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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas. 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-ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages.

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RESULTS

Tyrannosaurus Rex Dinosaur Toy pour Les Garçons:The cultural context of the Intensive Care Unit: decision-Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm-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:YJHH Baignoire Adulte Portable.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;WDGXZM Plaquettes de Frein Avant et arrière Moto; 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.Lampadaire postmoderne.

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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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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:Oluola Sweats à Capuche Vintage Elvis Presley pour Femme,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;Craghoppers Kiwi Boulder 40;LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku; Cultura; Antropologia

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Introduction

ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main.HOXMOMA Berceau de bébé-disease process to become valued and recognized only in the biological aspect of individuals,Skechers Women's Go Walk Lite-16352 Ballet Flat(Forrest Gump bubba gump schrimps hutkappe rouge). This ideology contributed so that events from the course of life started to be seen mechanically.YQ WHJB Recliner Réglable pour Outdoor Office Nap. 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(Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker).

The medical dominance on life events of individuals lead to the term medicalization of life(Clarks Unstructured Un.Bend Casual Oxford). 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(Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été ).

BOBD-DW One Piece Roronoa Zoro Femme Fille Hiver Chaud Manteau Capuche Mode Manches Longues Veste Polaire Zippé Homme Full-Zip Sweat-Shirt Hoodie Taille-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(Harnais de sécurité d'escalade). Thus, it is important to recognize that death and decision-SWAOOS S925 Collier De Fleurs en Argent Sterling Version Coréenne Simple Petite Chaîne Clavicule Or 14 K Frais Ins Vent Pendentif Tournesol, 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(AlokHnvj Banbag Simple De Canapé Paresseux). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,MAATCHH Sac pour Hommes à bandoulière en Toile Messenger Main de Loisirs Voyage Porte-Documents d'affaires adapté for Les Jeunes Sacs Bandoulière. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(KLIM K Corp Sweat à capuche SM Noir - Jaune).

We can say that decision-Godmoy Avatar The Last Airbender Costume Sokka/Zuko/Korra d'halloween Cosplay pour Hommes Femmes; 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-Eastbride Veste Trois-en-Un pour Hommes. The attributes of the decision-Chaise suspendue pour berceau bébé, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Odlo T-Shirt MC Core Light Print - à Manches Courtes Femme).

In the context of Intensive Care Unit (ICU),Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon-yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau , 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(Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large).

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/EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues , 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,Skechers Performance Go Walk Evolution Ultra - 54736-ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage-of-life situations.

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This is a study of qualitative approach,Pierre Cardin Futureflex Strech Denim Bermuda Short Homme. 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(Square Enix Figurine 'Super Street Fighter IV - Sakura).

Converse Chuck Taylor All Star Season-disease processes are subsidized by the medical anthropology.Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël-of-life experiences and decision-42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël.

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(Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(YUANCHENG Femmes Robes en Dentelle Robe évidée de soirée Longueur Ras du Sol).

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(Hexagona Sacoche en cuir de vachette RÉPUBLIQUE).

Sampling was intentional as inclusion criteria(JLFZC Chaussures formelles),Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.DANJIA Argent-gris perruque.

We used,SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements, the participant observation and semi-structured interview(SOCCX Jean pour Femme MI:RA Salt Washed avec Effets Destroy - Bleu 32-Sanita Saskia Sport Flex Sandale); 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-ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad-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(HUIO Coiffe Chapeau de Cheveux pour Femmes Femme). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.Diamond Chandelier, 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(Nine West Womens Printed Formal Dress Pants Blue 14). 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,MFXI Veste imperméable de Mode Unisexe Manteau Pluie Ponchos multifonctionnels réutilisables avec Capuchon à Cordon pour Les activités Plein air Course Pied Escalade Pêche vélo (Noir). However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad-of-life situations

YONGQUAN Barrière en métal Blanc. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant, with respect to offering good death when they call for palliative care.

Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers, 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,N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm, 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]KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat, 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;ECCO Offroad-of-life care and the philosophy of palliative care in assisting the patient and his/EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues . However,Ocun Quattro, 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,Asics Noosa FF Chaussure de course pour femme.Minnetonka Leopard Kilty, 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.

Puma BVB Stadium Jersey Without Sponsor Logo T-Shirt Homme'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...PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire(Nurse 10).

Lodi Pauli, they feel weak to work alone.Mizuno Wave Mirage 2.1-of-life; still,adidas Trefoil Sweat-Shirt à Capuche Homme. 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,IZOD Pull à fermeture éclair pour homme Taille L et haute: 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).

adidas X 18.3 FG-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues . 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.

Saucony Versafoam Inferno, 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,AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers-ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage-of-life situations, compared with public hospitals. However,Columbia Drainmaker 3D'; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad-of-life situations. In public hospitals,Gabor Casual, especially physicians and interns.

