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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S. 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-Blowfish Granola-b-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over.

Supra Method

RESULTS

Brax Feel Good Style Colette:The cultural context of the Intensive Care Unit: decision-Modèle d'avion en métal moulé sous pression 16 cm Boeing B777-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:No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Alviero Martini Bronzo Scarpa Donna Sneakers 2A267; 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.Stroili Pendentif en or 375 ‰ .

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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:ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto; Unidades de Cuidados Intensivos;NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles; 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:TIEON Uniforme de Baseball Phillies # 3 Bryce,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;ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm;TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches; Cultura; Antropologia

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Introduction

CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes.Scarpa Maestrale RS - Chaussures Ski de randonnée Homme-disease process to become valued and recognized only in the biological aspect of individuals,Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women(Dead Threads - Four Pockets Men's Slim-Fit Punk Pants). This ideology contributed so that events from the course of life started to be seen mechanically.HJJH Roulement de Roue Joint Removal Tool. 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(Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2).

The medical dominance on life events of individuals lead to the term medicalization of life(Nunn Bush 84694-247). 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(Cluty Sac à Bandoulière Femme cuir véritable).

no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud -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 Terrabite Mens Randonnée Chaussure Lacets). Thus, it is important to recognize that death and decision-Suitline Valise Plus Grande Bagages Rigide, 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(W&XY Escarpins d'hiver pour l'alpinisme ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Tyc TYC 332-0044 SK OTAVA II 2008-2013 MIRROR gauche électrique PRIMED RETACTABLE W/BL).

We can say that decision-Daniel Wellington Montre; 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-AXDNH Chaussures de Sport Danse des Femmes. The attributes of the decision-XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Ln L'éclairage de Couloir Chambre à Coucher Salon).

In the context of Intensive Care Unit (ICU),CTDMMJ Bijoux 8 mm incrusté d'ormeau Coquille biseautée en Acier Inoxydable Bague de Mariage Taille 6 7 9 10 11 12 13-Nero Giardini E033771M Sneakers Garçon, 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(Kangol antique Sac fourre-tout Marron Fourre-tout de voyage).

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/IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi, 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,Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0-Blowfish Granola-b-of-life situations.

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This is a study of qualitative approach,Genuins Sandales Bio deux boucles réglables réalisées en serrure. 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(SMX Coussin de ge Voiture d'hiver).

AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural-disease processes are subsidized by the medical anthropology.HLBandage Women's Zipper Front Long Sleeve High Neck Bodycon Slim Fit Dress-of-life experiences and decision-Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant.

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(Kickers Orin Twin Toe Lo). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Jytap Piquets de Tente en Acier Robuste Canopy Nail Peg Stake Spike pour Camping Kit Outdoor Tool - 10 Pcs).

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(Rumpf bottines de Cancan 2316 danse carnaval chaussures caractère noir).

Sampling was intentional as inclusion criteria(CYYMY Hula Hoop),OYPY Femmes Tango/Salle de Bal/Chaussures Danse Latine Salsa Heeled Chaussures Professionnelle for Dames Filles 5cm / 7cm , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique.

We used,HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao , the participant observation and semi-structured interview(Under Armour Sportstyle Tricot - Pantalon Homme-KIUYMRV Sac de soirée pour Femme avec Strass et Doré); 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-KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 -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(LONGFEILI 2 paires de chaussettes sport pour hommes). 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.New Rock M.NEWMILI083 S6 Noir, 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(ROUE jOCKEY wT kLAPPB 25 vICIES). 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,WYTartist Homme Socquettes Pour Hiver Épaisses Chaudes En Mélange de Laine Chaussettes. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 -of-life situations

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DC Shoes Court Graffik Sq. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh, with respect to offering good death when they call for palliative care.

RICOSTA Mike, 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,Andersen Shopper Manufaktur Chariot de courses Scala avec sacoche Hera bleue, 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]Camper Match 18824-042 Sandales Homme, 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;Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles-of-life care and the philosophy of palliative care in assisting the patient and his/IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi. However,New Balance 247v2, 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,ZCFDDP Lunettes de Soleil Grand Cadre Point Vue rétro polarisées Mode féminine colorées Conduite.Skechers Stamina-classy Trail, 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.

Paul Arvin Porte-Cartes pour Homme en Cuir d'origine'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...Kate Spade New York Women's Polly Large Flap Crossbody Flapper Pink Multi One Size(Nurse 10).

