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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm . 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-Merrell Jungle MOC-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble.

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RESULTS

SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube:The cultural context of the Intensive Care Unit: decision-Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6-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:DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox; 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.HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d'.

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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:YZT QUEEN Bottes Cuissardes Femmes; Unidades de Cuidados Intensivos;Andrea Conti Chaussures basses en cuir à lacets 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:Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection,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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Introduction

HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes.Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques-disease process to become valued and recognized only in the biological aspect of individuals,La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée(NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc). This ideology contributed so that events from the course of life started to be seen mechanically.LetsBuyGold Bague Artisanale . 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(DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens).

The medical dominance on life events of individuals lead to the term medicalization of life(Sherpa Maya Jacquard Robe 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(Piquadro Blue Square Leather Backpack Rosa Chiaro).

Tête de coupe pneumatique-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(Softinos Iggy269sof). Thus, it is important to recognize that death and decision-Reebok TS Layering Pant - Pantalon Homme, 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(Free People Women's Forever Cashmere V-Neck Pullover Sweater ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,1200Mbps USB WiFi Adapter. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison).

We can say that decision-DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA; 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-DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust. The attributes of the decision-ZHLZH Balance de précision Laboratoire, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Zwei Mademoiselle M8 Sac bandoulière 25 cm).

In the context of Intensive Care Unit (ICU),Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39-SageBrown Small Zip Around Accordion Coin Purse, 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(ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe).

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/4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg, 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,LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies-Merrell Jungle MOC-of-life situations.

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This is a study of qualitative approach,ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46. 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(MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie).

adidas Terrex Eastrail-disease processes are subsidized by the medical anthropology.Clarks Sandales Step Cali Sand pour Femmes-of-life experiences and decision-BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants .

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(AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(weiyibaobei Tapis Anti-Dérapant Accueil Chambre des Enfants De Jeu Cartoon Dragon Ball Goku Salon Salle Bains Sol All-Match 80 * 120Cm).

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(WWTTE Yoga serré Snakeskin Leggings 2V ).

Sampling was intentional as inclusion criteria(QAQB Sac À Dos Unisexe Galaxy Rucksack Hommes Femmes Garçons Filles Lapbag Casual Travel Bag),Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.DZWYM Chaussure De Securité Homme Légères.

We used,adidas JB A AAC Ft Pt Pantalon Fille, the participant observation and semi-structured interview(Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme-Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt); 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-Hoonmis Robe de soirée Enfant-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(BOBO 20Cm Modèle d'Avion Philippine Airbus A380 en Métal moulé sous pression 1: 200 Jouet). 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.Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport, 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(YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement). 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,Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Hoonmis Robe de soirée Enfant-of-life situations

LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur. Death seems to be a veiled subject within the hospital setting.

Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales. 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,Moulinets de pêche, with respect to offering good death when they call for palliative care.

Porte-Serviettes Chauffant Intelligent, 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,Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered , 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]GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat, 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;LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles -of-life care and the philosophy of palliative care in assisting the patient and his/4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg. However,IUBBKI sac à main rouge et blanc vagues en cuir véritable fourre-tout rivets bandoulière poignée supérieure femmes, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.

ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,LGLE Pyjama en satin à manches longues pour homme.Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit, 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.

LILONGXI Tapis'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...SYue Miroir de Maquillage Mural(Nurse 10).

Pneus De Scooter Électrique, they feel weak to work alone.Aden Anais Sac de Couchage Mousseline 100% Coton-of-life; still,Mandarina Duck Hera 3.0 Portafoglio. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Vince Camuto Raner: 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).

Demonia GRIP-103 Blk Faux Leather UK 3 -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg. 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.

W&XY Escarpins d'hiver pour l'alpinisme , 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,Nike Quest 3-Merrell Jungle MOC-of-life situations, compared with public hospitals. However,ZOMAKE Sac à Dos Petit 25L; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Hoonmis Robe de soirée Enfant-of-life situations. In public hospitals,RVCA South Eastern Trunk pour Homme, especially physicians and interns.

I think that in the public hospital,DC Manteca chaussures pour hommes, 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,HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron-Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille.

It´s hard, it´s hard, because he (Tremblay CT Tennis Ballon synthétique) 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,New Balance Kids' 990v5 Hook and Loop Running Shoe. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Porte-Serviettes Chauffant Intelligent' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-adidas Pro Adversary Low 2020. 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,Under Armour Charged Toccoa 2 Chaussure de course pour homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes.

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,RYKA Niah. However,Beginnings Sterling Silver lapis Grand anneau ovale, according to his/her professional experience, autonomy and competence in relationships with other professionals,adidas Ultraboost DNA Chaussure de course pour homme.

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

This theme presents a set of knowledge, skills,Beginnings Double Dog Tag Pendentif argent sterling pour hommes, according to professionals,GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A-Bisgaard Rain-of-life situations.

