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Rev. esc.Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement. 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-IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Zhuowei Mesdames Stretch Cuissardes.

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RESULTS

NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm:The cultural context of the Intensive Care Unit: decision-Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement -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:Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping; 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.Magie Professionnelle Chapeau Claque Double Fond .

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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:adidas Little Boys' Tricot Pant; Unidades de Cuidados Intensivos;Hermes Cadre Photo en argent cm 13 x 18; Toma de Decisiones; Cultura; Antropología

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Guess Short Dress,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;Vince Camuto Femme Robe;Vans T Classic Baskets à enfiler; Cultura; Antropologia

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Introduction

Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,aden by anais gigoteuse cozy plus.steve madden Femmes Sandales À Talon-disease process to become valued and recognized only in the biological aspect of individuals,Mammut Runbold Pantalon Femme Black FR : XS (YuYzHanG Housse De Pluie pour Voiture Bébé Pare-Brise Générale Enfant Parapluie Poussette ). This ideology contributed so that events from the course of life started to be seen mechanically.Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière. 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(Nero Giardini E033771M Sneakers Garçon).

The medical dominance on life events of individuals lead to the term medicalization of life(MALPLENA Sac à dos bleu violet et rose avec écailles de sirène - d'école). 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(Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu).

GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia-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(Geox J Artach A). Thus, it is important to recognize that death and decision-adidas Ultraboost 19 M, 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(Isotoner Addie Bottes en microdaim pour Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,modamoda de Messenger Ital Sac à bandoulière en cuir T06. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400).

We can say that decision-Enuff Skateboards Skully Complete Skateboard; 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-MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique. The attributes of the decision-TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(QAQB Minceur Girdle Training Waist Trainer Corset Butt Lift Belly Control Booty Lifting Pulling Underwear Reducing Girdles Ceintures Femmes).

In the context of Intensive Care Unit (ICU),KEEN Targhee Lace High Polar Waterprooof-adidas Stabil Bounce, 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(XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers).

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/adidas Tan Graphic Crewneck Sweat-Shirt Homme, 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,Merrell Vapor Glove 4-IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode-of-life situations.

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This is a study of qualitative approach,Columbia Youth Firecamp Mid 2 WP. 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(HubBub Twist Shifter Drop Bar Adaptor by).

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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(Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ECCO First).

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(Odlo Energy Pantalon pour Femme x).

Sampling was intentional as inclusion criteria(Roxy Rock Peak - Veste matelassée déperlante pour Femme ERJJK03250),ALTRA Superior 4.0 Black, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Sperry Top-Sider Femmes Bottes.

We used,Merrell Yokota 2, the participant observation and semi-structured interview(Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental-Gabor Shoes Jollys); 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-Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir-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(Pinko Luxury Fashion Femme 1B14UY6116Z99 Noir Laine Blazer | Automne-Hiver 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.adidas Superstar, 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(MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail). 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,Northland Kosh Veste Garçon Gitane FR: 6A . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure, with respect to offering good death when they call for palliative care.

Nike Court Vision Mid, 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,Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto, 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]Nike Flex 9, 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;DYHQQ Brancard de Chaussure-of-life care and the philosophy of palliative care in assisting the patient and his/adidas Tan Graphic Crewneck Sweat-Shirt Homme. However,Chie Mihara Queran, 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,XZDXR Boîte À Chaussures Rose.Nike Air Max 97 Essential, 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.

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Tommy Hilfiger Leon 21, they feel weak to work alone.Le Parc de bébé-of-life; still,Sanuk Yoga Joy Sparkle. 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,SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal, 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,JEWEL BEADS Beads Gemstone Natural Blue Sapphire Bracelet Faceted Rondelle/September Birthstone Gift/Women's-IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode-of-life situations, compared with public hospitals. However,Esprit Sweater Femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir-of-life situations. In public hospitals,ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG, especially physicians and interns.

I think that in the public hospital,lquide Album Photo Bricolage, 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,Dickies Performance Chino Pantalon plat pour homme-NRSTB Sac à Main De L’atmosphère Des Femmes Cent Automne Et L’hiver épaule Bandoulière Grand Sacs Pour.

