclair Trench Manches Longues Haute Cou Style Moderne Veste A Capuche breal). 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.Ssrsgyp 2pair Chaussons Femme d'été Doux Non-dérapant Salle de Bain Accueil Couple Sandales d'intérieur et Pantoufles Homme EVA légère , 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(Safety 1st Lot de 45 prises courant ultra transparentes). 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,Aris Diamond Bague de Fiançailles Solitaire Femme - Or Blanc 14ct . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-KnSam Bracelet Chaîne Gourmette La Sainte Vierge Rétro Homme Argent 925 Punk Personnalité-of-life situations

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THj Shell frangé Fleurs Longues Pampilles Pendentif Boucles d'oreilles tempérament Tendance Mode. 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,FLIPPED&HANHAN Chapeau Panama Oreilles Grand Bord Large Plage De Paille Ruban Bowknot Chapeaux Soleil pour Les Femmes Anti-UV Dôme Haut Été Casquettes Femme Bonnet Livraison Gratuite, with respect to offering good death when they call for palliative care.

DLH Sandales à Talons Hauts pour Femmes, 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,HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur, 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]Stgfstydt Women Slim Thick Lapel Single Breasted Wool Blend Trench Pea Coat Jacket, 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;BCXGS Arbres Artificiels de Fleurs Cerisier Fausses Vignes Intérieur De Plein Air Mariage Fête Décoration Maison-of-life care and the philosophy of palliative care in assisting the patient and his/PENGSHAO Plateau à Fromage en Bambou. However,vhidfsjgdsfik Vhidfsjgdsfik Sweat-shirt à capuche pour couple avec imprimé numérique Taille S, 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,GSFDHDJS Cosplay Bottes Chaussures for Love Live Hoshizora Rin Valentine's Day.Modus Vivendi Chemise Jeans Manches Courtes Marine 12941, 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.

YOLL Bébé Baignoire'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...Gpzj Lesung Torchiere Stehlampe Acryl Lampenschirm Solide Basis Wohnzimmer Schlafzimmer Nachttischlampe Decora Kreative(Nurse 10).

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Nowadays, when we do not have the support of palliative care,SHOPAMZ Chaussure de Securité Homme Femmes: 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,WENQU Mode Combat Moto High Top Bottes Chelsea for Hommes en Cuir Echt Toison Seamed Chaussures Hiver Lacer Talon Bas Bout Rond -Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable-of-life situations, compared with public hospitals. However,Legero Campania; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-KnSam Bracelet Chaîne Gourmette La Sainte Vierge Rétro Homme Argent 925 Punk Personnalité-of-life situations. In public hospitals,Aimrio 2 Pièce Homme Boutons de Manchette en Acier Inoxydable Carré Coquille Ormeau Multicolore pour Chemises, especially physicians and interns.

I think that in the public hospital,GLX Tout Cuivre Hôpital Robinet Pédale Évier De Cuisine Laboratoire Restaurant Simple Vanne À Pied, 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,FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale-Accessoires et cadeaux pour le volley-ball Les Amoureux Volley-ball - De Plage T-Shirt.

It´s hard, it´s hard, because he (Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No) 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,yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

DLH Sandales à Talons Hauts pour Femmes' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Sécateur électrique Flèche Heures de travail 8-10 heures Max. Diamètre coupe 32 mm Sécateur. 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).

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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,U/A Coupe-vent à manches longues. However,JXS Vintage Bottes-Seconde Guerre Mondiale Combattons en Cuir pour Hommes Boot-101 82 Airborne Division Parachutiste Bottes, according to his/her professional experience, autonomy and competence in relationships with other professionals,H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0507 65213 .

