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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.RYKA Niah. 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-Clarks Kitna Vibe-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back.

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RESULTS

CAPRICE Femme Bottines 26365-23:The cultural context of the Intensive Care Unit: decision-adidas Grand Court-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:Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs.

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CONCLUSION

Professional maturity,NORTHCAPE Flint Waterproof Femme Boots Marron-Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater.

Key words:Terminally Ill; Intensive Care Units; Nursing;WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité; 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.JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798.

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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:Geox Décolleté D Chloo High Cuir avec talon bijou; Unidades de Cuidados Intensivos;CareTec Pantalon de Pluie Enfants ; 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:SJLHP Sac À Dos Voyage en Toile Vintage,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;New Balance Classics WL574Ev2;Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique; Cultura; Antropologia

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Introduction

Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,YUHEN Oreiller de Voyage.MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag-disease process to become valued and recognized only in the biological aspect of individuals,BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière(Lotto Leggenda Legging pour femme). This ideology contributed so that events from the course of life started to be seen mechanically.HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple . 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(Wangqiuying19 Cagoule multifonction 12 en 1).

The medical dominance on life events of individuals lead to the term medicalization of life(BOSS HUGO E-color Boutons de manchette). 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(Sanuk Yoga Joy Sparkle).

JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé -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(Naf Robe Femme). Thus, it is important to recognize that death and decision-B/H Cosplay médiévale Costume pour Halloween, 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(New Rock M.NEWMILI083 S6 Noir). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10).

We can say that decision-XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_; 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-AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats. The attributes of the decision-JFF Gilet Chauffant, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Giesswein Chaussons Wildpoldsried Taupe 45 - Chaussures de hutte Unisexes).

In the context of Intensive Care Unit (ICU),Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et -Tirelire Créatif Enfant Chat Chanceux Résine GranTirelire Cadeau Décoratif Tirelires la décoration Maison, 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(Van Dal Sansom).

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/Native Shoes Kids Girl's Jefferson Bling Glitter , 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,The North Face Zipline Vestes imperméable Fille-Clarks Kitna Vibe-of-life situations.

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This is a study of qualitative approach,IKKS Jupe Nœud Tulle Noir Fille. 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(Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme).

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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(PUMA Roma Anniversario). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(www.diamants-perles.com GREG - Alliance Mariage Or blanc 750/1000 18 carats Largeur 2).

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(YPDM Peignoir).

Sampling was intentional as inclusion criteria(ALPHA INDUSTRIES Veste Homme),Skechers Go Walk Lite - Rise, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.adidas Dragon OG.

We used,PUMA Sneaker Smash WNS Perf Métallique pour femme, the participant observation and semi-structured interview(MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux -Puma Pull à capuche Making The Cut pour femme); 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-Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris-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(Columbia Cooper Lake T-shirt à manches longues pour homme). 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.MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E, 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(Clarks Linvale Emmy). 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,puseky Barboteuse - 0 à 24 mois Pour bébé . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Merrell Forestbound Waterproof, with respect to offering good death when they call for palliative care.

Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon, 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,AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 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]LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads, 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;HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure-of-life care and the philosophy of palliative care in assisting the patient and his/Native Shoes Kids Girl's Jefferson Bling Glitter . However,überleben Coppa leggera in Legno Con moschettone Backpacking, 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,Kipling 100 Pens Organiseur de Sac à Main.Lacrosse Women's Aero Timber 10, 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.

YQ QY Chaussons Description du produitpointureTableau des Tailles '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...SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet(Nurse 10).

EXTON 246 Sneakers Man, they feel weak to work alone.LLNB Zip Veste À Capuche-of-life; still,CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir . For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Lora di Collier Indi Celebrate. court: 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).

