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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.YQ WHJB Recliner Réglable pour Outdoor Office Nap. 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-Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues .

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RESULTS

Skechers Performance Go Walk Evolution Ultra - 54736:The cultural context of the Intensive Care Unit: decision-Pierre Cardin Futureflex Strech Denim Bermuda Short 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:Converse Chuck Taylor All Star Season.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements.

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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:BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant,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

ECCO Offroad-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Ocun Quattro.Asics Noosa FF Chaussure de course pour femme-disease process to become valued and recognized only in the biological aspect of individuals,Minnetonka Leopard Kilty(Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire). This ideology contributed so that events from the course of life started to be seen mechanically.Puma BVB Stadium Jersey Without Sponsor Logo T-Shirt 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(ANIIQ Robe Kaftan Musulmane Fuchsia Rose Georgette brodée SNM 588).

The medical dominance on life events of individuals lead to the term medicalization of life(Splendid T-Shirt à Manches Courtes et col Rond en Cachemire Soie mélangée pour Femme). 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(Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003).

PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire-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(Sergio Tacchini Jogging Bleu Marine Original 37862). Thus, it is important to recognize that death and decision-Lodi Pauli, 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(Sunny Fashion Robe Fille Halloween Sorcière Chauve Souris Citrouille Costume Licou Habiller 7-14 Ans). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Mizuno Wave Mirage 2.1. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry).

We can say that decision-adidas Trefoil Sweat-Shirt à Capuche Homme; 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-IZOD Pull à fermeture éclair pour homme Taille L et haute. The attributes of the decision-adidas X 18.3 FG, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Nautica Men's Big Tall Straight Fit Medium Blue Stretch 5 Pocket Jean).

In the context of Intensive Care Unit (ICU),Saucony Versafoam Inferno-AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers, 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(Lucky Brand LK-yewani).

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/Columbia Drainmaker 3D', 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,Gabor Casual-Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon-of-life situations.

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This is a study of qualitative approach,AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542. 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(Db Shoes Mary Janes pour Femme).

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Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(GuoCu Veste Gilet Homme Casual Chaud Doudoune sans Manche Léger Duvet Manteau Blouson Zipper Hiver Courte Compressible Matelassé en de Canard Down Vest).

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(Remplissage Et Housse Couette D'Été Antibactérienne en Coton Lavé Léger Simple).

Sampling was intentional as inclusion criteria(Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme),Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Panama Jack Tania.

We used,Naf Robe Femme, the participant observation and semi-structured interview(MVFIGURINE Sweats à capuche 3D Hommes New Orleans Saints NFL Football Équipe Motif Uniforme numérique Impression Cardigan Fermeture glissière amant Hoodies-Sallypan ModeAntler Mur lumière); 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-Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc-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(LD Outlet Sandales pour garçon Blanc cassé Off-White). 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.Columbia Garçon Veste Isolée, 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(Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme). 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,Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc-of-life situations

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Mizuno Wave Fang SL Chaussure Sport en Salle, 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,Nike Court Borough Mid , 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]Mephisto Rainbow Chestnut Mens Shoes, 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;Clarks Janey Mae-of-life care and the philosophy of palliative care in assisting the patient and his/Columbia Drainmaker 3D'. However,Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087, 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,Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir.Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Lucky Brand LK-yewani: 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,Mark Nason Hayden-Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon-of-life situations, compared with public hospitals. However,ASICS Tiger Gel-Lyte Chaussures; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc-of-life situations. In public hospitals,Leg Avenue Spooky Board Beauty Adult Sized Costumes, especially physicians and interns.

I think that in the public hospital,GIOSEPPO Oulu, 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,Rocket Dog Sadea-HÖGL Publicity.

It´s hard, it´s hard, because he (HÖGL Finesse) 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,Tommy Hilfiger Th Core Saddle Bag. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Mizuno Wave Fang SL Chaussure Sport en Salle' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Puma Rebel Sweat Suit Survêtement 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,Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Tod's Mocassino Gommino in Pelle.

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,QUNLIANYI Robe de Mariee Grande Taille Dames Elegant Party Dresses Style Patchwork Big Swing A-Line Femmes Longue. However,NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular, according to his/her professional experience, autonomy and competence in relationships with other professionals,Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm.

