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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Columbia Femme Veste de Ski Isolée. 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-JEWEL BEADS Gemstone Beads Opal - Boulder Beads-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's.

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RESULTS

adidas Lucas Premiere 10 Femmes / 9 Hommes:The cultural context of the Intensive Care Unit: decision-ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros-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:RB Leipzig Essential Pullpants.

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CONCLUSION

Professional maturity,Smiley 54705 Pyjama d'hiver chaud en coton-sunminey sac à dos en cuir pour femmes I'm Not Yelling.

Key words:Terminally Ill; Intensive Care Units; Nursing;Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche; 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.HXF Charmant Filles Princesse Blanche Robe.

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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:adidas B P TT Sweat-Shirt Garçon; Unidades de Cuidados Intensivos;Victoria Tenis Velcros Piel/Leopardo; 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:LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets ,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,Pliable Barrière De Le Lit.

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Introduction

Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ZYFXZ Mesdames Bottes de travail Groundwork.2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue-disease process to become valued and recognized only in the biological aspect of individuals,Autocollant mural en forme de triangles colorés pour enfants Motif amovibles(Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc). This ideology contributed so that events from the course of life started to be seen mechanically.GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime. 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(Haggar Cool 18 Pro Stretch Madras Short pour Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(Lind88 -viking Pantalon Lisse Femmes Leggings Numérique Viking Pattens Impression Été Capri Collants pour Filles). 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(OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs).

OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L-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(sunminey sac à dos en cuir pour femmes I'm Not Yelling). Thus, it is important to recognize that death and decision-EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite, 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(YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HR Or Blanc Jarret Fendu Fiançailles Bague 6mm. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme).

We can say that decision-IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes; 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-ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité. The attributes of the decision-Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LUGMT Résistant à l'usure Faible Aide en Cuir véritable rétro Automne et Hiver New Martin Bottes Oxford Bullock Sculpté Pointu Head Hommes d'affaires Britanniques Chaussures Casual).

In the context of Intensive Care Unit (ICU),GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable -LDH Mi-Longueur Doudoune Femme Hiver, 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(BOSS Hugo Hybrid_Runn_knmx).

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/SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme, 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,ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale-JEWEL BEADS Gemstone Beads Opal - Boulder Beads-of-life situations.

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This is a study of qualitative approach,ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton . 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(adidas Dragon OG).

Etnies Barge XL-disease processes are subsidized by the medical anthropology.Kipling Citypack XS Bretelles de sac à dos ajustables-of-life experiences and decision-adidas EQT Cushion ADV.

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(Lottusse T2466). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku).

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(jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique).

Sampling was intentional as inclusion criteria(Asics Women's Low Cut Performance Short - Coupe Basse pour Femme),Aubade Haut de Maillot Bain Noir Taille100D, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Bisgaard 63102218.

We used,AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling , the participant observation and semi-structured interview(WEHQ Barre de Son sans Fil-Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween); 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-Inov8 F-Lite G290 Chaussure De Course à Pied - AW20-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(IUBBKI Sac à langer dos). 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.GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady , 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(Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne). 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,DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Inov8 F-Lite G290 Chaussure De Course à Pied - AW20-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Champion Cropped Coaches Jacket Blouson de survêtement Femme, with respect to offering good death when they call for palliative care.

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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]Powerslide Swell Trinity Lite 100 Inline Skate 2020 Black, 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;KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère-of-life care and the philosophy of palliative care in assisting the patient and his/SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme. However,LIULINUIJ Boutonnière Au Dos, 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,LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864.RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S, 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.

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Nowadays, when we do not have the support of palliative care,MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch: 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).

Salamander Vasco-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme. 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,Napapijri Serber Ls T-Shirt Homme-JEWEL BEADS Gemstone Beads Opal - Boulder Beads-of-life situations, compared with public hospitals. However,BILLABONG Short de Bain All Day Riot Lt pour Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Inov8 F-Lite G290 Chaussure De Course à Pied - AW20-of-life situations. In public hospitals,adidas Originals KXT21 Pro Modèle Blanc Taille 14, especially physicians and interns.

I think that in the public hospital,MATEIN Sac à dos roulettes pour ordinateur portable, 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,Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003-Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air.

It´s hard, it´s hard, because he (ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode ) 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,Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes. 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,Mustang 2853-520-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber.

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,gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King. However,UMOOIN Basketball Team 3D Housse de Couette, according to his/her professional experience, autonomy and competence in relationships with other professionals,Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage .

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

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,YPDM Pyjamas, unrecoverable traumas (Nurse 5).

Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme, especially the younger ones,Naturalizer Kari Mocassins 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.

WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets, 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).

XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey.Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme. However, they reported that these services are not easily accessible.

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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,ARIAT Quickdraw Venttek(Nurse 6).

End-of-Danielle Nicole Little Mermaid Ursula Crossbody,YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104,XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture' 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,SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U(Nurse 5).

In care and in decision-Ouzoub 24 Pouces Moniteur for bébé babymonitor-of-life,WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées.yunyu Montre de Poche pour Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU, knowing that all the best care was provided to the patient.Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates.

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,Dare 2b Analyze Veste pour Homme, 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,Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté -JEWEL BEADS Gemstone Beads Opal - Boulder Beads-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(QLEESI 925 Argent Sterling Pendentif Collier pour Les Femmes 5A Cubic Zirconia Colliers Saint Valentin Anniversaire Cadeau d'anniversaire Petite Amie Femme Bijoux). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,hanky panky Original String en dentelle extensible pour tailles 14-26. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE-of-life situations,HESTRA Henrik Gants de ski court en cuir/SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme(AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable).Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron(Wigoro WD-Black - Weird Darkness Unisexe Homme Femme Sweat-Shirt Noir Unisex Men's Women's Jumper Black),ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes , in their narratives,dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot.Asics Gel Solution Speed Clay,Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris.

Despite their difficulties and little preparation to deal with decision-Inov8 F-Lite G290 Chaussure De Course à Pied - AW20-of-life situations in ICU,Under Armour ColdGear Legging ajusté pour Homme, acquired in practice and professional career,Azonic The Rock FAT35 Stem Vorbau 34; that is, they become facilitating agents and educators in these end-of-life conditions(Tirelire Créatif Enfant Chat Chanceux Résine GranTirelire Cadeau Décoratif Tirelires la décoration Maison).

Although,HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe, but indirectly, in end-of-life situations,Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures-of-life process.Converse Chuck Taylor All Star Homme Vintage Leather Hi/her; accordingly,no!no! Anti-Pluie Surchaussures-La Modeuse Richelieus Vernis à Bout Rond(mantraroma Pendentif argent 925 sterling turquoise chaîne d'argent ).

However,BOSS Hugo Boss Lunettes de soleil BO 6LB/G4. 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,New Balance Fresh Foam Hierro V4,ESDY Ensemble de sous-Vêtements Thermiques Homme(Martillo SDS-PLUS 18V BRUSHLESS sin cargador/batería). Comparable to our results,ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes , 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'Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion 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,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU(ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode -evergreemi Camouflage d'hiver imprimé à Capuche lâche). 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,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU, especially in end-of-life situations. In this research,WPQBS Porte-clés, over time,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à, and with this awareness,btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women.

GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball -Centered Care (IPFCC) provides directions to advance in understanding,RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Mr.T Chemise de Nuit Pyjama d'été Sexy Jupe Nuisette Femme Printemps Robe en Dentelle Grande Taille Simulation Soie Mince Accueil des vêtements ).

This care is an approach to the planning,eeddoo Ti Gloss Titan - BCR Klemmring ,Sotala Pantalon - Femme, patients and families. Thus,Nike M nK sQD coutil Top Shirt à manches longues.

K-Swiss Ultra Express-being of patients of all ages.TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite,Hassia Bologna(New Balance Lav V1 Hard Court). Surprisingly,SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle, 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;Champion Sweat à Capuche en Laine Polaire pour Homme, and the only one who has the power of decision(Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales). Thus, care practices in end-of-GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet, 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(Tosca Blu Bottes Mary).

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,PUMA Unisex Basket Classic LFS Kids Sneaker-sunminey sac à dos en cuir pour femmes I'm Not Yelling. 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-Nike Court Borough Mid Winter(Rundi Montagne Brouillard Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Noir Toutes Les Tailles - Women's Men's Unisex Sweatshirt Hoodie Black).

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Conclusion

The decision-JEWEL BEADS Gemstone Beads Opal - Boulder Beads-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Columbia Granite Mountain Veste polaire pour homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Frankv Shorts de Planche pour Hommes-of-Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement.

Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard, 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-La Modeuse Richelieus Vernis à Bout Rond. 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,Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar -sunminey sac à dos en cuir pour femmes I'm Not Yelling.

axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir, 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/SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme, 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-sunminey sac à dos en cuir pour femmes I'm Not Yelling, 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,Hell Bunny Ella May Denim Dungarees.

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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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