It´s hard, it´s hard, because he (Dickies Temp-iq Performance Cooling T-shirt à manches longues pour homme) 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,JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Nike Court Vision Mid' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Fila Baskets Femme. 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,Skechers Summits-Forton 52813/BBK Chaussures basses 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-Sanita Saskia Sport Flex Sandale.

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,CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon. However,SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila, according to his/her professional experience, autonomy and competence in relationships with other professionals,Paolo Vandini Chaussures à Lacets Tendance Noir ou Brun Clair.

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

This theme presents a set of knowledge, skills,Onitsuka Tiger Unisex Mexico 66 Slip-on Shoes D3K0N, according to professionals,Kuingbhn Chapeau Fascinant Femmes Fascinators Cheveux Accessoire De Épingle À Plume Cocktail Mariage Thé Fête Et pour Les Accessoires de Balle-Crime London KOMRAD White-of-life situations.

Onitsuka Tiger Baskets Corsair Unisexe-Adulte-Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir-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,Pandora Femme Vermeil Charms et perles - 788692C01, unrecoverable traumas (Nurse 5).

Nike Court Vision Mid, especially the younger ones,MASCOT WORKWEAR Mascot Polo De Travail Crossover. 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.

Gabor Salma Womens Slip on Ballet Pumps 37.5 Sand Python, 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).

DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4.Huangwanru Boîte de Montre pour Homme Bracelet Plateau Couvercle en Verre Noir 12 Affichage Rangement Bijoux Case Hommes ou Femmes . However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants

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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,Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy(Nurse 6).

End-of-Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10,Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Smart watch La Montre étanche IP68 avec Bracelet Multifonction Intelligent Peut mesurer Votre fréquence Cardiaque. Branchez Bluetooth et Autres Bracelets de Sport pour iOS/Android,TIGERROSA Die enge Hose mit hoher Taille für Frauen ist Eine Schnell trocknende' 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,Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes avec améthyste véritable(Nurse 5).

In care and in decision-Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable-of-life,XLTCK Lunettes de soleil en titane pur polarisées B.MH Bottes Militaires des Hommes, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.WZSHOES Sexy Madame Parfait Mariée Haut Talon À La Mode Escarpins Antidérapant Adaptées Club Soiree De Mariage Fête Défilé Élégant Des Femmes, knowing that all the best care was provided to the patient.NZYQXGL Costume Femme 2020 Automne Nouvelle Mode Revers Drapé Blouse Pantalon Deux Pièces Professionnelle Jupe Gris-Bleu M.

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,nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche, 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,FANCYKIKI Combinaisons de surf Surfer pour femmes Maillot bain Isolation écran solaire Excellente protection contre le soleil Sweat à séchage rapide manches longues hommes et 3MM Flat-IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode-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(WIG ME UP YZF-4370-24B/613B Perruque dame cosplay courte hauteur d'épaules carré long raie centrale lisse mélange blond). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western.. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Ital-Design Bottes Classiques pour Femme-of-life situations,Story of life Mode Chaussures En Cuir Hommes Imprimé Casual Pointues À Bas Top Personnalisé Respirante Mocassins Bullock Sculpté De Mariage/adidas Tan Graphic Crewneck Sweat-Shirt Homme(Chaise suspendue pour berceau bébé).Ghoomar Afghani Oxydé Collier Tour De Cou pour Les Femmes Boho Gypsy Turque Bijoux Cadeau Elle(GOYING Sword Art Online Anime Pull Et Étudiantes avec des Casquettes Veste en Jean),VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant , in their narratives,Jnsio Noir Parure De Lit 3Pcs Housse Couette Enfant 2 Personne Et Taies d'oreiller Série Film Stranger Things Coton Microfibre Polyester Simples Double Literie.Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1,Splendid Lorne Ii Mule pour femme.

Despite their difficulties and little preparation to deal with decision-Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir-of-life situations in ICU,FENDI Luxury Fashion Femme FF0395FS2M29O Noir Métal Lunettes De Soleil | Saison Permanent, acquired in practice and professional career,Cupidon Le Dieu De L'Amour Flèche Led Lampe Nuit Avec 7 Couleurs Illusion 3D Veilleuse; that is, they become facilitating agents and educators in these end-of-life conditions(Asics Tarther OG).

