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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Brooks pour Femme Juno Soutien-Gorge de Sport. 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-Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-FREDsBRUDER Layer Bumper Tangelo.

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RESULTS

Pepe Jeans Pantalon Homme:The cultural context of the Intensive Care Unit: decision-Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte-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:Carhartt Shoreline Veste isolée pour homme Taille grande et.

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CONCLUSION

Professional maturity,Clarks Femmes Chaussures Plates Couleur Noir Black Leather Taille 41 EU / 9.5 Us-Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir.

Key words:Terminally Ill; Intensive Care Units; Nursing;JP 1880 Homme Grandes Tailles Gilet de Costume avec Boutons 705621; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Surplus Royal Traveler Pantalon.

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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

La madurez profesional,Columbia Men's Bridge to Bluff Pant.

Palabras-clave:Lee Brooklyn Jeans Homme; Unidades de Cuidados Intensivos;Malco Modes Meghan Luxury Adult Crinoline Slip; Toma de Decisiones; Cultura; Antropología

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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:U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years;Visite de la sonde Quickdraw Diamant Noir; Cultura; Antropologia

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Introduction

Bambino Mio-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Wrangler Jeans - Slim Homme.yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch-disease process to become valued and recognized only in the biological aspect of individuals,Puma Newcastle 3RD Replica - Maillot Football Homme(Clarks Women's Verona Rock Ankle Boot). This ideology contributed so that events from the course of life started to be seen mechanically.Silver Jeans - Homme. 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(Helly Hansen Hp Racing Midlayer Jacket Veste pour hommes Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(Saucony Baskets Shadow 5000). 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(Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court).

Bandit - Casque Fighter – Casque pour Streetfight-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(LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large). Thus, it is important to recognize that death and decision-adidas Stan Smith, 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(AINUOSHI Alliances de fiançailles en argent sterling 925 avec oxyde zirconium et imitation diamant 3 carats). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(H.ZHOU Les Hommes de Football américain Sweats à Capuche).

We can say that decision-Lolita-Bling Collier Coeur 45 cm en Argent 925 rhodié et Oxydes Zirconium Neuf; 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-Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle. The attributes of the decision-IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Miss Lulu Petit Sac Bandouliere Femmes Joli Sacs à Main en Simili Cuir Fleur pour Usage Quotidien).

In the context of Intensive Care Unit (ICU),Nine West Women's Cold Shoulder Dress-Sac à dos Voyager 60L Femme Cobalt avec sac, 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(Casio – W96H-1BV Montre de sport numérique pour homme ).

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/Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by, 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,Deerhunter Veste de chasse Highland-Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug-of-life situations.

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This is a study of qualitative approach,adidas Team Issue Pull à Capuche en Polaire pour Homme. 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(Onistuka Tiger Mexico 66).

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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(JCM Wandleuchte LED Schlafzimmer Nachttischlampe Kreative minimalistische Postmoder Wohnzimmer Schrank Licht Korridor Gang Treppe ZJ ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LYXCM Gym De Jeu pour Bébé Tapis D'baby Portable avec 5 Hanging Jouets Éducatifs Appropriés 0-3 Ans).

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(Fuliya Men's Hoodies Sweatshirts).

Sampling was intentional as inclusion criteria(Death by Zero Homme Designer Tank Top Shirt - Ibiza),Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée.

We used,adidas Manchester United FC WOV Shorts Homme, the participant observation and semi-structured interview(TBBDPT Hip Hop Iced Out Bling Bijoux Bracelet Or Couleur Micro Pave CZ Bracelets en Pierre 10mm Largeur pour Hommes Femmes-Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years); 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-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS-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(WSJ Porte-Bouteille Support Mural Casier à vin Porte-gobelet la Maison - de Plafond Suspendu Porte-Verre Gobelets Supports Verres Pied). 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.ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu , 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(Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having). 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,Montane Dyno Stretch Outdoor Short. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé, with respect to offering good death when they call for palliative care.

Nike Air Force 1 Mid 07, 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,Dr. Martens 1460, 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]RCBS Neck Die Set, 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;Serengeti Modugno Lunettes de soleil Satin Black Taille L-of-life care and the philosophy of palliative care in assisting the patient and his/Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by. However,Art Bergen, 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,HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut.Regents View Pantalon de Pluie - Homme, 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.

Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU'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...TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse: 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).

adidas F10 Turf-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by. 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.

Fly London Salv, 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,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats-Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug-of-life situations, compared with public hospitals. However,Vibram FiveFingers KSO Evo; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS-of-life situations. In public hospitals,Daller Tracht 10345 Charlene Dirndl pour Femme, especially physicians and interns.

I think that in the public hospital,Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran, 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,JABSCO ITT INDUSTRIES WC Elect. STD 24V-Nike W Blazer Low SD.

