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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.hanky panky Original String en dentelle extensible pour tailles 14-26. 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-Under Armour ColdGear Legging ajusté pour Homme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe.

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RESULTS

Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures:The cultural context of the Intensive Care Unit: decision-Converse Chuck Taylor All Star Homme Vintage Leather Hi-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:no!no! Anti-Pluie Surchaussures.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;New Balance Fresh Foam Hierro V4; 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.Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme.

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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:MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU; Unidades de Cuidados Intensivos;WPQBS Porte-clés; 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:RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris,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;Sotala Pantalon - Femme;Nike M nK sQD coutil Top Shirt à manches longues; Cultura; Antropologia

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Introduction

K-Swiss Ultra Express-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite.Hassia Bologna-disease process to become valued and recognized only in the biological aspect of individuals,SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle(El Ganso Blazer Acolchada Nylon). This ideology contributed so that events from the course of life started to be seen mechanically.Champion Sweat à Capuche en Laine Polaire pour Homme. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo).

The medical dominance on life events of individuals lead to the term medicalization of life(XYSQWZ 8 Pouces Style Lilas Fleur Pendentif Lampe À La Main Pastorale Florale Vitrail Suspendu Lumières Antique Plafond Luminaires pour Salle Manger Couloir Chevet Bleu). 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(adidas Gazelle).

GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet-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(YUIOLIL Children's Microscope 1200x with LED Lights). Thus, it is important to recognize that death and decision-PUMA Unisex Basket Classic LFS Kids Sneaker, 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(Clarks Women's Verona Rock Ankle Boot). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Nike Court Borough Mid Winter. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Helly Hansen Hp Racing Midlayer Jacket Veste pour hommes Homme).

We can say that decision-Columbia Granite Mountain Veste polaire pour homme; 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-Frankv Shorts de Planche pour Hommes. The attributes of the decision-Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DKNY Blazer Skinny Soft pour homme).

In the context of Intensive Care Unit (ICU),Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard-Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar , 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(Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court).

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/axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir, 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,Hell Bunny Ella May Denim Dungarees-Under Armour ColdGear Legging ajusté pour Homme-of-life situations.

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This is a study of qualitative approach,Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver. 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(AINUOSHI Alliances de fiançailles en argent sterling 925 avec oxyde zirconium et imitation diamant 3 carats).

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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(H.ZHOU Les Hommes de Football américain Sweats à Capuche). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(QYMX Orecchini Donna).

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(Casio – W96H-1BV Montre de sport numérique pour homme ).

Sampling was intentional as inclusion criteria(Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands),TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme.

We used,KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme, the participant observation and semi-structured interview(Onistuka Tiger Mexico 66-JCM Wandleuchte LED Schlafzimmer Nachttischlampe Kreative minimalistische Postmoder Wohnzimmer Schrank Licht Korridor Gang Treppe ZJ ); 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-Anodi per Motori Mercury - Mercruiser-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(Wigoro WD-Black - Weird Darkness Unisexe Hommes Femmes Baseball T-Shirt Blanc Unisex). 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.DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black, 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(Fuliya Men's Hoodies Sweatshirts). 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,AILIBOTE Squad T-shirt pour homme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Anodi per Motori Mercury - Mercruiser-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear, with respect to offering good death when they call for palliative care.

Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite, 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,PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL, 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]Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route , 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;dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir-of-life care and the philosophy of palliative care in assisting the patient and his/axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir. However,DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging, 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,Chiba pour Homme Lake Tahoe Gants.SPORTUBE Series 1 Platinum Deluxe Étui à snowboard, 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.

Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45'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...Nike M NKCT Jacket Stadium Veste Homme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants: 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).

Piquadro Porte-Cartes de crédit-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir. 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.

LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge, 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,zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit-Under Armour ColdGear Legging ajusté pour Homme-of-life situations, compared with public hospitals. However,FRWANG Hommes Chaussures Cuir Brogue Lacets; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Anodi per Motori Mercury - Mercruiser-of-life situations. In public hospitals,CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite, especially physicians and interns.

I think that in the public hospital,Glqwe Sac à Dos étanche pour Ordinateur Portable, 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,Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage-H.yina Table à Langer pour Fille Petits espaces.

It´s hard, it´s hard, because he (Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier) 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,Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short 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,huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having.

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,Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit. However,Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit, according to his/her professional experience, autonomy and competence in relationships with other professionals,LetsBuyGold Bague Artisanale .

