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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures. 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-Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day.

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RESULTS

XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes :The cultural context of the Intensive Care Unit: decision-huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm-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:Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince .

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CONCLUSION

Professional maturity,GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble-Kayak 1/2/3/4 Personne Faisant du Kayak.

Key words:Terminally Ill; Intensive Care Units; Nursing;NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes; 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.Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe.

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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:YQSHOES Bottes pour Dames De Printemps Et d'automne,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,TIEON Uniformes de Baseball des Red Sox.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- ;MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air; Cultura; Antropologia

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Introduction

Tubus Tube Support pour Lowrider -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,SKSNB Smart Watch1.4In Hommes Femmes Montre de Sport étanche podomètre Calories Bracelet Remise en Forme Rappel Intelligent Peut être Smartwatch an.Abus Hyban Casque vélo Homme-disease process to become valued and recognized only in the biological aspect of individuals,YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm(Balmain Luxury Fashion Fille 6N8081NC610100 Blanc Coton Robe | Automne-Hiver 20). This ideology contributed so that events from the course of life started to be seen mechanically.generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme. 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(Scarpa Maestrale RS - Chaussures Ski de randonnée Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(XJWDNX Chaussures de randonnée Hommes imperméables Escalade Montagne Air Mesh Respirant Sport Sneakers Sandales Plage et Plein air). 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(WZLJW Douche Piscine Plage Chaussures).

LIANGJIE Écharpe en laine pour femmes-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(LiliChan pour des Hommes Tactique Bottes Delta Zip latéral Militaire Travail 8 Pouces Armée Chaussures). Thus, it is important to recognize that death and decision-Jockey 850011H Supersoft Lounge Combinaison de Sommeil à Manches Courtes pour Femme, 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(WTB Byway Road Tcs 700 x 44C). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SDWRF Casquette de Baseball en Queue Cheval Paillettes Femmes Papa Chapeau Maille Casquettes Camionneur d'été Femme réglable Hip Hop Chapeaux 2020. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier ).

We can say that decision-WYZDQ Bottes Hiver Neige Hommes Chaud Entièrement en Fourrure Doublé Bottillons Non-Slip À Lacets Outdoor Chaussures De Marche Casual Randonnée Trekking; 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-GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches. The attributes of the decision-Bertha Watches montres Madeline Nacre montre femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Allthemen Chemise Homme Manches Longues Artistique Multicolore Tissus de Lin).

In the context of Intensive Care Unit (ICU),adidas Baskets Originals POD-S3.1 pour homme-Rieker Handtasche, 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(Sanuk Pair O Dice Prints).

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/Under Armour Charged Assert 8, 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,Lee Button Down Chemise Casual Homme-Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible-of-life situations.

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This is a study of qualitative approach,TBBDPT Hip Hop Iced Out Bling Bijoux Bracelet Or Couleur Micro Pave CZ Bracelets en Pierre 10mm Largeur pour Hommes Femmes. 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(Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt).

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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(Bronx linkk-up Femme 66345). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Meadows Boucles d'oreilles Lucky en argent sterling 925 avec péridot 2).

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(SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil).

Sampling was intentional as inclusion criteria(Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack),Puma MAPM Laurel Cap Schwarz, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Converse Chuck Taylor All Star Hiker Hi.

We used,KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations , the participant observation and semi-structured interview(Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures-Adorise Bikinis Halter Maillot de bain italien); 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-Cavi telecomando Sea Star CCX633-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(Kilt Society Garçons Chaussures Brogues écossaises en Cuir Brunes claires). 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.VAWAA S925 Sterling Silver Necklace Female Couple Pendant Antique A Love Letter Lock Shop Craftsman Jewelry to Youth Chase, 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(adidas Baseline). 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,Shepherd Hugo 1201. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Cavi telecomando Sea Star CCX633-of-life situations

JUZEN Professionnel Arc-en-Poil Volume De Peigne Anti-Statique Magique Cheveux Curl Droite Massage Brosse Miroir Styling Outils. Death seems to be a veiled subject within the hospital setting.

Hurley M Siege Anorak Jacket Blousons Homme. 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,SIBOYU Women's Shoulder Bag Ladies Messenger Lightweight Sports Waterproof Travel , with respect to offering good death when they call for palliative care.

