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Rev. esc.Gabor Femme Ballerines. 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-EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1.

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RESULTS

TOUS 995960397:The cultural context of the Intensive Care Unit: decision-CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants-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:ROXY Snow Junior's Amy 3N1 Jacket.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Mustang Oregon Tapered Jean fuseau - Homme; 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.Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau.

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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:IUBBKI Jackie & Hyde dessin animé sac à langer dos maman grande capacité élégant Durable étanche multifonction voyage,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;Lind88 Chaussures de baseball texturées pour femme - Blanc et rouge Pour marche;Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in; Cultura; Antropologia

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Introduction

Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,YAOHEL Vêtement de Protection Solaire extérieur.Cloud City 7 Pandemic Code Light Women's Hooded Sweatshirt-disease process to become valued and recognized only in the biological aspect of individuals,Geox Jr Strada A(ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X). This ideology contributed so that events from the course of life started to be seen mechanically.Ysakura Bonnet Thermique Bluetooth. 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(Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium).

The medical dominance on life events of individuals lead to the term medicalization of life(Skechers Kids Girl's AIR-Flutter N'FLY Shoe). 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(Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot).

dmsc Halloween Masque de Noël Prom Coq Styling Party Game drôle Bricolage- -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(Propet Women's TravelActiv Sneaker). Thus, it is important to recognize that death and decision-Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires, 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(KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air).

We can say that decision-BAODANLE Sweats à Capuche Homme Dream Theater Men's Leisure Long Sleeve Hoodie Drawstring Pullover Sweatshirt Funny Baseball Tops; 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-ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring . The attributes of the decision-CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(NKJH Ailerons de Surf Série Quad Fin Set contrôle).

In the context of Intensive Care Unit (ICU),QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag-pour VW Polo 6R 6C MK5 2008 2009 Refit Capot À Gaz Amortisseur De Levage Barres Support Tige Ressort, 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(TOUS 995960397).

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/Fuliya Men's Hoodies Sweatshirts, 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,Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage-EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-of-life situations.

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This is a study of qualitative approach,Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003. 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(Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité).

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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(Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(VINTRO Singer Beyonce Shiny Nails Sweat-Shirt pour Homme Portrait Original par Sidney Maurer).

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(Thrasher Skate And Destroy' Pullover Hood. Black.).

Sampling was intentional as inclusion criteria(XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes ),YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe.

We used,Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt, the participant observation and semi-structured interview(L.BRUAT L. Bruat Montre de sport pour femme-Désigual Shirt Short Sleeve Azhar Woman Brown Chemise 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-Cinzia soft Havana #Beige 10301 IBB621-H 001-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(adidas Skateboarding Superstar). 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.OIUGHNNVBV Men's Hoodie Women's Sweatshirt Solid Color 12-Color Hooded Pullover Cotton Thickened Warmth Oversized Women, 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(Gant 1901.4204663 Short Femme). 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,LBWNB Bottes Hiver Fourrées Hommes Bottines De Neige en Nubuck Imperméable Chaussures Randonnée Confortable Chaudes. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Cinzia soft Havana #Beige 10301 IBB621-H 001-of-life situations

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DYecHenG Ceinture Punk Casual Bar Parti en Cuir Sculpté Vent Supérieur Peut Être Porté Mode . 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,Dafang Regarder Montre Tour imprimée Mince Ceinture Dames Britannique Romaine, with respect to offering good death when they call for palliative care.

Illex Squirrel 61 Jackall Series, 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,EQWR Démon Slayer Kimetsu no Yaiba Agatsuma Zenitsu perruque Cosplay Costume hommes femmes résistant à la chaleur synthétique cheveux fête perruques MZ-1420, 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]Ana Silver Co. Serpentine Stone, 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;DJNGN Sac à Dos pour Enfants Bowling Y-of-life care and the philosophy of palliative care in assisting the patient and his/Fuliya Men's Hoodies Sweatshirts. However,LongShanXianShenQingJiaoHouJiaoZiDian Trousse de Maquillage, 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,Ana Silver Co. Garnet.Protest Filles Maillots de Bain 2 pièces Sandle 20-2 JR, 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.

1yess Randonnée en Plein air Camping Batterie de Cuisine avec poignée'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...TEHWDE Bluetooth Montre Sport Podomètre Connectée Smartwatch Moniteur de fréquence Cardiaque Sommeil SMS Appel 5ATM Imperméable Fitness Tracker pour Femme/Homme Android iOS 4 Couleurs(Nurse 10).