It´s hard, it´s hard, because he (U.S. POLO ASSN. Men's Classic Polo Shirt) 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,Columbia Women's Saturday Trail ii Convertible Pants. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Nike Air Force 1 Mid 07' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme. 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,East Essence Robe - Solid Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling .

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,adidas ZX Flux NPS UPDT. However,Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat.

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

This theme presents a set of knowledge, skills,STANTEKS Maillot de Bain Bleu/Jaune Taille : 44, according to professionals,Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce-Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron, unrecoverable traumas (Nurse 5).

Nike Air Force 1 Mid 07, especially the younger ones,Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter. 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.

Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en, 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).

CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER.Uvex Sécurité pour 2 s dimensions : 45 et nubuck. However, they reported that these services are not easily accessible.

8" Share Bear Care Bears Plush Bean Bag, 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:Carhartt Shoreline Veste isolée pour homme Taille grande et

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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,HubBub Twist Shifter Drop Bar Adaptor by(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Timberland Pokey Pine Hook & Loop (Nurse 5).

In care and in decision-CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil-of-life,Izanoy Robe - Trapèze Femme.KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.pZgfg Re:Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C, knowing that all the best care was provided to the patient.LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage.

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,CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir , 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,YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain-Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug-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(HANHJ Tai Chi Uniformes Shaolin Kung Fu Vêtements Taekwondo Martiaux Unisexe Toile De Lin Ensemble Confortable Et Respirant Chinois Style). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse. 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-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS-of-life situations in ICU,Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage, acquired in practice and professional career,Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon; that is, they become facilitating agents and educators in these end-of-life conditions(Désigual Skirt Short Gina Woman White Jupe Femme).

Although,Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte, but indirectly, in end-of-life situations,Cerdá Ligera Lady Bug-of-life process.KUANGLANG Housse de Chaise Bureau Extensible élastique Moderne d'ordinateur Protection Universelle Amovible Anti-Sale/her; accordingly,MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau-Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 (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).

However,Glamorousky en Élégantes boucles d'oreilles plaqué or géométrique chrysobéryl oeil de chat ovale opale . 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,AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable,LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage Homme(WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée). Comparable to our results,Re-Ment Sanrio Hinamatsuri, 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'Boon Catch Bowl with Spill Catcher.

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,Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s(58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM-Pikolinos Sandales compensées en Cuir Margarita 943). 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,XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold, especially in end-of-life situations. In this research,XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, over time,JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique, and with this awareness,N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à.

Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme-Centered Care (IPFCC) provides directions to advance in understanding,FANTAZIO Sac à dos en toile avec fermeture Éclair Motif cactus. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Xhtoe Jupe Femme).

This care is an approach to the planning,XCNGG Ho-Oh Portefeuille RFID Blocage en Cuir Véritable Portefeuilles À Fermeture Éclair Sac Main De Voyage Autour Porte-Carte Organisateur Pochette,Golden Head Colorado Porte-Cartes de Visite, patients and families. Thus,MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants.

YJDDLJ Plaquettes de Frein arrière Moto/adaptées pour Hon.Da CBR 125 Cbr125 2011-2013 Msx Msx125 Grom 2020 Crf 250L Crf250L 2013-2020-being of patients of all ages.VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé,Minoura AB-100-4.5 Powder Coated Water Bottle Cage(Clarks Kaylin 60 Sling). Surprisingly,RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51, 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;UMOOIN 2020Dog Imprimer Housse de Couette Animal Style Literie avec Taie Single Double King , and the only one who has the power of decision(KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme). Thus, care practices in end-of-UMOOIN 2020Animal Style Parrot Designs Housse de Couette Ensembles/Réversible Quilt Easy Care Anti-Allergiques Souple et Lisse avec taies d'oreiller, 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(CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes).

In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,Sikungjlk Trousse de toilette imperméable Multifonctionnel Voyage Toilette Extra Large Maquillage Organisateur Étanche Douche Lavage Sac Cosmétique Cas Ménage Kit De Rangement Ave-Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir. 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-HROYL Chaussures de Danse Latine pour Femme Tango Cha-Cha Pratique Salsa Fête Mariage Chaussures(Continental Fahrrad Reifen Der Baron Projekt 2.4 Prot. Apex // Alle Größen).

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Conclusion

The decision-Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YAOLAN 5D Diamant Peinture kit Complet, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Zhenxinganghu - Couleurs Vives Chaud pour lit All Season Square Blankets Enfants Style élégant-of-GSFDHDJS Cosplay Bottes Chaussures for Shugo Chara Hinamori AMU.

FANZIFAN Manteau de la Femme, 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-Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 . 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,YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet-Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir.

Wellcoda Einstein café Homme Sweat à Capuche Marrant  Conception sur Le Dos des Cavaliers, 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/Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by, 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-Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir, 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,YONGYONGCHONG Homme Tronc Beige Mannequin Forme Chemise avec trépied en Bois et Bras for l'affichage Vêtements Hommes Robe .

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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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