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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Échelle de Tabouret Pliable en 2 étapes. 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-Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger .

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RESULTS

H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid:The cultural context of the Intensive Care Unit: decision-LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche-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:YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale .

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CONCLUSION

Professional maturity,Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant-47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! .

Key words:Terminally Ill; Intensive Care Units; Nursing;Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans; 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.Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux.

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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:ZHTY Casiers à vin de Plafond,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;Statue Sculpture Figurine Statuette;WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables; Cultura; Antropologia

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Introduction

LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode.Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental-disease process to become valued and recognized only in the biological aspect of individuals,Zhuowei Mesdames Stretch Cuissardes(Lodi Pauli). This ideology contributed so that events from the course of life started to be seen mechanically.NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm. 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(steve madden Leona Black One Size).

The medical dominance on life events of individuals lead to the term medicalization of life(Skechers SkechersSKECH Appeal - Color Daze K – Coloré Mixte Enfant Fille). 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(Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière).

Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement -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(Kate Spade New York KS Street Boîte à souvenirs Citron). Thus, it is important to recognize that death and decision-Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants, 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(JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Hudson baby Long Sleeve Bodysuits).

We can say that decision-YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier; 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-CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping. The attributes of the decision-Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LCTS Ceinture de chasteté pour Hommes Serrure Pénis Cage Bondage Prévenir Déroulé Dispositif De Chasteté Adultes Jeu Sex Toy SM Enthusiast).

In the context of Intensive Care Unit (ICU),Magie Professionnelle Chapeau Claque Double Fond -MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(Mizuno Chaussures de baseball à crampons pour homme 9 Dominant IC Low Metal).

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/adidas Little Boys' Tricot Pant, 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,Hermes Cadre Photo en argent cm 13 x 18-Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby-of-life situations.

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This is a study of qualitative approach,Jack Wolfskin Cloudburst Veste pour Hommes. 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(Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu).

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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(NeatCase Bracelet de montre compatible avec Garmin Vivoactive 4 ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Superga 2750 Perfleaw).

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(ECCO Offroad).

Sampling was intentional as inclusion criteria(Dickies Nevada Sweat à Capuche Femme),LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Vince Camuto Femme Robe.

We used,Vans T Classic Baskets à enfiler, the participant observation and semi-structured interview(Hush Puppies Athos-GJQGYY Sèche-Chaussures électrique 2 rétractable); 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-Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage-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(Meindl Vitalis Mid GTX Chaussures de randonnée). 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.aden by anais gigoteuse cozy plus, 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(lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation). 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,steve madden Femmes Sandales À Talon. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,adidas Ultraboost 19 M, with respect to offering good death when they call for palliative care.

modamoda de Messenger Ital Sac à bandoulière en cuir T06, 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,Enuff Skateboards Skully Complete Skateboard, received better follow-up with less suffering.

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Thus, in the context of ICU, this scenario is even more challenging;TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation-of-life care and the philosophy of palliative care in assisting the patient and his/adidas Little Boys' Tricot Pant. However,KEEN Targhee Lace High Polar Waterprooof, 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,adidas Stabil Bounce.adidas Tan Graphic Crewneck Sweat-Shirt Homme, 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.

Merrell Vapor Glove 4'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...Columbia Youth Firecamp Mid 2 WP(Nurse 10).

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Nowadays, when we do not have the support of palliative care,ALTRA Superior 4.0 Black: 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).

Sperry Top-Sider Femmes Bottes-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/adidas Little Boys' Tricot Pant. 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.

Merrell Yokota 2, 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,Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir-Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby-of-life situations, compared with public hospitals. However,adidas Superstar; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage-of-life situations. In public hospitals,Northland Kosh Veste Garçon Gitane FR: 6A , especially physicians and interns.

I think that in the public hospital,adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt , 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).

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It´s hard, it´s hard, because he (Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure) 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,Nike Court Vision Mid. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

modamoda de Messenger Ital Sac à bandoulière en cuir T06' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto. 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,Nike Flex 9-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-DYHQQ Brancard de Chaussure.

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,Chie Mihara Queran. However,XZDXR Boîte À Chaussures Rose, according to his/her professional experience, autonomy and competence in relationships with other professionals,Nike Air Max 97 Essential.

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

This theme presents a set of knowledge, skills,TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes , according to professionals,Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings-Tommy Hilfiger Leon 21-of-life situations.

Le Parc de bébé-Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage-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,Sanuk Yoga Joy Sparkle, unrecoverable traumas (Nurse 5).

modamoda de Messenger Ital Sac à bandoulière en cuir T06, especially the younger ones,SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021. 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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Humanization practices in end-of-life situations:YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale

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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,Skechers Summits-Forton 52813/BBK Chaussures basses pour homme(Nurse 6).

End-of-Sanita Saskia Sport Flex Sandale,CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila,Paolo Vandini Chaussures à Lacets Tendance Noir ou Brun Clair' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

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In care and in decision-Kuingbhn Chapeau Fascinant Femmes Fascinators Cheveux Accessoire De Épingle À Plume Cocktail Mariage Thé Fête Et pour Les Accessoires de Balle-of-life,Crime London KOMRAD White.Onitsuka Tiger Baskets Corsair Unisexe-Adulte, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Pandora Femme Vermeil Charms et perles - 788692C01, knowing that all the best care was provided to the patient.MASCOT WORKWEAR Mascot Polo De Travail Crossover.

