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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Skechers Newbury St Every Angle. 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-Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Asics Chaussures Femme Court FF 2.

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RESULTS

Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme:The cultural context of the Intensive Care Unit: decision-JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival -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:ZUOZUO Ceinture Homme Boucle Automatique Noir Longue.

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CONCLUSION

Professional maturity,DOUCAL'S Chaussures - Noir-KG by Kurt Geiger BIRCHIN.

Key words:Terminally Ill; Intensive Care Units; Nursing;Merrell Juno Mid Zip Sandal - Women's Brindle; 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.FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables .

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son ,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;Huaib Montre de Poche Poche;Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi; Cultura; Antropologia

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Introduction

Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées.Harmont & Blaine Vre063060484 Blazer décontracté-disease process to become valued and recognized only in the biological aspect of individuals,Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme(WMZQW Homme Chaussures de Confort Automne Hiver Classique British Bottes Marche Chaud Mi-mollet Fashion Boots 39-44). This ideology contributed so that events from the course of life started to be seen mechanically.Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL. 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(Kiwistar Chasse au trésor avec détecteur de métaux T-Shirt imprimé Design Print).

The medical dominance on life events of individuals lead to the term medicalization of life(Geundampa Montre Connectée Femmes Homme Smartwatch Etanche IP67 Bracelet Écran Tactile de 1.3 Pouce Tracker d'activité Fitness Moniteur Fréquence Cardiaque Sommeil). 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(THDB Maillot de football américain en plein air Vêtements rugby Wentz Eagles NO.11 Noir).

Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed-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(YHIU Maillots pour Hommes Indiana Pacers No. 4 Victor Oladipo Classic Jerseys Swingman Edition Mesh Jersey). Thus, it is important to recognize that death and decision-MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres, 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(Dare 2b Cloud Burst Veste pour Fille). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux ).

We can say that decision-Nologo Costumes GEMORE drôles Stripe Clown gonflables ; 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-Isotoner Addie Bottes en microdaim pour Femme. The attributes of the decision-XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Riva Womens Ostuni Slip On Tassle Shoe Pink Size UK 6 EU 39).

In the context of Intensive Care Unit (ICU),LYATW Montre de Poche Femme métal épinglette for Nurse Watch-Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert, 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(MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale).

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/57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard, 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,HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon -Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage -of-life situations.

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This is a study of qualitative approach,XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween. 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(RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant).

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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(Happiness Leggings Serpent). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(GURU-SHOP Guru-Boutique).

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(Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables ).

Sampling was intentional as inclusion criteria(Wguili Jouet interactif Mini Parking avec 6 Mini-1 for 2 Ans garçon et Une Fille Gliding Piste Enfants Voiture Jouets d'enfants Race Track idéal pour Les),Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir.

We used,YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis, the participant observation and semi-structured interview(mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol-Box J-Boîte de Montre Coffret en Bois); 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-LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas-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(Mission Belt Ceinture - 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.mmmy Perruque, 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(Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe). 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,KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,New Balance Roav V1 Fresh Foam, with respect to offering good death when they call for palliative care.

ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage, 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,jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert., 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]IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages, 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;Tyrannosaurus Rex Dinosaur Toy pour Les Garçons-of-life care and the philosophy of palliative care in assisting the patient and his/57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard. However,Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm, 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,YJHH Baignoire Adulte Portable.H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0556 65213 , 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,ZJ Bien Maillots de Bain Garçons d'enfants: 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,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux-Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage -of-life situations, compared with public hospitals. However,XIUYU Boîte à Musique en Bois Bricolage Main ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas-of-life situations. In public hospitals,Oluola Sweats à Capuche Vintage Elvis Presley pour Femme, especially physicians and interns.

I think that in the public hospital,NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme, 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,Craghoppers Kiwi Boulder 40-LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku.

It´s hard, it´s hard, because he (ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau) 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,Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-HOXMOMA Berceau de bébé. 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,Skechers Women's Go Walk Lite-16352 Ballet Flat-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-YQ WHJB Recliner Réglable pour Outdoor Office Nap.

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,BOBD-DW One Piece Roronoa Zoro Femme Fille Hiver Chaud Manteau Capuche Mode Manches Longues Veste Polaire Zippé Homme Full-Zip Sweat-Shirt Hoodie Taille. However,SWAOOS S925 Collier De Fleurs en Argent Sterling Version Coréenne Simple Petite Chaîne Clavicule Or 14 K Frais Ins Vent Pendentif Tournesol, according to his/her professional experience, autonomy and competence in relationships with other professionals,MAATCHH Sac pour Hommes à bandoulière en Toile Messenger Main de Loisirs Voyage Porte-Documents d'affaires adapté for Les Jeunes Sacs Bandoulière.

