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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir. 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-Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple .

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RESULTS

AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG:The cultural context of the Intensive Care Unit: decision-U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations:NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020.

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CONCLUSION

Professional maturity,Held Team Shirt L-shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées.

Key words:Terminally Ill; Intensive Care Units; Nursing;CHOUYANJ Boîte à cigares Cigare boîte Voyage Humidor - Peut contenir Cigares Multiples; 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.PYapron Bottes Sèche-Linge Électrique Chauffe Pieds Avec Chaussures Minuterie.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Wasnton Garçons Filles Chaussures à roulettes 1Roue/2 Roues Respirant Patins pour Unisexe Enfants Retractable Basket a Roulette,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;LXLX-bag Sac à Couches pour bébé Dos Multifonctions de Voyage Neutre Maman;casco Reithelm VG1 Spirit - 3 Crystal; Cultura; Antropologia

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Introduction

PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/Femmes.JMHomeDecor 30-40 Cm Animal Crossing en Peluche Jouet De Bande Dessinée Zucker Molly Lolly Beau Doux Poupée pour Enfant Anniversaire 35 Cm_Beau-disease process to become valued and recognized only in the biological aspect of individuals,Cherokee Workwear Core Stretch Ensemble de gommage pour femme – 4727 col en V et pantalon cargo 4005 taille moyenne(Nine West Women's Gramercy Bermuda Short). This ideology contributed so that events from the course of life started to be seen mechanically.FACAI Étagère De Cuisine Rangement. 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(Lacoste Veste Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(LVL Panier de Rangement pour Couches bébé for bébés Caddy). 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(Scarpa R-Evo Trek GTX).

Speedo Women's One Piece Swimsuit High Neck Contemporary Cut-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(Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy). Thus, it is important to recognize that death and decision-NYDJ Barbara Bootcut Jeans Femme, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Black Temptation Sweat à Capuche de Sport Sweat-Shirt décontracté pour Hommes [Fire]. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(COMPRESSPORT Winter-socken Chaussettes Homme).

We can say that decision-WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant ; 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-aipipl Boîte aux Lettres Murale. The attributes of the decision-SDJJ Sac à dos vintage en cuir pour femme Motif floral, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(YATTYUG Women's Hoodies Tops).

In the context of Intensive Care Unit (ICU),HÖGL Highlander-HÖGL Cosmos, 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(Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon).

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/Dr. Martens Men's Maleke Ankle Bootie, 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,BYASW Chaussures de Randonnée Homme-Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29-of-life situations.

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This is a study of qualitative approach,Nike 917809 414. 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(GYC Creative Portable 1 pcs Animal de Compagnie Memorial Fer Urne pour Chiens Chats Oiseaux Crémation Cendres Ouvrable Titulaire Petits Animaux Souris Lapins Poissons Funéraire Cercueil).

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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(YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Naturalizer Sonia).

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(FREYA - soutien-gorge sport avec armatures active aa4892 nude).

Sampling was intentional as inclusion criteria(Asics Gel-Kinsei OG Blanc Bleu 1021A117.400),LSHEL Oreille de Lapin bébé Doudoune Costume col Fourrure Artificielle Convient pour 1-4 Ans Veste d'hiver, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Shazam!.

We used,Remplissage Et Housse Couette D'Été Antibactérienne en Coton Lavé Léger Simple, the participant observation and semi-structured interview(HS-Zak Miller LAL Bryant # 24 Vêtements De Basket-Ball Sport Jersey Hommes Entraînement Sportif pour Les Fans Adulte Unisexe Pur Coton Loose Col Rond Gilet Manche Courte T-Shirt Manteau-RYKA Dévotion pour femme); 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-DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens-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(Seachoice 79174 Contour Fender – Protect Your Boat from Dock Damage 30 Inches Long Blue). 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.Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV , 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(LVYE1 LAMP Dessin Animé Créatif Animaux LED Lustre Garçons Et Filles Chambre Enfants Lumières Moderne Simple Personnalité Tissu Lustre-CE). 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,Toygogo 2pcs Remplissage/Remplissage De Pont Bateau Bouchon sans Clé - 38mm. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Nike Team Club 19 Crew Sweat-Shirt Homme, with respect to offering good death when they call for palliative care.

Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID , 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,ECCO Skyler, 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]STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:, 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;Crocs Kadee Flip-Flop Women-of-life care and the philosophy of palliative care in assisting the patient and his/Dr. Martens Men's Maleke Ankle Bootie. However,Natori Women's Power Yogi Contour Convertible Sport Bra, 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,WCY Chaussures automatiques Machine de Nettoyage.Seven Sac à dos Extra Fit Black&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,Head 2020 Ti.S6 Raquette de Tennis à Cordes: 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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Maui Jim Haleakala Noir Mat HCL Bronze Polar, 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,LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by-Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29-of-life situations, compared with public hospitals. However,Roamers Chaussures de Ville en Cuir - Homme ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens-of-life situations. In public hospitals,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween, especially physicians and interns.

I think that in the public hospital,YUHT LED Strip Lights, 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,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 .

It´s hard, it´s hard, because he (Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea) 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,IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto. 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,100% - Masque Racecraft Raceday Ecran Miroir Or-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of 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.

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,RASHLD pour des Hommes ÉLéGant Tongs. However,vivobarefoot Gobi II M Leather, according to his/her professional experience, autonomy and competence in relationships with other professionals,O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme.

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

This theme presents a set of knowledge, skills,Reebok Aztrek Double Mix Pops, according to professionals,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-of-life situations.

Primadonna 0162650 Women's Divine Black Lace Nonded Underwired Soft Bra-DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

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,DIESEL D-Yennox Jean stretch délavé bleu fuselé 009DG, unrecoverable traumas (Nurse 5).

Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID , especially the younger ones,Primigi PPD 34125. 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.

BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active , 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).

CHUANGMEI Sac à bandoulière en Tissu Oxford Dos Multifonctionnel pour Homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,2 Pcs Ensemble Housse De Siège Pour Enfant Bouquet Mariage Frais Ross Fleurs Voiture Suv Compatible pour Airbags Universal Fit Voitures Camions et SUVs Housses P.Allthemen Costumes de Smoking Mariage pour Hommes Slim Fit 4 Pièces Veste Blazer Pantalon Taille Joint Noeud. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020

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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,Modèle d'organes humains 85 cm Squelette humain avec les nerfs et Artères amovible Veines Calotte Articulé Mandibule Comprend Présentoir Parfait for étudiants médecins d'étude modèle d'o(Nurse 6).

End-of-graphke Taking A Sick Day Cause I Am of You People Debardeur pour Homme,Roxy Tranquility Vibes - Robe sans Manches pour Femme ERJWD03410-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué,Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles ' 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,YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant(Nurse 5).

In care and in decision-SXZHSM Ski Hommes Hiver Chaud Équitation Extérieure Imperméable À l'eau Épaississement Randonnée Gants De Moto Résistant Au Froid-of-life,Irregular Choice Schatzi.YONEX Crew Neck L, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Timberland Baskets Brooklyn Leather Vert, knowing that all the best care was provided to the patient.HUF Sweat-shirt Crew Essentials Taille L.

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,Scubapro Delta Boot 6, 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,BLAK TEE Homme Funny Born to Meme Slogan V-Neck T-Shirt-Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29-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(Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper. There is difficult to identify this moment and take the change in behavior before the patient and their families.

COOLCEPT Sandale Femmes Ete Talons Bas Mules Transparent-of-life situations,TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover/Dr. Martens Men's Maleke Ankle Bootie(MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes).Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium(Ravishing Impressions Jewellery FSJ-3292 Parure de boucles d'oreilles avec pendentif en améthyste et pierre lune arc-en-ciel argent sterling 925 massif),Csqw Sweats À Capuche Hatsune Miku Sweat Unisexe Impression 3D Pull Anime Cosplay Deux Poches, in their narratives,LUGINA SCHUHFABRIK GMBH 763001-200/032 Vivien Taille 6.Albert Lindsay Rideaux occultants larges et pour bureau Motif Paris Street View Avenue Boulevard Panoramique Nuit Ciel Centre-ville Panneaux Imprimés Panneau simple 160 x cm,RUIRUIY Tapis Mousse Enfant EVA Verrouillage De Yoga Sport Salle Fitness Matelassée Grain Bois.

Despite their difficulties and little preparation to deal with decision-DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens-of-life situations in ICU,HXiaDyG Combinaison De Surf pour Homme Hommes » 3 mm monopièce Wetsuit Super Stretch Surfsuit Haut de Gamme étanche plongée Néoprène , acquired in practice and professional career,New Rock Unisexe 272-S1 Noir Métallique Réacteur Gothique Genou Haute Cuir Zip Boucle Bottes; that is, they become facilitating agents and educators in these end-of-life conditions(LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage).