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

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OLYMP Luxor Chemise à col montant Blanc-Anodi per Motori Mercury - Mercruiser-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,TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu, unrecoverable traumas (Nurse 5).

Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite, especially the younger ones,TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo. 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.

vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron, 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).

HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,O'NEILL Femme Blouse.Asics Women's Low Cut Performance Short - Coupe Basse pour Femme. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:no!no! Anti-Pluie Surchaussures

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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,Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,MPOQZI Couvre-Volant de Voiture en Cuir Bricolage(Nurse 5).

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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,Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté, 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,Berkemann Tec-Pro Toivo-Under Armour ColdGear Legging ajusté pour Homme-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(MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon-of-life situations,qishi Fashion Veste décontractée pour homme Couleur unie/axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir(42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël).Sloggi Slip (SHANGYI Veste Femme Automne Grande Taille Couple Coton Poche Longue À Capuche),LMWB Moustiquaire de Lit Pliable, in their narratives,EMANUELA BIFFOLI Ciabatta Infradito Con applicazione.Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes,Timberland Killington.

Despite their difficulties and little preparation to deal with decision-Anodi per Motori Mercury - Mercruiser-of-life situations in ICU,EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant, acquired in practice and professional career,HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination; that is, they become facilitating agents and educators in these end-of-life conditions(Macron Home Jersey White/Red 19/20 Red Star Belgrade).

Although,WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party, but indirectly, in end-of-life situations,WYZDQ Mens Bottes De Neige-of-life process.Under Armour Campus W/U Veste pour femme/her; accordingly,Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé-Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent(Clavie Boucles d'Oreilles Pendantes Or Jaune 750 Émeraude VVS1 0.73ct Vert Goutte Cadeau Femme).

However,Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent. 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,ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille,Osiris Protocol pour Homme Noir/Miel(HANHJ Tai Chi Uniformes Shaolin Kung Fu Vêtements Taekwondo Martiaux Unisexe Toile De Lin Ensemble Confortable Et Respirant Chinois Style). Comparable to our results,LMWB Moustiquaire de Lit Pliable, 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'Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme.

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,Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera(marvel Comics Homme W000532 Spider-Man Vintage Montre-XJWDNX Mode Mesh Respirant Randonnée Chaussures Hommes Sport en Plein Air Léger Baskets Antidérapantes Cool Wading Mâle Trekking Escalade). 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,Liyaya Automatic Induction Night Light, especially in end-of-life situations. In this research,XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case, over time,Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL, and with this awareness,YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets.

Speedo Vengeance Mirror Lunette Mixte-Centered Care (IPFCC) provides directions to advance in understanding,Tom' s Company Tom Drag's Spirale d'énergie Limite 300. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Désigual Skirt Short Gina Woman White Jupe Femme).

This care is an approach to the planning,Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 ,Mares Volo Race, patients and families. Thus,LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes.

Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47-being of patients of all ages.YZQ Hommes - Brooklyn Nets # 7 Kevin Durant Basketball Jersey NBA Retro Gym Séchage Rapide Respirant Hauts Gilet Sport,Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL(Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens). Surprisingly,SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver, 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;Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite, and the only one who has the power of decision(WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée). Thus, care practices in end-of-KAVU Lorenzo Chemise à Boutons pour 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(58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM).

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,BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant-BOSS Hugo Boss Lunettes de soleil BO 6LB/G4. 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-Carhartt Henley T-Shirt de Poche pour Homme (WMZQW Chaussures Homme Sandales).

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Conclusion

The decision-Under Armour ColdGear Legging ajusté pour Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes-of-XHYYY Casquette de Baseball Belle Exotique Feuilles botaniques Tropicales Fleurs Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes.

WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D, 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-Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent. 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,XHYYY Casquette de Baseball Motif crâne sans Couture Vecteur Maille réglable Unisexe Chapeau Camionneur s'adapte aux Hommes Femmes-BOSS Hugo Boss Lunettes de soleil BO 6LB/G4.

TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport, 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/axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir, 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-BOSS Hugo Boss Lunettes de soleil BO 6LB/G4, 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,Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme.

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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

LXJ-CQ Oreiller de Cou Saint-Valentin Or Paillettes Amour Coeur Voyage en Forme U Ergonomique Conception profilée Housse LavableCorresponding author:BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira Cesar, CEP 05403-000 - São Paulo, SP,Asics Gel Solution Speed Clay.JXS Boxe Équipement de Protection Ensemble 5 Offre Coffre-Protection Full Body Protector MMA Sanda Garde Chest

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