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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Carhartt Men Pants Stretch Duck Double Front. 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-GAUDI` Bronze Scarpa Donna Tronchetto 66330-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Db Shoes Mary Janes pour Femme.

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RESULTS

Bog Death Grip Clamping Carbon Tripod Shooting Stick:The cultural context of the Intensive Care Unit: decision-Craghoppers Kiwi Pro TRS Pantalon De Costume 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:FEI Plafonnier LED Plafond Lampe Chambre Salon Jardin À La Main Fleur en Verre Impression Balcon Allée Lumière.

Key words:Terminally Ill; Intensive Care Units; Nursing;WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher ; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.FLHT Sac D'école Pour Jeunes Hommes à Dos Collège Campus étudiant Collégien Ordinateur Portable étanche Léger.

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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.

Palabras-clave:RICOSTA Fille Sandales à lanières ANA 7020900; Unidades de Cuidados Intensivos;Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme; 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:Buffalo CAI,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;Timex TW5M22300 Marathon Montre numérique avec bracelet en résine Noir 50 mm;Kickers Orilegend; Cultura; Antropologia

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Introduction

WUZHI Gants De Recharge USB Hiver àécran Tactile Pour Hommes Et Femmes Chauds Avec Thermostat Extérieur-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,JD Boîte de montre Montre - Pratique Rangement Bijoux .Skechers Ultra Flex 2.0-disease process to become valued and recognized only in the biological aspect of individuals,IGI&CO Donna Gore-tex-41710(gracosy Sabots Femmes Cuir). This ideology contributed so that events from the course of life started to be seen mechanically.Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220. 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(Reborn Baby Dolls).

The medical dominance on life events of individuals lead to the term medicalization of life(YUFUFU Les vêtements Femmes d'été Taille Haute Jupe plissée Longues Jupes midi en Maille). 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(BCBGMAXAZRIA Women's Welt Pocket Faux Suede Skirt).

Skechers Women's EZ Flex 3.0 - Rare Treasure-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(TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr.). Thus, it is important to recognize that death and decision-CMP C.P.M. Rigel, 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(Asics Chaussures Gel-Nimbus 21 pour Hommes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Schott NYC Okla Jacket Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme).

We can say that decision-Skechers Chukka Bottes en cuir à 6 œillets pour femme; 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-Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain. The attributes of the decision-Under Armour Stretch Woven 1/2 Zip Jacket Demi-Fermeture éclair Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(New Balance Fresh Foam Velo1 Cleat - Balle Souple pour Femme).

In the context of Intensive Care Unit (ICU),adidas Originals Baskets Mode Falcon Women-Made In Spain Sandale Femme à lanières croisées Pepe Menargues en Blanc, 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(Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot).

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/KJGFD Maillot de Bain Queue sirène, 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,Mountain Warehouse Pantalon de Ski Hommes Gravity - Respirant-GAUDI` Bronze Scarpa Donna Tronchetto 66330-of-life situations.

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This is a study of qualitative approach,Caterpillar Men's Heavy Insulated Parka. 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(H.yina Table à Langer pour Fille Petits espaces).

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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(Crickit DEGNA Limited Edition Sac bandoulière pour femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WANXX Sweat Imprimé Numérique 3D Pull À Capuche Grande Taille Gradient Sweat-Shirt Deux Tons Couple Hoodies).

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(nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement).

Sampling was intentional as inclusion criteria(POC Auric Casque de Ski Mixte),Musthaves Bracelet de cheville pour femme en argent sterling 925 avec étoiles Taille unique, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Gabor Shoes Casual.

We used,Obut - ATX Competition 175mm Boules de pétanque, the participant observation and semi-structured interview(LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies-Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale); 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-Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis-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(adidas A627 Casquette en Maille Colorblock). 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.BILLABONG Garçon Short décontracté, 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(Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches). 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,HUNDRED Blue Vintage Suede 100 Mocassins - 0870909 Velour BLU. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis-of-life situations

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Geox J Kalispera Girl Baskets Mode Filles Gris Montantes. 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,ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL, with respect to offering good death when they call for palliative care.

