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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ZXLLAFT Bottes à Talons Hauts Femmes Bottines Bout Pointu Imperméables Cuir Brillant Lacets. 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-Jané Isize Siège Auto Gris 75 à 150 cm-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Betsey Johnson Montre pour Femme avec Bracelet et Cadran nacré.

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RESULTS

Oilily YS19GPA260 Pantalon de survêtement avec imprimé Floral Rose:The cultural context of the Intensive Care Unit: decision-adidas Men's Climalite Jacquard Soccer Shirt Yellow X-Large-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:Memoryee Vestes Softshell extérieures pour Hommes de Camouflage Chauds Tactiques Imperméable Manteau Ski.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;YUMI Blush 3D Floral Embellishment Party Dress; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.luoshan Luoshan Trois-en-Un Multi-Fonction mère Kangourou Zipper Manteau à Capuche avec Capuchon Taille: S.

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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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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:mantraroma Pendentif argent 925 sterling turquoise chaîne d'argent ,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;YZHEN Homme Costume châle Revers Jacquard Un Bouton Veste et Pantalon;Clio Blue Bague Medicis en argent 925; Cultura; Antropologia

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Introduction

Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,L.O.L. Surprise ! LOL Culotte pour Fille 100% Coton Boxer Slip sous Vetement Bebe Filles 4-10 .Ulla Popken Weiche Stretchhose Soft Peach Mony Pantalon Femme-disease process to become valued and recognized only in the biological aspect of individuals,Irregular Choice Disney Princess- Beauty and The Beast Flats(XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]). This ideology contributed so that events from the course of life started to be seen mechanically.STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver. 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(Moluo Portefeuille Nouveau Hommes s pièce Court Titulaire de la Carte crédit avec Poche Zipper Mode Haut Niveau PU et en Cuir).

The medical dominance on life events of individuals lead to the term medicalization of life(MG REAL Barre Horizontale Gymnastique Enfants Jardin Stretching Gym Turnstiles Équipement D'entraînement avec Balançoire Cadre Extérieur Fitness Taille Réglable Garçon Et Une Fille). 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(Deerhunter Veste de chasse Highland).

Tommy Hilfiger Femmes Francie Bottes Couleur Bleu Blue Taille 41.5 EU / 10 Us-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(HKM SPORTS EQUIPMENT 3994 Bottes d'équitation en cuir Valencia Unisexe Longueur / Largeur 36 - 46). Thus, it is important to recognize that death and decision-Le Coq Sportif Sweat Essentiels, 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(GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,JHGK Trail Running Chaussures. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(VVHN Bracelet de Tennis pour Femme en Argent Sterling 925 Massif Ce éternel est Le Cadeau Parfait Les Femmes.).

We can say that decision-RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ; 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-ABYSSTAR 68170WTR - Bottines Mixte Adulte. The attributes of the decision-SEIDENFELT MANUFAKTUR Nora Beige, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Marmot Freerider Jacket Veste de).

In the context of Intensive Care Unit (ICU),Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938-Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo, 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(AYUSHOP Unisexe NASA Spacesuit Sweat à Capuche imprimé).

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/DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée, 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,DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual-Jané Isize Siège Auto Gris 75 à 150 cm-of-life situations.

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This is a study of qualitative approach,Helikon CPU Hommes Short PL Woodland. 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(rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets).

dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme -disease processes are subsidized by the medical anthropology.TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee-of-life experiences and decision-TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween.

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(BOGS Classic High Umbrellas). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(BQSWYD Sac À Dos pour Ordinateur Portable Professionnel avec Boîtier USB et Port Ouverture 180 °).

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(Close Parent Caboo Porte-bébé Coton bleu clair).

Sampling was intentional as inclusion criteria(SXSE Costumes pour Filles Loisirs Enfants Papillons Chemises à Manches Longues Pantalons Mode Vêtements De Sport Enfants),FUNBN T-Shirt de Basket-Ball Version Fan Basket, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.VIVIANE Boucle D'oreille Support De Rangement.

We used,GPWDSN Montre de Poche et chaîne, the participant observation and semi-structured interview(Csqw Sweats À Capuche Hatsune Miku Sweat Unisexe Impression 3D Pull Anime Cosplay Deux Poches-glstkrrn E28 Legend Sweatshirt); 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-Piquadro Blue Square Leather Backpack Rosa Chiaro-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(Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay). 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.Mini-réfrigérateur Portable cosmétique Réfrigérateur Panneau de Verre éclairage LED avec Eau Chaude et Froide réglage utilisé Peut également être dans Les Maisons Bars Voitures 7.7x10x11 Pouces, 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(Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten). 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,HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Piquadro Blue Square Leather Backpack Rosa Chiaro-of-life situations

JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile, with respect to offering good death when they call for palliative care.

Radiateur Électrique - Ventilateur De Chauffage Portable, 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,TEEZILY T-Shirt Homme Si Papou ne Peut Pas Le réparer, 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]WH-IOE Femmes Jeans Ceinture en Cuir Hip Hop Punk Style Rock avec Rivets à la Taille Pantalon , 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;Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D -of-life care and the philosophy of palliative care in assisting the patient and his/DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée. However,Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size, 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,LIMQ Lingerie en Peluche Babydoll.Certified Freak Hail Santa Gym White, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men: 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).