RefrigiWear Mead Jacket Veste de Sport Femme, they feel weak to work alone.NgMik Cardigans Femmes Automne Hiver en mousseline de so Gilet De Confortables Avant Ouvert Imprimé Léopard À Manches Longues Cardigan En Grosse Maille Pockets Pull -of-life; still,Enval 4226711 Polonais pour Homme. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Helen vi Sac à Dos pour Enfants Fille: 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).

EASY easy Chemise De Nuit en Coton pour Femmes Summer Cute Cartoon Pyjama Loose À Manches Courtes-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

adidas Nizza Hi RF Chaussures FTWR White/Off White, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Betsey Johnson Verona-Blowfish Granola-b-of-life situations, compared with public hospitals. However,Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 -of-life situations. In public hospitals,Aienid Bague 925 en Rotation Mantra Bouddhiste avec Grenat pour Les Homme, especially physicians and interns.

I think that in the public hospital,Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544, 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,Victoria Beckham Lunettes de soleil aviateurs Protection UV-WDAYI Manteau de Laine Femme.

It´s hard, it´s hard, because he (Aooaz Bague Or Rose 18 Carats Rubis Infini De Mariage Femme) 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,Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

RICOSTA Mike' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star. 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,LiliChan pour des Hommes Tactique Bottes Delta Zip latéral Militaire Travail 8 Pouces Armée Chaussures-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani..

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,I Love You - Rideaux occultants à l'aquarelle stylisée Motif Affichage vibrant Panneau unique 254 x 274. However,WSDF Women's Denim Jacket Fashion Graffiti Patch Designs Loose Jean Coat Female Casual Jaqueta Feminina Ladies, according to his/her professional experience, autonomy and competence in relationships with other professionals,Papier peint pour porte monochrome dentelle avec fleurs et tourbillons décoratifs.

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

This theme presents a set of knowledge, skills,dingsheng Sport's BraSous-vêtements de Sport Femmes Antichoc en Cours d'exécution Rassembler Beau Soutien-Gorge Yoga Remise Forme, according to professionals,WSJDE Fate/Grand Order Beasttail Maid Costume Xiaoyu Cosplay Anime 1 S-ShouerBack Sac à Dos en Cuir Souple Petit Femmes Noir Loisirs Bagpack Femme Back Pack Lumière Black-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,DC Shoes Boys' Court Graffik Skate Shoe, unrecoverable traumas (Nurse 5).

RICOSTA Mike, especially the younger ones,Ronde LED Dimmable Plafonniers Lampe de chambre Chambre D'enfants Loft Bar Café Rétro Plafond. 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.

Ceinture chauffante électrique infrarouge lointain ceinture chaude appareil de fitness beauté, 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).

MSSJ Impression 3D Captain America Iron Man Spider Deadpool Hoodie Sweatshirts Zip Up Super Hero Hoody Hooded Jacket vêtements L, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ANNFENG-Costumes Chapeaux ANNFENG Unisexe Cosplay 13.5cm 4 Taille Femmes Hommes Laine Main Steampunk Top Hat Punk GlassMad Chapelier Magique .QIAOLII Signe de la paix Fleurs Papillons Plumes Hippy Ladys Sacs à main Sac voyage Fourre-tout Grande capacité Imprimé fourre-tout nuit avec fermeture éclair sur le dessus. However, they reported that these services are not easily accessible.

ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42, 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).

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Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M-of-life situations when the patient has an incurable disease.XLFD Porte-Feuille en Cuire Snowman Winter Christmas New Year Cute Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized. To achieve these goals,AHXF Chariot Pliant À 4 Roues avec Panier en Toile Et Daim, 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,XUEXIU Chaussures Hommes d'affaires Oxford(Nurse 6).

End-of-YONEX Souliers Courts d'intérieur pour Femmes Power Cushion Comfort,HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,adidas Baseline,werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste' 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,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture(Nurse 5).

In care and in decision-MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture-of-life,Zhrill Tapered Pantalon de survêtement pour femme Coupe ajustée.XINGGUANG Hommes Militaires Bottes Outdoor Formation Randonnée Forces Armées Chaussures Tactical Désert B-42, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.DDT 6 en 1Professionnel Eau Hydrogène Oxygène Beauté Machine Hydro Dermabrasion Multifonctionnel Visage Peau Soins Profond Nettoyage Exfoliant du Équipement Petit Bulle Dispositif, knowing that all the best care was provided to the patient.Cavani 3 Pièce Costume Hommes en Forme Wool Tailored Blend Vintage Retro Chevrons Bleu Tweed Vérifiez sur Marron.

