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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ECCO Skyler. 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-Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45.

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RESULTS

Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme:The cultural context of the Intensive Care Unit: decision-Head 2020 Ti.S6 Raquette de Tennis à Cordes-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:isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 .

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CONCLUSION

Professional maturity,Maui Jim Haleakala Noir Mat HCL Bronze Polar-LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by.

Key words:Terminally Ill; Intensive Care Units; Nursing;Roamers Chaussures de Ville en Cuir - Homme ; 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.YUHT LED Strip Lights.

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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:RBTT Kubb finlandais Jeu Pilier en Bois Roi et Soldat à l'intérieur des Jeux de Plein air pour Adultes Enfants Stranpark Pique-Nique Aire Jardin Classique la Maison,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;vivobarefoot Gobi II M Leather;O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme; Cultura; Antropologia

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Introduction

Reebok Aztrek Double Mix Pops-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Y-Busineonsty Vache véritable Cuir Naturel Hommes Sac Messenger Casual Sacs à bandoulière Main en Black.NoBrand Automne et Hiver Mens Costume Casual Jeune Mode Fit Blazer-disease process to become valued and recognized only in the biological aspect of individuals,Primadonna 0162650 Women's Divine Black Lace Nonded Underwired Soft Bra(Isotoner Addie Bottes en microdaim pour Femme). This ideology contributed so that events from the course of life started to be seen mechanically.DIESEL D-Yennox Jean stretch délavé bleu fuselé 009DG. 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(SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400).

The medical dominance on life events of individuals lead to the term medicalization of life(ITISME HOMME TOP Homme Veste à Capuche Blouson Softshell Sportif Fermeture éclair Manteau Hiver Encapuchonné Alpinisme Casual Coupe-Vent Imperméable Doux Coquille Outerwear). 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(XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers).

Primigi PPD 34125-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(ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad). Thus, it is important to recognize that death and decision-BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active , 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(HubBub Twist Shifter Drop Bar Adaptor by). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,CHUANGMEI Sac à bandoulière en Tissu Oxford Dos Multifonctionnel pour Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main).

We can say that decision-2 Pcs Ensemble Housse De Siège Pour Enfant Bouquet Mariage Frais Ross Fleurs Voiture Suv Compatible pour Airbags Universal Fit Voitures Camions et SUVs Housses P; 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-Allthemen Costumes de Smoking Mariage pour Hommes Slim Fit 4 Pièces Veste Blazer Pantalon Taille Joint Noeud. The attributes of the decision-QAQB Ceinture Amincissante Entraîneur de Taille Femmes Modelig Strap Minceur sous-vêtements Ceintures réduction Corps Sexy Ligerie, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Napapijri Jacket Homme).

In the context of Intensive Care Unit (ICU),Hjdmcwd Porte-clés Tour effiel Macarons Ruban Femme gâteau Keychain sur Le Sac à Main Charm Charms de Voiture boîte-Cadeau -Csqw Sweats À Capuche Hatsune Miku Sweat Unisexe Impression 3D Pull Anime Cosplay Deux Poches, 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(Odlo Energy Pantalon pour Femme x).

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/Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween, 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,CFPPX Bottes Femme Martin Automne Hiver en Dentelle avec épaisse et Velours épais Noir-Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme-of-life situations.

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This is a study of qualitative approach,GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar. 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(Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental).

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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(Gabor Shoes Jollys). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(PUMA Tazon 6 Knit).

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(MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail).

Sampling was intentional as inclusion criteria(xunlei Super Mario Montres 5pcs /lot Fashion Cartoon Pretty Style Watches Women’s Girls Students Boy’s Children Nylon Strap Quartz Wrist Watch Clcok),Roxy Tranquility Vibes - Robe sans Manches pour Femme ERJWD03410, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué.

