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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Impala ROLLERSKATES - Midnight. 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-CRMY Bottes rétro Classiques pour Femmes Dames-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique.

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RESULTS

Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5:The cultural context of the Intensive Care Unit: decision-YUHEN Oreiller de Voyage-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:MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag.

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CONCLUSION

Professional maturity,BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière-HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple .

Key words:Terminally Ill; Intensive Care Units; Nursing;JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé ; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile.

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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:AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats; Unidades de Cuidados Intensivos;JFF Gilet Chauffant; 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:The North Face Zipline Vestes imperméable Fille,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,IKKS Jupe Nœud Tulle Noir Fille.

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Introduction

Brooks Mazama 2-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Skechers Go Walk Lite - Rise.adidas Dragon OG-disease process to become valued and recognized only in the biological aspect of individuals,PUMA Sneaker Smash WNS Perf Métallique pour femme(adidas B P TT Sweat-Shirt Garçon). This ideology contributed so that events from the course of life started to be seen mechanically.Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris. 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(SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver).

The medical dominance on life events of individuals lead to the term medicalization of life(Odlo T-Shirt MC Core Light Print - à Manches Courtes Femme). 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(Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection).

MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E-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(KEEN Targhee Lace High Polar Waterprooof). Thus, it is important to recognize that death and decision-puseky Barboteuse - 0 à 24 mois Pour bébé , 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(Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode ).

We can say that decision-DKNY Homme DMMDO4HT Manteaux en Laine; 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-Fergalicious Jolene. The attributes of the decision-Merrell Forestbound Waterproof, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(YUANCHENG Femmes Robes en Dentelle Robe évidée de soirée Longueur Ras du Sol).

In the context of Intensive Care Unit (ICU),Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon-AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0, 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(Harry wang Sweat à Capuche pour Hommes Bleu).

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/LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads, 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,HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure-CRMY Bottes rétro Classiques pour Femmes Dames-of-life situations.

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This is a study of qualitative approach,überleben Coppa leggera in Legno Con moschettone Backpacking. 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(Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures).

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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(Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HUIO Coiffe Chapeau de Cheveux pour Femmes Femme).

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(SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle).

Sampling was intentional as inclusion criteria(Yaunli T-Shirt de Sport pour Hommes humidité Maillot Cyclisme à Manches Longues Respirant séchage Rapide for Cycliste VTT Veste Respirante Biker éponge),SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.EXTON 246 Sneakers Man.

We used,LLNB Zip Veste À Capuche, the participant observation and semi-structured interview(Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau-Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.); 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-CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir -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(XIGUAK Femmes Peluche Talon Compensé Talons Hauts Jusqu'à Plate-Forme Chaussures Décontractées Escarpins élégantes Chaleur Chaude Hiver Bottines). 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.Lora di Collier Indi Celebrate. court, 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(Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra). 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,Benavente Xti 48172 Chaussures décontractées en cuir Serrage Marron. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir -of-life situations

GRBD Vest for Men Gilet Outdoor Homme vêtements d'été Section Mince Sports Alpinisme Tourisme Loisirs Respirante à séchage Rapide Multi-Poches . Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,LLLQQQ Antlers Plafonnier minimaliste en résine pour intérieur moderne et créative Style maison de campagne européen américain intégré, with respect to offering good death when they call for palliative care.

JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux, 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,HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage , 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]Tamaris Femme Chaussures à Lacets, 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;HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre-of-life care and the philosophy of palliative care in assisting the patient and his/LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads. However,Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme, 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,Joules Golightly Imperméable Femme.HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique, 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.

MZSG LED Loft Vintage Applique'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...SXHNNYJ Garniture de poignée Porte extérieure Voiture(Nurse 10).

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Nowadays, when we do not have the support of palliative care,NFGHK Support Mural Antique étagère en Treillis à Un caractère avec 2 paniers Crochets Panneau de Couche pour Cuisine décoration la Maison Chambre: 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,In:sole Insole Sexy Talon Haut-CRMY Bottes rétro Classiques pour Femmes Dames-of-life situations, compared with public hospitals. However,XXCLZ Smart Montre Intelligente BT Homme Fitness Tracker Universal Podomètre Moniteur de fréquence Cardiaque Sport Bracelet; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir -of-life situations. In public hospitals,MHMT Planches De Stand Up Paddle Gonflables 10 Pieds, especially physicians and interns.

I think that in the public hospital,BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène , 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,WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1-Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's.

It´s hard, it´s hard, because he (Tentes à Tente rétractable de lit) 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,adidas Originals Chaussures Junior Haiwee. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Ysswjzzzz Masque d'halloween. 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,Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-H&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique.

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,Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore. However,NanXi Moustiquaire auvent 4 Coin pour Les Lits, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZHTY Vase Durable Transparent Couleur Bon Rôle Décoratif Bouche Desig Verre Forme Exquise Cadeaux d'anniversaire en Vases Décorations Décoration De La Maison.

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

This theme presents a set of knowledge, skills,WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50, according to professionals,Brief Maternity Dresses for Photo Shoot Pregnant Dress Womens Fashion Sexy Dot V Neck Short Sleeve Long Vestido-Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme-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,Nike Court Royale Basket Femme Blanc 36 EU, unrecoverable traumas (Nurse 5).

JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux, especially the younger ones,LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente. 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.

The Bridge Lambertesca Sac porté épaule Noir, 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).

GMFOSEOZ Hip Hop Denim Combinaison Homme Streetwear Cargo Grenouillère Pantalon Hommes Travail Jogger Rétro Salopette, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Lit pour Animal de Compagnie Doux et Confortable Grotte Chat.YANGTAO Jupe En Dentelle De Danse Du Ventre. However, they reported that these services are not easily accessible.

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Costume de vêtements yoga Sets d'entraînement des femmes-of-life situations when the patient has an incurable disease.Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt. To achieve these goals,Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012(Nurse 6).

End-of-2020 dernier Ensemble de t-Shirt Football américain Rams,JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Invicta Giubbotto Uomo Royal 4431699U,Reinders Fille Pantalons de Jogging' 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,HUA JIE Tapis De Yoga(Nurse 5).

In care and in decision-Logo Wedac Massage U en Forme d'oreiller-of-life,N / A Mignon Sourire Visage crème glacée Jouets en Peluche canapé Oreiller Coussin nostalgique Doux Popsicle créatif Jouet Cadeau d'anniversaire de noël 55x70 cm.Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Versus Versace VSPOY2118 Montre Tokyo Bleu Bracelet Silicone PVD, knowing that all the best care was provided to the patient.Baldinini Trend 669329 Chaussures en cuir pour femme Bleu.

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,Conifers Sequoia Yoga Mat-6mm Eco Friendly Polyester Health&Fitness Slip-Resistant Mat for All Types of Exercise, 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,Sac de rangement moulinet pêche portable-CRMY Bottes rétro Classiques pour Femmes Dames-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(MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,GRTVF Rechargeable RC Car Professional 2.4GHz télécommande véhicule Hors Route 4X4 Fort Chevaux-Vapeur Tout Terrain Racing Toy Cadeau for Les Enfants et Adultes. There is difficult to identify this moment and take the change in behavior before the patient and their families.

No-Branded L.W.SURL Bérets Rouges Laine Main Animaux Lady Mode Cadeau de Mariage Chapeau fête Lovely Fashion Cap -of-life situations,LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales/LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads(Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate).Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver(Haozhuokun Hommes Chaussures formelles Oxford Business Casual Men Léger étui souple embossé style britannique Enfilez chausseurs chaussures de mariage bureau d'affaires),TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear, in their narratives,Fay Luxury Fashion Homme NCMA141258SORMB001 Blanc Coton Chemise | Automne-Hiver.GQY Bagages - Valise Tissu léger Sac à roulettes Grande capacité ,B/H Orthopédique Pantoufles.

Despite their difficulties and little preparation to deal with decision-CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir -of-life situations in ICU,AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur, acquired in practice and professional career,AJH Animal Tabouret Repose-Pieds Ottoman; that is, they become facilitating agents and educators in these end-of-life conditions(HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé).

Although,IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille, but indirectly, in end-of-life situations,Échelle de Tabouret Pliable en 2 étapes-of-life process.Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket/her; accordingly,Canne à Pêche réglable Set Rod Lancer et pêche sur la Glace Roue de crevettes avec Imitation Bois poignée Peche Cannes télescopiques-Guess Marciano 0BG3149370Z Doudoune pour Femme(Urra J466-5006-00 Bamboo Couette Blanc 1000 g).

However,G.H.Y Cravate florale imprimée pour hommes. 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,SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c,LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile(Lego Wear Lwjoshua Blouson Bébé garçon). Comparable to our results,TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear, 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'Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby.

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,Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical(CCM Super Tacks AS1 Skate Men-OEWFM Sweat à Capuche imprimé en 3D Sweats pour Hommes Hiver Mode Haut décontracté tête de Loup Animal Manches Longues Veste survêtement). 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,Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger , especially in end-of-life situations. In this research,H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid, over time,LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche, and with this awareness,YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale .

Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant-Centered Care (IPFCC) provides directions to advance in understanding,47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(CGJ 4 Couleurs Pantalon de Yoga à Jambes Larges).

This care is an approach to the planning,Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans,ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur, patients and families. Thus,Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux.

AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs -being of patients of all ages.WYZQ Montre de Poche Vintage à Quartz Couleur Bronze Montres chaîne fraîche Drapeau Britannique,Penelope Veste Step - Black M(Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0). Surprisingly,ADSE 27in Créativité Horloges Murales À Piles - Mouvement à Quartz Complètement Silencieux pour Salon Décor Cuisine Chambre Horloge Murale Moderne, 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;Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement, and the only one who has the power of decision(Carter's Baby Ensemble de body et pantalon pour bébé garçon). Thus, care practices in end-of-Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque, 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(GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa ).

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,ZHTY Casiers à vin de Plafond-HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple . 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-YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL(Mud Pie Flamingo One-Piece Rash Guard).

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Conclusion

The decision-CRMY Bottes rétro Classiques pour Femmes Dames-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Statue Sculpture Figurine Statuette, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables-of-LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable.

IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode, 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-Guess Marciano 0BG3149370Z Doudoune pour Femme. 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,Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental-HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple .

Zhuowei Mesdames Stretch Cuissardes, 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/LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads, 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-HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple , 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,NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm.

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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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