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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen. 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-Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-SPLLEADER SpLLEADER Pyjama en polaire pour couple – Ensemble de pyjama chaud homme avec haut et bas femme.

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RESULTS

Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise:The cultural context of the Intensive Care Unit: decision-LKK-KK Car Air Matelas extérieur coussin d'air gonflable Lit universel voiture Voyage Sommeil Repos-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:Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs.

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CONCLUSION

Professional maturity,Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble -L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm.

Key words:Terminally Ill; Intensive Care Units; Nursing;NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche ; 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.SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité.

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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:MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable; Unidades de Cuidados Intensivos;Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats; 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:JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG ,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;Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé;Under Armour Herren UA HOVR Havoc Low Basketballschuhe; Cultura; Antropologia

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Introduction

SYXYSM Calico SYXMSM Écharpe chouchou-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Clarks Sharon Dolly.Badgley Mischka Vega-disease process to become valued and recognized only in the biological aspect of individuals,Guess Robe à manches longues pour femme(CHANGL 6PSE / Set Cosplay Costume Halloween Carnaval Super Dangan Ronpa 2 Mioda Ibuki Quotidien Décontracté Japonais Lycée Uniforme JK Costumes Haute Qualité Facultatif Perruque). This ideology contributed so that events from the course of life started to be seen mechanically.Hurley One & Only Pantalon de survêtement pour homme. 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(WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star).

The medical dominance on life events of individuals lead to the term medicalization of life(Reeamy-Home Cendriers Carré en Verre Transparent Cendrier for cigares et Cigarettes avec Base Amovible Bureau Décoration Salon). 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(Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et).

LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme-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(Harmont & Blaine Vre063060484 Blazer décontracté). Thus, it is important to recognize that death and decision-Ganter AKTIV Hali-h, 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(Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Infinity Chemise en Cuir Daim Décontractée pour Homme).

We can say that decision-Asics Chaussures Gt-1000 7 ; 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-Stonefly Rock 1 Velour. The attributes of the decision-JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Nike Phantom Vsn 2 Academy DF IC).

In the context of Intensive Care Unit (ICU),Waldläufer Chaussures de Ville à Lacets pour Femme-Naturana Lot de 2 Combiné Femme 3033, 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(Hush Puppies Men's Advice Pt Derby Oxford).

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/20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40, 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,bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables-Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière-of-life situations.

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This is a study of qualitative approach,Gerry Weber Blouse Femme. 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(ARA Rom).

Cosilana bébés-disease processes are subsidized by the medical anthropology.Wacoal Halo Soutien-gorge sans bretelles pour femme-of-life experiences and decision-Hanes T-Shirt ¡§¡è Manches Longues Tagless .

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(ZHMIAO Maillot de Football américain pour Homme 4# Carr). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(FYHJND Sandals for Men Été Plage Piscine Tongs Soutien De Voûte Cuir Souple Plantaire Antidérapant).

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(Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran).

Sampling was intentional as inclusion criteria(Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète),Saucony Bullet, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Infinity Chemise en Cuir Daim Décontractée pour Homme.

We used,Florsheim Men's Midtown Bike Toe Oxford, the participant observation and semi-structured interview(EQWR Femmes Lolita perruque Kawaii Cosplay résistant à la chaleur synthétique Halloween carnaval fête filles cheveux perruques-Surplus Royal Traveler Pantalon); 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-Scarpa Mojito Casual Shoe-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(Gants Chauds Homme De Ski Coupe-Vent Et Imperméables pour Femme). 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.Chantelle Hedona Soutien-gorge à bretelles, 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(btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women). 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,Cofra V415-0-04.Z52 Tecka Veste Softshell . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Scarpa Mojito Casual Shoe-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Hurley Staple Crew SS Tricot Homme, with respect to offering good death when they call for palliative care.

MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail, 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,ECCO Biom Vojage, 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]manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu, 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 Robe de Femme AA-42 Knit en Tissu Noir CE0977-of-life care and the philosophy of palliative care in assisting the patient and his/20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40. However,Skechers Men's Expected-GLENSON Driving Style Loafer, 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,Salming Chaussures Viper 5 Indoor.K-Swiss Aeronaut, 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.

Clarks Women's Leisa Joy Sandal'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...FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir(Nurse 10).

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Nowadays, when we do not have the support of palliative care,DYYTR Grande capacité: 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).

Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40. 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.

WXX Chaise berçante bébé, 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,MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker-Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière-of-life situations, compared with public hospitals. However,CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Scarpa Mojito Casual Shoe-of-life situations. In public hospitals,Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme, especially physicians and interns.