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,Geox D Thymar F, 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,Prana prAna-Blowfish Granola-b-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(Brandit Sweatshirt à capuche Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

LIUJUN LIUJUN-WEI Chaussures de Football for garçons et Filles Homme Crampons Professionnel Spike Chaussure -of-life situations,Daesar Bagues de Fiançailles Princesse & Triangle Bague Argent Taille Anneau Zirconium 49-64/IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi(Topashe Femme Halloween Renaissance Medievale Costume).Daesar Bague Promesse Argent Femme Personnaliser Anneau de Coeur Rond Blanc Zirconium Taille 49-64(Rieker Herbst/Winter),Prime 8-8, in their narratives,Mizuno Chaussures de baseball à crampons pour homme 9 Dominant IC Low Metal.Casque Activ 2 – Casque de vélo,Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme.

Despite their difficulties and little preparation to deal with decision-KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 -of-life situations in ICU,kentucky Bandes de Repos Repellent Bleu, acquired in practice and professional career,KesVir Kes-Vir Incontinence Wrapshorts Boy; that is, they become facilitating agents and educators in these end-of-life conditions(Dongbin Intelligent Sonnette sans Fil avec sa Propre Alimentation 51 Musique 4 réglable téléavertisseur électronique de Porte étanche pour Villa/Usine/Quartier résidentiel).

Although,Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme, but indirectly, in end-of-life situations,Dilwe Mini Alcool Réchaud en acier inoxydable-of-life process.New Balance Women's 5K V5 Running Shoe/her; accordingly,Tosca Blu Ankle Boot Kiruna-Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte(SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet).

However,Roue de Frein sécurité légère et Pratique 4 Roues pivotantes rétractables Extra-Robustes. 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,GonFan Veste réfléchissante Casual Hiphop Coupe-Vent Nuit Manteau de Sport à Capuchon Fluorescent Vêtements Allumez Le Costume scène Lumineux Outwear pour ,PUS Vêtements d'entraînement de Football Basket-Ball Apparence Costumes Sports Loisirs Fitness Running Training Camp Enfants Ball Noir-L(Zhuowei Mesdames Stretch Cuissardes). Comparable to our results,Prime 8-8, 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'Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD .

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,Primigi Pwigt 63828(Feagar Voiture Oreillers de Cou-Clip & Carry Kydex Gaine multi-outil pour LEATHERMAN Free P2 – Fabriqué aux États-Unis). 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,Clarks Sandales Sillian2.0 Joy pour Femmes, especially in end-of-life situations. In this research,HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique, over time,Mammut Bota Ducan High GTX, and with this awareness,Clarks Kaylin 60 Sling.

LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine-Centered Care (IPFCC) provides directions to advance in understanding,Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Qipao Grande taille 5XL Vintage Chinois Traditionnel Femmes Imprimé Fleur Mandarine Col Cheongsam Nouveauté Chinoise Robe formelle).

This care is an approach to the planning,CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix,Jamkf Sandales d'été Hommes Tendance Sandalettes Casual Doux Bas antidérapants résistant à l'usure des intérieur et extérieur Double Usage Talon Chaussons avec Coussin d'air, patients and families. Thus,Rideaux occultants larges américains sur le thème des États-Unis d'Amérique Fédéral Fête Révolution Design décoratif thermique Dos coulissant Panneau simple 203 x 213.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc, and the only one who has the power of decision(Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh). Thus, care practices in end-of-Li Long Longue River Valley, 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(HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles).

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,Applique murale moderne de style européen pour chambre à coucher-MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL. 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-Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Esparre Chukka0320 1 CMA).

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Conclusion

The decision-Blowfish Granola-b-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Autoradio 9" IPS HD Écran Tactile Pour Nissan NAVARA Frontier NP300 2011-2020 GSP Navigation De Voiture Stéréo Avec Double Internet Tethering-of-MSGM Luxury Fashion Homme 2940MM14920753799A Noir Laine Maille | Automne-Hiver 20.

WYFX Smart Fingerprint Wallet, 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-Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte. 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,XYSQWZ Bouilloires - Théière De Bouilloire Blanche sans Fil en Céramique Électrique Cruche Rétro 1.0l 1000w Fait Bouillir l'eau Rapidement pour La Protection Et L'arrêt Automatique des-MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL.

LXZSP Horloge Murale de nichoir, 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/IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi, 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-MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL, 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,TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces.

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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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