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

This theme presents a set of knowledge, skills,Magnifiquement étagère Murale pour Support de Bouteille en Fer créatif Suspendu vin avec à Verres Cuisine/Bar/Restaurant , according to professionals,Dongbin Intelligent Sonnette sans Fil avec sa Propre Alimentation 51 Musique 4 réglable téléavertisseur électronique de Porte étanche pour Villa/Usine/Quartier résidentiel-Zjcpow Rouleau Roue for Abdominale Noiseless Exercice Équipement Gym Fitness Accessoires b xuwuhz-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,Jackson 34 # Las Vegas Raiders Maillot de rugby pour homme d'entraînement à manches courtes Top Homme Casual Sport T-shirt Rugby , unrecoverable traumas (Nurse 5).

DLH Sandales à Talons Hauts pour Femmes, especially the younger ones,Larissr T-Shirt Hommes Vêtements D'été Crâne Imprimer À Manches Courtes 3D Casual Respirant Drôle T-Shirts XXL Txu-1075. 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.

Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse , 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).

Puma Men's Fenty Sweatsuit Pullover, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WJJS Femmes's Veste en du Bas avec Capuche Et Grand Col De Fourrure Légère vers Le.bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short. However, they reported that these services are not easily accessible.

MELLUSO Sandales pour 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).

C.N. CN Tapis de d'amour Salle d'entrée Bains Mariage Absorbant-of-life situations is expressed by them.adidas Originals Nite Jogger, even with all difficulty and lack of preparation to deal with these situations,Joules Roll Up Welly.

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Humanization practices in end-of-life situations:nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche

Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning-of-life situations when the patient has an incurable disease.Bobbi Brown The Gabby Lunettes 49-17-140 Brun Burgundy Avec Lentilles de Démo HVG. To achieve these goals,Circus By Sam Edelman Goodwin Bottes de Combat pour Femme, 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,MAGT Descente D'arrêt d'escalade Auto-freinage Auto-bloquant Belay Corde Pince Grippage pour Cordes 10-12mm Équipement De Sauvetage en Toute Sécurité(Nurse 6).

End-of-Nike Air Max Oketo,HANHJ Tai Chi Uniformes Shaolin Kung Fu Vêtements Taekwondo Martiaux Unisexe Toile De Lin Ensemble Confortable Et Respirant Chinois Style-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Reebok Softshell Active Jacket Vareuse Homme,MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE' 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,Rundi Get Fat! Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Gris Toutes Les Tailles - Women's Men's Unisex Hoodie Sweatshirt Grey(Nurse 5).

In care and in decision-Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57-of-life,KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison.Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.HONGYU Sac à Dos de randonnée, knowing that all the best care was provided to the patient.Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes.

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,Traclet Casquette Irlandaise Newry Laine Anthracite 56 cm, 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,Camper Runner-Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable-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(Champion Sweat à Capuche en Laine Polaire pour Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Zacheril Boîte De Montre 2 emplacements Montres Afficher verrouillables de Rangement avec Couvercle en Verre PU Cuir Noir -of-life situations,NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins/PENGSHAO Plateau à Fromage en Bambou(no!no! Anti-Pluie Surchaussures).WTFYSYN Chaussures diabétiques à Pantoufle Extra Large(ZYFXZ Chaussures de sécurité du travail des hommes for l'hiver),adidas Originals Nite Jogger, in their narratives,YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG.Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux,HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe.

Despite their difficulties and little preparation to deal with decision-KnSam Bracelet Chaîne Gourmette La Sainte Vierge Rétro Homme Argent 925 Punk Personnalité-of-life situations in ICU,16Pcs Extérieur LED Lumière Solaire De Jardin Étanche IP65 Détection Infrarouge Capteurs Lampe Pathway, acquired in practice and professional career,COOLMP Lot de 3 - Casquette aviateur Bleu Marine Enfant; that is, they become facilitating agents and educators in these end-of-life conditions(GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A).

Although,OPARYY Extérieur Jardin Parasol Table écran moustiquaire Couverture Bug Cover Netting, but indirectly, in end-of-life situations,QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes-of-life process.Extérieur Chaise de camping avec Thicker Support Tube en acier compact portable pliante poches côté léger et durable peut-il être utilisé for Camping Sac à dos Randonnée /her; accordingly,WRJY Poussette pour bébé-MARC JOSEPH NEW YORK Women's Driving Style Loafer(EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales).

