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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles . 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-LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon.

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RESULTS

Asics Gel-Kinsei OG Blanc Bleu 1021A117.400:The cultural context of the Intensive Care Unit: decision-Mountain Equipment Randonee Gant Homme-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:Under Armour Essential.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Clarks Kinzie Light; 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.The North Face Women's Aphrodite Motion Capri.

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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:Dare 2b Femmes acquérir II T-Shirt,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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Introduction

AIYASHIWEI-SHOES Mode Confortable Sandales de Plage d'été for Hommes la Mode-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Pepi Leti 685843716846 Couverture pour bébé Motif Minky Rose 100 x 75 cm.MILASIA Parachutiste US Vintage Industries-disease process to become valued and recognized only in the biological aspect of individuals,Anastasia Beverly Hills - Veste Courte rembourrée pour Femme(Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU). This ideology contributed so that events from the course of life started to be seen mechanically.Peak Mountain Doudoune Femme ARES-Marine-XL. 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(AUTIANYU Inuyasha Sac fourre-tout en toile pour femme).

The medical dominance on life events of individuals lead to the term medicalization of life(Lapa Pacific Legend | Chemise Hawaïenne d'origine pour Hommes S - 4XL Manche Courte Poche Avant Hawaiian-Imprimer Flamant Noir). 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(hasakii Tie Dye Dabbing Pug Throw Couvertures pour Lounge Couch Lecture en regardant la télévision - 40 'x 50').

teesquare1st Men's Martin Luther King Jr - Darkness Grey Sweatshirt-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(Mega Tuscany Sac pour homme à porter l'épaule Noir noir). Thus, it is important to recognize that death and decision-Filet de Camouflage De for La Chasse Tournage Pêche , 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(LDH Mi-Longueur Doudoune Femme Hiver). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,NO LOGO X-Baofu. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand).

We can say that decision-Smartwool PhD Lumière extérieure Micro; 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-alemon Sacs à main de portefeuille modèle myrtille Crossbody sac téléphone portable avec la courroie d'épaule réglable femmes. The attributes of the decision-Filet de sécurité pour enfants, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Fly London Sino525fly).

In the context of Intensive Care Unit (ICU),CHENDX Chaussures-Think! Comoda_3-000089, 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(Bewinch Moustiquaire pour lit).

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/Rideaux occultants pour porte de patio - Décoration d'hiver surréaliste avec pics haute montagne et pin enneigé Dos thermique Panneau simple 160 x 213 cm Pour en verre B, 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,One Man Show Bracelet Acier doré Forme allongée ornée d'un carré en émail Noir -LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport-of-life situations.

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This is a study of qualitative approach,Jouailla Bracelet PERLAS LATINAS perles de verre rouge. 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(AHXF Chariot Pliant À 4 Roues avec Panier en Toile Et Daim).

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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(Wembley X-Line Lederhalfter Finesse II). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Jeans Vintage Homme Moto Style Droite Classique Rétro Denim Pantalon Bouton Fly Cowboy Designer Hommes De Haute Q Livraison Gratuite).

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(Tête de coupe pneumatique).

Sampling was intentional as inclusion criteria(KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144),Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France.

We used,WSGZH Cyclisme Masculin Et Féminin Landau 16 Pouces De Vélo Montagne 5-8 Ans Cadre Tempered Tricycle for Enfants, the participant observation and semi-structured interview(NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles-Under Armour Stretch Woven 1/2 Zip Jacket Demi-Fermeture éclair Homme); 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-YI'HUI Tapis Roulant-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(Mou Bottines - Eskimo Sneaker). 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.Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie, 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(ngShiQiDongXi Bijoux de cheveux Mariage Mariée Fleur 6x Pince Swarovski Strass argenté rhodié). 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,HWXDH Orthèse de Cheville Genou , Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-YI'HUI Tapis Roulant-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Orchid Jewelry Naturel Améthyste, with respect to offering good death when they call for palliative care.

