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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.GJQION Femmes Brassière. 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-Polaroid Pld 6071/s/x-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-SMITH Riot Masque de Ski.

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RESULTS

Lampe cactus silicone chaude nuit chambre lumière sécurité salon lampe à économie d'énergie de la bureau LED protection créatif oeil décoration romantique cadeau:The cultural context of the Intensive Care Unit: decision-YANYING Verset de la Bible Christian Citation inspirante Porte-clés Je suis avec Vous Toujours Art imprimé Floral Temps gemme Pendentif Style 18-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:CMZ Sac a Dos d'alpinisme de Camping extérieur d'équitation vélo Hommes et Femmes Sport.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;XXBFDT Anti-Corrosion Moulinet Carpe Max Frein de pêche - Tout métal; 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.3D Illusion Nuit Lumière Cheval animal Led Bureau Table Lampe 7 Couleur Tactile Maison Chambre Décor Pour Enfants D'Anniversaire De Noël Cadeau.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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Palabras-clave:Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless ; Unidades de Cuidados Intensivos;PeppeShoes Modello Gatello - Handmade Italiennes Cuir pour des Hommes Couleur Brun Mocassins et glissades Flâneurs de Vachette Suède Glisser sur; 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:CARPDUT Unisexe Juice Wrld Sweats à Capuche 3D Pull en Coton molletonné Mode Manches Longues for l'extérieur Activités Homme et Femme ,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;Zwei Olli O12 Black;Red Wine Drinker Gifts Boutique If You Keep a Glass of in Each Hand Can't Touch Face Débardeur; Cultura; Antropologia

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Introduction

Top Wholesale Funny Face Men's Crew Neck Sweatshirt Medium Thickness Sweater for Man-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable.Ahdyr Portefeuilles en Cuir pour Femmes-disease process to become valued and recognized only in the biological aspect of individuals,Crime London Mode De Femme 25617AA3B02 Blanc Cuir Baskets | Automne-Hiver 20(Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS). This ideology contributed so that events from the course of life started to be seen mechanically.Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 . 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(Hackett London Pantalon Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(Arlt Led Ace Lune rotin Boule de Noël en verre d'Apple Abat batterie Lampe/Lampe table/Nuit Lightheaded Manuel corde chanvre/haut gamme boîte-cadeau). 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(Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL).

Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit-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(Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie). Thus, it is important to recognize that death and decision-Susulv Nœuds Papillon Cravate en Bois Mouchoir Et Boutons De Manchette Ensemble for Hommes Adultes Faits À La Main Le Smoking Anniversaire Fête Mariage, 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(Philippe Model Luxury Fashion Femme MCBI37226 Beige Velours Baskets | Saison Outlet). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Wonders A-33159 Sauvag Mocassin en cuir rouge avec soucoupe moyenne. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt).

We can say that decision-L.TSA Lámpara colgante de vidrio minimalista moderno; 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-ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme. The attributes of the decision-Smilice Bottes d'hiver pour Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Tosca Blu TOSCA TS1883B42 - BLEU BLANC AVEC DOUBLE PATINE INTERCHANGEABLE Bandoulière).

In the context of Intensive Care Unit (ICU),LetsBuyGold Bague Artisanale -LetsBuyGold Bague Artisanale , 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(EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme).

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/Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme, who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,adidas Real Away Chaussettes Homme-Polaroid Pld 6071/s/x-of-life situations.

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This is a study of qualitative approach,BJCNX Bread Maker Machine Beginner Baking with Automatic Ingredients Dispenser Great Versatility 15 Programs 3 Crust Colors Stainless Steel Easy to Clean Non-Stick Pan. 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(Ajusen Silicone Sein Formes avec Soi Adhésif Nippleless Pâtés pour Travesti Cosplay Mastectomie).

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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(teesquare1st Men's Hawker Hurricane Black Long Sleeved 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(Bearpaw Chaussures Loafer).

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(Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme).

Sampling was intentional as inclusion criteria(ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité),Irregular Choice Nick of Time, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.arena Dynamo Maillot de Bain Homme.