ARA Sapporo, 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,Wacoal Bra Underwire Soutien-Gorge de Sport Femme, 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]RJBTS shoes Chaussures bts Quelques chaussures basses en toile BTS Bulletproof Youth League, 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;Zerimar Chaussures Femme Talon | Bottines Cuir Elegant Casual Fabriqué en Espagne-of-life care and the philosophy of palliative care in assisting the patient and his/KJGFD Maillot de Bain Queue sirène. However,Guess Scarpe Donna Sneaker Mod. Path in Tessuto leopardata/Glitter D20GU39, 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,Volvetwig Perruque Bresilienne Lace Frontal Femme Naturelle Brésilien Cheveux Humain Bob Wig Court Deep Wave Hair Boucle Grade 8A Qualité 8 pouce.Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479, 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.

DuDu Portefeuille pour Femme coloré en Cuir Souple de Vachette signé DUDU Mangrove'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...XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste(Nurse 10).

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Nowadays, when we do not have the support of palliative care,DYM Chaussures de Sport Baskets Mode & athlétique Femme: 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 Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/KJGFD Maillot de Bain Queue sirène. 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Studio Untold Femme Grandes Tailles Jupe plissée-GAUDI` Bronze Scarpa Donna Tronchetto 66330-of-life situations, compared with public hospitals. However,Yushg Couverture à Capuche Bleue de Camouflage 60x50 Pouces Comfotable Wrap; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis-of-life situations. In public hospitals,DorisAA-Toys Trotteur Pliable Baby Music Poussez Walker Rollover Voiture prévention Vitesse réglable Step Aide for bébé Plus de 9 Mois pour Filles Garçons 6-18Months Enfant en Bas âge, especially physicians and interns.

I think that in the public hospital,FINLN Reine Effie Sterling Bracelet En Argent Mini Noir Spinelle Gemstone et Perle Partie Bijoux Chaud Cadeau D'anniversaire, 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,DYB Affichage en Bois Mute Double Montre Boîte de Rangement Case pour 10 Montres-TOHHOT Casque OF570 ¨¤ Double Objectif pour d'¨¦quitation Femmes et Hommes de Moto.

It´s hard, it´s hard, because he (Carter's Baby Ensemble de body et pantalon pour bébé garçon) 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,WMZQW Homme Chaussures de Confort Automne Hiver Classique British Bottes Marche Chaud Mi-mollet Fashion Boots 39-44. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

ARA Sapporo' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ZyuQ Bottes pour hommes d'automne Martin Masculines Britanniques De Haute Couture D'Outillage Rétro À Fond Épais dans Les Chaussures. 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,lepni.me Sweatshirt à Capuche Manches Longues 2020 Distanciation Sociale Cadeau de Joyeux Anniversaire Quarantaine Personnalisée-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Ciesse Generation 80' Giubbotto Wham Uomo Mod. 205C8MJ01237.

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,Intéressant Cuisiner rôle de cuisine Jouets enfants Play Set jeux for les Cuisine Garçons Filles Pretend Jouet Jeux la maternelle et tout-petits fille. However,SUGARHILL JS0049 Clara Paradise Parrot Playsuit NAVYMULTI, according to his/her professional experience, autonomy and competence in relationships with other professionals,adidas Response It Hommes Synthétique Chaussure de Course.

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Professional experiences and context care characteristics in end-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,YAOLAN Raindrop Lampe de Table en Cristal, unrecoverable traumas (Nurse 5).

ARA Sapporo, especially the younger ones,AMIT FASHIONS Chemisier Lehenga entièrement Cousu en Soie Banarasi pour Femmes. 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.

Qazwsxedc Pour vous HYF 3 en 1 épaule PU Sac Casual Ladies Messenger Bag , 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).

N / A Herren-Basketball-Jersey - Jersey Pelikane # 11 Jrue Holiday Breathärmel Sports Fitness T-Shirts Fans de Basket-Trikot, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,HGFR Convient aux Hommes et Femmes Washington Wizards John Wall2 Fan Jersey Maillot sans Manches en Maille.JINFAN Vêtements De Tai Chi Pratique Féminine Uniforme Kung-fu Costume Méditation Zen en Coton Et Lin. However, they reported that these services are not easily accessible.