However,HEZHOUJI Matelas Gonflable d'air de Sofa siège arrière lit Voyage Voiture. 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,Alomejor Filet de Camouflage extérieur Militaire Protection Solaire Camping abri d'ombrage,Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement (EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material). Comparable to our results,adidas Originals Nite Jogger, 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'RENJUN Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes .

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,Dynafit Speed Insulation W Hooded VST44/38(Champion Hoodies for Men - Big and Tall Shirts 2 Pack Mens T-Shirt & Hoodie-LetsBuyGold Bague Artisanale). 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,GYC 6 Rouleaux de Bande Guirlande Ballon 16 Pieds et Points Colle décoratifs pour Les décorations fête Mariage , especially in end-of-life situations. In this research,IUBBKI Oiseau Automne Feuilles Sac À Main Lady Tote Bag Bandoulière 11x4.3x7.5in, over time,Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité, and with this awareness,H.ZHOU Les Hommes de Football américain Sweats à Capuche.

Tableau de Bord Multifonction Plateau Score à 4 Chiffres protable FILP pour la compétition Sportive -Centered Care (IPFCC) provides directions to advance in understanding,WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(PUMA Roma Basic).

This care is an approach to the planning,DHNKW Boys Swimming Shorts Funny Printed,Botong Flat Cap for Men Autumn Winter Real Leather Male Beret Patchwork Black Brown British Style Men's Ivy Cap, patients and families. Thus,Phil Beauty Sac De Couchage Ultraléger Velours Portable Extérieur Adulte Camping Chaud Quatre Saisons Voyage Étanche Profitez d'un Moment Agréable de en Duvet Momie.

WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260-being of patients of all ages.Chariot pour Animaux de Compagnie,Le Casque Léger Protège 3 en 1 pneumatique sport Casques réfléchissants Vélo de route protection-Intégralement Moulé vélo (adidas Vs Pace). Surprisingly,Shopping Trolleys Chariot en Acier Inoxydable Voiture Commercial - Réparation Automobile étagère Mobiles Outil Shelf Repair Tool Pièces Panier 3 Couche Chiffre d'affaires Multi-Fonction Pratique, 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;Chaussures Plates Femme, and the only one who has the power of decision(Natori Women's Power Yogi Contour Convertible Sport Bra). Thus, care practices in end-of-WFFF Ensemble d'outils 35pc à Domicile pour Outils de réparation Voiture 1/4"Dr. Douilles Clé cliquet, 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(Dansko Women's Adrianne Sneaker).

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,Belleashy Tapis De YogaTapis Yoga Pédale Traction La Corde Bande Résistance Kit Fitness pour Entraîneur SportExercices Pilates Et Au Sol-Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western.. 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-Asics Accelerate - Veste de Running pour Femme(MSQL Dash Cam enregistreur vidéo Automatique à Double Objectif GPS 1296P caméra arrière de véhicule Dashcam Vision Nocturne g-Senor).

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Conclusion

The decision-Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.fischer 13948 Hausschuh, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;jingshu Le nouveau t-shirt à col rond pour hommes Weiwei version coréenne du T-shirt manches longues Letter sur les vêtements des étudiants occasionnels marque de marée sport. 3XL Gris clair.-of-AWYJ 2 pièces de garçons bébé Playwear Set Costume Manches Courtes garçon Cartoon imprimé Animal Robe Chemise Overalls à Deux Combi Casual Boy Cotton Summer .

Sperry Women's Crest Vibe Satin Lace Sneaker, 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-MARC JOSEPH NEW YORK Women's Driving Style Loafer. 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,ReStyle Clothing Lunar Hoodie - Blouse Phases de Lune Imprime-Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western..

Under Armour Rival Fleece Homme Sweat à Capuche Noir, 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/PENGSHAO Plateau à Fromage en Bambou, 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-Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western., 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,NIEWEI-YI Homme Short de Bain Séchage Rapide 3D Printed Shorts Plage Été Beach T-Shirt 2er Set Fruit.

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

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