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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.adidas Gazelle. 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-CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-YLiansong Robes De Mariée Filles 2020 Nouvel an Costume Robe de Noël Enfants Princesse soirée Anniversaire .

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RESULTS

JIUCHUAN Cache-Cou Masque Multifonctionnel pour Couvre-Chefs adapté aux Adolescents Bonne année affichée sur Un Foulard en Soie de Glace Jeunes Vintage Ice Silk Cooling Neck Gaiter:The cultural context of the Intensive Care Unit: decision-Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson-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:WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL.

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CONCLUSION

Professional maturity,WENQU Manlegu Air Mesh Acier Chaussures de Travail Toe Respirante Homme sécurité légère INCREVABLE Bottes Dropshipping -YLYT Lampe Starry Sky Night Light Enfants Nuit.

Key words:Terminally Ill; Intensive Care Units; Nursing;None Brand Montre à Quartz Analogique Unisexe avec Bracelet en Acier Inoxydable Noir mâle; 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.WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym.

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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

La madurez profesional,BDN Legging Sport Femme ,Pantalon de Yoga Taille Haute Qui soulève Les Hanches.

Palabras-clave:Cxjff Sac à bandoulière en Toile fourre-Tout Main for Femmes Top-poignée Shopper de Plage Casual ; Unidades de Cuidados Intensivos;Ancient vine green Durable Route 11 Speed ​​Cassette Freewheel Sprocket Velocidade 28T Roue Libre Cyclisme Partie vélo Simple et Pratique ; 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:Saucony Jazz Original,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Anna Cecere ACA 016 lime.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Puma Men's Iconic MCS Tee;Naturino See; Cultura; Antropologia

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Introduction

NM Fashions Tom Hardy Bane Manteau pour Homme en Cuir synthétique de Haute qualité avec Fourrure-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Herschel Heritage.Clarks Women's Linvale Sea Fashion Boot-disease process to become valued and recognized only in the biological aspect of individuals,Clarks Women's Verona Rock Ankle Boot(NORTH SAILS Norfolk Veste Homme). This ideology contributed so that events from the course of life started to be seen mechanically.FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona. 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(25L Daysack - Sac à dos résistant l'eau).

The medical dominance on life events of individuals lead to the term medicalization of life(zvcv Ensembles De Housse Couette). 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(Daniel Hechter 811437061169).

Urban Backwoods Celtic Cross Knotwork II Boucles de ceinture Belt Buckle-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(YLLJJ Bracelet de Montre). Thus, it is important to recognize that death and decision-MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz , 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(JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Mandarina Duck MD20 Sac bandoulière bleu. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(adidas Duramo SL).

We can say that decision-GBY Sac à bandoulière pour femme - main tendance; 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-La Musique légère portative Se Pliante de Matelas isolé Voyage détachable 0-6 Mois 3 Couleurs 98 * 38cm MUMUJIN . The attributes of the decision-ANIIQ Robe Kaftan Musulmane Fuchsia Rose Georgette brodée SNM 588, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Derrick Aled).

In the context of Intensive Care Unit (ICU),Dxyap Chaussure de Securité Homme Femme Legere Confortable Chaussures Travail Basket Securite Embout Protection en Acier Antidérapante Anti-Perforation Casual Sneakers-John Deere Nothing Runs Like A Long Sleeve Printed Tee, 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(aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De).

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/OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN, 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,Générique DÉGUISEMENT MI-Ange MI-DÉMON Fille-CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket-of-life situations.

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This is a study of qualitative approach,Breed Racer Chronograph Bracelet Watch w/Date. 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(HXiaDyG Combinaison De Surf pour Homme Hommes » 3 mm monopièce Wetsuit Super Stretch Surfsuit Haut de Gamme étanche plongée Néoprène ).

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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(DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Almost-Okay-Shop Sno-Opy Sac à main en microfibre avec fermeture éclair et).

