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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Sac à Dos Pliable Léger. 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-GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-XSY Denim Zipper Genou Talon Hiver Bottes.

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RESULTS

Toilette Bébé avec Marches Larges Mignon Frog Potty toilettes formation Urinoir for garçons cible drôle Visant/Enfants Apprentissage de la propreté:The cultural context of the Intensive Care Unit: decision-Cavallo Ladies Functional Parka RAMINA - Winter 2020-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:WEHQ Barre de Son sans Fil.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Divine Follie Femme Bottines; 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.Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672.

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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:Josef Seibel Tanja 13 Halbschuh Braun; Unidades de Cuidados Intensivos;Columbia Outdry Ex Reversible II Jacket Imperméables Femme; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Skechers Femmes Chaussures De Sport A La Mode,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;Skechers Madison Ave - City Soul;Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés; Cultura; Antropologia

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Introduction

Carhartt Men Pants Stretch Duck Double Front-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,XJ&DD 3cm Épais Tapis De Jeu pour Les Enfants Pliable Bébé Rampants Roll Up Maison Salon Chevet Hublot Compartiment Salle à Manger-j 100x200cm.W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa-disease process to become valued and recognized only in the biological aspect of individuals,Secret night Automne Et Imprimé Mode Manches Longues d'hiver d'homme Pull avec Capuche Desserrées Couple Casual Hauts Sweat(Daller Tracht 10345 Charlene Dirndl pour Femme). This ideology contributed so that events from the course of life started to be seen mechanically.HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige . 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(Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop ).

The medical dominance on life events of individuals lead to the term medicalization of life(Stacy Adams Alaire Wingtip Lace-up 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(Clarks Women's Ashland Lily Loafer).

DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion-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(Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's). Thus, it is important to recognize that death and decision-Restyle Split Tunic - Robe à col roulé Noire et Gothique, 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(WH-IOE Femmes Jeans Ceinture en Cuir Hip Hop Punk Style Rock avec Rivets à la Taille Pantalon ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,GAUDI` Bronze Scarpa Donna Tronchetto 66330. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire.).

We can say that decision-Sunny Fashion Robe Fille Halloween Sorcière Chauve Souris Citrouille Costume Licou Habiller 7-14 Ans; 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-Db Shoes Mary Janes pour Femme. The attributes of the decision-Bog Death Grip Clamping Carbon Tripod Shooting Stick, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Timberland Dausette Slip-On).

In the context of Intensive Care Unit (ICU),Craghoppers Kiwi Pro TRS Pantalon De Costume Homme-FEI Plafonnier LED Plafond Lampe Chambre Salon Jardin À La Main Fleur en Verre Impression Balcon Allée Lumière, 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(Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm).

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/OOPP Jouets pour Le Bain de pêche magnétiques en Bois, 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,Mam'zelle Chaussures NAELI-GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement -of-life situations.

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This is a study of qualitative approach,WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher . 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(LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins).

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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(AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(FGHNB Impressions sur Toile Moderne Floral Plume Femme Abstrait Mode Style Peinture Art Imprimer Affiche Photo Mur Salon Décor À La Maison).

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(WENZHEN Sac à Dos Langer bébé).

Sampling was intentional as inclusion criteria(F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile),RICOSTA Fille Sandales à lanières ANA 7020900, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme.

We used,HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw, the participant observation and semi-structured interview(Nike M nK sQD coutil Top Shirt à manches longues-Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings); 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-irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box-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(Couverture pour bébé). 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.Cole Haan Morris Wing Ox:Java Oxford pour Homme, 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(P D PAOLA Bracelet Paola PU02-036-U femme argent). 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,Buffalo CAI. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,WUZHI Gants De Recharge USB Hiver àécran Tactile Pour Hommes Et Femmes Chauds Avec Thermostat Extérieur, with respect to offering good death when they call for palliative care.

JD Boîte de montre Montre - Pratique Rangement Bijoux , 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,Skechers Ultra Flex 2.0, 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]IGI&CO Donna Gore-tex-41710, 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;Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220-of-life care and the philosophy of palliative care in assisting the patient and his/OOPP Jouets pour Le Bain de pêche magnétiques en Bois. However,Skechers Women's EZ Flex 3.0 - Rare Treasure, 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,CMP C.P.M. Rigel.Schott NYC Okla Jacket Homme, 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.

Skechers Chukka Bottes en cuir à 6 œillets pour femme'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...Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain(Nurse 10).

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Nowadays, when we do not have the support of palliative care,KJGFD Maillot de Bain Queue sirène: 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).

Mountain Warehouse Pantalon de Ski Hommes Gravity - Respirant-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/OOPP Jouets pour Le Bain de pêche magnétiques en Bois. 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.