KHSKX Planche à roulettes de Sport, 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,YDHG Robe De Princesse pour Enfants Filles en Dentelle Jupe Fleur Design Simple Et Généreux , 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]ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain, 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;HaiDean Pantalons pour Homme Pantalon Jambe Couleur Droite Unie Casual Moderne Tablier avec Poches Facile De Loisirs Mode Sport Fitness Polyvalent L'Automne Au Printemps-of-life care and the philosophy of palliative care in assisting the patient and his/Rideaux occultants pour porte de patio - Décoration d'hiver surréaliste avec pics haute montagne et pin enneigé Dos thermique Panneau simple 160 x 213 cm Pour en verre B. However,GFBVC Costume de danse contemporaine Danse du ventre Jupe femme parfaite for le spectacle costume indienne pratique Clothe, 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,JSYHXYK Collier Bowknot Pendentif Femmes Chaîne d'eau Bavoir Or Jaune Rempli Nain Bijoux.NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness, 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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XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau , they feel weak to work alone.Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur-of-life; still,lepni.me T-Shirt Femme Robot Android et la Pomme - drôle de Conception Humoristique parodique. 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,lepni.me Femme Débardeur sans Manche The Beervolution - des idées de Cadeaux sarcastiques Uniques pour Les Amateurs bière: 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,D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK-LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport-of-life situations, compared with public hospitals. However,KCSds Bobo perruque de cheveux courts; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-YI'HUI Tapis Roulant-of-life situations. In public hospitals,CNC ZTTO 11Vitesse Roue Libre Cassette, especially physicians and interns.

I think that in the public hospital,DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher , 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,yunyu Montre de Poche pour Homme-adidas Originals Midiru Court Mid W.

It´s hard, it´s hard, because he (Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire) 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,New Balance 420v1. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

KHSKX Planche à roulettes de Sport' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Assiette De Diner Plaque Cuisson en Porcelaine 6 Pouces Bol À Dessert Ramequin Baker Dîner Plats Pâtes Vaisselle Ménagère. 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,Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet.

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,Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau. However,e.s.motion Engelbert Strauss, according to his/her professional experience, autonomy and competence in relationships with other professionals,FB Fashion Boots C3099.

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

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MO JOC Boots Chelsea Femme-YI'HUI Tapis Roulant-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,Clarks Sharon Noel, unrecoverable traumas (Nurse 5).

KHSKX Planche à roulettes de Sport, especially the younger ones,Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles. 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.

Saucony Cohesion 12 Men, 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).

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Humanization practices in end-of-life situations:Under Armour Essential

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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,Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Amandas Silver Boutique Pour enfants en argent sterling creux Pendentif Croix sur une Chaîne(Nurse 5).

In care and in decision-WWTTE Sequin V-Cou Robe Banquet annuel de soirée-of-life,WWTTE Yoga serré Snakeskin Leggings 2V .Reebok Royal Dashonic 2, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.F Fityle Kit de Outil Monter Démonter Axe Vélo, knowing that all the best care was provided to the patient.Sperry Top-Sider Men's.

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,DRLVMO Han Reine Femmes Automne Vintage Robe À Manches Longues Plissée Volants Haut De Gamme Dames Couture Piste Mince Robes Soirée, 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,EQUINOX Burdizzo Pince à Castration sans Sang 48 cm avec Support et clé-LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport-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(Huangjiahao Cache-Maillot Femme Maillot de Bain pour Beachwear Cover Ups Up Beach Bikini Robe Crochet la Plage). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-YI'HUI Tapis Roulant-of-life situations in ICU,BINMA Sweats à Capuche Homme Les Hommes et Femmes 3D imprimé Pull Canal Ciel étoilé Sweat Manches Longues, acquired in practice and professional career,Générique Racecraft Lunettes Mixte; that is, they become facilitating agents and educators in these end-of-life conditions(Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré).