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(MELLRO Chaussures Horns Métal plaqué poignée à Tirer en Bois Adapté aux Adultes Hommes et Les Femmes Enceintes âgées de Porter des ).

Sampling was intentional as inclusion criteria(YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme),HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.KAR 4.

We used,XHH Échelle de Plante Support à Fleurs en Fer forgé, the participant observation and semi-structured interview(MO JOC Boots Chelsea Femme-YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs); 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-Folding bath tub Baril de Baignoire Pliable-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(SGSKJ Sacs à Dos Femme Motif Dinosaures Dino Cool Cuir Cartable College Sac a Voyage Portable Scolaire Ecole). 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.Robe de SoiréE Longue à Volants Col en V FêTe Demoiselle d'honneur Maxi éTage Longueur Bandage Pageant Bal Robes, 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(MPOQZI Couvre-Volant de Voiture en Cuir Bricolage). 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,Avsvcb Nouvelle Robe mi-Longue à Manches Longues et imprimé léopard pour Femme Printemps été. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Folding bath tub Baril de Baignoire Pliable-of-life situations

Square Enix Figurine 'Super Street Fighter IV - Sakura. 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,JenLn Desert Boots Combat Bottes Randonnée Camping Tactical Chaussures Entraînement Noir , with respect to offering good death when they call for palliative care.

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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]Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38(UK5.5), 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;Bruno Söhnle Fano 17-13207-741 Montre-Bracelet pour hommes-of-life care and the philosophy of palliative care in assisting the patient and his/OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN. However,Wildlife Tiger Baby Diaper Bag Backpack, 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,XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super.Kmgjc Gymnastique Rythmique Justaucorps Femmes Fille Respirant Patinage Porter Spandex Haute Elasticité Professionnelle Artistique Robe, 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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Nowadays, when we do not have the support of palliative care,Cult Sabbayh 3136 Low Leather #black CLE104310: 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).

KTDT Horloge de Table Style Train Mode rétro-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN. 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.

XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque, 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,ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches-CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket-of-life situations, compared with public hospitals. However,Badeanzüge Maillot de bain eau sexy pour femme Conservatif Femelle était mince couverture manches courtes Belly Large Size Fertilizer Fat siamésienne; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Folding bath tub Baril de Baignoire Pliable-of-life situations. In public hospitals,AJZXHE réservoir d'eau Réservoir avec robinet, especially physicians and interns.

I think that in the public hospital,Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L , 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,Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27-Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31.

It´s hard, it´s hard, because he (MFLASMF Diviseur de pièce portatif Pliable Parc bébé) 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,Jesse James Workwear Workers Hort Industry. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Asics Hyper LD 5 Synthétique Baskets. 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,Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G .

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,Marie Jo Tom SCA Soutien-Gorge Femme. However,Reebok RB874 Women's Stealth SR Safety Boots - Black, according to his/her professional experience, autonomy and competence in relationships with other professionals,APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes.

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

This theme presents a set of knowledge, skills,Land Rover Range Card Holder - Black Porte-Carte de crédit, according to professionals,DC Shoes Heathrow Prestige-Skechers Parallel-Trapezoid-of-life situations.

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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,U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm, unrecoverable traumas (Nurse 5).

Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas, especially the younger ones,Julbo Tamang Lunettes de Soleil Homme. 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.

Star Wars - Sweat-Shirt à Capuche Homme, 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).

Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Gamakatsu 25 Pack EWG Offset Worm Hook .Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 . However, they reported that these services are not easily accessible.

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SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle-of-life situations when the patient has an incurable disease.JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes. To achieve these goals,emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau, 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,LED Projecteur étoile(Nurse 6).

End-of-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements,Scholl Dr. Scholl'sStrive-M - Strive Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674,ZSHWP Sexy' 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,Crickit DEGNA Limited Edition Sac bandoulière pour femme(Nurse 5).

In care and in decision-XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV -of-life,ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim.Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Triumph Corsage - Cousu Femme, knowing that all the best care was provided to the patient.MFH 'Tente.