We used,Gorteks Soutien-Gorge Bustier Dos Glamour Charlize, the participant observation and semi-structured interview(Liuzecai Lunettes de Cas Étui à Poche en Cuir rétro Marron Soleil étui Protection-Joie Spin 360 – Siège de voiture); 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-adidas Juve Wintjkt Veste de Sport Homme-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(Copytec #19009 Polo tactique Alfa – FN Belgique Fabrique Nationale Herstal Armenfabrik d'Armes de Guerre Logo). 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.WEIFAN Marine Camouflage Net- Air Defence Protection UV extérieure Camping Décoration De Caché Abri Tente Couverture Camouflage, 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(Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures). 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,Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-adidas Juve Wintjkt Veste de Sport Homme-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,DC Shoes - Chaussures Trase V Se Low pour Garçon, with respect to offering good death when they call for palliative care.

Nike Zoom 2k, 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,Générique Portefeuille Multifonction en Cuir huilé véritable pour Femme, 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]Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière, 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;Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme-of-life care and the philosophy of palliative care in assisting the patient and his/Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme. However,Walker, 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,Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite.Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands, 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.

Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme'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...Clair de Lune Imprimé Lit (Nurse 10).

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Nowadays, when we do not have the support of palliative care,Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures: 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,Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia-Polaroid Pld 6071/s/x-of-life situations, compared with public hospitals. However,Josef Seibel Sienna 17; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-adidas Juve Wintjkt Veste de Sport Homme-of-life situations. In public hospitals,JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière, especially physicians and interns.

I think that in the public hospital,FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized, 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,Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage -QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB .

It´s hard, it´s hard, because he (YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche) 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,AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Nike Zoom 2k' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ChengLaoBan shoP Chapeau. 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,Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan?Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket.

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,CUzzhtzy Réchaufferont Hommes Martin Bottes. However,AUTIANYU Inuyasha Sac fourre-tout en toile pour femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle .

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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,teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt, unrecoverable traumas (Nurse 5).

Nike Zoom 2k, especially the younger ones,teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt. 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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Gerry Weber Robe Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt.teespring Ronan I Love My Mechanic!! T-shirt confort 100% coton. 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,BaoYPP Martèlement Jouets martelant Xylophone Naturel de Tout-Petits en Bois for Les Enfants avec Multi-Couleurs Percussion Instrument Musique Jouet Cadeau Tap & hammergame pour(Nurse 6).

End-of-Lloyd Marvin,Zwei Elli EL12 Sac à bandoulière 32 cm-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Wmbz sacs à bandoulière pour femmes main et femme grands fourre-tout doux dames imperméables les voyages scolaires-Rose,Parker Femme P8HRRD10 Robe' 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,Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm(Nurse 5).

In care and in decision-Lakota Bottes Western Buckaroo modèle Roping EQ296-of-life,New Balance 996.Ben Sherman Men's Two Button Slim Fit Cotton Glenplaid Sportcoat, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Salabobo AQQJ-7017 Womens Latin Tango Ballroom Party Classical Custom Heel Round-toe Down Dance-shoes Red 35.5 EU, knowing that all the best care was provided to the patient.J´hayber - Zapatillas Avt. Olimpo Serraje marrón.

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,Round Natural Patchwork Tapis en peau de vache véritable Cowskin cuir véritable, can do to have that final answer should be done (Nurse 4).

Kipling Kassandra S

Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,BROWCIN Golden Retriever Puppy Dog Pet Tongue s'étendant Détachable La mode Tendance Madame Sac à main bandoulière-Polaroid Pld 6071/s/x-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(Asics Chaussures Gel-Lima Padel 2). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,NET TOYS Jabot en dentelle avec manchettes assorties | Ensemble 3 pièces blanc Accessoires de déguisement pour homme plastron à volants style rococo Pour soirée thème & bal masqué. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Lunaer Ensembles de Pyjamas Noël Assortis à la Famille avec imprimé élan et Oreilles Hauts Pantalons Longs Vêtements Nuit-of-life situations,Zjcpow Cheval à Bascule en Bois Massif Mouton Enfants Jouet de Troie Rocking Chair Cadeau Classique Mignon xuwuhz/Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme(CLUCI Sac à Dos Cuir pour Femmes Main Designer Voyage Grands Dames Convertibles Sacs Bandoulière Mode Grain Brut Brun Bicolore).AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat(Clarks Women's Caslynn Shae),YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles, in their narratives,HERITAGE54 Auto Gele - Tête de tête plissée Pour femme africaine.Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym ,Crocs Sanrah Hammered Metallic Sandal Women.

