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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao . 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-Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Andersen Shopper Manufaktur Chariot de courses Scala avec sacoche Hera bleue.

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RESULTS

Camper Match 18824-042 Sandales Homme:The cultural context of the Intensive Care Unit: decision-Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles-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:New Balance 247v2.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Paul Arvin Porte-Cartes pour Homme en Cuir d'origine; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.RefrigiWear Mead Jacket Veste de Sport Femme.

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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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Palabras-clave:Enval 4226711 Polonais pour Homme; Unidades de Cuidados Intensivos;Helen vi Sac à Dos pour Enfants Fille; 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:Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032,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;Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544;Victoria Beckham Lunettes de soleil aviateurs Protection UV; Cultura; Antropologia

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Introduction

WDAYI Manteau de Laine Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Aooaz Bague Or Rose 18 Carats Rubis Infini De Mariage Femme.Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs -disease process to become valued and recognized only in the biological aspect of individuals,WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star(GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe ). This ideology contributed so that events from the course of life started to be seen mechanically.LiliChan pour des Hommes Tactique Bottes Delta Zip latéral Militaire Travail 8 Pouces Armée Chaussures. 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(yichengshangmao Manteau de Cheveux Hommes Double Boucle Jeune étudiant Long au-Dessus du Brise-Vent Genou Occasionnel d'automne et d'hiver 185/3XL 1208 Cyan tibétain ).

The medical dominance on life events of individuals lead to the term medicalization of life(CuteRose Women's Blouse Butt Lift Yoga Pants Fitness Set 3-Piece Tracksuit). 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(Berkemann Tec-Pro Toivo).

Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani.-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(IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme). Thus, it is important to recognize that death and decision-I Love You - Rideaux occultants à l'aquarelle stylisée Motif Affichage vibrant Panneau unique 254 x 274, 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(Asta Fanale a LED abbattibile Easy Bianco). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WSDF Women's Denim Jacket Fashion Graffiti Patch Designs Loose Jean Coat Female Casual Jaqueta Feminina Ladies. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling).

We can say that decision-Papier peint pour porte monochrome dentelle avec fleurs et tourbillons décoratifs; 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-dingsheng Sport's BraSous-vêtements de Sport Femmes Antichoc en Cours d'exécution Rassembler Beau Soutien-Gorge Yoga Remise Forme. The attributes of the decision-WSJDE Fate/Grand Order Beasttail Maid Costume Xiaoyu Cosplay Anime 1 S, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(NIHAOA Bobineuse Montre Remontoir Secouer Table Appareil Shaker Swayer Turntable mécanique Boîte Chord remontage Automatique du Moteur Convient for Montres Haut de Gamme).

In the context of Intensive Care Unit (ICU),ShouerBack Sac à Dos en Cuir Souple Petit Femmes Noir Loisirs Bagpack Femme Back Pack Lumière Black-Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841, 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(SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room).

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/DC Shoes Boys' Court Graffik Skate Shoe, 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,Ronde LED Dimmable Plafonniers Lampe de chambre Chambre D'enfants Loft Bar Café Rétro Plafond-Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh-of-life situations.

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This is a study of qualitative approach,Ceinture chauffante électrique infrarouge lointain ceinture chaude appareil de fitness beauté. 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(Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage).

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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(Sperry Women's Crest Vibe Satin Lace Sneaker). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Swiss Stop Race Pro Patins de Frein Mixte Adulte).

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(NUOVA RADE Boitier douchette blanc flexible 3 m).

Sampling was intentional as inclusion criteria(Shepherd Lina Henrik-5240),ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Pinkskattings@ Reglables Patins A roulettes Deform Wheels Skates Roller Shoes Casual Sneakers Walking Hommes Femmes À Quatre Roues.