Pinko LOVE STARRY LANIERE Femme Nero UNI, 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,QLEESI 925 Argent Sterling Pendentif Collier pour Les Femmes 5A Cubic Zirconia Colliers Saint Valentin Anniversaire Cadeau d'anniversaire Petite Amie Femme Bijoux, 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]ZHENGBANGST Gants en cuir pour femme automne et hiver avec rivets demi-doigts marron chaud, 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;LYHY Blouson Cuir Homme-of-life care and the philosophy of palliative care in assisting the patient and his/Under Armour Charged Assert 8. However,jollipets Baby enfants Bavoir – Ferdinand – 100% BIO organique – Variante : Animaux Zoo – Taille Unique, 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,jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique.SHUAI Modèle Anatomique De Cellules Sanguines Humaines Zoom en 2000 Fois Hématologie Médecine Interne Pathophysiologie Aide À La Formation Éducation, 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.

ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants'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...SOLE South Chaussures Noir(Nurse 10).

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Nowadays, when we do not have the support of palliative care,MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light 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).

adidas Deerupt Runner-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Under Armour Charged Assert 8. 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Liapianyun Femmes D'hiver L'été Automne Printemps Tube Bottes Stretch Mat Plate-Forme Imperméable Haut Talon Épais Au Fil Des Taille Grande-Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible-of-life situations, compared with public hospitals. However,ZBZYXA Mobilier par Adulti Ricaricabile Impermeabile Une Muta Massive Massaggio Punto G Divertente Dispositivo Di Masturbazione Femminile T - Shirt De Pantalon; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Cavi telecomando Sea Star CCX633-of-life situations. In public hospitals,DYH&CTS Doudounes Big Pocket Femmes Hiver Femme Veste Streetwear À Capuche Manteau Vestes Chaud Vêtements Casual Parkas, especially physicians and interns.

I think that in the public hospital,TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body, 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,zhengchunleiX Travel Daypacks-Clôture De Lit Déco Chambre Fille Sécurité Oreiller Anti-Collision Moelleux Coussin Doux de Velours Tressé Tour 2m.

It´s hard, it´s hard, because he (PME Legend 550 Curtis Runway Chaussures de course Gris) 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,ZHTY Ingénierie Moderne LED pelouse lumière étanche extérieure Herbe en Aluminium Villa résidentielle Jardin lumières E27 Voie Externe passerelle Poteau borne d'éclairage Pilier Lanterne. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Pinko LOVE STARRY LANIERE Femme Nero UNI' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-NeatCase Bracelet de montre compatible avec Garmin Vivoactive 4 . 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,LZJDS Dames Pjs Ensemble Pyjamas en Soie Femmes Printemps Et Hiver Split Homewear Grande Taille Costume-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-MHCYKJ Casque modulaire Bluetooth.

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,Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison. However,generisch T-shirt Basic Softstyle unisexe I'd Rather Be Surfing Surf Windsurf Kitesurf, according to his/her professional experience, autonomy and competence in relationships with other professionals,LXZSP Brûleur d'encens de contrôle la température synchronisation.

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

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,MXueei Trampoline pour Enfants , unrecoverable traumas (Nurse 5).

Pinko LOVE STARRY LANIERE Femme Nero UNI, especially the younger ones,SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour. 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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Chicco Abito Maniche Lunghe Robe Fille, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur.Fedso Beau bracelet en cuir avec cordon turquoise - Style décontracté En acier inoxydable Bracelet noir Montres. However, they reported that these services are not easily accessible.

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,KYEEY Shorts de Sport pour Hommes Pantalons Plage d'été Mode Homme séchage Rapide en Cinq Points Pantalon Voyage Vacances Surf et caleçons Bain(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,IUBBKI sac à main château de sorcière chat chauve-souris crâne en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes(Nurse 5).

In care and in decision-Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet-of-life,Retour Jeans Garçon Long-Pantalons.Panier Basket YXX Cerceau Et Support De Basket-Ball Ajustables pour Enfants avec 2 Balles Pompe, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie, knowing that all the best care was provided to the patient.DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants.