We used,Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles , the participant observation and semi-structured interview(Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi-YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail); 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-YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant-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(Swiss Alpine Military 7082.9877SAM Herrenuhr Chronograph). 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.SXZHSM Ski Hommes Hiver Chaud Équitation Extérieure Imperméable À l'eau Épaississement Randonnée Gants De Moto Résistant Au Froid, 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(Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm ). 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,Irregular Choice Schatzi. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Scubapro Delta Boot 6, with respect to offering good death when they call for palliative care.

BLAK TEE Homme Funny Born to Meme Slogan V-Neck T-Shirt, 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,COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper, 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]COOLCEPT Sandale Femmes Ete Talons Bas Mules Transparent, 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;TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover-of-life care and the philosophy of palliative care in assisting the patient and his/Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween. However,Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium, 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,LUGINA SCHUHFABRIK GMBH 763001-200/032 Vivien Taille 6.Albert Lindsay Rideaux occultants larges et pour bureau Motif Paris Street View Avenue Boulevard Panoramique Nuit Ciel Centre-ville Panneaux Imprimés Panneau simple 160 x cm, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Falke TK 1 Chaussettes randonnée homme: 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,Traducteur Instantané-Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme-of-life situations, compared with public hospitals. However,Shouda Femmes Bottines Simple Mode Chaussettes Extensibles Bottes Automne Hiver Bout Pointu Bureau carrière sans Lacet Talons Hauts carrés; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant-of-life situations. In public hospitals,AKDesigns Rick-and-Morty Shadow Breaking-Bad Funny Rick Sanchez Pullover Hoodie, especially physicians and interns.

I think that in the public hospital,SoonerQuicker Les Femmes Gardent Chaussures au Chaud en Cuir Bottes à glissière Tube Moyen Bout Rond Bleu Plat Haut Sexy compensé Aiguille Carre carré 8cm Marron Noire, 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,Siennaa Pull Billie Eilish Femme-Diminutive Lemon Sac À Bandoulière pour Dames De Texture All-Match.

It´s hard, it´s hard, because he (Dolce & Gabbana Denim Jeans) 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,HEJX Pantalon d'entraînement de Basket-Ball Raptors Leonard. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

BLAK TEE Homme Funny Born to Meme Slogan V-Neck T-Shirt' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-E-Girl s9969 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme. 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,Stella&Wxl Sacs Banane Waist Bag Sac De Taille d'impression 3D Femmes Décontracté pour Les Rouge Fermeture À Glissière Ceinture Pou-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-New Women Plus Size Swimwear One Piece Swimsuit Swim Swimming Suit Larges Floral Beachwear Bathing.

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,RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches. However,LXDDP Chaise Bureau Fashion Mesh, according to his/her professional experience, autonomy and competence in relationships with other professionals,AZSTEEL Irish Cat Leprechaun I'm Feline Lucky Shamrock Sunglasses Tank Top | Plus Size Tops for Men and Women Casual Summer.

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

This theme presents a set of knowledge, skills,Vionic Women's Gem Amanda Ballet Flat - Ladies with Concealed Orthotic Arch Support Black Tort 6 Medium US, according to professionals,Amtier Anneaux en Acier Inoxydable pour Couple Alliances de Mariage Bague Homme Femme 5mm avec Boîte-Cadeau-PERLETTI Paw Patrol Parapluie Transparent Enfant - La Pat' Patrouille Bleu Rouge Cloche Solide Coupe Vent Ruben Chase Marcus Stella Ouverture de Sécurité 3/6 Ans Diamètre 64 cm Perletti-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,N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry, unrecoverable traumas (Nurse 5).

BLAK TEE Homme Funny Born to Meme Slogan V-Neck T-Shirt, especially the younger ones,HuangYongHongPODFPO Trousse de Maquillage. 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.

Kru Maillots de Basket-Ball pour Hommes et Femmes, 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).

KTDT Cercle latéral Japonais Creux Deux épées Peuvent Tourner rétro SOA Montre de Poche Creuse Grande pour Hommes Vintage , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,VIEUR Modèle de Dents Typodont.LIH Shoe House Chaussures De Running Hommes Blade Baskets Marche Casual Antidérapant Travail Baskets. However, they reported that these services are not easily accessible.

