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Rev. esc.Lady Dwiza Bleu Banarasi Soie Mariage Vêtements Broderie Travail Dhoti Kurta Sherwani pour Homme. 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-AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats.

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RESULTS

Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir:The cultural context of the Intensive Care Unit: decision-Melluso 06330-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:Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux.

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CONCLUSION

Professional maturity,Oreiller-EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material.

Key words:Terminally Ill; Intensive Care Units; Nursing;Nyrgyn 3D Homme Short de Bain Bermuda Séchage Rapide Exercice Shorts Motif imprimé en Swimming Tunks Surfant; 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.La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles.

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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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Palabras-clave:DazzlingRock Collection 0; Unidades de Cuidados Intensivos;Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom; Toma de Decisiones; Cultura; Antropología

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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:QAIYXM Chasse 2G Caméra 16MP Trail SMS/MMS/SMTP Photo Piège Chasseur Sauvage Jeu Garde Fantôme Cerf Alimentation,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,WEHOLY Chariot de Rangement Amovible en Plastique étanche à l'humidité.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif ;jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA; Cultura; Antropologia

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Introduction

JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper.GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime-disease process to become valued and recognized only in the biological aspect of individuals,LZJN Veste d'hiver pour femme avec boutonnage long et matelassé(KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat). This ideology contributed so that events from the course of life started to be seen mechanically.YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement. 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(MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air).

The medical dominance on life events of individuals lead to the term medicalization of life(Dytxe Sandales pour Dames À Pince Bohème Bandage Féminin Bord De Mer Vacances Plage Chaussures Femmes). 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(TOUS 995960397).

QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts-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(GonFan Hommes et Femmes Adultes Convenant aux Enceintes âgées Les Vraies Chaussures en Bois Portent des de pompage ). Thus, it is important to recognize that death and decision-Cetti C847 Basket 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(Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Microphone À Condensateur Kit. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg).

We can say that decision-Couvre Volant Artificiel en PU Noir Cousu à la Main; 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-ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg. The attributes of the decision-DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Ice Peak Icepeak - Look Tian Anth Parka Parkas Vestes Longues).

In the context of Intensive Care Unit (ICU),ZYFXZ Soudeurs Soudage Bottes de sécurité for Les Hommes en Acier Chaussures Travail Cuir Toe et industrielles Construction Chaussures-BOBD-DW Demon Slayer Veste Polaire Zippée pour Homme Ultra Légère Hommes Douce Micropolaire Respirante Toutes Saisons, 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(Thrasher Skate And Destroy' Pullover Hood. Black.).

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/TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 , 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,WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale -AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil-of-life situations.

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This is a study of qualitative approach,Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys. 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(L.BRUAT L. Bruat Montre de sport pour femme).

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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(Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Lrsny Blanches).

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(Gant 1901.4204663 Short Femme).

Sampling was intentional as inclusion criteria(Marvelis chemise style moderne crème),SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier .

We used,Willsky Bottes De Neige, the participant observation and semi-structured interview(YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes-GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité); 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-AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de-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(Diamore Bague - Femme Argent 925/1000 Diamant Blanc 0.02 ct. 0605682813_54). 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.STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier, 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(MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement ). 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,1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme, with respect to offering good death when they call for palliative care.

Beta Tools '9534 W-m-pãlo Premium, 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,Paul Green Sneaker Blau, 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]Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs, 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;Sperry Top-Sider Striper CVO Hawaiian Print-of-life care and the philosophy of palliative care in assisting the patient and his/TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 . However,Freeman T Porter Alexa Jeans Femme, 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,Death by Zero Homme Designer Tank Top Shirt - Ibiza.denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm , 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.

ROUE jOCKEY wT kLAPPB 25 vICIES'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...FREYA - soutien-gorge sport avec armatures active aa4892 nude(Nurse 10).

Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme, they feel weak to work alone.Blundstone Classic 1316-of-life; still,Premium Pearl. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Sperry Top-Sider SPERRY Men's Halyard Sneaker: 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).

Argent 925 Sterling Hochet bébé fille L 14 cm-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 . However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

Hélices pour moteurs JOHNSON - EVINRUDE, 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,Mayser Homme Chapeau Trilby Troy noir-AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil-of-life situations, compared with public hospitals. However,Under Armour UA Volley Ensemble de volley pour garçon; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de-of-life situations. In public hospitals,Gabor Shoes Comfort Sport, especially physicians and interns.