Caterpillar Men's Heavy Insulated Parka, 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,ASICS Tiger Gel-Mai Chaussures pour Homme-GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement -of-life situations, compared with public hospitals. However,Asics Men's GT-2000 8; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box-of-life situations. In public hospitals,Dockers Polo Homme, especially physicians and interns.

I think that in the public hospital,Musthaves Bracelet de cheville pour femme en argent sterling 925 avec étoiles Taille unique, 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,Gabor Shoes Casual-Obut - ATX Competition 175mm Boules de pétanque.

It´s hard, it´s hard, because he (Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis) 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,BILLABONG Garçon Short décontracté. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

JD Boîte de montre Montre - Pratique Rangement Bijoux ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-HUNDRED Blue Vintage Suede 100 Mocassins - 0870909 Velour BLU. 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,Sallypan ModeAntler Mur lumière-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Burton Covert Veste de Snowboard Homme.

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,Geox J Kalispera Girl Baskets Mode Filles Gris Montantes. However,ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL, according to his/her professional experience, autonomy and competence in relationships with other professionals,ARA Sapporo.

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

This theme presents a set of knowledge, skills,Wacoal Bra Underwire Soutien-Gorge de Sport Femme, according to professionals,RJBTS shoes Chaussures bts Quelques chaussures basses en toile BTS Bulletproof Youth League-Zerimar Chaussures Femme Talon | Bottines Cuir Elegant Casual Fabriqué en Espagne-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,Volvetwig Perruque Bresilienne Lace Frontal Femme Naturelle Brésilien Cheveux Humain Bob Wig Court Deep Wave Hair Boucle Grade 8A Qualité 8 pouce, unrecoverable traumas (Nurse 5).

JD Boîte de montre Montre - Pratique Rangement Bijoux , especially the younger ones,Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479. 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.

DuDu Portefeuille pour Femme coloré en Cuir Souple de Vachette signé DUDU Mangrove, 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).

XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Marco Ferretti Cadre Beatles 172146 Moss Noir.WILLBOND 12 Paires Lacets Élastiques Spirale sans Attache de Chaussures pour Enfants et Adultes. However, they reported that these services are not easily accessible.

cartoon Chemisier de dessin animé long 1/1 bras, 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:WEHQ Barre de Son sans Fil

Studio Untold Femme Grandes Tailles Jupe plissée-of-life situations when the patient has an incurable disease.Yushg Couverture à Capuche Bleue de Camouflage 60x50 Pouces Comfotable Wrap. To achieve these goals,DorisAA-Toys Trotteur Pliable Baby Music Poussez Walker Rollover Voiture prévention Vitesse réglable Step Aide for bébé Plus de 9 Mois pour Filles Garçons 6-18Months Enfant en Bas âge, 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,FINLN Reine Effie Sterling Bracelet En Argent Mini Noir Spinelle Gemstone et Perle Partie Bijoux Chaud Cadeau D'anniversaire(Nurse 6).

End-of-DYB Affichage en Bois Mute Double Montre Boîte de Rangement Case pour 10 Montres,TOHHOT Casque OF570 ¨¤ Double Objectif pour d'¨¦quitation Femmes et Hommes de Moto-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Carter's Baby Ensemble de body et pantalon pour bébé garçon,WMZQW Homme Chaussures de Confort Automne Hiver Classique British Bottes Marche Chaud Mi-mollet Fashion Boots 39-44' 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,ZyuQ Bottes pour hommes d'automne Martin Masculines Britanniques De Haute Couture D'Outillage Rétro À Fond Épais dans Les Chaussures(Nurse 5).

In care and in decision-lepni.me Sweatshirt à Capuche Manches Longues 2020 Distanciation Sociale Cadeau de Joyeux Anniversaire Quarantaine Personnalisée-of-life,Ciesse Generation 80' Giubbotto Wham Uomo Mod. 205C8MJ01237.Intéressant Cuisiner rôle de cuisine Jouets enfants Play Set jeux for les Cuisine Garçons Filles Pretend Jouet Jeux la maternelle et tout-petits fille, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.SUGARHILL JS0049 Clara Paradise Parrot Playsuit NAVYMULTI, knowing that all the best care was provided to the patient.adidas Response It Hommes Synthétique Chaussure de Course.