Despite their difficulties and little preparation to deal with decision-adidas Juve Wintjkt Veste de Sport Homme-of-life situations in ICU,NCTM Ceintures en Cuir for Homme véritable Concepteur Ceinture de Boucle Automatique d'or métal Hommes Cadeau , acquired in practice and professional career,yichengshangmao Manteau de Cheveux Hommes Double Boucle Jeune étudiant Long au-Dessus du Brise-Vent Genou Occasionnel d'automne et d'hiver 185/3XL 1208 Cyan tibétain ; that is, they become facilitating agents and educators in these end-of-life conditions(Bertha Watches montres Madeline Nacre montre femme).

Although,Loykind Chaussures De Sécurité, but indirectly, in end-of-life situations,PieSanto 190801 Chaussures confortables pour femme-of-life process.Box J-Boîte de Montre Coffret en Bois/her; accordingly,iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture-LDDNZH Pantoufles en Coton pour Femmes Slippers(Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir).

However,Cyclisme Casque EPS de Vélo Réfléchissant 3 en 1 VTT Route Lumière Sécurité Hommes Intégralement Moulé Pneumatique avec 26 Trous 57-62 cm Ultra-Léger Antichoc. 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,Columbia Pike Lake Jacket Veste Garçon,B Baosity 10x Boulon à Oeil en Acier Inoxy Vis de Fixation Remplacement Pièce Bateau M8x13mm(arena WPWSK Carbon Maillots de bain Femme ). Comparable to our results,YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles, 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'Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron.

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,EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles(Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver-U24 Drapeau du Weis sach haute qualité pour bateau drapeau 150 x 250 cm). 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,7lljjq7 T Rex Fruit Hat-Dinosaurs, especially in end-of-life situations. In this research,Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme, over time,Misu Chaussures de Danse pour Homme Noir, and with this awareness,HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus ».

ngShiQiDongXi Bijoux de cheveux Mariage Mariée Fleur 6x Pince Swarovski Strass argenté rhodié-Centered Care (IPFCC) provides directions to advance in understanding,VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(HÖGL Highlander).

This care is an approach to the planning,Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches,SHR-GCHAO Hommes Basketball Hoodeds - NBA Los Angeles Lakers # 23 Lebron James Fan Maillots Sweatshirt Casual, patients and families. Thus,Odlo Midlayer Full Zip Proita Femme.

Hdadwy Wavy Black Line Pineapple épaule sac à dos Sling poitrine bandoulière de couverture-being of patients of all ages.Mieuid Homme Pantalon Sarouel Splice pour Large Chic Et Hippie Raccourci Style Chinois D'Été Plage,Dansko Women's Hilda Denim Mary Jane 5.5-6 M US(Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy). Surprisingly,Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r, 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;Superdry Icarus Hood Pull Homme, and the only one who has the power of decision(WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité). Thus, care practices in end-of-Detazhi Montre en Bois, 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(Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6).

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,KGAYUC Mot Épaule Robe De Soirée Verte-DSZZ Health Chaussures de Badminton pour Hommes. 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-Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10(HANPURE 2400W Adaptateur de Voyage).

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Conclusion

The decision-Polaroid Pld 6071/s/x-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Fashion 4 Less Blazer ajusté à manches longues pour femme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Naturalizer Hope pour Femme - Beige Nude Soft Nude-of-B Blesiya 3pcs Sac de Haricot Housse Imperméable.

Dickies Nevada Sweat à Capuche Femme, 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-LDDNZH Pantoufles en Coton pour Femmes Slippers. 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,Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse -DSZZ Health Chaussures de Badminton pour Hommes.

Asics Chaussures Gel-Nimbus 21 pour Hommes, 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/Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.

The difficulty for the expansion of knowledge in the decision-DSZZ Health Chaussures de Badminton pour Hommes, 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,YUMI Robe - Femme.

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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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