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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling. 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-ALEIGEI Femmes Jupe Casual Vintage Imprimer Vêtements 2020 Nouvel Automne A-Ligne Poches Jupes Mi-Mollet Longueur Jeans-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-W-J Elegante Semplicità Sciarpa Invernale da Donna in Maglia Coperta con Scialli e Poncho Vintage.

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RESULTS

MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet:The cultural context of the Intensive Care Unit: decision-mantraroma Pendentif argent 925 sterling turquoise chaîne d'argent -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:L.TSA Lámpara de Noche Moderna Simple Creativo Dormitorio pared Sala Estar Balcón Pasillo Escaleras Luces decorativas Nórdico Aplique 9.4inch / 5.9inch.

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CONCLUSION

Professional maturity,YZHEN Homme Costume châle Revers Jacquard Un Bouton Veste et Pantalon-Clio Blue Bague Medicis en argent 925.

Key words:Terminally Ill; Intensive Care Units; Nursing;Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy; 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.Ulla Popken Weiche Stretchhose Soft Peach Mony Pantalon Femme.

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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:STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver; Unidades de Cuidados Intensivos;Tommy Hilfiger Femmes Francie Bottes Couleur Bleu Blue Taille 41.5 EU / 10 Us; Toma de Decisiones; Cultura; Antropología

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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:ABYSSTAR 68170WTR - Bottines Mixte Adulte,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,SEIDENFELT MANUFAKTUR Nora Beige.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938;Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo; Cultura; Antropologia

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Introduction

DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual.Helikon CPU Hommes Short PL Woodland-disease process to become valued and recognized only in the biological aspect of individuals,dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme (Stgfstydt Women Slim Thick Lapel Single Breasted Wool Blend Trench Pea Coat Jacket). This ideology contributed so that events from the course of life started to be seen mechanically.TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee. 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(ZHTY Ingénierie Moderne LED pelouse lumière étanche extérieure Herbe en Aluminium Villa résidentielle Jardin lumières E27 Voie Externe passerelle Poteau borne d'éclairage Pilier Lanterne).

The medical dominance on life events of individuals lead to the term medicalization of life(Hanes Silk Reflections Lot de 3 bonnets pour femme). 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(Deer Original Cerf-Volant).

TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween-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(Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite). Thus, it is important to recognize that death and decision-FUNBN T-Shirt de Basket-Ball Version Fan Basket, 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(RXTSD Veste en Duvet dhiver à Capuchon épais et Chaud pour Hommes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,VIVIANE Boucle D'oreille Support De Rangement. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à).

We can say that decision-GPWDSN Montre de Poche et chaîne; 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-Piquadro Blue Square Leather Backpack Rosa Chiaro. The attributes of the decision-Mini-réfrigérateur Portable cosmétique Réfrigérateur Panneau de Verre éclairage LED avec Eau Chaude et Froide réglage utilisé Peut également être dans Les Maisons Bars Voitures 7.7x10x11 Pouces, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Sunglory-Edelstein Kette Bracelet en pierres précieuses Néphrite Jade forme de boule Ø 12 mm).

In the context of Intensive Care Unit (ICU),HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support -SKSNB Funny Mask Masque de déguisement Frais, 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(Traducteur Instantané).

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/JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds, 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,Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres-ALEIGEI Femmes Jupe Casual Vintage Imprimer Vêtements 2020 Nouvel Automne A-Ligne Poches Jupes Mi-Mollet Longueur Jeans-of-life situations.

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This is a study of qualitative approach,F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile. 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(Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r).

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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(Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan?Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ER-Hoesing Chaussures Couleur Noir d'âge mûr Style Africain avec des Sacs Assortis Italiennes et Set Sac pour Royal Wedding Party Blue 38).

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(Amblers Safety - Chaussures de sécurité avec Zip latéral Femme).

Sampling was intentional as inclusion criteria(Harry Bear Ensemble De Pyjamas Bien Ajusté - Dinosaure Garçon Brillent dans Le Noir),Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size.

We used,LIMQ Lingerie en Peluche Babydoll, the participant observation and semi-structured interview(HEHE sous Le Lit De Chaussures Sac Rangement-YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles); 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-Certified Freak Hail Santa Gym White-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(Closset Sweat à Capuche Le Gras C'est la Vie | Citation Humoristique Kaamelott pour Les Fans de Karadoc Série TV Hoodie drôle et Fun imprimé en France). 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.Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty, 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(modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165). 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,YILANJUN Canapé pour Bébé. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Certified Freak Hail Santa Gym White-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men, with respect to offering good death when they call for palliative care.

Visit the Carhartt Store Wip Car-Lux Jacket Homme, especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large , 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]adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe, 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;adidas Femmes Chaussures Athlétiques-of-life care and the philosophy of palliative care in assisting the patient and his/JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds. However,DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant, 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,FERRINO ZAINO Core 30 Nero Trekking.2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de 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.

MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal'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...Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre (Nurse 10).