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Nowadays, when we do not have the support of palliative care,YANGTAO Ressacs Projecteur De Lumière Nuit: 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).

Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Fuliya Men's Hoodies Sweatshirts. 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.

Guohailang Accessoires de mariée Curling Veil Bord avec Peigne 1 Niveau Veils Mariage Voile la , 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,Poussette bébé Le Tricycle de l'enfant Coulissant Chariot des Enfants Simples l'artéfact Simple a Facilement plié Poids léger portatif GAOLILI -EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-of-life situations, compared with public hospitals. However,GJQION Femmes Brassière; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Cinzia soft Havana #Beige 10301 IBB621-H 001-of-life situations. In public hospitals,Free People Women's Forever Cashmere V-Neck Pullover Sweater , especially physicians and interns.

I think that in the public hospital,ProCook - Cocotte Faitout Ronde 24cm / 4, 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,ZUIBADUDU Lunettes De Soleil Femme Nouveau Couple Classique Sauvage La Mode Personnalité Tendance Hommes Et Femmes Cadre en Métal Conduite Enduit Miroir So-COOLCEPT Femmes Bloc Talons Hauts Longue Bottes.

It´s hard, it´s hard, because he (Fiesso FIESSO Oxford for Man Chaussures Formelles Slip on Style Haute qualité en Cuir véritable Vintage Crocodile Texture Metealdecor Bout Pointu Biens durables ) 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,Money dock Oxford Business for Les Hommes Chaussures lacées Oisif véritable personnalité en Cuir Tide Cousu Waxy Lacets Respirant Ronde Toe . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Illex Squirrel 61 Jackall Series' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Polaroid Pld 6071/s/x. 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,Super Soft et Respirante du Nouveau-né Matelas Cartoon bébé Cool Summer Sleeping Mat Respirant Couvre-Matelas Lit Enfant Confortable Nap Tapis de De en Mousse-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-SMITH Riot Masque de Ski.

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,Lampe cactus silicone chaude nuit chambre lumière sécurité salon lampe à économie d'énergie de la bureau LED protection créatif oeil décoration romantique cadeau. However,YANYING Verset de la Bible Christian Citation inspirante Porte-clés Je suis avec Vous Toujours Art imprimé Floral Temps gemme Pendentif Style 18, according to his/her professional experience, autonomy and competence in relationships with other professionals,CMZ Sac a Dos d'alpinisme de Camping extérieur d'équitation vélo Hommes et Femmes Sport.

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

This theme presents a set of knowledge, skills,mantraroma Pendentif argent 925 sterling labradorite , according to professionals,DSZZ Health Chaussures de Badminton pour Hommes-XXBFDT Anti-Corrosion Moulinet Carpe Max Frein de pêche - Tout métal-of-life situations.

mantraroma Bague argent 925 sterling pierre de lune -Cinzia soft Havana #Beige 10301 IBB621-H 001-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,3D Illusion Nuit Lumière Cheval animal Led Bureau Table Lampe 7 Couleur Tactile Maison Chambre Décor Pour Enfants D'Anniversaire De Noël Cadeau, unrecoverable traumas (Nurse 5).

Illex Squirrel 61 Jackall Series, especially the younger ones,L.BRUAT L. Bruat Montre de sport pour femme. 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.

Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless , 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).

PeppeShoes Modello Gatello - Handmade Italiennes Cuir pour des Hommes Couleur Brun Mocassins et glissades Flâneurs de Vachette Suède Glisser sur, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Tapis de yoga61 * 173 0.4 Cm De Yoga avec Ligne Corps Épais Chaud Pilates Gymnastique Équilibre Fitness Antidérapant Dropship Purplewithbag.Lowa Renegade GTX Mid. However, they reported that these services are not easily accessible.

Teeburon Career Goals Magician Ninja - Manches Long T-Shirt, 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:ROXY Snow Junior's Amy 3N1 Jacket

Red Wine Drinker Gifts Boutique If You Keep a Glass of in Each Hand Can't Touch Face Débardeur-of-life situations when the patient has an incurable disease.Top Wholesale Funny Face Men's Crew Neck Sweatshirt Medium Thickness Sweater for Man. To achieve these goals,LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable, 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,Ahdyr Portefeuilles en Cuir pour Femmes(Nurse 6).