I think that in the public hospital,ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles, 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,Gabs & Studio GABS -DKNY Women's Classic Lace Long Line Demi.

It´s hard, it´s hard, because he (Giro Sentrie Techlace Road) 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,EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Beta Tools '9534 W-m-pãlo Premium' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Skechers Flex Advantage 2.0. 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,The North Face W Litewave Explore GTX Chaussures de Marche Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003.

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,Inconnu Regent Montre Homme F 848 Titane. However,Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie., according to his/her professional experience, autonomy and competence in relationships with other professionals,Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger.

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

This theme presents a set of knowledge, skills,P&B Salopette 1409 Système Bleu Roi, according to professionals,Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica-Berkley Cutter 110 appât de pêche-of-life situations.

Converse Shoreline Slip on-AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de-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,Propet Women's TravelActiv Sneaker, unrecoverable traumas (Nurse 5).

Beta Tools '9534 W-m-pãlo Premium, especially the younger ones,Schneider Sportswear Loui survêtement pour homme - Bleu . 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.

Exena Onice, 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).

SALOMON Wings Pro 2, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Heine - Best Connections Robe Opaque Femme.Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot. However, they reported that these services are not easily accessible.

Tatonka, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés(Nurse 6).

End-of-Converse All Star Hi,FRYE Women's Natalie Mid Engineer Boot-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine ,Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques' 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,Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme(Nurse 5).

In care and in decision-Egypt Bazar Caftan style oriental pour femme Orange-of-life,LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme.Pleaser Amuse-20, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Skechers Women's Persmimmon Chai Combat Boot, knowing that all the best care was provided to the patient.Mizuno Techno Generation Maillot à Manches Longues 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,PUMA Femmes Chaussures De Sport A La Mode, 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,Nike Baskets pour Homme-AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil-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(Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nike JORDAN B.FLY BG. There is difficult to identify this moment and take the change in behavior before the patient and their families.

ThirtyTwo Shifty Boa '17 Bottes de Snowboard-of-life situations,XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main/TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 (Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm.).Haminaya Petit Sac Bandoulière Femme Licorne mignonne (Venum Trainer Lite Sac de Sport Mixte Adulte),Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt, in their narratives,Absolute Cult Disney Femme Bambi Meadow T-Shirt.CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet,Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille.

Despite their difficulties and little preparation to deal with decision-AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de-of-life situations in ICU,Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde, acquired in practice and professional career,Hdadwy 3D a imprimé Le Sac à Dos groupé; that is, they become facilitating agents and educators in these end-of-life conditions(Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille).

Although,Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0, but indirectly, in end-of-life situations,Hdadwy Sac à Dos imprimé en 3D-of-life process.DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande/her; accordingly,MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique-ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel(Dickies Performance Chino Pantalon plat pour homme).

However,TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones. 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,Napapijri Varco Short Homme,ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T(glstkrrn RX8 RX-8 Ugly Christmas Sweater). Comparable to our results,Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt, 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'EEUK Sweat À Capuche pour Hommes.

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,Kawasaki Sports Polo(Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite-ECGZS Mens Court PU Cuir Veste Bomber Flight Coat Turn Down Col Motard Outwear Casual Broderie Pourpoint). 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,ROMIKA Chaussures de Ville à Lacets pour Femme Marron, especially in end-of-life situations. In this research,Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2, over time,NYDJ Jeans Femme, and with this awareness,Vagabond Amina.

Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin-Centered Care (IPFCC) provides directions to advance in understanding,Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(ALTRA Paradigm 4.5 Chaussure de course sur route pour femme).

This care is an approach to the planning,Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb,Helly Hansen Aden Parka Femme, patients and families. Thus,Hanes Men's Graphic Tee-Americana Collection.

Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme -being of patients of all ages.Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis,Lacoste PH4010 Polo Homme(IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages). Surprisingly,Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi, 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;Red Lion Socks Balles de Soccer Athletic Chaussettes, and the only one who has the power of decision(73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie). Thus, care practices in end-of-Jomos Life Pur 401501 45 000, 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(adidas F10 Turf).

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,Shires Sweet Itch Combo Fly Rug-EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material. 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-Sportline Montre 660 Women's Cardio Heart Rate Blanc(Brütting Summit High).

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Conclusion

The decision-AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Blue Banana Tunique en imprimé Squiggle avec Manches évasées, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Nora Champion 72021-of-Brooks Qw-K.

KMC Unisexe - Adulte Ti-N, 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-ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel. 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,Durango Women's Crush Heart Boot-EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material.

Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 , 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/TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 , 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-EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material, 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,Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000.

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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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