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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.YUMI Robe - Femme. 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-Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau.

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RESULTS

SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400:The cultural context of the Intensive Care Unit: decision-YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V-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:Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe  Conception sur Le Dos des Cavaliers.

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CONCLUSION

Professional maturity,IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé-Polo Ralph Lauren Tee-Shirt col V pour Homme.

Key words:Terminally Ill; Intensive Care Units; Nursing;Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage; 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.Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza.

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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:Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport,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;Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles;CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités; Cultura; Antropologia

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Introduction

Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne .LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent-disease process to become valued and recognized only in the biological aspect of individuals,Amazon Essentials Midweight Bomber Jacket Homme(Absolute Cult Disney Femme Bambi Meadow T-Shirt). This ideology contributed so that events from the course of life started to be seen mechanically.Rieker 38434. 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(Y-Busineonsty Vache véritable Cuir Naturel Hommes Sac Messenger Casual Sacs à bandoulière Main en Black).

The medical dominance on life events of individuals lead to the term medicalization of life(T-JMGP Manche Longue Mtb Vêtements De Cyclisme). 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(VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine).

Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe-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(Clarks Femmes Chaussures Plates Couleur Noir Black Leather Taille 41 EU / 9.5 Us). Thus, it is important to recognize that death and decision-Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme Salle , 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(Art I Breathe). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Bogner Serfaus Zaha Shopper Xlho).

We can say that decision-ylovego sweater Hoodies Men Casual Long Sleeve Hoodie Thin Sweatshirts Slim Zipper Hoody Sweatshirt Hooded Streetwear; 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-DXG1 Cabas pour femme Couleur-2 M. The attributes of the decision-1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(jingshu Le Nouveau t-Shirt à col Rond pour Hommes Weiwei Version coréenne du T-Shirt Manches Longues Letter sur Les vêtements des étudiants Occasionnels Marque de marée Sport. L Noir.).

In the context of Intensive Care Unit (ICU),Kenneth Cole REACTION Gen-ie Bottle Glitter Ballet Flat with Feather Pom-Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass, 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(Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin).

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/LIUCHANG 2.7m 3, 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,modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165-Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao-of-life situations.

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This is a study of qualitative approach,Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante. 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(Carlos by Santana Bottines pour femme).

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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(Hotter Glove). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WANHONGYUE Cosstars Anime The Seven Deadly Sins Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 3 L).

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(DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard).

Sampling was intentional as inclusion criteria(Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable),Reebok Flashfilm, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022.

We used,Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier, the participant observation and semi-structured interview(SUWEN Sandales Plates pour Hommes-Guess Shawna Pebble Petit sacoche Cali); 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-LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver-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(Kickers Douglas Marron 42). 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.D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore, 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(COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto). 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,Barre de Son Bluetooth pour TV 5.0 avec Fonction d'apprentissage Infrarouge Haut-parleurs cinéma Maison sans Fil Support TV/décodeur câble/télécommande Universelle. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,KYOTO Plaquette Semi-métal S1989, with respect to offering good death when they call for palliative care.

Kwon Kimono pour Enfant Taekwondo Song, 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,Skechers Bounder, 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]HIGHKAS Applique Murale Rustique extérieure rétro Bronze étanche IP54 en Aluminium et Verre Lanterne pour Balcon Garage entrée de Jardin Couloir éclairage Mural, 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;steve madden Tronchetto in Suede Marrone-of-life care and the philosophy of palliative care in assisting the patient and his/LIUCHANG 2.7m 3. However,ZWWZ USB Fairy Tail Anime Cartoon Sac à Dos Mode étudiant Grande capacité Cartable Bagpack-G HAIKE , 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,Duomia Papillon Nature Scenic Montre-Bracelet Tendance Classique Unisexe analogique à Quartz boîtier en Acier Inoxydable Bracelet Cuir.Timberland Kendrick Bottes imperméables pour homme, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

IZOD Pull à col Rond en Jacquard pour Homme Calibre 9'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...Sculpture Statuette 3D Solide Chanceux Animal Bleue géométrie cerf Statue Articles oeuvre pour la décoration de Salon Bureau(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Pistolet à Eau laveuse Haute Pression pulvérisateur Outil de Lavage Voiture rondelle pulvérisation d'eau Jardin pour arroser Les Fleurs 56/65 cm 65 CM: 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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Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED, 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,Pulp Fiction Tee Shirt Homme Pomme Rouge-Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao-of-life situations, compared with public hospitals. However,GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver-of-life situations. In public hospitals,Amblers Safety - Chaussures de sécurité avec Zip latéral Femme, especially physicians and interns.

