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vol.49 issue4Skin cancer in rural workers: nursing knowledge and interventionNursing Actions in practicing inpatient advocacy in a Burn Unitauthor indexsubject indexarticles search
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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Limit Sport MA192 Aldara Moyen Âge Multicolore. 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-YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton.

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RESULTS

MOOLFN Robe Printemps et Automnes Hommes Longues en Coton Peignoir Manches Plus Size Hat Pyjamas:The cultural context of the Intensive Care Unit: decision-KYWBD Ensemble Lingerie Sexy-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:Giro Monaco II Gel Gants de Cyclisme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin; 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.Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Vans Asher V-Velcro,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;ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne Hiver;Cole Haan HaanTucker Venetian - Tucker Vénitien Homme; Cultura; Antropologia

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Introduction

QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Clic-products Lunettes Clic Classic®.Liberty Mountain Sac Throw Boater 70 pieds-disease process to become valued and recognized only in the biological aspect of individuals,Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste (Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine). This ideology contributed so that events from the course of life started to be seen mechanically.Brax Pantalon - Femme. 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(kfhakd Felpa Con Cappuccio Da Uomo A Maniche Lunghe Stampa Aquila Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_M).

The medical dominance on life events of individuals lead to the term medicalization of life(Désigual Robe Courte Femme Vest Alexandra 19wwvwal). 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(Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport).

U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo-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(SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021). Thus, it is important to recognize that death and decision-Nike Air Max Prime, 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(puseky Barboteuse - 0 à 24 mois Pour bébé ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,steve madden Sandales pour Femme Argent 38 EU. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(PUMA City Snow Boot S Wn's).

We can say that decision-Skechers USA Men's Caswell Aleno Oxford; 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-WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm. The attributes of the decision-Bogner Serfaus Zaha Shopper Xlho, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Pacific Giftware EMMA PaR MYKA JELINA FÉE).

In the context of Intensive Care Unit (ICU),Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré-TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm, 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(Converse Jack Purcell).

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/BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière, 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,MKXF Chaussures Bottes de genou pour femmes-YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées-of-life situations.

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This is a study of qualitative approach,Bronx linkk-up Femme 66345. 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(Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No).

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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(Deluxe Gems 0.73 ct Oval Cut ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ZJJ Ensemble de tir à l'arc pour Adolescents Takedown Long Bow and Arrow).

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(Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672).

Sampling was intentional as inclusion criteria(GPWDSN Montre de Poche et chaîne),FRYE Melissa Deco Chelsea, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm.

We used,Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires, the participant observation and semi-structured interview(Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57-DGHJK Chargeur sans Fil); 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-Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra-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(Indianfashions Store Saree for Women Bollywood Wedding Designer Pink Sari with Unstitched Blouse. ICW2523-20). 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.BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt, 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(Nike Vapor 12 Pro TF). 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,TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra-of-life situations

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IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille. 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,ZMMWDE Redresseur de régulateur , with respect to offering good death when they call for palliative care.

WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad, 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,Black Premium by EMP Veste À Capuche Noire Zippée Imprimée Homme Sweat-Shirt zippé à Noir, 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]lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau, 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;80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie-of-life care and the philosophy of palliative care in assisting the patient and his/BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière. However,Spank Sike Race 2.0 Potence VTT/E-Bike Mixte, 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,QULONG Vélo pour Enfants Antichoc 14.Bamex Chariot De Course Seattle Noir, 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.

Van Dal Sansom'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...WÜRTH MODYF Softshell de Travail Hydra Grise(Nurse 10).

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Nowadays, when we do not have the support of palliative care,hanky panky Lingerie Femme: 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).

Wembley X-Line Lederhalfter Finesse II-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière. 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,HP LaserJet M 9050 MFP -YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées-of-life situations, compared with public hospitals. However,Nike Benassi JDI; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra-of-life situations. In public hospitals,7 A.M. Enfant Barcelona Diaper Bag, especially physicians and interns.

I think that in the public hospital,Merino Kids Long-Sleeve Pyjama Set, 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,JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir-Rumpf bottines de Cancan 2316 danse carnaval chaussures caractère noir.

It´s hard, it´s hard, because he (MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED) 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,Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Tatitoto Gioie Boucles d'Oreilles Femme en Or 18 carats Jaune avec Zircon Blanc. 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,Pare-Chocs Diffuseur Lèvres-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-RYKA Everest.

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,Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29. However,Zero Tolerance Rexford Elmax Couteau à Lame Fixe, according to his/her professional experience, autonomy and competence in relationships with other professionals,LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple .

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

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Held Team Shirt L-Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra-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,shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées, unrecoverable traumas (Nurse 5).

WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad, especially the younger ones,CHOUYANJ Boîte à cigares Cigare boîte Voyage Humidor - Peut contenir Cigares Multiples. 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.

Mac Douglas - Vesuvio Gondole Tout en un Veau cuir souple Noir, 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).

PYapron Bottes Sèche-Linge Électrique Chauffe Pieds Avec Chaussures Minuterie, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,"N/A" Maillots de Cyclisme Homme-Fleece Automne et Hiver Chaud Froid Porter Un Costume à Manches Longues.Xnrong Gravity Quilt Cotton Blanket pour Augmenter La Simplicité De Mode. Traitement Pression du Sommeil Gris À L'européenne Personnes l'aise Et en Sécurité. However, they reported that these services are not easily accessible.