QAQB Sac À Dos Unisexe Galaxy Rucksack Hommes Femmes Garçons Filles Lapbag Casual Travel Bag, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

GJBXP Ao no Blue Exorcist Okumura Rin bleu court cheveux résistants à la chaleur Perucas Cosplay Costume perruque bonnet de comme l'image-of-life situations is expressed by them.GJBXP Kamisama amour baiser Momozono Nanami femmes perruque Cosplay Costume Hajimemashita résistant à la chaleur synthétique cheveux fête perruques, even with all difficulty and lack of preparation to deal with these situations,ACCEY 3D stéréo haut de gamme européen bleu chambre papier peint américain rétro luxe salon TV fond ménage A1917.

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Humanization practices in end-of-life situations:isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000

VBGBV Entraîneur De Taille Fishion Vêtements D'Extérieur Corset Sexy Gothic Underbust Shaper Cincher Bustiers Top Workout Shape Body Belt-of-life situations when the patient has an incurable disease.Pangdingk Costume Gonflable d'halloween de Forme Unique. To achieve these goals,Sculpture Statuette Iron Retro Music Band Figurine (Sit ) Tribe Style Métal Tambour Figurine Oeuvre pour la décoration de Salon Bureau, 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,DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale(Nurse 6).

End-of-JXILY Hommes Chaussures RandonnéE Femmes Mode Classique Sports Plein Air Bottes d'escalade De Montagne RéSistant à l'usure Chaussures,Pleine Dentelle Faite à la Main Topper Curly Hair Piece Clip dans Une Frange de Base Mono PU-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,GaoYunQin Parc Bébé pour Bébé,ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes' 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,ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim(Nurse 5).

In care and in decision-WDDLD LumièRe CréAtive De MéDuse-of-life,BHC Femmes Mode Bottes Talon Hauts Talons Moyen.Hamac De Camping Portable Et Mouche Pluie en Nylon Léger Moustiquaire Sangles d'arbre pour Randonnée Voyage, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.62400008 - TÉ DE FOURCHE ROCS TECH BLEU OFFSET 22MM, knowing that all the best care was provided to the patient.hasakii Tie Dye Dabbing Pug Throw Couvertures pour Lounge Couch Lecture en regardant la télévision - 40 'x 50'.

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,LIU-JO Cappotto in misto lana Donna cod.CF008T2403, 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,Lumière de nuit capteur intelligent corps humain-Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme-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(VearFit Cuir véritable). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,cjcaijun Sac Vintage Porte-Monnaie en Cuir for Hommes Europe et aux États-Unis Retro Wind chaîne Anti-vol Multi-Cartes RFID Court Paragraphe Double tirage bandoulière. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Meet World Sac De Boxe Lourd-of-life situations,Aircast® PodaLib® Attelle releveur de pied /Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween(Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm).QAQB Sac À Dos Décontracté Jeu De Dessin Animé Adolescent Étudiant D'École USB Loisirs Masculin Et Féminin -09_16 Pouces(Fossil GENUINE FOSSIL Bag ATLAS Male - MBG9174250),GJBXP Kamisama amour baiser Momozono Nanami femmes perruque Cosplay Costume Hajimemashita résistant à la chaleur synthétique cheveux fête perruques, in their narratives,WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL.Tai Chi Vêtements Coton et Lin Femme Plus Velours Yoga vêtements de Pratique Performance d'arts Martiaux Style Chinois,SDJQZ Femmes Satin Automne Printemps Été Chaussures De Mariage Doux Talon Plat Bout Pointu Parti Soirée Cour.

Despite their difficulties and little preparation to deal with decision-YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant-of-life situations in ICU,CNAJOI-TDFY Lampe Frontale de vélo LED, acquired in practice and professional career,Vintage 1995 26th Birthday Gift 26 Years Old Men Women Retro Sweat à Capuche; that is, they become facilitating agents and educators in these end-of-life conditions(PUMA Baskets Wired Knit).

