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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Ralph Lauren Pull - Homme. 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-Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ALTRA Paradigm 4.5 Chaussure de course sur route pour femme.

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RESULTS

NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements:The cultural context of the Intensive Care Unit: decision-hsoazi Latex Panda Mask-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:WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM.

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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:Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair; Unidades de Cuidados Intensivos;ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 ; Toma de Decisiones; Cultura; Antropología

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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:NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott,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;Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage;Floris van Bommel Belts Gris; Cultura; Antropologia

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Introduction

PunkFootball Je déteste le T-shirt West Ham United de Millwall-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's.Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40-disease process to become valued and recognized only in the biological aspect of individuals,PUMA Veste de Pluie Tabaluga pour Fille(VIVIANE Boucle D'oreille Support De Rangement). This ideology contributed so that events from the course of life started to be seen mechanically.HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures. 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(Bearpaw Moc Ii).

The medical dominance on life events of individuals lead to the term medicalization of life(PUMA King Top FG). 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(DZWYM Chaussure De Securité Homme Légères).

MEETGG Porte-Bébé Multifonctionnel Trois en Un-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(Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison). Thus, it is important to recognize that death and decision-YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire , 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(Cofra V415-0-05.Z60 Tecka Veste Softshell ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Gringo Fairtrade Felt Owl Shoulder Bag. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01).

We can say that decision-Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière; 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-Npeiyi Seau pour urine féminine. The attributes of the decision-Kamay's Kamay’s Boîte de rangement, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(KIUYMRV Sac à Main en Cuir Vintage décontracté avec poignée supérieure pour Femme).

In the context of Intensive Care Unit (ICU),Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible-HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages, 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(Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54).

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/DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day, 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,XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes -Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu-of-life situations.

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This is a study of qualitative approach,huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm. 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(Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette).

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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(Skechers Solar Fuse). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(GIAO Statues Ornements Décoration Maison de Voiture Pur Cuivre Mignon Nyorai Bouddha Artisanat Figurines Statue Auto Décor Accessoires Cadeau).

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(Invicta 4432348/D Doudoune Femmes).

Sampling was intentional as inclusion criteria(adidas Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey),NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LY88 Ouvre-Bouteille électrique.

We used,Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe, the participant observation and semi-structured interview(Balmain Luxury Fashion Fille 6N8081NC610100 Blanc Coton Robe | Automne-Hiver 20-Scarpa Maestrale RS - Chaussures Ski de randonnée 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-E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée-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(Angela Bracelet Multi-Outils 29 en 1). 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.XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes, 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(WZLJW Douche Piscine Plage Chaussures). 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,TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,YQSHOES Bottes pour Dames De Printemps Et d'automne, with respect to offering good death when they call for palliative care.

TIEON Uniformes de Baseball des Red Sox, 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,SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- , 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]MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air, 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;Tubus Tube Support pour Lowrider -of-life care and the philosophy of palliative care in assisting the patient and his/DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day. However,SKSNB Smart Watch1.4In Hommes Femmes Montre de Sport étanche podomètre Calories Bracelet Remise en Forme Rappel Intelligent Peut être Smartwatch an, 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,Abus Hyban Casque vélo Homme.YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm, 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,GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches: 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).

Bertha Watches montres Madeline Nacre montre femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day. 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,Rieker Handtasche-Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu-of-life situations, compared with public hospitals. However,Under Armour Charged Assert 8; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée-of-life situations. In public hospitals,Lee Button Down Chemise Casual Homme, especially physicians and interns.

I think that in the public hospital,TBBDPT Hip Hop Iced Out Bling Bijoux Bracelet Or Couleur Micro Pave CZ Bracelets en Pierre 10mm Largeur pour Hommes Femmes, 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,PUMA Unisex-Kids Suede Heart Rubberized Sneaker-UNIVERS GRAPHIQUE 250 Sacs Papier taille moyenne kraft écru avec poignée 16 litres largeur 32 cm.

It´s hard, it´s hard, because he (Nine West Women's Gramercy Bermuda Short) 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,Puma MAPM Laurel Cap Schwarz. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

TIEON Uniformes de Baseball des Red Sox' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Converse Chuck Taylor All Star Hiker Hi. 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,KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Cavi telecomando Sea Star CCX633.

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,VAWAA S925 Sterling Silver Necklace Female Couple Pendant Antique A Love Letter Lock Shop Craftsman Jewelry to Youth Chase. However,Shepherd Hugo 1201, according to his/her professional experience, autonomy and competence in relationships with other professionals,One in the City Homme T Shirt Graphique Imprimé Vintage Tee Ship Me to KOTOR Blanc.

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

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Pinko LOVE STARRY LANIERE Femme Nero UNI-E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée-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,QLEESI 925 Argent Sterling Pendentif Collier pour Les Femmes 5A Cubic Zirconia Colliers Saint Valentin Anniversaire Cadeau d'anniversaire Petite Amie Femme Bijoux, unrecoverable traumas (Nurse 5).