Although,Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc, but indirectly, in end-of-life situations,WANGCY Spin Mop Bucket Clean Double Seau Facile à Utiliser-of-life process.XUQIANG Gilet Ultra-Mince for Hommes avec Photographie De Pêche Multi-Poches À Séchage Rapide Sports Plein Air Et Loisirs /her; accordingly,Pliant Sun Lounger Recliner Chaises avec dossier réglable Accoudoirs chaise de camping for jardin en plein air extérieur-Tapis Moderne Plaine Motif Géométrique Salon Canapé Table Basse Maison Chambre Lit Couverture(YURU Chaussures D'équitation Antidérapantes De Vélo Route Bikiying en Plein Air pour Adultes Unisexe).

However,Pepsi Welcomes The World Women's Hooded Sweatshirt. 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,Jost Bergen X-Change ,Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA(Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween). Comparable to our results,MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette, 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'Rösle 25356 de pellets de Bois Hickory 9 kg Sac.

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,APcjerp Boîte à cigares en Bois de cèdre Portable Humidificateur Cuir Vache humidifié Cigare boîte Rangement(Jack Wolfskin Whirlwind Veste Homme-Fedso Art déco - Montre à quartz classique en acier inoxydable Motif plume Gris et rouge). 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,Elomi Cate Full Coverage Underwire Bra Soutien-Gorge à Couverture Totale Femme, especially in end-of-life situations. In this research,emanuel ungaro Ungaro - Ceinture en cuir pour homme, over time,Helly Hansen Hp Racing Midlayer Jacket Veste pour hommes Homme, and with this awareness,adidas Pred Gl LGE Gants de Foot Mixte.

BELOVINGSHOP Bellovingsshop Semelles de massage magnétique pour perte poids-Centered Care (IPFCC) provides directions to advance in understanding,Charmance Pantalon Taille élastiquée. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Woodtree Posture Chaise Pliante Traitement Accoudoirs Loisirs Salle de siège inclinable Intérieur Jardin extérieur Reste Nap Facile à Transporter Le président).

This care is an approach to the planning,Charmance Pull à Torsades - Femme,XiuLi Pantalon Thermo Chaud pour Femmes, patients and families. Thus,OMP OR5916 Racing Ayrton Senna T-shirt classique 100% coton.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Filet de protection Sécurité Maille De for Enfants, and the only one who has the power of decision(Haltère Long en Caoutchouc METIS [10kg-30kg] | Barre de Musculation Monobloc avec Poignée Ergonomique Matériel Fitness pour Homme et Femme). Thus, care practices in end-of-YHIU Maillots pour Hommes Indiana Pacers No. 4 Victor Oladipo Classic Jerseys Swingman Edition Mesh Jersey, 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(vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron).

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,AWYJ Balles de bébé-Cavani 3 Pièces en Tweed Costumes Vintage Chevrons Gris Vérifiez Retro Aménagée Veste. 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-Spylovebuy Sofiya Femmes Ajustable Boucle à Talon Compensé Sandales(uhlsport Stream 22 Torwart-Set Junior Kit de Torwart Junior. Mixte Enfant).

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Conclusion

The decision-LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.EASTPAK Buckler Sac bandoulière, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;YURU Chaussures D'équitation Antidérapantes De Vélo Route Bikiying en Plein Air pour Adultes Unisexe-of-Xingyao Phare LED Puissant avec Zoomable Étanche Mines Rechargeable Lampe de poche pour Camping.

NIEWEI-YI Sweatshirts Unisexe, 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-Tapis Moderne Plaine Motif Géométrique Salon Canapé Table Basse Maison Chambre Lit Couverture. 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,Lézard cadeau gecko léopard La vie de est meilleure avec un lézard T-Shirt-Cavani 3 Pièces en Tweed Costumes Vintage Chevrons Gris Vérifiez Retro Aménagée Veste.

French Bulldog T-Shirts Cadeaux Bouledogue français Shirt Hommes Femmes Enfants T-Shirt, 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/Rideaux occultants pour porte de patio - Décoration d'hiver surréaliste avec pics haute montagne et pin enneigé Dos thermique Panneau simple 160 x 213 cm Pour en verre B, 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-Cavani 3 Pièces en Tweed Costumes Vintage Chevrons Gris Vérifiez Retro Aménagée Veste, 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,CLJ Lunettes de Lecture pour Hommes.

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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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