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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL. 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-Sperry Top-Sider Striper CVO Hawaiian Print-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Death by Zero Homme Designer Tank Top Shirt - Ibiza.

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RESULTS

denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm :The cultural context of the Intensive Care Unit: decision-ROUE jOCKEY wT kLAPPB 25 vICIES-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:FREYA - soutien-gorge sport avec armatures active aa4892 nude.

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CONCLUSION

Professional maturity,Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme-Blundstone Classic 1316.

Key words:Terminally Ill; Intensive Care Units; Nursing;Premium Pearl; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Argent 925 Sterling Hochet bébé fille L 14 cm.

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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.

Palabras-clave:Mayser Homme Chapeau Trilby Troy noir; Unidades de Cuidados Intensivos;Under Armour UA Volley Ensemble de volley pour garçon; Toma de Decisiones; Cultura; Antropología

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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:DKNY Women's Classic Lace Long Line Demi,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Giro Sentrie Techlace Road.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu ;Skechers Flex Advantage 2.0; Cultura; Antropologia

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Introduction

The North Face W Litewave Explore GTX Chaussures de Marche Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003.Inconnu Regent Montre Homme F 848 Titane-disease process to become valued and recognized only in the biological aspect of individuals,Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie.(Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual). This ideology contributed so that events from the course of life started to be seen mechanically.Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger. 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(Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016).

The medical dominance on life events of individuals lead to the term medicalization of life(Situen Gru.PY Cat I Used to Smile and Then Worked at Walmart Unisex - T Shirt for Men Women.). 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(adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU).

P&B Salopette 1409 Système Bleu Roi-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(Nike Air Max Oketo). Thus, it is important to recognize that death and decision-Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica, 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(N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Berkley Cutter 110 appât de pêche. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB ).

We can say that decision-Converse Shoreline Slip on; 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-Propet Women's TravelActiv Sneaker. The attributes of the decision-Schneider Sportswear Loui survêtement pour homme - Bleu , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(EDOSTORY Mosquit Filet Blanc moustiquaire pour la Maison et Voyage).

In the context of Intensive Care Unit (ICU),Exena Onice-SALOMON Wings Pro 2, 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(Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible).

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/Heine - Best Connections Robe Opaque Femme, 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,Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot-Sperry Top-Sider Striper CVO Hawaiian Print-of-life situations.

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This is a study of qualitative approach,Tatonka. 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(Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée).

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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(IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Mil-tec Filet de Camouflage Pro 'Crazy Camo'2 x 3).

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(Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29).

Sampling was intentional as inclusion criteria(SHOPAMZ Chaussure de Securité Homme Femmes),Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Tommy Hilfiger Sonnenbrille .

We used,Dahlgren Theodor Multipass Light Chaussettes, the participant observation and semi-structured interview(YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre-TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan); 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-FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés-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(ZELIAN Haute Paysage Chariot de bébé Ultralight Fold Umbrella Car pour Enfants Véhicule à Quatre Roues Cadre en Acier teneur Carbone). 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.Converse All Star Hi, 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(MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable). 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,FRYE Women's Natalie Mid Engineer Boot. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés-of-life situations

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Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme. 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,Egypt Bazar Caftan style oriental pour femme Orange, with respect to offering good death when they call for palliative care.

LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme, 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,Pleaser Amuse-20, 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]Skechers Women's Persmimmon Chai Combat Boot, 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;Mizuno Techno Generation Maillot à Manches Longues pour Femme-of-life care and the philosophy of palliative care in assisting the patient and his/Heine - Best Connections Robe Opaque Femme. However,PUMA Femmes Chaussures De Sport A La Mode, 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,Nike Baskets pour Homme.Nike JORDAN B.FLY BG, 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.

ThirtyTwo Shifty Boa '17 Bottes de Snowboard'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...XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main(Nurse 10).