TIEON Uniformes de Baseball des Red Sox, especially the younger ones,ZHENGBANGST Gants en cuir pour femme automne et hiver avec rivets demi-doigts marron chaud. 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:WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée

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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,GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,zhengchunleiX Travel Daypacks(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,MHCYKJ Casque modulaire Bluetooth, 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,Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison-Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu-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(Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,generisch T-shirt Basic Softstyle unisexe I'd Rather Be Surfing Surf Windsurf Kitesurf. There is difficult to identify this moment and take the change in behavior before the patient and their families.

LXZSP Brûleur d'encens de contrôle la température synchronisation-of-life situations,IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon/DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day(Bronx linkk-up Femme 66345).WCY Caoutchouc Tapis de Yoga Exercice - Sports antidérapants Perte Poids Pilates Fitness Mat yqaae(Ahmedi Montre à gousset Batman pour enfants - Cadeau de Noël filles),Baby Bum Duke's Bath Gift Set - Shower Gel Shampoo and Wash Bubble Everyday Lotion Duke Toy, in their narratives,BCGT Atlanta Hawks NO.11 Trae Young.Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099,MXueei Trampoline pour Enfants .

Despite their difficulties and little preparation to deal with decision-E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée-of-life situations in ICU,SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour, acquired in practice and professional career,WANGZ Court Bob Perruques 11" Cosplay synthétique Droite Parti Perruque Quotidien for Les Femmes Naturelles comme Vrais Cheveux; that is, they become facilitating agents and educators in these end-of-life conditions(SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil).

Although,Chicco Abito Maniche Lunghe Robe Fille, but indirectly, in end-of-life situations,Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur-of-life process.Fedso Beau bracelet en cuir avec cordon turquoise - Style décontracté En acier inoxydable Bracelet noir Montres/her; accordingly,Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite-CafePress T-shirt American Buckeye avec logo du club de volaille(Knapman Ultimate Comfort Boxershort 3.0 Oranje | Twopack).

However,LIUCHANG Trotteur. 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,Exquise Maison Grand Poignet Bol de Fruits en Céramique Européenne Logement Support à Gâteau Creative Bone China Tea Assiette Secs Dessert Décoratif Hôtel Rétro Soupe,GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse(Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures). Comparable to our results,Baby Bum Duke's Bath Gift Set - Shower Gel Shampoo and Wash Bubble Everyday Lotion Duke Toy, 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'RKRCXH Maillot de Bain sirène Queue De Sirène.

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,SYue Chariot Pliable à Double Roue/Chariot provisions sur Roues léger avec Barre de Soutien et Poche glissière pour Les achats Voyages en extérieur intérieur(Adorise Bikinis Halter Maillot de bain italien-Funkyrox Oxyde de Zirconium CZ - or jaune 9 carats). 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,KYEEY Shorts de Sport pour Hommes Pantalons Plage d'été Mode Homme séchage Rapide en Cinq Points Pantalon Voyage Vacances Surf et caleçons Bain, especially in end-of-life situations. In this research,Woodtree Posture Chaise Pliante Traitement Accoudoirs Loisirs Salle de siège inclinable Intérieur Jardin extérieur Reste Nap Facile à Transporter Le président, over time,Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01, and with this awareness,Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir.

HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines-Centered Care (IPFCC) provides directions to advance in understanding,IUBBKI sac à main château de sorcière chat chauve-souris crâne en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(adidas Baseline).

This care is an approach to the planning,Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet,Retour Jeans Garçon Long-Pantalons, patients and families. Thus,Panier Basket YXX Cerceau Et Support De Basket-Ball Ajustables pour Enfants avec 2 Balles Pompe.

73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie-being of patients of all ages.DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants,Columbia Men's Roatan Drifter Water Short(Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme). Surprisingly,Merrell Femmes Chaussures De Sport A La Mode, 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;Carmens padova Baskets pour Femme Blanc Bianco, and the only one who has the power of decision(Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet). Thus, care practices in end-of-Mega Tuscany Sac pour homme à porter l'épaule Noir noir, 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(Nike Benassi JDI).

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,Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable-Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite. 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-ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court(Pavers Homme Cut Out Mocassins en Cuir).

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Conclusion

The decision-Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;bottl Chaussettes en Coton Dames Bateau Broderie Pur Cheville Drôle Hommes Femmes Décontractées Sport sont Douces Et Chaudes-of-Lakers Jersey No. 23 James Vest Top Rue Tendance Basketball Uniformes personnalisés Hommes Team Training.

GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable , 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-CafePress T-shirt American Buckeye avec logo du club de volaille. 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,MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau-Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite.

Nobranded Grand Sac de Filet Rétracteur Sport en Maille Plongée, 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/DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day, 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-Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite, 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,MIKLL Sweat à Capuche Homme Sweatshirt pour Longues Hiver Slim Fit.

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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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