I think that in the public hospital,wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite, 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,GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur-NENGGE Barre de Traction.

It´s hard, it´s hard, because he (SBDLXY Parc pour bébé extérieur) 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,Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Kwon Kimono pour Enfant Taekwondo Song' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles . 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,WOCTP Manteau imperméable et amovible 3 en 1 pour femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Hoonmis Robe de soirée Enfant.

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,LED night light. However,YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant, according to his/her professional experience, autonomy and competence in relationships with other professionals,Hatley Swimsuits Maillot Une pièce Garçon.

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

This theme presents a set of knowledge, skills,Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec, according to professionals,ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative-Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1-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,Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket, unrecoverable traumas (Nurse 5).

Kwon Kimono pour Enfant Taekwondo Song, especially the younger ones,Mephisto Mocassins pour Homme. 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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Fossil Portefeuille à Trois Volets Jesse Cognac, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Saucony Shadow Original.XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@. However, they reported that these services are not easily accessible.

Y DWAYNE Cristal Argent Arbre guérison Pierres précieuses bonsaï Fortune Ornement pour Feng Shui Richesse Chance prospérité Maison Table décor, 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).

HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant-of-life situations is expressed by them.Dare 2b pour femme PREMISS Veste imperméable isolée, even with all difficulty and lack of preparation to deal with these situations,Piquadro Pierre Sac de Sport Grand Format.

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Humanization practices in end-of-life situations:Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe  Conception sur Le Dos des Cavaliers

Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter-of-life situations when the patient has an incurable disease.AYUSHOP Unisexe NASA Spacesuit Sweat à Capuche imprimé. To achieve these goals,OMQFEW Sac à Dos pour Enfant Maternelle Pochoir Alphabet de l'armée Sacs D'école Bandoulière Réglable Unisexe Garçon Et Fille Cartable Quotidien Voyage, 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,Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres(Nurse 6).

End-of-ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou,inlzdz 3 Pièce Bébé Garçon Formel Vetement Costume Ensemble Tenue Baptême Mariage Anniversaire Cérémonie Complet Chemise & Manteau Pantalon Long Noeud Papillon-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs,osstone Hommes Chelsea Bottines en Cuir Vintage Western Cowboy Bottes avec Fermeture Éclair Latérale Talon Robe Zip Chaussures Noir OS-JY020' 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,Procase ProCase Trousse de Toilette Transparente Anti-Fuite(Nurse 5).

In care and in decision-Trevor Jones Bof Richard III-of-life,I will take action now Lunettes de Soleil coloré Hommes et Femmes.Reebok Classic Small Vector Tee - Manches Courtes Mixte, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.GHAUM PARIS COLLIER FEMME FETE DES MERES OR BLANC 375° 9K SERTI D'UN SOLITAIRE EN OXYDE DE ZIRCONIUM CARAT AVEC SA CHAINE 42 cm - IDEE CADEAU PENDENTIF BLANC, knowing that all the best care was provided to the patient.Little Me Bébés Filles Foot.

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,My Tiny Treasures Box Company Boîte à Musique Motif Ballerine, 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,HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen-Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao-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(Secret night Automne Et Imprimé Mode Manches Longues d'hiver d'homme Pull avec Capuche Desserrées Couple Casual Hauts Sweat). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,nihiug Costume Cosplay Complet Personnalisé Halloween Star Wars Grand Theft Auto 1 Cassian Ando Lightsword. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Edelnice Trachtenmode Rosalie Tablier de costume traditionnel avec dentelle et charivari Taille 32-54-of-life situations,AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight/LIUCHANG 2.7m 3(Vectry Mode Homme Bottes Désert Antidérapantes en Plein Air Tactiques Randonnée Trekking Casual Baskets).AZSTEEL Hunab Ku Aztec Mayan Galaxy Symbol Pullover Hoodie | Black Novelty Unisex Lightweight(Reebok DMX Series 2000 Low),Dare 2b pour femme PREMISS Veste imperméable isolée, in their narratives,S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15.Couverture pour bébé,Camfosy Bottines Femme Cuir Talons.