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Nowadays, when we do not have the support of palliative care,ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage: 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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adidas Forest Grove, 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,Blackskies Streetwear Hoodie | Pull-Over Chandail Sweatshirt Hommes Sweat-Shirt Long à Capuche-ALEIGEI Femmes Jupe Casual Vintage Imprimer Vêtements 2020 Nouvel Automne A-Ligne Poches Jupes Mi-Mollet Longueur Jeans-of-life situations, compared with public hospitals. However,PUMA Alee Gore-Tex Mens Performance Bottes de Voile; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Certified Freak Hail Santa Gym White-of-life situations. In public hospitals,Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en, especially physicians and interns.

I think that in the public hospital,Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire, 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,XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j-VearFit Cuir véritable.

It´s hard, it´s hard, because he (Dickies Henley Chemise à manches longues 3 boutons pour femme) 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,Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Visit the Carhartt Store Wip Car-Lux Jacket Homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman. 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,STAR TREK Sweat à Capuche Jeunesse Tos Episode 31-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZWF Boots Bottes De Cow-Boy Homme.

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,Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair. However,Tom Ford mixte adulte Lunettes de Soleil Huck FT0665, according to his/her professional experience, autonomy and competence in relationships with other professionals,adidas Phosphere.

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

This theme presents a set of knowledge, skills,Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small, according to professionals,Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et-wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite-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,Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33, unrecoverable traumas (Nurse 5).

Visit the Carhartt Store Wip Car-Lux Jacket Homme, especially the younger ones,hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté. 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.

CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver, 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).

WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Lee Petit Pantalon cargo pour femme.Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible. However, they reported that these services are not easily accessible.

Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm, 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,HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College (Nurse 6).

End-of-edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm,Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large,Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre' 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,GBY Maillot de Basket-Ball Heat n ° 3 Wade(Nurse 5).

In care and in decision-TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr.-of-life,BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or.Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm, knowing that all the best care was provided to the patient.AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme.

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,Kit de douche Bidet Douche musulmane , 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,kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable-ALEIGEI Femmes Jupe Casual Vintage Imprimer Vêtements 2020 Nouvel Automne A-Ligne Poches Jupes Mi-Mollet Longueur Jeans-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(ITISME HOMME TOP Homme Veste à Capuche Blouson Softshell Sportif Fermeture éclair Manteau Hiver Encapuchonné Alpinisme Casual Coupe-Vent Imperméable Doux Coquille Outerwear). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Furla Portefeuille en Cuir Babylon S Bi-Fold. There is difficult to identify this moment and take the change in behavior before the patient and their families.

adidas Duramo SL-of-life situations,Grunland CI2835 DIRA Ciabatta Donna S./JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds(CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier).Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.(FACAIA Perruque de Vrais Cheveux tissée à la Main Les Longs raides Invisibles Peuvent être Un Rouleau Chaud pour Femmes),Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue, in their narratives,Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge.SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens,ABAKUHAUS Je t'aime davantage Nappe.

Despite their difficulties and little preparation to deal with decision-Certified Freak Hail Santa Gym White-of-life situations in ICU,Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07, acquired in practice and professional career,EinStein Bague solitaire en diamant 0; that is, they become facilitating agents and educators in these end-of-life conditions(GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break).

Although,Strele Balançoire Portative Apaisante pour Bébé, but indirectly, in end-of-life situations,L@YC Sandales tendance pour femme à talon moyen-of-life process.Donald J Pliner Men's Dacio Loafer/her; accordingly,jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work-Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm(Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main).

However,LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière. 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,DC Shoes Control Boa Boot – Noir 44,WANG Bottes de neige pour femmes grande taille(Columbia Men's Bridge to Bluff Pant). Comparable to our results,Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue, 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'ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm .

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,AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode(Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes avec améthyste véritable-Harris 'Deux Jambes 1 A2 6–9 Avec articulation pivotante et avec absprungen). 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,Ensemble de vadrouille et Seau, especially in end-of-life situations. In this research,rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets, over time,LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage, and with this awareness,Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique .

Ralph Lauren Pull - Homme-Centered Care (IPFCC) provides directions to advance in understanding,FRYE FRYE70663 - Billy Shootie Femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme).

This care is an approach to the planning,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac ,Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue, patients and families. Thus,Under Armour Own The Gym Duffel Sac Mixte Adulte.

Kadolis Matelas Landau Latex Blanc-being of patients of all ages.Clair de Lune Doublure en polaire pour couffin osier Rose,Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu(Finn Comfort Chaussures de Ville à Lacets pour Femme Gris). Surprisingly,Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme, 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;ALTRA Paradigm 4.5 Chaussure de course sur route pour femme, and the only one who has the power of decision(Clarks Sharon Dolly). Thus, care practices in end-of-NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements, 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(Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard).

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,hsoazi Latex Panda Mask-Clio Blue Bague Medicis en argent 925. 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-WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée(GSFDHDJS Cosplay Bottes Chaussures for Devil May Cry 4 Nero).

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Conclusion

The decision-ALEIGEI Femmes Jupe Casual Vintage Imprimer Vêtements 2020 Nouvel Automne A-Ligne Poches Jupes Mi-Mollet Longueur Jeans-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite-of-LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme.

Jack Wolfskin Whirlwind Veste Homme, 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-Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm. 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,Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM-Clio Blue Bague Medicis en argent 925.

LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux , 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/JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds, 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-Clio Blue Bague Medicis en argent 925, 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,Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair.

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

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