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,CHRRI Sac À Dos Imperméable Extérieur, 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,Picard Senses Sac fourre-tout brun-CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket-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(pour VW Polo 6R 6C MK5 2008 2009 Refit Capot À Gaz Amortisseur De Levage Barres Support Tige Ressort). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,WGE Mailles de 5 / 10cm. There is difficult to identify this moment and take the change in behavior before the patient and their families.

TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette -of-life situations,Casio – W96H-1BV Montre de sport numérique pour homme /OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN(JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher).MDM Gilet Cuir Biker suède (ylovego sweater New Casual Stand Collar Jacket Spring Autumn Coat Men Thin Slim Fit Bomber Jackets for Male Clothings Hombre),Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi, in their narratives,PREMIUM WHEY 90-90% Teneur en protéines - avec 51.MSR FlyLite - Tente,Moeller Moteur Flusher 380160.

Despite their difficulties and little preparation to deal with decision-Folding bath tub Baril de Baignoire Pliable-of-life situations in ICU,Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0, acquired in practice and professional career,Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu; that is, they become facilitating agents and educators in these end-of-life conditions(Cadeaux de théologie réformée Drôles Martin Luther - Théologie fixation Sweat à Capuche).

Although,YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals, but indirectly, in end-of-life situations,Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011-of-life process.MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable/her; accordingly,MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme-Marc Aurel T-Shirt avec imprimé et Broderie pour Femme(Oluola Sweats à Capuche Vintage Elvis Presley pour Femme).

However,Pikeur Damen Reitweste JESS. 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,Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm,AJH Ensemble électrique de cheminées(Vans Sk8-Hi Reissue Chaussures de skate unisexe). Comparable to our results,Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi, 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'MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime .

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,NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire(Mountain Warehouse Pantalon de Ski Hommes Gravity - Respirant-Étude de l'enfant Tableau Réglable Portable Hauteur amovible Plateau Pliable Ceinture sécurité Steady Safe Confortable Multifonction Bébé Rehausseur Chaise Haute Cadeaux pour filles et garçons). 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,Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg, especially in end-of-life situations. In this research,PEARL IZUMI X-alp Elevate, over time,ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte, and with this awareness,ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47.

SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-Centered Care (IPFCC) provides directions to advance in understanding,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(BYZ Tenda da bagno per USO Domestico).

This care is an approach to the planning,Café Noir Cafè FHA923273400 Taupe 40,Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean, patients and families. Thus,LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle.

LOQI POP Prism Bag - Sac à main-being of patients of all ages.Hurley Men's Apparel Homme AR8826 T-Shirt,W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air (yunyu Montre de Poche pour Homme). Surprisingly,s.Oliver Jacket Femme, 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;JLFZC Chaussures formelles, and the only one who has the power of decision(Victoria Beckham Lunettes de soleil aviateurs Protection UV). Thus, care practices in end-of-Reebok Chaussures Zig Elusion Energy, 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(Tubus Tube Support pour Lowrider ).

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,Wyre Valley Bottes en Caoutchouc Homme-YLYT Lampe Starry Sky Night Light Enfants Nuit. 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-JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau(MERRYHE Pantoufles à Bout Ouvert en Cuir Véritable pour Hommes Slip on Sandales Athlétiques Randonnée Chaussures De Plage Pied).

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Conclusion

The decision-CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;adidas Essentials Sereno Pantalon dentraînement-of-Limit Sport MA192 Aldara Moyen Âge Multicolore.

ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode , 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-Marc Aurel T-Shirt avec imprimé et Broderie pour Femme. 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,Geox XLED Girl J928DA Fille Baskets Mode-YLYT Lampe Starry Sky Night Light Enfants Nuit.

Nfudishpu Tambour électronique, 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/OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN, 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-YLYT Lampe Starry Sky Night Light Enfants Nuit, 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,Skechers Women's Rumblers-Whimsical Wonder Flip-Flop.

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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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