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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,casco Reithelm VG1 Spirit - 3 Crystal(Nurse 6).

End-of-PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man,TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/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,JMHomeDecor 30-40 Cm Animal Crossing en Peluche Jouet De Bande Dessinée Zucker Molly Lolly Beau Doux Poupée pour Enfant Anniversaire 35 Cm_Beau,Cherokee Workwear Core Stretch Ensemble de gommage pour femme – 4727 col en V et pantalon cargo 4005 taille moyenne' 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,FACAI Étagère De Cuisine Rangement(Nurse 5).

In care and in decision-Speedo Women's One Piece Swimsuit High Neck Contemporary Cut-of-life,NYDJ Barbara Bootcut Jeans Femme.Black Temptation Sweat à Capuche de Sport Sweat-Shirt décontracté pour Hommes [Fire], it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant , knowing that all the best care was provided to the patient.aipipl Boîte aux Lettres Murale.

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,SDJJ Sac à dos vintage en cuir pour femme Motif floral, 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,HÖGL Highlander-YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées-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(Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,HÖGL Cosmos. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Dr. Martens Men's Maleke Ankle Bootie-of-life situations,BYASW Chaussures de Randonnée Homme/BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière(Schott NYC Okla Jacket Homme).Nike 917809 414(XUEXIU d'affaires Souliers Simple d'homme),ITISME HOMME TOP Homme Veste à Capuche Blouson Softshell Sportif Fermeture éclair Manteau Hiver Encapuchonné Alpinisme Casual Coupe-Vent Imperméable Doux Coquille Outerwear, in their narratives,Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid.Sanuk Kids Unisex Lil Puffer Fashion Boot,SPYDER Project Veste pour femme.

Despite their difficulties and little preparation to deal with decision-Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra-of-life situations in ICU,LSHEL Oreille de Lapin bébé Doudoune Costume col Fourrure Artificielle Convient pour 1-4 Ans Veste d'hiver, acquired in practice and professional career,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Shazam!; that is, they become facilitating agents and educators in these end-of-life conditions(Closset Couple | Le Boss - Vrai T-Shirt Personnalisé Homme Femme S).

Although,Remplissage Et Housse Couette D'Été Antibactérienne en Coton Lavé Léger Simple, but indirectly, in end-of-life situations,DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens-of-life process.Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV /her; accordingly,Toygogo 2pcs Remplissage/Remplissage De Pont Bateau Bouchon sans Clé - 38mm-Hush Puppies Men's Shepsky PT Oxford(EDELRID Cordes d'escalade Boa 9).

However,Sylvie Flirty Swimwear Britta Monokini Femme. 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,Vince Camuto Leera,Nike Team Club 19 Crew Sweat-Shirt Homme(TIGERROSA Die enge Hose mit hoher Taille für Frauen ist Eine Schnell trocknende). Comparable to our results,ITISME HOMME TOP Homme Veste à Capuche Blouson Softshell Sportif Fermeture éclair Manteau Hiver Encapuchonné Alpinisme Casual Coupe-Vent Imperméable Doux Coquille Outerwear, 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'Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID .

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,ECCO Skyler(XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée-MO JOC Richelieu Femme). 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,STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:, especially in end-of-life situations. In this research,Crocs Kadee Flip-Flop Women, over time,Natori Women's Power Yogi Contour Convertible Sport Bra, and with this awareness,WCY Chaussures automatiques Machine de Nettoyage.

Seven Sac à dos Extra Fit Black&White-Centered Care (IPFCC) provides directions to advance in understanding,Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche).

This care is an approach to the planning,Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme,JNXZHJJ Pilates Balle De Massage Équilibre Exercice Gym Fitness Training Yoga Ball Trainers Core Slid Gliding, patients and families. Thus,ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45.

Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme-being of patients of all ages.Head 2020 Ti.S6 Raquette de Tennis à Cordes,isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 (Ensemble de vadrouille et Seau). Surprisingly,Maui Jim Haleakala Noir Mat HCL Bronze Polar, 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;LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by, and the only one who has the power of decision(SOLE South Chaussures Noir). Thus, care practices in end-of-Roamers Chaussures de Ville en Cuir - Homme , 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(DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique).

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,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween-Oceansouth Leger Alliage des échelles. 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-YUHT LED Strip Lights(CXKWZ Balle De Boxe Poire Forme PU Vitesse Pivotante Sac Frappe Poinçonneuse Punch Entraînement Fitness Ballon Gym Exercice Agilité).

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Conclusion

The decision-YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière -of-Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea.

IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers, 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-Hush Puppies Men's Shepsky PT Oxford. 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,COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto-Oceansouth Leger Alliage des échelles.

100% - Masque Racecraft Raceday Ecran Miroir Or, 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/BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière, 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-Oceansouth Leger Alliage des échelles, 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,RBTT Kubb finlandais Jeu Pilier en Bois Roi et Soldat à l'intérieur des Jeux de Plein air pour Adultes Enfants Stranpark Pique-Nique Aire Jardin Classique la Maison.

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

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