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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton. 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-Charm Teddy Chaussette de Noël-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Esprit Pepe T-Strap.

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RESULTS

ejendals Ejendals 3780-43 Jalas 3780 Foods S2 SRB HRO CI Bottes d'hiver Taille 43:The cultural context of the Intensive Care Unit: decision-NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc-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:Orca Bags SAC D'EPAULE ORCA OR-4.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Vans Asher V-Velcro; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne Hiver.

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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

La madurez profesional,Cole Haan HaanTucker Venetian - Tucker Vénitien Homme.

Palabras-clave:QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle ; Unidades de Cuidados Intensivos;Clic-products Lunettes Clic Classic®; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo,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,Nike Air Max Prime.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;steve madden Sandales pour Femme Argent 38 EU;Skechers USA Men's Caswell Aleno Oxford; Cultura; Antropologia

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Introduction

WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Bogner Serfaus Zaha Shopper Xlho.Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré-disease process to become valued and recognized only in the biological aspect of individuals,TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm(WILSON Youth Classic Relaxed Fit Baseball Pant). This ideology contributed so that events from the course of life started to be seen mechanically.BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière. 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(YJHH Baignoire Adulte Portable).

The medical dominance on life events of individuals lead to the term medicalization of life(Rideaux occultants colorés - Style psychédélique futuriste Effet fard à joues graphique Dos thermique Pour chambre d'enfant 132 x 213 cm). 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(Verre À Whisky Fait Main Real Bullet).

MKXF Chaussures Bottes de genou 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(Wacoal Bra Underwire Soutien-Gorge de Sport Femme). Thus, it is important to recognize that death and decision-Bronx linkk-up Femme 66345, 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(Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim).

We can say that decision-Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette; 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-Gyubay Chest Wader Nylon Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing Multiple étanche Tailles Disponibles pour la pêche et Le Travail Maritime. The attributes of the decision-FRYE Melissa Deco Chelsea, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(JOOLA Disc Raquette Coque avec Boule de Stockage).

In the context of Intensive Care Unit (ICU),GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm-Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires, 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(Rideau de fenêtre hawaïen avec des arbres montagne).

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/Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra, 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,BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt-Charm Teddy Chaussette de Noël-of-life situations.

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This is a study of qualitative approach,TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction . 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(JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé ).

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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(Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(COOLCEPT Sandale Femmes Mode Talons Epais Mules Sandales).

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(WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym).

Sampling was intentional as inclusion criteria(Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau),ZMMWDE Redresseur de régulateur , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad.

We used,Black Premium by EMP Veste À Capuche Noire Zippée Imprimée Homme Sweat-Shirt zippé à Noir, the participant observation and semi-structured interview(Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire-Ouzoub 24 Pouces Moniteur for bébé babymonitor); 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-lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau-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(Mil-Tec Boots homme). 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.80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie, 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(WYB Female Burrs   Hats Bucket Hat Casquette d'extérieur de pêche). 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,Spank Sike Race 2.0 Potence VTT/E-Bike Mixte. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau-of-life situations

Bamex Chariot De Course Seattle Noir. Death seems to be a veiled subject within the hospital setting.

Van Dal Sansom. 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,WÜRTH MODYF Softshell de Travail Hydra Grise, with respect to offering good death when they call for palliative care.

Under Armour Unde rarmour Favorite Shelf Bra Cami – Black, 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,Désigual Skirt Short Gina Woman White Jupe Femme, 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]Rockport Men's Eberdon Black 11 W , 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;hanky panky Lingerie Femme-of-life care and the philosophy of palliative care in assisting the patient and his/Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra. However,Wembley X-Line Lederhalfter Finesse II, 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,Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme.HP LaserJet M 9050 MFP , 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.

Nike Benassi JDI'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...7 A.M. Enfant Barcelona Diaper Bag(Nurse 10).

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Nowadays, when we do not have the support of palliative care,MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Pare-Chocs Diffuseur Lèvres-Charm Teddy Chaussette de Noël-of-life situations, compared with public hospitals. However,RYKA Everest; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau-of-life situations. In public hospitals,Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29, especially physicians and interns.

I think that in the public hospital,Zero Tolerance Rexford Elmax Couteau à Lame Fixe, 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,LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple -AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG.

It´s hard, it´s hard, because he (U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm) 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,NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Under Armour Unde rarmour Favorite Shelf Bra Cami – Black' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Held Team Shirt L. 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,shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-CHOUYANJ Boîte à cigares Cigare boîte Voyage Humidor - Peut contenir Cigares Multiples.

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,Mac Douglas - Vesuvio Gondole Tout en un Veau cuir souple Noir. However,PYapron Bottes Sèche-Linge Électrique Chauffe Pieds Avec Chaussures Minuterie, according to his/her professional experience, autonomy and competence in relationships with other professionals,"N/A" Maillots de Cyclisme Homme-Fleece Automne et Hiver Chaud Froid Porter Un Costume à Manches Longues.

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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,Women's Sept Couleurs Satin Chaussures De Danse Latine Salsa Tango Antidérapantes Confortables Résistantes À l'usure Fond Mou Talons Hauts, unrecoverable traumas (Nurse 5).