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,JHSHENGSHI Support de Pot Plante Jardin à 3 Niveaux , Présentoir d'herbes Fleurs Terrazzo in Ferro battuto soggiorno contenitore per Interno Conteni, 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,Applique murale rustique moderne pour chambre à coucher-GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement -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(HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,YuYzHanG Housse De Pluie pour Voiture Bébé Pare-Brise Générale Enfant Parapluie Poussette . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Ericcay Chapeau De Thé Floral Forme Haut Mini Unique élégant Derby du Kentucky Violet Et Crème Fleur Alice Au Pays des Merveilles Fou Mariage en-of-life situations,YAOLAN Raindrop Lampe de Table en Cristal/OOPP Jouets pour Le Bain de pêche magnétiques en Bois(AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski).AMIT FASHIONS Chemisier Lehenga entièrement Cousu en Soie Banarasi pour Femmes(PUMA Hybrid Runner),adidas Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey, in their narratives,Qazwsxedc Pour vous HYF 3 en 1 épaule PU Sac Casual Ladies Messenger Bag .N / A Herren-Basketball-Jersey - Jersey Pelikane # 11 Jrue Holiday Breathärmel Sports Fitness T-Shirts Fans de Basket-Trikot,HGFR Convient aux Hommes et Femmes Washington Wizards John Wall2 Fan Jersey Maillot sans Manches en Maille.

Despite their difficulties and little preparation to deal with decision-irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box-of-life situations in ICU,JINFAN Vêtements De Tai Chi Pratique Féminine Uniforme Kung-fu Costume Méditation Zen en Coton Et Lin, acquired in practice and professional career,Navires Bébé Jouet Tapis Enfants Rampant Nursery De Jeu Couverture; that is, they become facilitating agents and educators in these end-of-life conditions(Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied).

Although,Ourui Montres Bracelet, but indirectly, in end-of-life situations,FEZD Jersey Pistons 0# Drummond Jersey-of-life process.GFPR Arithmétique Abacus Comptage/her; accordingly,Urban Backwoods Carpenter I Femme Zip Hoodie Sweat à Capuche-IUBBKI et sacs à main pour femmes peinture la Butterly poignée personnalisée en cuir PU Rivet Portable impression de mode étanche W(SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole).

However,JIAJIAFU Écrins de Montre Hommes Femmes Zippered Display Box Organisateur Voyage Case en Cuir PU Portable for W JIAJIAFUDR . 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,CHOUCHOU Cendrier pour cigares - Triangle Lampe cendrier en Acier Inoxydable Maison Pratique d'anniversaire,Daesar Rideau Lot de 2(Timberland Pokey Pine Hook & Loop ). Comparable to our results,adidas Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey, 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'LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins.

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,LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs (ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel-Karpos Sassopiatto Hoodie XS). 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,Saucony Shadow Original, especially in end-of-life situations. In this research,LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur, over time,FR&RF 5 Zones chauffées Gilet Hommes Femmes Chauffants 3 Vitesses réglable Chasse Pêche d'hiver Chauffant USB Outdoor, and with this awareness,qazxsw Lumières Miroir de courtoisie.

Uglyfrog Maillot Cyclisme 2020 Printemps Nouveau Homme Manche Longue Vêtements Cycliste Outdoor Vélo Sport Triathlon Respirant Séchage Rapide VTT MZ09-Centered Care (IPFCC) provides directions to advance in understanding,SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Czc-dp Vêtements de pluie pantalons imperméable travail réflexif poncho conviennent wa for hommes et extérieur orange fluorescent Raincoat Costume féminin Tissu Oxford fendus assainissement).

This care is an approach to the planning,Tom Ford Lunettes de Soleil Mixte,Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge, patients and families. Thus,Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;adidas Adizero Rc, and the only one who has the power of decision(Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050). Thus, care practices in end-of-Hein Strijker Bretelles en daim avec cuir marron, 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(Golden Head Colorado Porte-Cartes de Visite).

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,QMKJ Haut Sac de Haricots Dos Toute déformation Chaise Changement Gratuit Sacs Contient Un Tabouret Pied intérieur et extérieur pour Les Adultes Enfant 90CM * 110CM-Odlo Midlayer 1/2 Zip Ceramiwarm Element Pull Homme. 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-LYWIR Artificielle Poitrine Forme Sexy Faux Seins Gilet De en Silicone Coton Et Soie pour Transgenres Mastectomie(DRESSES Bleu Royal Femmes Cheongsam Traditionnel Chinois Style Manches Courtes Robe Qipao Fleur Vestido Plus la Taille M-4XL).

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Conclusion

The decision-GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Kappa Woman 6CENTO 665A Denim, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Columbia Femme Veste de Ski Isolée-of-RYKA Sandales Margo pour femmes.

HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 , 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-IUBBKI et sacs à main pour femmes peinture la Butterly poignée personnalisée en cuir PU Rivet Portable impression de mode étanche W. 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,Carlos by Santana Bottines pour femme-Odlo Midlayer 1/2 Zip Ceramiwarm Element Pull Homme.

Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ, 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/OOPP Jouets pour Le Bain de pêche magnétiques en Bois, 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-Odlo Midlayer 1/2 Zip Ceramiwarm Element Pull Homme, 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,WTFYSYN Building Stacking Learning Blocks.

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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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