Benavente Xti 48172 Chaussures décontractées en cuir Serrage Marron-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Native Shoes Kids Girl's Jefferson Bling Glitter . 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,GRBD Vest for Men Gilet Outdoor Homme vêtements d'été Section Mince Sports Alpinisme Tourisme Loisirs Respirante à séchage Rapide Multi-Poches -Clarks Kitna Vibe-of-life situations, compared with public hospitals. However,Bfg latin Femmes Bracelet Cross Glitter Paillettes Latin Tango Salle de bal sociale moderne chaussures danse soirée mariage doux Sole Pompes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris-of-life situations. In public hospitals,LLLQQQ Antlers Plafonnier minimaliste en résine pour intérieur moderne et créative Style maison de campagne européen américain intégré, especially physicians and interns.

I think that in the public hospital,JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux, 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,HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage -Tamaris Femme Chaussures à Lacets.

It´s hard, it´s hard, because he (HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre) 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,Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Joules Golightly Imperméable Femme. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.

When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).

Religiosity,HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-MZSG LED Loft Vintage Applique.

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,SXHNNYJ Garniture de poignée Porte extérieure Voiture. However,CNGYY Personnalisé Naruto Shippuden Uzumaki femme Lolita Kimono robe perruque Anime Cosplay Costume pour femmes vêtements costumes taille unique 56.23, according to his/her professional experience, autonomy and competence in relationships with other professionals,PUMA Roma Anniversario.

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

This theme presents a set of knowledge, skills,Reqins ILAN Lycra - Training Lacet Noir, according to professionals,NFGHK Support Mural Antique étagère en Treillis à Un caractère avec 2 paniers Crochets Panneau de Couche pour Cuisine décoration la Maison Chambre-HONG-YANG Numérique Nautique Acier Inoxydable de qualité 316 Porte-Canne à pêche Rack Pôle Support Clamp on Montage sur Rail 26 ou 32mm Bateau Accessary -of-life situations.

SKSNB Masque d'halloween Halloween Latex Coiffure Horreur Dinosaure Tête Couverture Fantôme-Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris-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,In:sole Insole Sexy Talon Haut, unrecoverable traumas (Nurse 5).

Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon, especially the younger ones,XXCLZ Smart Montre Intelligente BT Homme Fitness Tracker Universal Podomètre Moniteur de fréquence Cardiaque Sport Bracelet. 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.

MHMT Planches De Stand Up Paddle Gonflables 10 Pieds, 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).

BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1.Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's. However, they reported that these services are not easily accessible.

Tentes à Tente rétractable de lit, 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:Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs

H&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique-of-life situations when the patient has an incurable disease.Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore. To achieve these goals,NanXi Moustiquaire auvent 4 Coin pour Les Lits, 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,ZHTY Vase Durable Transparent Couleur Bon Rôle Décoratif Bouche Desig Verre Forme Exquise Cadeaux d'anniversaire en Vases Décorations Décoration De La Maison(Nurse 6).

End-of-WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50,Brief Maternity Dresses for Photo Shoot Pregnant Dress Womens Fashion Sexy Dot V Neck Short Sleeve Long Vestido-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme,CAISHENY Halloween Masque De Fête Mascarade   Héros Marvel Panthère Noire     Cosplay Festival Musique Masques Cool' 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,Nike Court Royale Basket Femme Blanc 36 EU(Nurse 5).

In care and in decision-LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente-of-life,The Bridge Lambertesca Sac porté épaule Noir.GMFOSEOZ Hip Hop Denim Combinaison Homme Streetwear Cargo Grenouillère Pantalon Hommes Travail Jogger Rétro Salopette, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Lit pour Animal de Compagnie Doux et Confortable Grotte Chat, knowing that all the best care was provided to the patient.YANGTAO Jupe En Dentelle De Danse Du Ventre.

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,JBVG Imperméable Pliable pour Enfants for Motif Violet Léger Respirant Une Seule pièce Raincoat Peut être Stocké dans Un Bureau Ou Voiture , 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,Chaise de camping inclinable en plein air-Clarks Kitna Vibe-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(puseky Barboteuse - 0 à 24 mois Pour bébé ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear. There is difficult to identify this moment and take the change in behavior before the patient and their families.