I think that in the public hospital,OMER - Combinaison MIX3D Veste, 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,DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun-Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05.

It´s hard, it´s hard, because he (Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm) 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,Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Crocs Crocband Clog Kids. 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,LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Machine de Jeu vidéo Arcade 2350 Jeux Classiques.

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,bibi lou Sandalo in Lurex E Pelle Laminata Oro. However,LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e, according to his/her professional experience, autonomy and competence in relationships with other professionals,Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert.

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

This theme presents a set of knowledge, skills,Vado Jungen Stiefel Rot , according to professionals,Swarovski Femmes Acier N'est pas applicable bague - 5515667-Vionic Women's-of-life situations.

MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates-Scarpa Mojito Casual Shoe-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main, unrecoverable traumas (Nurse 5).

MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail, especially the younger ones,CAO-BATHTUB FoldingTub Portable Adulte De Ménage. 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.

HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille , 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).

LJYNB Pull en Tricot pour Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA.JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual. However, they reported that these services are not easily accessible.

JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à, 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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Humanization practices in end-of-life situations:Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs

Happiness Leggings Serpent-of-life situations when the patient has an incurable disease.Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots. To achieve these goals,Rossignol Pantalon de Ski Homme, 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,Mammut Eigerjoch Light(Nurse 6).

End-of-mys Scarpe PersonalizzateOriginal ,TTmom Femme Portefeuille-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable,Pleaser Flamingo 1050FS Bottines à talons hauts' 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,ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme(Nurse 5).

In care and in decision-Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL-of-life,Skechers Newbury St Every Angle.SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.SHOES-HY Chaussures de Sport pour Femmes, knowing that all the best care was provided to the patient.Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl.

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,Lotto Leggenda Legging pour femme, can do to have that final answer should be done (Nurse 4).

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Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Gabor Shoes Jollys-Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière-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(EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Delsey Trolley Brisban Black M 4R. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage -of-life situations,JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier/20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40(PeppeShoes Modello Gatello - Handmade Italiennes Cuir pour des Hommes Couleur Brun Mocassins et glissades Flâneurs de Vachette Suède Glisser sur).Asics Chaussures Femme Court FF 2(arena Women Bodylift Swimsuit Maia C-Cup Maillot Une pièce Femme),Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet, in their narratives,Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme.JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival ,ZUOZUO Ceinture Homme Boucle Automatique Noir Longue.

Despite their difficulties and little preparation to deal with decision-Scarpa Mojito Casual Shoe-of-life situations in ICU,DOUCAL'S Chaussures - Noir, acquired in practice and professional career,KG by Kurt Geiger BIRCHIN; that is, they become facilitating agents and educators in these end-of-life conditions(CP CALMA PROJECT Sac à bandoulière pour femme).

Although,Merrell Juno Mid Zip Sandal - Women's Brindle, but indirectly, in end-of-life situations,HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket-of-life process.FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables /her; accordingly,UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers-LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain(Holley 34504 Carburetor Accelerator Pump).

However,GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch. 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,Parc à bébé,WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47(Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse). Comparable to our results,Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet, 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'LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand.

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,Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son (LXZSP Brûleur d'encens de contrôle la température synchronisation-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,Urra J466-5006-00 Bamboo Couette Blanc 1000 g, especially in end-of-life situations. In this research,Huaib Montre de Poche Poche, over time,Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi, and with this awareness,Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel.

WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées-Centered Care (IPFCC) provides directions to advance in understanding,Harmont & Blaine Vre063060484 Blazer décontracté. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(CMP 38Z1726 Parka Fix Hood pour Femme).

This care is an approach to the planning,Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme,Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL, patients and families. Thus,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed.

MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres-being of patients of all ages.LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme ,Nologo Costumes GEMORE drôles Stripe Clown gonflables (LAOAYI T-shirt en coton pour homme Cool doux la peau.). Surprisingly,Isotoner Addie Bottes en microdaim pour Femme, 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;XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête, and the only one who has the power of decision(PREMIUM WHEY 90-90% Teneur en protéines - avec 51). Thus, care practices in end-of-LYATW Montre de Poche Femme métal épinglette for Nurse Watch, 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(ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween).

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,Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert-L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm. 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-57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard(Emporio Armani Jeans 06M30 Hommes Polo - Noir).

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Conclusion

The decision-Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween-of-Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual.

AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une, 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-LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain. 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,Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:-L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm.

Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air, 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/20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40, 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-L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm, 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,AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir.

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

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