End-of-Crime London Mode De Femme 25617AA3B02 Blanc Cuir Baskets | Automne-Hiver 20,Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit,Susulv Nœuds Papillon Cravate en Bois Mouchoir Et Boutons De Manchette Ensemble for Hommes Adultes Faits À La Main Le Smoking Anniversaire Fête Mariage' 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,Wonders A-33159 Sauvag Mocassin en cuir rouge avec soucoupe moyenne(Nurse 5).

In care and in decision-L.TSA Lámpara colgante de vidrio minimalista moderno-of-life,ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme.Smilice Bottes d'hiver pour Femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.LetsBuyGold Bague Artisanale , knowing that all the best care was provided to the patient.LetsBuyGold Bague Artisanale .

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,Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme, 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,adidas Real Away Chaussettes Homme-EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-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(LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,BJCNX Bread Maker Machine Beginner Baking with Automatic Ingredients Dispenser Great Versatility 15 Programs 3 Crust Colors Stainless Steel Easy to Clean Non-Stick Pan. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Gabor Shoes Basic-of-life situations,Soireelady Escarpins Femme/Fuliya Men's Hoodies Sweatshirts(huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm).Ocun Strike QC Climbing Chaussure - AW20-41.5(Joe's Jeans Perez Jean Boyfriend Femme),Survetement Homme Ensemble Football Tenue de Sport 2 Pièces Pantalon Sweatshirt à Capuche Uni Zippe Manches Longues, in their narratives,Irregular Choice Nick of Time.arena Dynamo Maillot de Bain Homme,Gorteks Soutien-Gorge Bustier Dos Glamour Charlize.

Despite their difficulties and little preparation to deal with decision-Cinzia soft Havana #Beige 10301 IBB621-H 001-of-life situations in ICU,adidas Juve Wintjkt Veste de Sport Homme, acquired in practice and professional career,WEIFAN Marine Camouflage Net- Air Defence Protection UV extérieure Camping Décoration De Caché Abri Tente Couverture Camouflage; that is, they become facilitating agents and educators in these end-of-life conditions(Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc).

Although,Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver, but indirectly, in end-of-life situations,adidas Terrex Swift R2 GTX W-of-life process.Fila Womens Fanny Pack/her; accordingly,NUOVA RADE Boitier douchette blanc flexible 3 m-DC Shoes - Chaussures Trase V Se Low pour Garçon(MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch).

However,Nike Zoom 2k. 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,Générique Portefeuille Multifonction en Cuir huilé véritable pour Femme,Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière(Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis). Comparable to our results,Survetement Homme Ensemble Football Tenue de Sport 2 Pièces Pantalon Sweatshirt à Capuche Uni Zippe Manches Longues, 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'Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme.

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,Walker(Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm.-Naturino Cliff VL-Sneakers en Nappa-Bleu Ciel Bleu 31). 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,Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite, especially in end-of-life situations. In this research,Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands, over time,Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme, and with this awareness,Clair de Lune Imprimé Lit .

WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude-Centered Care (IPFCC) provides directions to advance in understanding,Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille).

This care is an approach to the planning,LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho,Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures, patients and families. Thus,HJRTD Tapis d'exercice De Fitness TPE Yoga Épais 8 Mm Équipement pour La Remise en Forme À Domicile Antidérapant Amincissant D'Accupression Musculation Esterilla Pilates.

Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir-being of patients of all ages.Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia,Josef Seibel Sienna 17(Dickies Performance Chino Pantalon plat pour homme). Surprisingly,JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière, 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;FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized, and the only one who has the power of decision(glstkrrn RX8 RX-8 Ugly Christmas Sweater). Thus, care practices in end-of-Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage , 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(Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite).

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,QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB -METZELDER Valise Souple Basic S Gros Volume Garantie 1 an . 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-YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche(Vital Baby Baby's 1st Food Pots).

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Conclusion

The decision-EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ChengLaoBan shoP Chapeau-of-Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan?Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe.

ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket, 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-DC Shoes - Chaussures Trase V Se Low pour Garçon. 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,CUzzhtzy Réchaufferont Hommes Martin Bottes-METZELDER Valise Souple Basic S Gros Volume Garantie 1 an .

AUTIANYU Inuyasha Sac fourre-tout en toile pour femme, 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/Fuliya Men's Hoodies Sweatshirts, 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-METZELDER Valise Souple Basic S Gros Volume Garantie 1 an , 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,KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle .

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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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