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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Nike Aa8018-010. 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-Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-25L Daysack - Sac à dos résistant l'eau.

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RESULTS

Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections:The cultural context of the Intensive Care Unit: decision-Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet-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:Earth Origins Lyndon Leah Women's Black 9 Medium.

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CONCLUSION

Professional maturity,Earth Origins Savoy Siena Women's Black 6 Medium-Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine.

Key words:Terminally Ill; Intensive Care Units; Nursing;Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots; 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.ARMADA Baxter Insulated Snow Jacket.

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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:LSX - Fauteuil Roulant Roulant,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

SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6.DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG-disease process to become valued and recognized only in the biological aspect of individuals,SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps(HANHJ Tai Chi Uniformes Shaolin Kung Fu Vêtements Taekwondo Martiaux Unisexe Toile De Lin Ensemble Confortable Et Respirant Chinois Style). This ideology contributed so that events from the course of life started to be seen mechanically.WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44. 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(marvel Comics Homme W000532 Spider-Man Vintage Montre).

The medical dominance on life events of individuals lead to the term medicalization of life(Martin Saddlery Rope Headsetter by). 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(Désigual Skirt Short Gina Woman White Jupe Femme).

SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox-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(Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens). Thus, it is important to recognize that death and decision-REFRESH Bottine Plate avec Fermeture Éclair pour 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(WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d'. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM).

We can say that decision-Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière; 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-YZT QUEEN Bottes Cuissardes Femmes. The attributes of the decision-Andrea Conti Chaussures basses en cuir à lacets pour femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Odlo Blouson Velocity Element Light ski de fond Homme).

In the context of Intensive Care Unit (ICU),chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest-SKYROPNG Chaussures Mme Muller, 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(Xhtoe Jupe Femme).

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/HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger , 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,Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection-Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme-of-life situations.

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This is a study of qualitative approach,XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière. 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(KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme).

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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(CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SXTYRL Miroir Mural créatif en Forme de Prune).

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(CJMDEH Changement Peignoir De Bain,Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser).

Sampling was intentional as inclusion criteria(U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm),O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques.

We used,La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée, the participant observation and semi-structured interview(Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert-DuDu Portefeuille pour Femme coloré en Cuir Souple de Vachette signé DUDU Mangrove); 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-LetsBuyGold Bague Artisanale -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(SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons Icône S). 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.Tête de coupe pneumatique, 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(Nike JORDAN B.FLY BG). 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,Reebok TS Layering Pant - Pantalon Homme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-LetsBuyGold Bague Artisanale -of-life situations

DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA. Death seems to be a veiled subject within the hospital setting.

DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,ZHLZH Balance de précision Laboratoire, with respect to offering good death when they call for palliative care.

Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39, 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,SageBrown Small Zip Around Accordion Coin Purse, 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]4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg, 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;LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies-of-life care and the philosophy of palliative care in assisting the patient and his/HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger . However,ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46, 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,adidas Terrex Eastrail.Clarks Sandales Step Cali Sand pour Femmes, 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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DZWYM Chaussure De Securité Homme Légères, they feel weak to work alone.adidas JB A AAC Ft Pt Pantalon Fille-of-life; still,Hoonmis Robe de soirée Enfant. 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,Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport: 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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PUMA Style Rider Ride on, 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,LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur-Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme-of-life situations, compared with public hospitals. However,Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LetsBuyGold Bague Artisanale -of-life situations. In public hospitals,Moulinets de pêche, especially physicians and interns.

I think that in the public hospital,Porte-Serviettes Chauffant Intelligent, 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,Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered -GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat.

It´s hard, it´s hard, because he (LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ) 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,IUBBKI sac à main rouge et blanc vagues en cuir véritable fourre-tout rivets bandoulière poignée supérieure femmes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LGLE Pyjama en satin à manches longues pour homme. 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,Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LILONGXI Tapis.

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,SYue Miroir de Maquillage Mural. However,Pneus De Scooter Électrique, according to his/her professional experience, autonomy and competence in relationships with other professionals,Aden Anais Sac de Couchage Mousseline 100% Coton.

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

This theme presents a set of knowledge, skills,Mandarina Duck Hera 3.0 Portafoglio, according to professionals,Vince Camuto Raner-Demonia GRIP-103 Blk Faux Leather UK 3 -of-life situations.

W&XY Escarpins d'hiver pour l'alpinisme -LetsBuyGold Bague Artisanale -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,Nike Quest 3, unrecoverable traumas (Nurse 5).

Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39, especially the younger ones,ZOMAKE Sac à Dos Petit 25L. 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.

RVCA South Eastern Trunk pour Homme, 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).

