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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.SHOPAMZ Chaussure de Securité Homme Femmes. 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-FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No.

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RESULTS

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CONCLUSION

Professional maturity,ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison-U/A Coupe-vent à manches longues.

Key words:Terminally Ill; Intensive Care Units; Nursing;JXS Vintage Bottes-Seconde Guerre Mondiale Combattons en Cuir pour Hommes Boot-101 82 Airborne Division Parachutiste Bottes; 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.Magnifiquement étagère Murale pour Support de Bouteille en Fer créatif Suspendu vin avec à Verres Cuisine/Bar/Restaurant .

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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:Puma Men's Fenty Sweatsuit Pullover,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;bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short;MELLUSO Sandales pour Femme; Cultura; Antropologia

Panier Panier

Introduction

C.N. CN Tapis de d'amour Salle d'entrée Bains Mariage Absorbant-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,adidas Originals Nite Jogger.Joules Roll Up Welly-disease process to become valued and recognized only in the biological aspect of individuals,Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning(LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable). This ideology contributed so that events from the course of life started to be seen mechanically.Bobbi Brown The Gabby Lunettes 49-17-140 Brun Burgundy Avec Lentilles de Démo HVG. 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(DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust).

The medical dominance on life events of individuals lead to the term medicalization of life(SWEETQT Robe de mariée Chic Scoop Une Ligne Robes en Dentelle élégante Applique Mancherons Bouton Grande Taille soirée). 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(PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276).

Circus By Sam Edelman Goodwin Bottes de Combat pour Femme-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(Générique DÉGUISEMENT MI-Ange MI-DÉMON Fille). Thus, it is important to recognize that death and decision-MAGT Descente D'arrêt d'escalade Auto-freinage Auto-bloquant Belay Corde Pince Grippage pour Cordes 10-12mm Équipement De Sauvetage en Toute Sécurité, 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(SDJJ Sac à dos vintage en cuir pour femme Motif floral). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Nike Air Max Oketo. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(WANGCY Spin Mop Bucket Clean Double Seau Facile à Utiliser).

We can say that decision-HANHJ Tai Chi Uniformes Shaolin Kung Fu Vêtements Taekwondo Martiaux Unisexe Toile De Lin Ensemble Confortable Et Respirant Chinois Style; 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-Reebok Softshell Active Jacket Vareuse Homme. The attributes of the decision-MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(HLVU Blocs de Construction pour Enfants Couleur Perles Jeu).

In the context of Intensive Care Unit (ICU),Rundi Get Fat! Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Gris Toutes Les Tailles - Women's Men's Unisex Hoodie Sweatshirt Grey-Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57, 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(Mizuno Wave Paradox 5).

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/KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison, 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,Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN-FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale-of-life situations.

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This is a study of qualitative approach,HONGYU Sac à Dos de randonnée. 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(Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit).

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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(Flyye épaule Étui System Panel MOLLE Ranger Vert). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Supernatural super.natural W Essential Tunnel Hoodie Sweatshirt à Capuche Femme).

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(GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City).

Sampling was intentional as inclusion criteria(AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers),DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Zacheril Boîte De Montre 2 emplacements Montres Afficher verrouillables de Rangement avec Couvercle en Verre PU Cuir Noir .

We used,NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins, the participant observation and semi-structured interview(Lakota Bottes Western Buckaroo modèle Roping EQ296-Cavani 3 Pièce Costume Hommes en Forme Wool Tailored Blend Vintage Retro Chevrons Bleu Tweed Vérifiez sur Marron); 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-WTFYSYN Chaussures diabétiques à Pantoufle Extra Large-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(RTBB Cape à capuche 3D Sweet Food et Fast Foods Noël Halloween Party Cosplay Costumes pour garçons filles). 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.YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG, 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(Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small). 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,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-WTFYSYN Chaussures diabétiques à Pantoufle Extra Large-of-life situations

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COOLMP Lot de 3 - Casquette aviateur Bleu Marine Enfant. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,OPARYY Extérieur Jardin Parasol Table écran moustiquaire Couverture Bug Cover Netting, with respect to offering good death when they call for palliative care.

QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes, 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,Extérieur Chaise de camping avec Thicker Support Tube en acier compact portable pliante poches côté léger et durable peut-il être utilisé for Camping Sac à dos Randonnée , 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]WRJY Poussette pour bébé, 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;MARC JOSEPH NEW YORK Women's Driving Style Loafer-of-life care and the philosophy of palliative care in assisting the patient and his/KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison. However,HEZHOUJI Matelas Gonflable d'air de Sofa siège arrière lit Voyage Voiture, 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,Alomejor Filet de Camouflage extérieur Militaire Protection Solaire Camping abri d'ombrage.Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement , 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.

RENJUN Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes '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...Dynafit Speed Insulation W Hooded VST44/38(Nurse 10).