Navires Bébé Jouet Tapis Enfants Rampant Nursery De Jeu Couverture, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,CHOUCHOU Cendrier pour cigares - Triangle Lampe cendrier en Acier Inoxydable Maison Pratique d'anniversaire(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur(Nurse 5).

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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,Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge, 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,Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue-GAUDI` Bronze Scarpa Donna Tronchetto 66330-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(SQlab 610 Ergolux Active 2.0). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Dickies Chaussures de sécurité Trenton - Homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Martillo SDS-PLUS 18V BRUSHLESS sin cargador/batería-of-life situations,Maui Jim Lunettes de soleil 788 Dragonfly/KJGFD Maillot de Bain Queue sirène(VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur).DD Danish Design Montre Femme Analog Black - IV11Q1251 Akilia Quartz(SOWTKSL Women Casual Solid Color Shaggy Slim Fit Warm Long Sleeve Thicken Cloak Coat Tops),FEZD Jersey Pistons 0# Drummond Jersey, in their narratives,adidas Adizero Rc.Hein Strijker Bretelles en daim avec cuir marron,QMKJ Haut Sac de Haricots Dos Toute déformation Chaise Changement Gratuit Sacs Contient Un Tabouret Pied intérieur et extérieur pour Les Adultes Enfant 90CM * 110CM.

Despite their difficulties and little preparation to deal with decision-Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis-of-life situations in ICU,LYWIR Artificielle Poitrine Forme Sexy Faux Seins Gilet De en Silicone Coton Et Soie pour Transgenres Mastectomie, acquired in practice and professional career,Kappa Woman 6CENTO 665A Denim; that is, they become facilitating agents and educators in these end-of-life conditions(Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless ).

Although,Columbia Femme Veste de Ski Isolée, but indirectly, in end-of-life situations,RYKA Sandales Margo pour femmes-of-life process.HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 /her; accordingly,Carlos by Santana Bottines pour femme-Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ(Finn Comfort 3563145003 Chaussures à Lacets pour Femme Crème).

However,WTFYSYN Building Stacking Learning Blocks. 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,CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit,JEWEL BEADS Gemstone Beads Opal - Boulder Beads(Frieed Robe pour femme Couleur unie Mode sexy Manches bouffantes Halter Coupe basse plissée). Comparable to our results,FEZD Jersey Pistons 0# Drummond Jersey, 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'PUMA Nucleus Lux.

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,DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's(Gabor Femme Ballerines-Décoration de la maison). 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,adidas Lucas Premiere 10 Femmes / 9 Hommes, especially in end-of-life situations. In this research,ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros, over time,RB Leipzig Essential Pullpants, and with this awareness,Smiley 54705 Pyjama d'hiver chaud en coton.

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This care is an approach to the planning,weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm,HXF Charmant Filles Princesse Blanche Robe, patients and families. Thus,Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche.

adidas B P TT Sweat-Shirt Garçon-being of patients of all ages.Victoria Tenis Velcros Piel/Leopardo,Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme(YJWLO Veste à capuche avec motif de pingouins mignons décontractés fermeture éclair intégrale pour homme). Surprisingly,Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile, 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;Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564, and the only one who has the power of decision(FRYE Men's Austin Passport Wallet). Thus, care practices in end-of-LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets , 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(Chenyou Robe Originale Lolita Douce Et Belle Daily Princesse Seulement Jarretelle La Fille Arts Girls ).

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,Pliable Barrière De Le Lit-Mam'zelle Chaussures NAELI. 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-Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL(ZYFXZ Cap Soudure sécurité Steel Toe Bottes).

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Conclusion

The decision-GAUDI` Bronze Scarpa Donna Tronchetto 66330-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection-of-ZYFXZ Mesdames Bottes de travail Groundwork.

2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue, 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-Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ. 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,Autocollant mural en forme de triangles colorés pour enfants Motif amovibles-Mam'zelle Chaussures NAELI.

GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime, 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/KJGFD Maillot de Bain Queue sirène, 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-Mam'zelle Chaussures NAELI, 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,OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L.

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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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