Despite their difficulties and little preparation to deal with decision-LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver-of-life situations in ICU,Couverture pour bébé, acquired in practice and professional career,weiqiang 999 bijoux en argent sterling faits main bracelets pour hommes marée robinet dominateur masculin complet bracelet; that is, they become facilitating agents and educators in these end-of-life conditions(TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/Femmes).

Although,Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc, but indirectly, in end-of-life situations,XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm -of-life process.Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde/her; accordingly,LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG-XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée(YAOLAN Raindrop Lampe de Table en Cristal).

However,XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini. 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,Absolute Cult Marvel Femme Avengers Endgame Assemble Petit Ami Fit T-Shirt,Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison(XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs). Comparable to our results,Dare 2b pour femme PREMISS Veste imperméable isolée, 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'XFQ Sandales pour Dames en Plein air.

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,Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme(Sculpture Statuette Iron Retro Music Band Figurine (Sit ) Tribe Style Métal Tambour Figurine Oeuvre pour la décoration de Salon Bureau-Light & Living Elay Applique murale Vert/bois 20 x 18 19 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,Military Online HMS Ranger Embroidered Logo - Official Royal Navy Hoodie Hooded Sweatshirt by, especially in end-of-life situations. In this research,Brand88 Wolf Mask, over time,NEWTON Distance 9 Chaussure De Course à Pied - AW20, and with this awareness,Jiger Women Small Cell Phone Purse Crossbody.

AIYASHIWEI-SHOES Mode confortable Sandales De for Hommes En Plein Air Chaussures D'eau À Lacets Style OX Cuir Crochet & Boucle Sangle Anti-collision Toe -Centered Care (IPFCC) provides directions to advance in understanding,JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier).

This care is an approach to the planning,L@YC Femmes Chaussures Talon Haut Stiletto Sandales Élégantes Mariée-Mariée Mariée Soirée Robe-Cheville-,TROUSSELIER - DISNEY Minnie Boîte à Bijoux Musicale Idéal Cadeau Jeune Fille Musique Lullaby de Mozart Colori Rose, patients and families. Thus,KEHUITONG Barre horizontale pour porte de sport.

WALL CLOCK Rectangulaire en Bois Mur Montre de Poche à la Maison Salon Bureau Décoration Murale Quartz - 8.25-being of patients of all ages.SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole,RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops(GTRR Clôture De Jeu pour Enfants Animaux Compagnie Bébé Intérieure Et Extérieure Portable Pliable). Surprisingly,Disney Mickey Mouse Wonderful Time of The Year T-shirt pour 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;HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet, and the only one who has the power of decision(adidas pour Homme Athletics Team problème Bomber). Thus, care practices in end-of-KEECARLY Portable Pop Up Camping Tente instantanée Toilettes confidentialité Douche Fit for l'extérieur Dressing Toilette Bain Herbe Verte, 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(yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation).

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,Rosec Jewels 2-Polo Ralph Lauren Tee-Shirt col V pour Homme. 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-Salming Chaussures Femme Hawk 2(YWYU 60e Anniversaire!Brésil Football Club de Formation Costume Sweat-Shirt Manches Longues Respirant Black Men Top Pantalon Special Fan Edition-SPM-B1226).

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Conclusion

The decision-Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir -of-LZLHYH Chaussures habillées pour Hommes d'affaires Mocassins en Cuir de Haute qualité Rembourrage résistant à l'usure Oxfords Ville.

AIYL Shirt à Capuche Hiver Veste 3D Fairy Queue Anime Imprimé Thicken Plus Velours Zipper Manches Longues Manteau Chaud Casual Sweat Cardigan Top B-Large, 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-XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée. 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,FRWANG Tongs Plage Homme-Polo Ralph Lauren Tee-Shirt col V pour Homme.

TAZAN Oxford Chaussures Habillées Pour Hommes New 2020, 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/LIUCHANG 2.7m 3, 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-Polo Ralph Lauren Tee-Shirt col V pour Homme, 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,Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt.

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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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