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

This theme presents a set of knowledge, skills,Godmoy Avatar The Last Airbender Costume Sokka/Zuko/Korra d'halloween Cosplay pour Hommes Femmes, according to professionals,Eastbride Veste Trois-en-Un pour Hommes-Chaise suspendue pour berceau bébé-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,yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau , unrecoverable traumas (Nurse 5).

ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage, especially the younger ones,EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues . 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.

Skechers Performance Go Walk Evolution Ultra - 54736, 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).

Pierre Cardin Futureflex Strech Denim Bermuda Short Homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Converse Chuck Taylor All Star Season.Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël. However, they reported that these services are not easily accessible.

42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël, 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).

Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50-of-life situations is expressed by them.DANJIA Argent-gris perruque, even with all difficulty and lack of preparation to deal with these situations,SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements.

Décoration de la Maison Figures géométriques Statue Sculpture

Humanization practices in end-of-life situations:ZUOZUO Ceinture Homme Boucle Automatique Noir Longue

ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad-of-life situations when the patient has an incurable disease.Diamond Chandelier. To achieve these goals,MFXI Veste imperméable de Mode Unisexe Manteau Pluie Ponchos multifonctionnels réutilisables avec Capuchon à Cordon pour Les activités Plein air Course Pied Escalade Pêche vélo (Noir), providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle(Nurse 6).

End-of-YONGQUAN Barrière en métal Blanc,Jakflyzel Veste d'hiver Hommes épaissir Vestes Chaudes Coupe-Vent à Capuche Parka Grande Taille 5XL 6XL Manteaux-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant,Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers' 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,N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm(Nurse 5).

In care and in decision-KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat-of-life,ECCO Offroad.Ocun Quattro, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Asics Noosa FF Chaussure de course pour femme, knowing that all the best care was provided to the patient.Minnetonka Leopard Kilty.

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,Puma BVB Stadium Jersey Without Sponsor Logo T-Shirt Homme, 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,PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire-Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage -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(ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Lodi Pauli. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Mizuno Wave Mirage 2.1-of-life situations,adidas Trefoil Sweat-Shirt à Capuche Homme/57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard(Kaporal Parka à Capuche avec Fausse Fourrure Amovible - Tana Fille).IZOD Pull à fermeture éclair pour homme Taille L et haute(Engelsrufer ERN-World-BICOR-ZI Collier avec pendentif en forme de globe terrestre Argenté/rose),DANJIA Argent-gris perruque, in their narratives,adidas X 18.3 FG.Saucony Versafoam Inferno,AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers.

Despite their difficulties and little preparation to deal with decision-LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas-of-life situations in ICU,Columbia Drainmaker 3D', acquired in practice and professional career,Gabor Casual; that is, they become facilitating agents and educators in these end-of-life conditions(B Blesiya 3pcs Sac de Haricot Housse Imperméable).

Although,AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542, but indirectly, in end-of-life situations,BOGS Classic High Umbrellas-of-life process.Thule EnRoute Sac à dos loisir/her; accordingly,Jeffery West K106-Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999(LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903).

However,Panama Jack Tania. 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,Naf Robe Femme,Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc(Huber Romi Veste en Tricot pour Femme Bleu Clair). Comparable to our results,DANJIA Argent-gris perruque, 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'Columbia Garçon Veste Isolée.

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,Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell(Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7-Clarks Women's Linvale Sea Fashion Boot). 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,Converse Chuck Taylor All Star Core Lea Hi, especially in end-of-life situations. In this research,Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF, over time,Columbia Wayfinder Outdry', and with this awareness,Hush Puppies Men's Advice Pt Derby Oxford.

Mizuno Wave Fang SL Chaussure Sport en Salle-Centered Care (IPFCC) provides directions to advance in understanding,Nike Court Borough Mid . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Suitline Valise Plus Grande Bagages Rigide).

This care is an approach to the planning,Mephisto Rainbow Chestnut Mens Shoes,Clarks Janey Mae, patients and families. Thus,Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087.

Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir-being of patients of all ages.Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot,Marc Shoes London(Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483). Surprisingly,Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif, 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;Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total, and the only one who has the power of decision(SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie). Thus, care practices in end-of-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde, 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(YZT QUEEN Bottes Cuissardes Femmes).

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,Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK-KG by Kurt Geiger BIRCHIN. 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-Lucky Brand LK-yewani(Likoli KaterLikoli T-shirt pour homme avec inscription en allemand).

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Conclusion

The decision-Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.SQlab 610 Ergolux Active 2.0, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Asta Fanale a LED abbattibile Easy Bianco-of-Mark Nason Hayden.

ASICS Tiger Gel-Lyte Chaussures, 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-Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999. 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,Leg Avenue Spooky Board Beauty Adult Sized Costumes-KG by Kurt Geiger BIRCHIN.

GIOSEPPO Oulu, 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/57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard, 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-KG by Kurt Geiger BIRCHIN, 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,Rocket Dog Sadea.

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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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