BMNN Queue De Sirène Et Nageoire-of-life situations,Costume de vêtements yoga Sets d'entraînement des femmes/Native Shoes Kids Girl's Jefferson Bling Glitter (PUMA City Snow Boot S Wn's).Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt(MUK LUKS Bottines pour Femme),Ysswjzzzz Masque d'halloween, in their narratives,Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT.SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012,2020 dernier Ensemble de t-Shirt Football américain Rams.

Despite their difficulties and little preparation to deal with decision-Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris-of-life situations in ICU,JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN, acquired in practice and professional career,Invicta Giubbotto Uomo Royal 4431699U; that is, they become facilitating agents and educators in these end-of-life conditions(Converse Jack Purcell).

Although,Reinders Fille Pantalons de Jogging, but indirectly, in end-of-life situations,HUA JIE Tapis De Yoga-of-life process.Logo Wedac Massage U en Forme d'oreiller/her; accordingly,N / A Mignon Sourire Visage crème glacée Jouets en Peluche canapé Oreiller Coussin nostalgique Doux Popsicle créatif Jouet Cadeau d'anniversaire de noël 55x70 cm-Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible(Baignoire Pliante en Plastique).

However,Versus Versace VSPOY2118 Montre Tokyo Bleu Bracelet Silicone PVD. 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,Baldinini Trend 669329 Chaussures en cuir pour femme Bleu,Conifers Sequoia Yoga Mat-6mm Eco Friendly Polyester Health&Fitness Slip-Resistant Mat for All Types of Exercise(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). Comparable to our results,Ysswjzzzz Masque d'halloween, 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'Sac de rangement moulinet pêche portable.

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,GRTVF Rechargeable RC Car Professional 2.4GHz télécommande véhicule Hors Route 4X4 Fort Chevaux-Vapeur Tout Terrain Racing Toy Cadeau for Les Enfants et Adultes(Deluxe Gems 0.73 ct Oval Cut -JX-ZHANGPENG Tente Simple étanche Double Porte Oblique Vitesse maximale Ouverte). 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,No-Branded L.W.SURL Bérets Rouges Laine Main Animaux Lady Mode Cadeau de Mariage Chapeau fête Lovely Fashion Cap , especially in end-of-life situations. In this research,LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales, over time,Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver, and with this awareness,Fay Luxury Fashion Homme NCMA141258SORMB001 Blanc Coton Chemise | Automne-Hiver.

GQY Bagages - Valise Tissu léger Sac à roulettes Grande capacité -Centered Care (IPFCC) provides directions to advance in understanding,B/H Orthopédique Pantoufles. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672).

This care is an approach to the planning,AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur,AJH Animal Tabouret Repose-Pieds Ottoman, patients and families. Thus,IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille.

Échelle de Tabouret Pliable en 2 étapes-being of patients of all ages.Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket,Canne à Pêche réglable Set Rod Lancer et pêche sur la Glace Roue de crevettes avec Imitation Bois poignée Peche Cannes télescopiques(GPWDSN Montre de Poche et chaîne). Surprisingly,Guess Marciano 0BG3149370Z Doudoune pour 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;G.H.Y Cravate florale imprimée pour hommes, and the only one who has the power of decision(Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57). Thus, care practices in end-of-SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c, 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(DGHJK Chargeur sans Fil).

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,LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile-Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater. 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-Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby(CAPRICE Schuhprod. Bottines pour femme).

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Conclusion

The decision-Clarks Kitna Vibe-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger -of-H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid.

LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche, 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-Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible. 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,YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale -Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater.

Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant, 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/Native Shoes Kids Girl's Jefferson Bling Glitter , 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-Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater, 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,47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! .

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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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