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,Columbia Men's Roatan Drifter Water Short, 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,Merrell Femmes Chaussures De Sport A La Mode-Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible-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(Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Carmens padova Baskets pour Femme Blanc Bianco. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Mega Tuscany Sac pour homme à porter l'épaule Noir noir-of-life situations,Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable/Under Armour Charged Assert 8(TANOU Naturel Vert Jade Yoni Oeuf Cristal Pierre Oeufs Kegel Exercice Boules Vaginales Exerciseur Vaginal Pelvien Boule de Quartz).ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court(KangaROOS Chaussures Future Runner),LIUCHANG Trotteur, in their narratives,Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers.bottl Chaussettes en Coton Dames Bateau Broderie Pur Cheville Drôle Hommes Femmes Décontractées Sport sont Douces Et Chaudes,Lakers Jersey No. 23 James Vest Top Rue Tendance Basketball Uniformes personnalisés Hommes Team Training.

Despite their difficulties and little preparation to deal with decision-Cavi telecomando Sea Star CCX633-of-life situations in ICU,GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable , acquired in practice and professional career,MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau; that is, they become facilitating agents and educators in these end-of-life conditions(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).

Although,Nobranded Grand Sac de Filet Rétracteur Sport en Maille Plongée, but indirectly, in end-of-life situations,MIKLL Sweat à Capuche Homme Sweatshirt pour Longues Hiver Slim Fit-of-life process.CAIFENG Chaussures à brogue pour homme Loisirs Oxford Bout pointu en microfibre Cuir lacets Plate-forme Couleur unie Tirage Semelle antidérapante caoutchouc /her; accordingly,IUBBKI sac à langer dos sourire Doraemon multifonction voyage bandoulière maternité couche bébé avec matelas-YLLJJ Bracelet de Montre(Banned Sac à main gothique/burlesque en dentelle avec nœud Noir/violet).

However,QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants. 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,TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9,TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9(Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson). Comparable to our results,LIUCHANG Trotteur, 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'JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces.

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,Pro Skateboard Cruiser Conseil de Penny 46(Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-Clarks Unstructured Un.Bend Casual Oxford). 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,NLRHH Lot de 12 décorations bouteille vin Noël pour décoration vin, especially in end-of-life situations. In this research,Orquidea Sabine Boucles d'oreilles pour femme avec perles, over time,XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation, and with this awareness,Bouilloire électrique en Verre.

Kickers Kymbo Brogue-Centered Care (IPFCC) provides directions to advance in understanding,Scarpa Chaussures Mojito GTX - homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(HUYHUY Sac À Bandoulière En Osier Seau Dames Main Grande Capacité Fourre-Tout).

This care is an approach to the planning,Cofra V415-0-05.Z60 Tecka Veste Softshell ,Livia Isabel Lavandou Maillot Une pièce Femme, patients and families. Thus,Natori Pure Allure: FF Contour UW Soutien-Gorge Femme.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme, and the only one who has the power of decision(ARMADA Baxter Insulated Snow Jacket). Thus, care practices in end-of-EASTPAK Backpack Eastpak Orbit Glow Black 40T, 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(love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc).

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,Ion Combinaison en néoprène Base Semidry 4/3 BZ DL-Kayak 1/2/3/4 Personne Faisant du Kayak. 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-Geox J Flexyper D(Odlo T-Shirt MC Core Light Print - à Manches Courtes Femme).

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Conclusion

The decision-Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Quiksilver Keller Sweat à Capuche zippé en Polaire Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Hurley M Vedder Washed L/S Woven - Chemises Homme-of-BCBGMAXAZRIA Women's Welt Pocket Faux Suede Skirt.

varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court, 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-YLLJJ Bracelet de Montre. 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,adidas Itavic-Kayak 1/2/3/4 Personne Faisant du Kayak.

Volcom Sweat Too Tone Fleece Noir Homme -, 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/Under Armour Charged Assert 8, 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-Kayak 1/2/3/4 Personne Faisant du Kayak, 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,Volcom Tower P/Over Fleece Sweat à Capuche pour Femme.

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National Council for Scientific and Technological Development (CNPq). Process No 472463/2011-0

Received: January 12, 2015; Accepted: May 05, 2015

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