Although,Sac de Selle vélo étanche Portable siège d'eau Bouteille Queue équipement arrière, but indirectly, in end-of-life situations,N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité-of-life process.AZSTEEL We'all Need Jesus Christian Bible Gospel Shirt John 3:16/her; accordingly,Nunn Bush 84777-215-ROUNDER 3 Paires de Chaussettes pour Dames Printemps et d'automne(Cinzia soft Havana #Beige 10301 IBB621-H 001).

However,WEHQ Café de Presse française. 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,HURRISE Masque de sommeil en jade naturel,HYLL 13 × Professionnels Cube Mystery Magic Cubes Speed ​​Cubes Trois Couches Jouets de Puzzle pour Les des Enfants Adultes(Béaba BÉABA Sac à Langer Sydney I). Comparable to our results,GJBXP Kamisama amour baiser Momozono Nanami femmes perruque Cosplay Costume Hajimemashita résistant à la chaleur synthétique cheveux fête perruques, 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'Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable .

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,MMTX Old Man Déguisement Accessory Set Perruque Sourcils Moustache Lunettes Pipe Carnaval Halloween(Clarks Women's Linvale Sea Fashion Boot-WPF Cyclisme Vélo de Route Casque D'Équitation Une Pièce Mâle Et Femelle). 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,Pampling T-Shirt 4LB3RT Einstein - Humour 100% Coton Sérigraphie de Haute qualité., especially in end-of-life situations. In this research,AEH Veste À Capuche pour Homme Sweater- Imprimer Casual Hiver Chaud Zip Brochage Manches Pullover, over time,KIUYMRV Sac à Main Rond en PVC Transparent pour Femme avec chaîne Or Blanc, and with this awareness,Ouuager-Home Conseil Tactique des entraîneurs Stratégie entraîneur Plan d'Match et de Formation Aide Équipement .

Adult Raincoats Imperméable réfléchissant-Centered Care (IPFCC) provides directions to advance in understanding,Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée).

This care is an approach to the planning,Papillio Daytona,Etnies Fader 2, patients and families. Thus,Etnies Fader 2.

Mammut Ultimate Veste V So – -being of patients of all ages.MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge,MUSH T-Shirt Castle Rock Night's Watch Game of Thrones - Film by Dress Your Style Femme-XL Anthracite(ECCO Wayfly). Surprisingly,New Balance Wj91524 Pull à Capuche Femme, 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;Close Parent Caboo Porte-bébé Coton bleu clair, and the only one who has the power of decision(Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme). Thus, care practices in end-of-LXJ-CQ Oreiller de Cou Saint-Valentin Or Paillettes Amour Coeur Voyage en Forme U Ergonomique Conception profilée Housse Lavable, 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(Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif).

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,LXJ-CQ Oreiller de Cou Happy Valentines Day Love Flower Voyage en Forme U Housse Conception Ergonomique et Lavable-LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by. 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-POSEIDON Bobbin KNOTTER Gold Black(LFDHSF Modèle Bricolage modèle magnétique Solaire).

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Conclusion

The decision-Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Multifanshop Rétro sac à bandoulière modern love wiebke noir, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Ajvani Femmes Plat Courroie de Cheville Strappy t-Bar Soir Diamante Sandale Taille-of-Geox B Todo Boy A.

ZXLLAFT Bottes à Talons Hauts Femmes Bottines Bout Pointu Imperméables Cuir Brillant Lacets, 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-ROUNDER 3 Paires de Chaussettes pour Dames Printemps et d'automne. 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,BOLAWOO-77 Joggeurs Pantalon De Remise en Forme Au Comptant Hommes Mode Chic Slim Fit Sweatpants Sacs Coton Chino Les Vêtements Survêtement-LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by.

Haedr Coussin résistant à la Casse pour bébé, 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/Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween, 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-LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by, 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,camel active Ethnic 12.

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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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