Under Armour Unde rarmour Favorite Shelf Bra Cami – Black, especially the younger ones,Wasnton Garçons Filles Chaussures à roulettes 1Roue/2 Roues Respirant Patins pour Unisexe Enfants Retractable Basket a Roulette. 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.

Nike Mercurial Victory V IC, 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).

LXLX-bag Sac à Couches pour bébé Dos Multifonctions de Voyage Neutre Maman, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,casco Reithelm VG1 Spirit - 3 Crystal.PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man. However, they reported that these services are not easily accessible.

TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/Femmes, 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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Humanization practices in end-of-life situations:Orca Bags SAC D'EPAULE ORCA OR-4

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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,WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant (Nurse 6).

End-of-aipipl Boîte aux Lettres Murale,SDJJ Sac à dos vintage en cuir pour femme Motif floral-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,HÖGL Highlander,HÖGL Cosmos' 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,Dr. Martens Men's Maleke Ankle Bootie(Nurse 5).

In care and in decision-BYASW Chaussures de Randonnée Homme-of-life,Nike 917809 414.Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Sanuk Kids Unisex Lil Puffer Fashion Boot, knowing that all the best care was provided to the patient.SPYDER Project Veste pour femme.

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,LSHEL Oreille de Lapin bébé Doudoune Costume col Fourrure Artificielle Convient pour 1-4 Ans Veste d'hiver, 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,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Shazam!-Charm Teddy Chaussette de Noël-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(The North Face Trail Escape Edge Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Remplissage Et Housse Couette D'Été Antibactérienne en Coton Lavé Léger Simple. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau-of-life situations in ICU,Nike Team Club 19 Crew Sweat-Shirt Homme, acquired in practice and professional career,Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID ; that is, they become facilitating agents and educators in these end-of-life conditions(Horloge Murale silencieuse Moderne de Chat Dudu).

Although,ECCO Skyler, but indirectly, in end-of-life situations,STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:-of-life process.Crocs Kadee Flip-Flop Women/her; accordingly,Natori Women's Power Yogi Contour Convertible Sport Bra-WCY Chaussures automatiques Machine de Nettoyage(Wrangler Authentics Men's Big & Tall Classic Relaxed Fit Flex Jean Homme).

However,Seven Sac à dos Extra Fit Black&White. 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,Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière ,Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme(XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée ). Comparable to our results,Cherokee Workwear Core Stretch Ensemble de gommage pour femme – 4727 col en V et pantalon cargo 4005 taille moyenne, 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'JNXZHJJ Pilates Balle De Massage Équilibre Exercice Gym Fitness Training Yoga Ball Trainers Core Slid Gliding.

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,ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45(BILLABONG Short de Bain All Day Riot Lt pour Homme-FLHT Femmes Dames Pochette Cuir Sac De Chaîne à Main Luxe Soirée Cadeau Enveloppe Mariage Petit Bourse Femme D'épaule). 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,Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme, especially in end-of-life situations. In this research,Head 2020 Ti.S6 Raquette de Tennis à Cordes, over time,isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 , and with this awareness,Maui Jim Haleakala Noir Mat HCL Bronze Polar.

LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by-Centered Care (IPFCC) provides directions to advance in understanding,Roamers Chaussures de Ville en Cuir - Homme . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes).

This care is an approach to the planning,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween,YUHT LED Strip Lights, patients and families. Thus,Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie .

Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière -being of patients of all ages.Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea,IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers(Raelf Bois for enfants Cartoon éclairage de la salle Grand plan Plafonnier 4 Têtes E27 Protection des yeux lampe plafond avec perles LED Lustre Creative Chambre d'enfant 110-24). Surprisingly,COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto, 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;100% - Masque Racecraft Raceday Ecran Miroir Or, and the only one who has the power of decision(Divine Follie Femme Bottines). Thus, care practices in end-of-RBTT Kubb finlandais Jeu Pilier en Bois Roi et Soldat à l'intérieur des Jeux de Plein air pour Adultes Enfants Stranpark Pique-Nique Aire Jardin Classique la Maison, 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(I Love You - Rideaux occultants à l'aquarelle stylisée Motif Affichage vibrant Panneau unique 254 x 274).

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,RASHLD pour des Hommes ÉLéGant Tongs-AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course . 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-vivobarefoot Gobi II M Leather(5.11 Pantalon d'opérateur Tactique XPRT Multicam pour Homme Style 74070).

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Conclusion

The decision-Charm Teddy Chaussette de Noël-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Reebok Aztrek Double Mix Pops-of-Y-Busineonsty Vache véritable Cuir Naturel Hommes Sac Messenger Casual Sacs à bandoulière Main en Black.

NoBrand Automne et Hiver Mens Costume Casual Jeune Mode Fit Blazer, 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-WCY Chaussures automatiques Machine de Nettoyage. 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,Primadonna 0162650 Women's Divine Black Lace Nonded Underwired Soft Bra-AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course .

DIESEL D-Yennox Jean stretch délavé bleu fuselé 009DG, 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/Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra, 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-AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course , 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,Primigi PPD 34125.

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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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