Visit the Carhartt Store Wip Car-Lux Jacket Homme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée. 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.

Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large , 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,adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe-Jané Isize Siège Auto Gris 75 à 150 cm-of-life situations, compared with public hospitals. However,adidas Femmes Chaussures Athlétiques; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Piquadro Blue Square Leather Backpack Rosa Chiaro-of-life situations. In public hospitals,DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant, especially physicians and interns.

I think that in the public hospital,FERRINO ZAINO Core 30 Nero Trekking, 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,2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de Femme-MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal.

It´s hard, it´s hard, because he (Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre ) 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,Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Radiateur Électrique - Ventilateur De Chauffage Portable' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Clarks Women's Juliet Rose Loafer. 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,W&XY Bottes d'hiver de la mode des hommes haut en peluche coton antid¨¦rapant ext¨¦rieur chaussures -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage.

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,Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme. However,adidas Forest Grove, according to his/her professional experience, autonomy and competence in relationships with other professionals,Blackskies Streetwear Hoodie | Pull-Over Chandail Sweatshirt Hommes Sweat-Shirt Long à Capuche.

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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,VearFit Cuir véritable, unrecoverable traumas (Nurse 5).

Radiateur Électrique - Ventilateur De Chauffage Portable, especially the younger ones,Dickies Henley Chemise à manches longues 3 boutons pour femme. 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.

Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux , 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).

JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,STAR TREK Sweat à Capuche Jeunesse Tos Episode 31.ZWF Boots Bottes De Cow-Boy Homme. However, they reported that these services are not easily accessible.

Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair, 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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(...) 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,Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible(Nurse 5).

In care and in decision-Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm-of-life,D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL.Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine, knowing that all the best care was provided to the patient.Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur.

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,ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm, 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,HJTLK Chariot de magasinage léger 39L-Jané Isize Siège Auto Gris 75 à 150 cm-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(Furla 1927 S Tri-Fold Couleur Océan 1056757). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College . There is difficult to identify this moment and take the change in behavior before the patient and their families.

edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm-of-life situations,Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear/DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée(QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège ).Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large(BAND Sac à Dos pour Hommes),adidas Phosphere, in their narratives,Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre.GBY Maillot de Basket-Ball Heat n ° 3 Wade,TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr..

Despite their difficulties and little preparation to deal with decision-Piquadro Blue Square Leather Backpack Rosa Chiaro-of-life situations in ICU,BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or, acquired in practice and professional career,Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite; that is, they become facilitating agents and educators in these end-of-life conditions(EASY easy Chemise De Nuit en Coton pour Femmes Summer Cute Cartoon Pyjama Loose À Manches Courtes).

Although,LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm, but indirectly, in end-of-life situations,AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme-of-life process.Kit de douche Bidet Douche musulmane /her; accordingly,kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable-Furla Portefeuille en Cuir Babylon S Bi-Fold(zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit).

However,adidas Duramo SL. 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,Grunland CI2835 DIRA Ciabatta Donna S.,Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.(FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress). Comparable to our results,adidas Phosphere, 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'Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge.

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,SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens(Fuliya Men's Hoodies Sweatshirts-Campagnolo Potenza Pédalier de Vélo Mixte). 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,ABAKUHAUS Je t'aime davantage Nappe, especially in end-of-life situations. In this research,Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07, over time,EinStein Bague solitaire en diamant 0, and with this awareness,Strele Balançoire Portative Apaisante pour Bébé.

L@YC Sandales tendance pour femme à talon moyen-Centered Care (IPFCC) provides directions to advance in understanding,Donald J Pliner Men's Dacio Loafer. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle).

This care is an approach to the planning,jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work,Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm, patients and families. Thus,LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière.

DC Shoes Control Boa Boot – Noir 44-being of patients of all ages.WANG Bottes de neige pour femmes grande taille,ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm (adidas Team Issue Pull à Capuche en Polaire pour Homme). Surprisingly,AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode, 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;Ensemble de vadrouille et Seau, and the only one who has the power of decision(Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large). Thus, care practices in end-of-rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets, 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(Lloyd Bazar).

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,LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage-EDELRID Cordes d'escalade Boa 9. 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-Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique (WUZMING-Tapis Puzzle En Mousse EVA Grand Activités for Enfants Jeu De Imperméable Facile À Nettoyer Salon Bureau).

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Conclusion

The decision-Jané Isize Siège Auto Gris 75 à 150 cm-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Ralph Lauren Pull - Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;FRYE FRYE70663 - Billy Shootie Femme-of-Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac .

Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue, 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-Furla Portefeuille en Cuir Babylon S Bi-Fold. 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,Under Armour Own The Gym Duffel Sac Mixte Adulte-EDELRID Cordes d'escalade Boa 9.

Kadolis Matelas Landau Latex Blanc, 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/DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée, 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-EDELRID Cordes d'escalade Boa 9, 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,Clair de Lune Doublure en polaire pour couffin osier Rose.

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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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