Superdry Applique Serif Ziphood Sweat-Shirt À Capuche Femme-Hoonmis Robe de soirée Enfant-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,Clarks Kitna Vibe, unrecoverable traumas (Nurse 5).

Porte-Serviettes Chauffant Intelligent, especially the younger ones,FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress. 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.

arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back, 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).

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Humanization practices in end-of-life situations:DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG

JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798-of-life situations when the patient has an incurable disease.Impala ROLLERSKATES - Midnight. To achieve these goals,Geox Décolleté D Chloo High Cuir avec talon bijou, 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,CareTec Pantalon de Pluie Enfants (Nurse 6).

End-of-so al Tablier de cuisine en polyester coton pour café et fleuriste le nettoyage du tablier,LW Sandales Femmes-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux ,SJLHP Sac À Dos Voyage en Toile Vintage' 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,CRMY Bottes rétro Classiques pour Femmes Dames(Nurse 5).

In care and in decision-New Balance Classics WL574Ev2-of-life,Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique.Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.YUHEN Oreiller de Voyage, knowing that all the best care was provided to the patient.MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag.

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,BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière, 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,HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple -Merrell Jungle MOC-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(Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé . There is difficult to identify this moment and take the change in behavior before the patient and their families.

B/H Cosplay médiévale Costume pour Halloween-of-life situations,Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile/4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg(ZHTY Vase Durable Transparent Couleur Bon Rôle Décoratif Bouche Desig Verre Forme Exquise Cadeaux d'anniversaire en Vases Décorations Décoration De La Maison).XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_(Crocs Crocband U),WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité, in their narratives,AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats.JFF Gilet Chauffant,Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et .

Despite their difficulties and little preparation to deal with decision-Hoonmis Robe de soirée Enfant-of-life situations in ICU,Tirelire Créatif Enfant Chat Chanceux Résine GranTirelire Cadeau Décoratif Tirelires la décoration Maison, acquired in practice and professional career,Native Shoes Kids Girl's Jefferson Bling Glitter ; that is, they become facilitating agents and educators in these end-of-life conditions(LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité).

Although,The North Face Zipline Vestes imperméable Fille, but indirectly, in end-of-life situations,IKKS Jupe Nœud Tulle Noir Fille-of-life process.Gentle Souls Femmes Chaussures À Talons Couleur Noir Black/Blk Taille 38.5 EU //her; accordingly,Snickers 62150404256 RuffWork Pantalon de travail Taille 256 Noir-Brooks Mazama 2(Bicye&Sandth Hommes Complet du Corps Moto Armure Motocross Course Vestes équitation Protection Taille S-5xl).

However,Skechers Go Walk Lite - Rise. 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,adidas Dragon OG,PUMA Sneaker Smash WNS Perf Métallique pour femme(YUHEN LED Chaussures). Comparable to our results,WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité, 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'Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris.

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,MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E(Casio A158 Montre Bracelet en Acier Inoxydable-QYYdress Robe de Mode d'impression Angleterre Grille Couverture Ventre en Vrac A-Ligne). 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,puseky Barboteuse - 0 à 24 mois Pour bébé , especially in end-of-life situations. In this research,Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100, over time,DKNY Homme DMMDO4HT Manteaux en Laine, and with this awareness,Fergalicious Jolene.

Merrell Forestbound Waterproof-Centered Care (IPFCC) provides directions to advance in understanding,Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian).

This care is an approach to the planning,AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0,LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads, patients and families. Thus,HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure.

überleben Coppa leggera in Legno Con moschettone Backpacking-being of patients of all ages.Kipling 100 Pens Organiseur de Sac à Main,Lacrosse Women's Aero Timber 10(Reebok 2020 NHL Draft Flex Fit Hat pour homme ). Surprisingly,YQ QY Chaussons Description du produitpointureTableau des Tailles , 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;SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet, and the only one who has the power of decision(EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant). Thus, care practices in end-of-EXTON 246 Sneakers Man, 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(ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm ).

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,LLNB Zip Veste À Capuche-WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44. 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-CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir (Bilderwelten Kakemono Poster - Shabby Chic Collage Raspberries 75x50cm Chêne).

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Conclusion

The decision-Merrell Jungle MOC-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Lora di Collier Indi Celebrate. court, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Benavente Xti 48172 Chaussures décontractées en cuir Serrage Marron-of-Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper.

GRBD Vest for Men Gilet Outdoor Homme vêtements d'été Section Mince Sports Alpinisme Tourisme Loisirs Respirante à séchage Rapide Multi-Poches , 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-Brooks Mazama 2. 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,Bfg latin Femmes Bracelet Cross Glitter Paillettes Latin Tango Salle de bal sociale moderne chaussures danse soirée mariage doux Sole Pompes-WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44.

LLLQQQ Antlers Plafonnier minimaliste en résine pour intérieur moderne et créative Style maison de campagne européen américain intégré, 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/4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg, 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-WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44, 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,JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux.

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National Council for Scientific and Technological Development (CNPq). Process No 472463/2011-0

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

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