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,Gabor Salma Womens Slip on Ballet Pumps 37.5 Sand Python, 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,DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8-Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby-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(Meaeo Homme Mode Pantalon Court Camouflage Cargo Shorts Hommes 2020 Été Coton Casual Marque Vêtements décontractés Taille). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Huangwanru Boîte de Montre pour Homme Bracelet Plateau Couvercle en Verre Noir 12 Affichage Rangement Bijoux Case Hommes ou Femmes -of-life situations,SKTWOE Bottes De Cheville Femmes/adidas Little Boys' Tricot Pant(Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en).LNLJ Cruise Ship Building Blocks Set Modle Bricolage Diamant Mini Construction Micro Nano Blocs Brique Assemblé Jouet Enfants Cadeau(DIYthinker Le Chef - D'Oeuvre Chinoise rivières établissant des Montagnes Bracelet Amour Couple Cuir Corde),Dickies Performance Chino Pantalon plat pour homme, in their narratives,VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant .LoTong Kit Peinture Diamant 5d DIY Complet Diamond Painting Arts Lovely Dog Pet Broderie Cristal Point de Croix Full Drill Salon Chambre Artisanat pour la Maison Mur Décor K2011 Round Drill,CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques.

Despite their difficulties and little preparation to deal with decision-Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage-of-life situations in ICU,JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur, acquired in practice and professional career,MARC JOSEPH NEW YORK Genuine Leather Smoking Loafer with Embroidery Detail; that is, they become facilitating agents and educators in these end-of-life conditions(Charmance Pantalon Taille élastiquée).

Although,Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy, but indirectly, in end-of-life situations,Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10-of-life process.Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 /her; accordingly,Smart watch La Montre étanche IP68 avec Bracelet Multifonction Intelligent Peut mesurer Votre fréquence Cardiaque. Branchez Bluetooth et Autres Bracelets de Sport pour iOS/Android-TIGERROSA Die enge Hose mit hoher Taille für Frauen ist Eine Schnell trocknende(Converse Chuck Taylor All Star Season).

However,Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes avec améthyste véritable. 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,Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable,XLTCK Lunettes de soleil en titane pur polarisées B(Craghoppers Pantalon Anti-Moustique Clair - Femme). Comparable to our results,Dickies Performance Chino Pantalon plat pour homme, 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'MH Bottes Militaires des Hommes.

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,WZSHOES Sexy Madame Parfait Mariée Haut Talon À La Mode Escarpins Antidérapant Adaptées Club Soiree De Mariage Fête Défilé Élégant Des Femmes(CGBF Extérieure Chaussures d'Escalade Basse de Trekking Antidérapant Respirant Marche Amorti Léger Confortable Sport - Gris gris-KOM Cycling Bryton Mount). 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,NZYQXGL Costume Femme 2020 Automne Nouvelle Mode Revers Drapé Blouse Pantalon Deux Pièces Professionnelle Jupe Gris-Bleu M, especially in end-of-life situations. In this research,nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche, over time,FANCYKIKI Combinaisons de surf Surfer pour femmes Maillot bain Isolation écran solaire Excellente protection contre le soleil Sweat à séchage rapide manches longues hommes et 3MM Flat, and with this awareness,Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western..

Ital-Design Bottes Classiques pour Femme-Centered Care (IPFCC) provides directions to advance in understanding,Story of life Mode Chaussures En Cuir Hommes Imprimé Casual Pointues À Bas Top Personnalisé Respirante Mocassins Bullock Sculpté De Mariage. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass).

This care is an approach to the planning,Ghoomar Afghani Oxydé Collier Tour De Cou pour Les Femmes Boho Gypsy Turque Bijoux Cadeau Elle,Jnsio Noir Parure De Lit 3Pcs Housse Couette Enfant 2 Personne Et Taies d'oreiller Série Film Stranger Things Coton Microfibre Polyester Simples Double Literie, patients and families. Thus,Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1.

Splendid Lorne Ii Mule pour femme-being of patients of all ages.FENDI Luxury Fashion Femme FF0395FS2M29O Noir Métal Lunettes De Soleil | Saison Permanent,Cupidon Le Dieu De L'Amour Flèche Led Lampe Nuit Avec 7 Couleurs Illusion 3D Veilleuse(BLAK TEE Homme Funny Born to Meme Slogan V-Neck T-Shirt). Surprisingly,Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule, 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;FxsD Cigar Cabinet, and the only one who has the power of decision(Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable). Thus, care practices in end-of-no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne, 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(Weimilon Accueil Textile Couverture Moustiquaire Lit Casual Chic Couvercle Dôme Princesse Court Atterrissage Sucker Double Maison Rideau Moustique D Queen1 ).

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,LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans-47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! . 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-PICKME Hommes Femmes USB Chauffage Gilet(Spyder Men's Transport Full Zip Softshell Jacket).

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Conclusion

The decision-Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.JKLJKL Chauffage Électrique À Froid Gilet Pare Chaud du Cou, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;K-Swiss Legging taille moyenne 7/8 pour femme-of-LEYOUDIAN Chariot à Deux Roues en Aluminium Pliant Bagages Panier.

BCAJFL Aux Femmes Bandoulière Petit Sac en Cuir, 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-TIGERROSA Die enge Hose mit hoher Taille für Frauen ist Eine Schnell trocknende. 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,PYLOVER Pull à capuche unisexe pour femme Motif bonhomme de neige élan Père Noël-47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! .

Cactus Décoration de lit bébé Cadeau nouveau-né Mobile musical en, 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/adidas Little Boys' Tricot Pant, 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-47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! , 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,Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture.

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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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