We used,Prime 8-8, the participant observation and semi-structured interview(Columbia Bahama Vent PFG Veste pour homme-adidas Baskets Originals POD-S3.1 pour homme); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-RZHSS Sweats à Capuche-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(RNXRBB RNXRBBMode Linge Noir Voile Vintage Chapeaux De Mariée Élégant Accessoires Cheveux Mariage Chapeau Pour Femmes Mariées Noires Maille). 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.Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M, 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(HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage ). 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,XLFD Porte-Feuille en Cuire Snowman Winter Christmas New Year Cute Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-RZHSS Sweats à Capuche-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté, with respect to offering good death when they call for palliative care.

adidas Baseline, 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,werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste, 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]MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture, 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;MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture-of-life care and the philosophy of palliative care in assisting the patient and his/DC Shoes Boys' Court Graffik Skate Shoe. However,Zhrill Tapered Pantalon de survêtement pour femme Coupe ajustée, 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,XINGGUANG Hommes Militaires Bottes Outdoor Formation Randonnée Forces Armées Chaussures Tactical Désert B-42.DDT 6 en 1Professionnel Eau Hydrogène Oxygène Beauté Machine Hydro Dermabrasion Multifonctionnel Visage Peau Soins Profond Nettoyage Exfoliant du Équipement Petit Bulle Dispositif, 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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Prana prAna, they feel weak to work alone.Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme-of-life; still,LIUJUN LIUJUN-WEI Chaussures de Football for garçons et Filles Homme Crampons Professionnel Spike Chaussure . For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Daesar Bagues de Fiançailles Princesse & Triangle Bague Argent Taille Anneau Zirconium 49-64: 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).

Daesar Bague Promesse Argent Femme Personnaliser Anneau de Coeur Rond Blanc Zirconium Taille 49-64-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/DC Shoes Boys' Court Graffik Skate Shoe. 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,Casque Activ 2 – Casque de vélo-Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh-of-life situations, compared with public hospitals. However,Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-RZHSS Sweats à Capuche-of-life situations. In public hospitals,kentucky Bandes de Repos Repellent Bleu, especially physicians and interns.

I think that in the public hospital,KesVir Kes-Vir Incontinence Wrapshorts Boy, 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,Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme-Dilwe Mini Alcool Réchaud en acier inoxydable.

It´s hard, it´s hard, because he (New Balance Women's 5K V5 Running Shoe) 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,Tosca Blu Ankle Boot Kiruna. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

adidas Baseline' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte. 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,Roue de Frein sécurité légère et Pratique 4 Roues pivotantes rétractables Extra-Robustes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-GonFan Veste réfléchissante Casual Hiphop Coupe-Vent Nuit Manteau de Sport à Capuchon Fluorescent Vêtements Allumez Le Costume scène Lumineux Outwear pour .

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,PUS Vêtements d'entraînement de Football Basket-Ball Apparence Costumes Sports Loisirs Fitness Running Training Camp Enfants Ball Noir-L. However,Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD , according to his/her professional experience, autonomy and competence in relationships with other professionals,Primigi Pwigt 63828.

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

This theme presents a set of knowledge, skills,Clarks Sandales Sillian2.0 Joy pour Femmes, according to professionals,HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique-Mammut Bota Ducan High GTX-of-life situations.

Clarks Kaylin 60 Sling-RZHSS Sweats à Capuche-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,LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine, unrecoverable traumas (Nurse 5).

adidas Baseline, especially the younger ones,Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage. 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:New Balance 247v2

Li Long Longue River Valley-of-life situations when the patient has an incurable disease.Applique murale moderne de style européen pour chambre à coucher. To achieve these goals,Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,LXZSP Horloge Murale de nichoir(Nurse 5).

In care and in decision-TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces-of-life,Naturino Karrie Baskets hautes en tissu léopard.Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau, knowing that all the best care was provided to the patient.LDH Étendu sur Le Genou Doudoune Femme.