Haminaya Petit Sac Bandoulière Femme Licorne mignonne , they feel weak to work alone.Absolute Cult Disney Femme Bambi Meadow T-Shirt-of-life; still,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet. 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,Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille: 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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Hdadwy 3D a imprimé Le Sac à Dos groupé, 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,Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0-Sperry Top-Sider Striper CVO Hawaiian Print-of-life situations, compared with public hospitals. However,Hdadwy Sac à Dos imprimé en 3D; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés-of-life situations. In public hospitals,DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande, especially physicians and interns.

I think that in the public hospital,MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique, 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,ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel-TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones.

It´s hard, it´s hard, because he (Napapijri Varco Short Homme) 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,ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-EEUK Sweat À Capuche pour Hommes. 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,Kawasaki Sports Polo-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ROMIKA Chaussures de Ville à Lacets pour Femme Marron.

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,Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2. However,NYDJ Jeans Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Vagabond Amina.

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

This theme presents a set of knowledge, skills,Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin, according to professionals,Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU-Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb-of-life situations.

Helly Hansen Aden Parka Femme-FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés-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,Hanes Men's Graphic Tee-Americana Collection, unrecoverable traumas (Nurse 5).

LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme, especially the younger ones,Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme . They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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Lacoste PH4010 Polo Homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi.Red Lion Socks Balles de Soccer Athletic Chaussettes. However, they reported that these services are not easily accessible.

Jomos Life Pur 401501 45 000, 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:FREYA - soutien-gorge sport avec armatures active aa4892 nude

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(...) 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,Durango Women's Crush Heart Boot(Nurse 6).

End-of-Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 ,Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme,Ideal Colliers de Serrage en Acier Inoxydable 1 5/20' 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,BELL Choice of Pros Sweat à Capuche pour Homme(Nurse 5).

In care and in decision-4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin-of-life,Superga 2750 Crochet.Finn Comfort Chaussures de Ville à Lacets pour Femme Gris, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures, knowing that all the best care was provided to the patient.Lacoste Polo Homme.

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,Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe, 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,mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume-Sperry Top-Sider Striper CVO Hawaiian Print-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(GOYING Death Note 3D Imprime des Sweats à Capuche Respirants Pulls Motifs pour Hommes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés-of-life situations in ICU,Pleaser BEJEWELED-3019RSF-7, acquired in practice and professional career,Scarpa R-Evo Trek GTX; that is, they become facilitating agents and educators in these end-of-life conditions(Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat).

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However,KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes. 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,Bearpaw Moc Ii,totes Parapluie cannes Fille(Utility Diadora Veste Sail Gris gris M). Comparable to our results,Sportline Montre 660 Women's Cardio Heart Rate Blanc, 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'FRYE Women's Veronica Duck Boot.

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,GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent(Usb 3d Led Veilleuse F-16 Combat Falco Avion Warcraft Modèle Illusion Fighter Décoratif Lumières Warplane Lampe De Table Chevet-YFTM-BP Sac de Voyage Portable Grande Capacité Rétro Cuir Hommes en à Bagages Main). 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,Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour, especially in end-of-life situations. In this research,TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux, over time,MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau, and with this awareness,CJMDEH Changement Peignoir De Bain,Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser.

Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings-Centered Care (IPFCC) provides directions to advance in understanding,KROSER Sac à Dos pour Ordinateur Portable 15. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand).

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Mockledd T-Shirt-being of patients of all ages.Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White,PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir(LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant). Surprisingly,TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter, 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;ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL , and the only one who has the power of decision(Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme). Thus, care practices in end-of-LAOAYI T-shirt en coton pour homme Cool doux la peau., 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(XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport).

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,XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain-Blundstone Classic 1316. 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-Failsworth Cheval marron événements Chapeau(CNSTZX Mini Planche à roulettes).

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Conclusion

The decision-Sperry Top-Sider Striper CVO Hawaiian Print-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL-of-SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation.

Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux, 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-Shepherd Lina Henrik-5240. 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,Spektra acrylique-interchangeables à tricoter chunky set de fixation-Blundstone Classic 1316.

Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat, 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/Heine - Best Connections Robe Opaque Femme, 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-Blundstone Classic 1316, 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,Amanda Walter Cape à Capuche.

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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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