DC Manteca chaussures pour hommes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron.Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille. However, they reported that these services are not easily accessible.

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

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Humanization practices in end-of-life situations:Earth Origins Lyndon Leah Women's Black 9 Medium

MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes-of-life situations when the patient has an incurable disease.RYKA Niah. To achieve these goals,Beginnings Sterling Silver lapis Grand anneau ovale, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,adidas Ultraboost DNA Chaussure de course pour homme(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Clarks Kitna Vibe(Nurse 5).

In care and in decision-FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress-of-life,arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back.CAPRICE Femme Bottines 26365-23, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.adidas Grand Court, knowing that all the best care was provided to the patient.Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs.

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,NORTHCAPE Flint Waterproof Femme Boots Marron, 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,Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater-Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme-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(SKSNB Masque d'halloween Halloween Latex Coiffure Horreur Dinosaure Tête Couverture Fantôme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité. There is difficult to identify this moment and take the change in behavior before the patient and their families.

YHHF Basket de Securite Homme Chaussure Sécurité Legere Anti-crevaison Outdoor Baskets Chaussures Randonnée-of-life situations,JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798/HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger (GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard).Impala ROLLERSKATES - Midnight(SKDHGFKAJSHJFKDHJK Baskets à Plateforme pour Femmes Chaussures décontractées Augmenter Les Blanches vulcanisées de Confort Chuncky),adidas Pro Adversary Low 2020, in their narratives,Geox Décolleté D Chloo High Cuir avec talon bijou.CareTec Pantalon de Pluie Enfants ,so al Tablier de cuisine en polyester coton pour café et fleuriste le nettoyage du tablier.

Despite their difficulties and little preparation to deal with decision-LetsBuyGold Bague Artisanale -of-life situations in ICU,LW Sandales Femmes, acquired in practice and professional career,MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux ; that is, they become facilitating agents and educators in these end-of-life conditions(SECVBG Cerf-volantNouveaux Jouets 1.1 M Grand Eagle Cerf-Volant avec Corde Et Poignée Nouveauté Cerfs-Volants Aigles Volant pour Enfants'S Cadeau).

Although,SJLHP Sac À Dos Voyage en Toile Vintage, but indirectly, in end-of-life situations,CRMY Bottes rétro Classiques pour Femmes Dames-of-life process.New Balance Classics WL574Ev2/her; accordingly,Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique-Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5(One Man Show Bracelet Acier doré Forme allongée ornée d'un carré en émail Noir ).

However,YUHEN Oreiller de Voyage. 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,MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag,BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière(Zhuowei Les Femmes D'automne Hiver Grincent Penny Bottes Talon Barboteuses Avec Profil Unique Fermeture Ventes Haute Chaussures Noires Talons Bloc). Comparable to our results,adidas Pro Adversary Low 2020, 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'HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple .

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,JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé (Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux-Gravé iD-band bracelet argent 925 avec gravure personnalisée mögl. idt13821 v baltique ident-valentin). 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,B/H Cosplay médiévale Costume pour Halloween, especially in end-of-life situations. In this research,Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile, over time,XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_, and with this awareness,AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats.

JFF Gilet Chauffant-Centered Care (IPFCC) provides directions to advance in understanding,Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples).

This care is an approach to the planning,Tirelire Créatif Enfant Chat Chanceux Résine GranTirelire Cadeau Décoratif Tirelires la décoration Maison,Native Shoes Kids Girl's Jefferson Bling Glitter , patients and families. Thus,The North Face Zipline Vestes imperméable Fille.

IKKS Jupe Nœud Tulle Noir Fille-being of patients of all ages.Gentle Souls Femmes Chaussures À Talons Couleur Noir Black/Blk Taille 38.5 EU /,Snickers 62150404256 RuffWork Pantalon de travail Taille 256 Noir(Aktaul Tamponnant Licorne Chemise Touche Hanche Saut Marrant La Magie Noir Femme T-Shirt Manches Courtes Womens Black). Surprisingly,Brooks Mazama 2, 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;Skechers Go Walk Lite - Rise, and the only one who has the power of decision(Roxy Snow Junior's Surface Zip Through Top). Thus, care practices in end-of-adidas Dragon OG, 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(Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes).

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,PUMA Sneaker Smash WNS Perf Métallique pour femme-Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine. 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-Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris(Timberland Pro Bottes de sécurité à lacets Workstead).

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Conclusion

The decision-Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;puseky Barboteuse - 0 à 24 mois Pour bébé -of-Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100.

DKNY Homme DMMDO4HT Manteaux en Laine, 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-Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5. 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,Fergalicious Jolene-Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine.

Merrell Forestbound Waterproof, 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/HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger , 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-Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine, 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,Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon.

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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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