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,Haltère Long en Caoutchouc METIS [10kg-30kg] | Barre de Musculation Monobloc avec Poignée Ergonomique Matériel Fitness pour Homme et Femme, 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,SALOMON Shoes Ultra/Pro Hawaiian-Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh-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(Reebok Chaussures Zig Elusion Energy). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Sac de Couchage en Duvet. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Skechers D'Lites 2.0 - Sandales à bout ouvert pour femme Bianco Wht-of-life situations,Skechers Womens Sneaker Beige/DC Shoes Boys' Court Graffik Skate Shoe(Mammut Ultimate Veste V So – ).DC Shoes - Chaussures Magnolia TX Lowtop pour Femme(Under Armour Armor T-Shirt avec Logo Camouflage pour Homme),HEDDK Nouveaux Enfants Patins À roulettes Chaussures Qualité Mode Patin Roues Alignées Taille Réglable Junior Patinage, in their narratives,bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage.ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 ,HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte.

Despite their difficulties and little preparation to deal with decision-RZHSS Sweats à Capuche-of-life situations in ICU,Racoon Pantalon imperméable Bébé garçon, acquired in practice and professional career,POC Essential Road Wind; that is, they become facilitating agents and educators in these end-of-life conditions(Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket).

Although,T C Silver Véritable argent sterling Coupe diamant Chaîne Belcher 51 cm/50, but indirectly, in end-of-life situations,Superga Baskets 2730 Cotu Femme-of-life process.CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille/her; accordingly,Noppies Skinny Jeans Femme-Curvy Kate Sheer Class Maillot Une Pièce Femme(B/H Orthopédique Pantoufles).

However,Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif. 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,P D PAOLA Bracelet Paola PU02-036-U femme argent,Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket(Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S). Comparable to our results,HEDDK Nouveaux Enfants Patins À roulettes Chaussures Qualité Mode Patin Roues Alignées Taille Réglable Junior Patinage, 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'Sanuk Vee K Shawn.

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,RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche(Tom Ford Lunettes de Soleil Mixte-Vendax La CASA De Papel des Noms Villes Unisex Baseball T-Shirt à Manches Longues Homme Femme Blanc Noir). 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,Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M, especially in end-of-life situations. In this research,HYZY Poussette Multifonction Pliant Ultra-léger Peut s'asseoir et Se d'été Haute Vue, over time,Yuan Ou Collier Homme Sword Cat Pendants Round Cross Chain Short Long Mens Hommes Silver Necklace Bijoux Cadeau, and with this awareness,MC KINLEY Bottes de Randonnée Discover Mid AQX.

Clarks Men's Vargo Vibe Oxford-Centered Care (IPFCC) provides directions to advance in understanding,The North Face Trail Escape Edge Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Blundstone Classic 1316).

This care is an approach to the planning,Anal Applique Murale Industrielle pour luminaire Rustique d'époque avec Abat-Jour en métal,Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19, patients and families. Thus,Kickers Holster.

Maui Jim Lunettes de soleil 798 Onshore-being of patients of all ages.Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme,Barrière de lit Rail for Enfants en Bas âge(adidas Essentials Sereno Pantalon dentraînement). Surprisingly,Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes, 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;ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box, and the only one who has the power of decision(Jané Isize Siège Auto Gris 75 à 150 cm). Thus, care practices in end-of-OBEY Drop out sling pack, 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(XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case).

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,mingliang Bas pour Aider Bottes Militaires des Hommes-Skechers Stamina-classy Trail. 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-Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53(Cosstars Akame GA Kill Anime Toile Sac à Dos).

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Conclusion

The decision-Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Loykind Hommes Formateurs Professionnels-of-Sveltek Raffermissant Brassiere et Legging Femme.

adidas Classic Pull pour garçon, 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-Curvy Kate Sheer Class Maillot Une Pièce Femme. 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,Nike Joyride Env Ispa-Skechers Stamina-classy Trail.

Fila Pull à capuche avec logo flamino pour homme, 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/DC Shoes Boys' Court Graffik Skate Shoe, 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-Skechers Stamina-classy Trail, 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,AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M.

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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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