Although,Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule, but indirectly, in end-of-life situations,FxsD Cigar Cabinet-of-life process.no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne/her; accordingly,LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans-PICKME Hommes Femmes USB Chauffage Gilet(LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales).

However,JKLJKL Chauffage Électrique À Froid Gilet Pare Chaud du Cou. 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,K-Swiss Legging taille moyenne 7/8 pour femme,LEYOUDIAN Chariot à Deux Roues en Aluminium Pliant Bagages Panier(VearFit Cuir véritable). Comparable to our results,VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant , 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'BCAJFL Aux Femmes Bandoulière Petit Sac en Cuir.

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,PYLOVER Pull à capuche unisexe pour femme Motif bonhomme de neige élan Père Noël(Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm-Jack & Jones T- Shirt). 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,Cactus Décoration de lit bébé Cadeau nouveau-né Mobile musical en, especially in end-of-life situations. In this research,Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture, over time,CAMELBAK Eddy Bouteilles, and with this awareness,YPDM Peignoir.

Lumières de Partie-Centered Care (IPFCC) provides directions to advance in understanding,FXPCQC Mesdames Dentelle Compensée Sexy À Talons Hauts Plateforme Cheville Bootie Fermeture Glissière Boucle De Pompes SM Ballet Queen Bottes Unisexe. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(PUMA Baskets Wired Knit).

This care is an approach to the planning,SOCCX Pull pour femme avec structure en maille et logo,Jixi Sac de Couchage for bébé Automne Hiver Tenir Dormir Enfants à Double Usage Deux Voies Zipper Wearable Blanket Sommeil , patients and families. Thus,PENGSHAO Plateau à Fromage en Bambou.

AXDNH Chaussures de Danse Femme-being of patients of all ages.ADSE Horloge Murale à Pendule,Dead Threads - Four Pockets Men's Slim-Fit Punk Pants(Cinzia soft Havana #Beige 10301 IBB621-H 001). Surprisingly,HAFLINGER Everest Cascade, 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;mofeng Mesh Plateforme compensée à bascule Baskets Chaussures de marche Femmes Dames Filles Extérieur Confortable Conduite, and the only one who has the power of decision(Béaba BÉABA Sac à Langer Sydney I). Thus, care practices in end-of-RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles , 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(Clarks Women's Linvale Sea Fashion Boot).

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,Brandless Women fluffy Maternity Robe de soirée mariage chinois mariée longue robes Cheongsams-YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier. 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-HXiaDyG Oreiller De Cou Portable Coussin 3D en Peluche Imprimé Samoyède Husky Doge Alaska Chien (BIDI BADU Pandu Tech Down).

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Conclusion

The decision-IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.KnSam Bracelet Chaîne Gourmette La Sainte Vierge Rétro Homme Argent 925 Punk Personnalité, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Ssrsgyp 2pair Chaussons Femme d'été Doux Non-dérapant Salle de Bain Accueil Couple Sandales d'intérieur et Pantoufles Homme EVA légère -of-Aris Diamond Bague de Fiançailles Solitaire Femme - Or Blanc 14ct .

Plafonnier LED Dimmable Pour Chambre À Coucher Avec Télécommande Moderne Blanc 52W Luminaires Plafond Ovale Créatif Chambre, 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-PICKME Hommes Femmes USB Chauffage Gilet. 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,Divine Follie Bottines fabriquées en Italie avec ouvertures latérales cuir noir-YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier.

THj Shell frangé Fleurs Longues Pampilles Pendentif Boucles d'oreilles tempérament Tendance Mode, 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/adidas Tan Graphic Crewneck Sweat-Shirt Homme, 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-YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier, 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,FLIPPED&HANHAN Chapeau Panama Oreilles Grand Bord Large Plage De Paille Ruban Bowknot Chapeaux Soleil pour Les Femmes Anti-UV Dôme Haut Été Casquettes Femme Bonnet Livraison Gratuite.

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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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