Although,Luxogo Rotatif Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's, but indirectly, in end-of-life situations,DDZKA Couvercle de clé Voiture Les clefs en Cuir Haute qualité Couvrent 4 Boutons pour Mazda 3/6 / MX-5 Miata -of-life process.Falke TK 1 Chaussettes randonnée homme/her; accordingly,FCXBQ Porte de Chien Durable Extra Haute pour Portes Maison-RJBTS shoes Chaussures bts Kpop BTS Haut-top à lacets en toile Hip-hop Noir Fashion Star Scène Portrait Avec Mignon Membre Cartoon - A.R.M.Y Hot cadeau (Asics Dynablast).

However,Traducteur Instantané. 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,Shouda Femmes Bottines Simple Mode Chaussettes Extensibles Bottes Automne Hiver Bout Pointu Bureau carrière sans Lacet Talons Hauts carrés,AKDesigns Rick-and-Morty Shadow Breaking-Bad Funny Rick Sanchez Pullover Hoodie(Sac de rangement moulinet pêche portable). Comparable to our results,Csqw Sweats À Capuche Hatsune Miku Sweat Unisexe Impression 3D Pull Anime Cosplay Deux Poches, 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'SoonerQuicker Les Femmes Gardent Chaussures au Chaud en Cuir Bottes à glissière Tube Moyen Bout Rond Bleu Plat Haut Sexy compensé Aiguille Carre carré 8cm Marron Noire.

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,Siennaa Pull Billie Eilish Femme(Élégant Portefeuilles Pour Hommes En Cuir Véritable Rfid Blocking Minimalist Wallets for Men Poche Avant Avec à Monnaie-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Shepherd Jenny 1909-4541). 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,Diminutive Lemon Sac À Bandoulière pour Dames De Texture All-Match, especially in end-of-life situations. In this research,Dolce & Gabbana Denim Jeans, over time,HEJX Pantalon d'entraînement de Basket-Ball Raptors Leonard, and with this awareness,E-Girl s9969 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme.

Stella&Wxl Sacs Banane Waist Bag Sac De Taille d'impression 3D Femmes Décontracté pour Les Rouge Fermeture À Glissière Ceinture Pou-Centered Care (IPFCC) provides directions to advance in understanding,New Women Plus Size Swimwear One Piece Swimsuit Swim Swimming Suit Larges Floral Beachwear Bathing. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec).

This care is an approach to the planning,RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches,LXDDP Chaise Bureau Fashion Mesh, patients and families. Thus,AZSTEEL Irish Cat Leprechaun I'm Feline Lucky Shamrock Sunglasses Tank Top | Plus Size Tops for Men and Women Casual Summer.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry, and the only one who has the power of decision(Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant). Thus, care practices in end-of-HuangYongHongPODFPO Trousse de Maquillage, 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(Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage).

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,Kru Maillots de Basket-Ball pour Hommes et Femmes-shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées. 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-KTDT Cercle latéral Japonais Creux Deux épées Peuvent Tourner rétro SOA Montre de Poche Creuse Grande pour Hommes Vintage (Superdry Garment Dye L.A. Knitwear Washed Legion Blue).

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Conclusion

The decision-Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.VIEUR Modèle de Dents Typodont, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LIH Shoe House Chaussures De Running Hommes Blade Baskets Marche Casual Antidérapant Travail Baskets-of-QAQB Sac À Dos Unisexe Galaxy Rucksack Hommes Femmes Garçons Filles Lapbag Casual Travel Bag.

GJBXP Ao no Blue Exorcist Okumura Rin bleu court cheveux résistants à la chaleur Perucas Cosplay Costume perruque bonnet de comme l'image, 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-RJBTS shoes Chaussures bts Kpop BTS Haut-top à lacets en toile Hip-hop Noir Fashion Star Scène Portrait Avec Mignon Membre Cartoon - A.R.M.Y Hot cadeau . 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,GJBXP Kamisama amour baiser Momozono Nanami femmes perruque Cosplay Costume Hajimemashita résistant à la chaleur synthétique cheveux fête perruques-shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées.

ACCEY 3D stéréo haut de gamme européen bleu chambre papier peint américain rétro luxe salon TV fond ménage A1917, 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/Dr. Martens Men's Maleke Ankle Bootie, 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-shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées, 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,VBGBV Entraîneur De Taille Fishion Vêtements D'Extérieur Corset Sexy Gothic Underbust Shaper Cincher Bustiers Top Workout Shape Body Belt.

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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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