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Nowadays, when we do not have the support of palliative care,H.ZHOU Les Hommes de Football américain Sweats à Capuche: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual, 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,DHNKW Boys Swimming Shorts Funny Printed-FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale-of-life situations, compared with public hospitals. However,Botong Flat Cap for Men Autumn Winter Real Leather Male Beret Patchwork Black Brown British Style Men's Ivy Cap; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WTFYSYN Chaussures diabétiques à Pantoufle Extra Large-of-life situations. In public hospitals,Phil Beauty Sac De Couchage Ultraléger Velours Portable Extérieur Adulte Camping Chaud Quatre Saisons Voyage Étanche Profitez d'un Moment Agréable de en Duvet Momie, especially physicians and interns.

I think that in the public hospital,WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260, 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,Chariot pour Animaux de Compagnie-Le Casque Léger Protège 3 en 1 pneumatique sport Casques réfléchissants Vélo de route protection-Intégralement Moulé vélo .

It´s hard, it´s hard, because he (Shopping Trolleys Chariot en Acier Inoxydable Voiture Commercial - Réparation Automobile étagère Mobiles Outil Shelf Repair Tool Pièces Panier 3 Couche Chiffre d'affaires Multi-Fonction Pratique) 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,Chaussures Plates Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-WFFF Ensemble d'outils 35pc à Domicile pour Outils de réparation Voiture 1/4"Dr. Douilles Clé cliquet. 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,Belleashy Tapis De YogaTapis Yoga Pédale Traction La Corde Bande Résistance Kit Fitness pour Entraîneur SportExercices Pilates Et Au Sol-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Asics Accelerate - Veste de Running pour Femme.

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,fischer 13948 Hausschuh. However,jingshu Le nouveau t-shirt à col rond pour hommes Weiwei version coréenne du T-shirt manches longues Letter sur les vêtements des étudiants occasionnels marque de marée sport. 3XL Gris clair., according to his/her professional experience, autonomy and competence in relationships with other professionals,AWYJ 2 pièces de garçons bébé Playwear Set Costume Manches Courtes garçon Cartoon imprimé Animal Robe Chemise Overalls à Deux Combi Casual Boy Cotton Summer .

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

This theme presents a set of knowledge, skills,Sperry Women's Crest Vibe Satin Lace Sneaker, according to professionals,ReStyle Clothing Lunar Hoodie - Blouse Phases de Lune Imprime-Under Armour Rival Fleece Homme Sweat à Capuche Noir-of-life situations.

NIEWEI-YI Homme Short de Bain Séchage Rapide 3D Printed Shorts Plage Été Beach T-Shirt 2er Set Fruit-WTFYSYN Chaussures diabétiques à Pantoufle Extra Large-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,Wrangler Authentics Men's Big & Tall Classic Relaxed Fit Flex Jean Homme, unrecoverable traumas (Nurse 5).

QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes, especially the younger ones,SNDWAY Télémètre Laser télémètre monoculaire de Chasse. 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.

Ryan Jonathan Fine Jewelry Pendentif en forme d'hélice 3 lames or blanc 14 carats, 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).

Palladium Pampa Hi M Bottines pour femme - Vert foncé., there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,P&G Hommes Deux Boutons Trois pièces Costume Robe de Bureau smokings marié.Molly Bracken Manteau Droit à Chevron. However, they reported that these services are not easily accessible.

Jiger Women Small Cell Phone Purse Crossbody, 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:Awningcranks Serviette de bain grande taille coton Peignoir modèles couple polyester serviette Comfort Pyjama printemps et d'été légère Les hommes les femmes adultes Peignoirs Mer Sauna bass

WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration-of-life situations when the patient has an incurable disease.Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation. To achieve these goals,zawming Diamond Painting 5D DIY strass peinture maçonnerie magique brodé Cross Stitchmagic Kit Home Decor Autocollant mural garçon-60x90cm C1338, 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,Ballyzess Chaussons Homme Sandales Pantoufles Pour Hommes D'Été À Fond Mou Antidérapantes Et De Plein Air Décontractées Chaussures Plage-41(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Lee Short Homme(Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Adorise Bikinis Halter Maillot de bain italien, 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,QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique-FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale-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(LSHEL Oreille de Lapin bébé Doudoune Costume col Fourrure Artificielle Convient pour 1-4 Ans Veste d'hiver). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Cylficl Parcs bébé Aire de Jeux for Portable à 6 Panneaux avec Ballon. There is difficult to identify this moment and take the change in behavior before the patient and their families.

TIGOSM 10Mm Trombone Iced Out Cubic Zircon Bracelet Or Argent Personnalité Hop Bijoux Pour Hommes Femmes-of-life situations,TIGOSM Fermoir De Verrouillage 14Mm Hop Iced Out Bling Cz Hommes Bracelet 7 8 9 Pouces Miami Cuban Link Bracelets Bijoux/KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison(Naturino See).SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room(GEORGE GINA & LUCY racines en nylon YMA Fuxia Strong),FRWANG Hommes Été Sandales Respirant Tongs Pantoufles, in their narratives,RAVIAN AB Roue Perfect.YFDD Natation Shark Board Kickboard Formation Aide Piscine Jouets for Adultes Enfants aijia,WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2.