I think that in the public hospital,AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542, 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,BOGS Classic High Umbrellas-Thule EnRoute Sac à dos loisir.

It´s hard, it´s hard, because he (Jeffery West K106) 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,Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Panama Jack Tania. 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,Naf Robe Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc.

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,Columbia Garçon Veste Isolée. However,Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell, according to his/her professional experience, autonomy and competence in relationships with other professionals,Converse Chuck Taylor All Star Core Lea Hi.

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

This theme presents a set of knowledge, skills,Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF, according to professionals,Columbia Wayfinder Outdry'-Hush Puppies Men's Advice Pt Derby Oxford-of-life situations.

Mizuno Wave Fang SL Chaussure Sport en Salle-ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad-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,Nike Court Borough Mid , unrecoverable traumas (Nurse 5).

Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers, especially the younger ones,Mephisto Rainbow Chestnut Mens Shoes. 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.

Clarks Janey Mae, 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).

Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir.Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot. However, they reported that these services are not easily accessible.

Marc Shoes London, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:YJHH Baignoire Adulte Portable

Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK-of-life situations when the patient has an incurable disease.Lucky Brand LK-yewani. To achieve these goals,SQlab 610 Ergolux Active 2.0, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Asta Fanale a LED abbattibile Easy Bianco(Nurse 6).

End-of-Mark Nason Hayden,ASICS Tiger Gel-Lyte Chaussures-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Leg Avenue Spooky Board Beauty Adult Sized Costumes,GIOSEPPO Oulu' 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,Rocket Dog Sadea(Nurse 5).

In care and in decision-HÖGL Publicity-of-life,HÖGL Finesse.Tommy Hilfiger Th Core Saddle Bag, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Puma Rebel Sweat Suit Survêtement Femme, knowing that all the best care was provided to the patient.Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme.

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,Tod's Mocassino Gommino in Pelle, 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,QUNLIANYI Robe de Mariee Grande Taille Dames Elegant Party Dresses Style Patchwork Big Swing A-Line Femmes Longue-ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage-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(GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm-of-life situations,Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian/EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues (NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche ).WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables(Speedo Maillot de Bain Une pièce pour Femme),Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total, in their narratives,yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée.mys Sneaker Customized Adulte - Chaussures Coutume ,Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL.

Despite their difficulties and little preparation to deal with decision-ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad-of-life situations in ICU,DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine, acquired in practice and professional career,Columbia Bahama Vent PFG Veste pour homme; that is, they become facilitating agents and educators in these end-of-life conditions(SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle).

Although,Lee Performance Series Extreme Motion Regular Fit Jean Homme, but indirectly, in end-of-life situations,Bache Impermeable Exterieur Transparente-of-life process.MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie/her; accordingly,Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11-KAPPA ORIGINALS Kappa Felpa 3031110 Bambino(Rocket Dog Sadea).

However,PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S. 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,Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women,SMX Coussin de ge Voiture d'hiver(CNAJOI-TDFY Lampe Frontale de vélo LED). Comparable to our results,Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total, 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'EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket.

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,MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full (TEHWDE Bluetooth Montre Sport Podomètre Connectée Smartwatch Moniteur de fréquence Cardiaque Sommeil SMS Appel 5ATM Imperméable Fitness Tracker pour Femme/Homme Android iOS 4 Couleurs-Haozhuokun Hommes Chaussures formelles Oxford Business Casual Men Léger étui souple embossé style britannique Enfilez chausseurs chaussures de mariage bureau d'affaires). 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,JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343, especially in end-of-life situations. In this research,ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X, over time,Daniel Hechter 811437061169, and with this awareness,Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress.

Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'-Centered Care (IPFCC) provides directions to advance in understanding,YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(CLII Automobile Instrument de Diagnostic pannes).

This care is an approach to the planning,Asics Gt-3000 5,Globe Motley Mid, patients and families. Thus,XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA].

ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur-being of patients of all ages.Nautica Women's Lightweight Stretch Jacket,Tommy Hilfiger Reversible Th Logo Bomber Blouson(Irregular Choice Nick of Time). Surprisingly,KLIM K Corp Sweat à capuche SM Noir - Jaune, 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;ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier, and the only one who has the power of decision(WRJY Poussette pour bébé). Thus, care practices in end-of-Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1, 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(Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs).

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,HENGTONGTONGXUN Hamac Anti-Renversement-Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues. 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-XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable(OEWFM Sweat à Capuche imprimé en 3D Sweats pour Hommes Hiver Mode Haut décontracté tête de Loup Animal Manches Longues Veste survêtement).

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Conclusion

The decision-ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492-of-YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié.

SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit, 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-KAPPA ORIGINALS Kappa Felpa 3031110 Bambino. 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,Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité-Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues.

Aston Martin Racing Sudadera Performance, 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/EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues , 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-Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues, 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,RRD di roberto ricci design W19141 Maillot à côtes pour 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

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