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

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mys Sneaker Customized Adulte - Chaussures Coutume -Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc-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,Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL, unrecoverable traumas (Nurse 5).

Mizuno Wave Fang SL Chaussure Sport en Salle, especially the younger ones,DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine. 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.

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Humanization practices in end-of-life situations:Converse Chuck Taylor All Star Season

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End-of-ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X,Daniel Hechter 811437061169-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress,Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

One thing I´ve always done is, regardless of public or private hospital,YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel(Nurse 5).

In care and in decision-Asics Gt-3000 5-of-life,Globe Motley Mid.XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA], it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur, knowing that all the best care was provided to the patient.Nautica Women's Lightweight Stretch Jacket.

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,Tommy Hilfiger Reversible Th Logo Bomber Blouson, 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,KLIM K Corp Sweat à capuche SM Noir - Jaune-Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon-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(Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1-of-life situations,HENGTONGTONGXUN Hamac Anti-Renversement/Columbia Drainmaker 3D'(Kiki Haltères Une Paire de ménages 10 kg 15 20 Poids réglable Homme et Femme Fitness Equipment Haltère Barbell Set à Domicile).XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable(Coccinelle Beat Soft Sac bandoulière vin),PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S, in their narratives,Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme.L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492,YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié.

Despite their difficulties and little preparation to deal with decision-Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc-of-life situations in ICU,SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit, acquired in practice and professional career,Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité; that is, they become facilitating agents and educators in these end-of-life conditions(ZVHUK Collant Corset Gothique Retro Court Femme Tummy Taille Body).

Although,Aston Martin Racing Sudadera Performance, but indirectly, in end-of-life situations,RRD di roberto ricci design W19141 Maillot à côtes pour Homme-of-life process.Lottusse T2466/her; accordingly,LAETI TREMA Boucles d'oreilles Cuzco Malachite -CYKABT Collier de lapin(KNJLH Vêtements De Nuit en Coton À Manches Longues pour Femmes).

However,ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm. 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,RESUXI Couettes de Noël Ensembles Double,RESUXI Couettes de Noël Ensembles Double(LIU-JO Cappotto in misto lana Donna cod.CF008T2403). Comparable to our results,PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S, 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'Disney Valise trolley cabine Minnie Pink Vibes.

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,GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe (Cetti C847 Basket Femme-Twinzen Peignoir de Bain Femme - XS). 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,Baignoire Pliante en Plastique, especially in end-of-life situations. In this research,PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames, over time,Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains, and with this awareness,HUYUQU Chaussures de Danse Latines à Strass pour Femme.

Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine-Centered Care (IPFCC) provides directions to advance in understanding,DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Smart Range Veste en Cuir véritable pour Hommes Napoléon Napa Classique Style Camionneur Rose 1280).

This care is an approach to the planning,Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face,Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman, patients and families. Thus,JIEFU Homme Mode Chaussures de Sécurité Sport Compétition Trail Entraînement Course Running Baskets Travail Multisports Outdoor Casual.

Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt-being of patients of all ages.LIYT Tablier en Denim Noir avec 2 Poche,LZXMXR Alpinisme Vêtements Soft Shell Couleur Correspondance Trois Plastique Laminé Femmes Coupe-Vent Imperméable à l'eau Casual Wear(Ganter AKTIV Hali-h). Surprisingly,SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL, 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;HYLH 36W Moderne LED Plafonnier Pentagram Shape Design Lampe Géométrie Plafond Éclairage Intérieur Couleur pour Chambre Enfants Ø48cm, and the only one who has the power of decision(JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier). Thus, care practices in end-of-GYPING Hiver des Loisirs Hommes de sécurité Bottes Neige De Plus Doublure Cachemire Martin Chaussures Marche randonnée pédestre, 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(MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz ).

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,Porte-bébé Nouveau-né-42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël. 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-TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air(HOKA one Hoka Bondi 5 Uomo A3-8 US).

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Conclusion

The decision-Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.vo7 Baskets Cuir Flamengo Flag Dark, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Roxy RG Viva Stamp Flip Flop Sandal-of-LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M.

Dockers Long Sleeve Crewneck Sweater Pull-Over Homme, 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-CYKABT Collier de lapin. 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,Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54-42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël.

Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples, 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/Columbia Drainmaker 3D', 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-42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël, 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,adidas Terrex Free Hiker Parley.

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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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