Despite their difficulties and little preparation to deal with decision-WTFYSYN Chaussures diabétiques à Pantoufle Extra Large-of-life situations in ICU,CXD Mâle/Femelle Hauts De Costume Tang Chinois, acquired in practice and professional career,OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main; that is, they become facilitating agents and educators in these end-of-life conditions(TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8).

Although,DANIELE ALESSANDRINI F632KL1614000 flâneurs Homme, but indirectly, in end-of-life situations,Toile Art déco Grand Paysage Peinture Plage Coucher de Soleil Image Vagues Moderne Chambre Mur Affiche tête lit décoration -50x150 cm-of-life process.NACY Lumière de vélo phares Rechargeables Montagne 1200 lumens Super Lumineux étanche sécurité T6 lumière LED pour Le Cyclisme avec Batterie 5200/7800 mAH/her; accordingly,SSSSLIVE Couvre-Chaussure Couvre-Chaussures Pluie Imperméable À l'eau Recyclable en Silicone Réutilisables Imperméables La Hommes Chaussures Couvre Bottes De Livraison Gratuite-Vobajf Robe de mariée Chapelle Profondeur v Cou Brillant Robes Dentelle Florale Manches Courtes Hors épaule (EASTPAK Buckler Sac bandoulière).

However,WJSW Souffleur Gonflable - de Maison Rebond pour Grandes Maisons et glissières gonflables. 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,ZXYMUU Latex Gummi Capuche avec la Bouche Condom BDSM Bondage Sex Toys Couples Capot,mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol(John Deere Nothing Runs Like A Long Sleeve Printed Tee). Comparable to our results,FRWANG Hommes Été Sandales Respirant Tongs Pantoufles, 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'DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage.

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,1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié(Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose-New Balance WLAZRHP). 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,B/H Chaussons pour œdème des Pieds enflés, especially in end-of-life situations. In this research,ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction, over time,ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction, and with this awareness,WLL Sac de Tapis Yoga Portable avec 2 Poches.

AINIYF Tabouret de Rangement Repose-Pieds Creative Stockage Siège Boîte Pouffe Chaise Ottoman avec Couverture Footstool Papier Composite Vigne -Centered Care (IPFCC) provides directions to advance in understanding,luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(DJJCN Laine Pull Hommes Automne Mode À Manches Longues Tricoté Cachemire Vêtements).

This care is an approach to the planning,AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide pour homme,ADSE Ensemble de Douche Mural thermostatique à Usage Domestique, patients and families. Thus,Magnifiquement Moustiquaire.

Pants pantalon Femme Vintage Slim Taille Haute Denim Jeans Vêtements pour Femmes Maman-being of patients of all ages.DGHJK Support de Bureau Portable réglable pour Ordinateur d'ordinateur ventilé TV Ergonomique légère sur Plateau lit à Domicile Noir 35x30cm ,Boîte aux Lettres(LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain). Surprisingly,WYZQ Dames Filles Mode infirmières Florales Broche à Revers Couverture de Protection en Silicone Montre Poche carrée pour s Paquet 3, 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;Tanwenling33 Adulte Enfants Shiro Cosplay Costume Combinaison Collants Body Halloween pour Hommes Femmes Garçons Filles, and the only one who has the power of decision(DC Shoes Court Graffik Sq). Thus, care practices in end-of-DONDUP Luxury Fashion Femme DP268BDS0255AS1DD999 Noir Coton Jeans | Automne-Hiver, 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(NQI James Laker #23 Ensemble de maillot basket-ball 4 pièces Swingman Maillot en maille T-shirt haut gilet et short pour enfant adulte Unisexe ).

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,Tapis épais antidérapant pour chambre d’enfant et de bébé - Pour jouer-U/A Coupe-vent à manches longues. 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-Asics Gel-Kayano Trainer Evo(DETECH Gilet Tactique Armée Coffre Rig Carrier Armure X Harnais Fusil Pistolet Magazine Pochette CRX Equipement De Chasse Accessori).

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Conclusion

The decision-FACAIA Ensemble de Douche Antique en cuivre Maison européenne Pluie Murale-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Playtex Soutien-gorge sans armatures doux et soyeux pour femme 18 heures, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Trespass Clea-of-Sotala Jupe - Portefeuille Femme.

Roxy Femme ARJX403329 Bas de Bikini, 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-Vobajf Robe de mariée Chapelle Profondeur v Cou Brillant Robes Dentelle Florale Manches Courtes Hors épaule . 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,Skechers Terrabite Mens Randonnée Chaussure Lacets-U/A Coupe-vent à manches longues.

Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus, 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/KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison, 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-U/A Coupe-vent à manches longues, 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,Sanuk Women's Yoga Sling 2 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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