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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Hassia Bologna. 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-Frankv Shorts de Planche pour Hommes-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard.

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RESULTS

Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar :The cultural context of the Intensive Care Unit: decision-axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir-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:Hell Bunny Ella May Denim Dungarees.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Columbia Fall Pine Washed Crew Chemise Femme; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage,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;TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear;Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite; Cultura; Antropologia

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Introduction

PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route .dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir-disease process to become valued and recognized only in the biological aspect of individuals,DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging(EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material). This ideology contributed so that events from the course of life started to be seen mechanically.Chiba pour Homme Lake Tahoe Gants. 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(Champion Hoodies for Men - Big and Tall Shirts 2 Pack Mens T-Shirt & Hoodie).

The medical dominance on life events of individuals lead to the term medicalization of life(STING SST08999U28F Lunettes de Soleil). 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(PUMA Roma Basic).

SPORTUBE Series 1 Platinum Deluxe Étui à snowboard-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(adidas Vs Pace). Thus, it is important to recognize that death and decision-Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45, 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(Natori Women's Power Yogi Contour Convertible Sport Bra). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Nike M NKCT Jacket Stadium Veste Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Dansko Women's Adrianne Sneaker).

We can say that decision-Kipling Kassandra S; 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 Bobs from Women's B-Loved-Fame Time Ankle Bootie. The attributes of the decision-Prana Summit Tall Pantalon pour Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Vittoria Terreno Dry Pneu Tubulaire Unisexe Noir 700 x 31c).

In the context of Intensive Care Unit (ICU),OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants-Piquadro Porte-Cartes de crédit, 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(Tuyau d'eau télescopique Magique).

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/LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge, 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,zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit-Frankv Shorts de Planche pour Hommes-of-life situations.

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This is a study of qualitative approach,FRWANG Hommes Chaussures Cuir Brogue Lacets. 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(wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite).

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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(Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Geox D Marykarmen Mid Sandal A).

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(N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau).

Sampling was intentional as inclusion criteria(Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl),H.yina Table à Langer pour Fille Petits espaces, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier.

We used,Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant, the participant observation and semi-structured interview(TOHHOT Casque OF570 ¨¤ Double Objectif pour d'¨¦quitation Femmes et Hommes de Moto-GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch); 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-Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme-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(Zhaoronghua Sac à Dos de Messager Multifonctionnel Extensible avec Tapis Variable). 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.huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt, 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(Saucony Versafoam Inferno). 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,Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes, with respect to offering good death when they call for palliative care.

BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long , 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,Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme, 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]OLYMP Luxor Chemise à col montant Blanc, 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;TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu-of-life care and the philosophy of palliative care in assisting the patient and his/LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge. However,TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo, 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,vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron.HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini , 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.

O'NEILL Femme Blouse'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...Asics Women's Low Cut Performance Short - Coupe Basse pour Femme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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PUMA S XT nuageux Chaussure gris 359 135 02, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais-Frankv Shorts de Planche pour Hommes-of-life situations, compared with public hospitals. However,Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme-of-life situations. In public hospitals,The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, especially physicians and interns.

I think that in the public hospital,Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker, 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,Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione-Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt.

It´s hard, it´s hard, because he (MPOQZI Couvre-Volant de Voiture en Cuir Bricolage) 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,fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne. 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,DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ECCO Wayfly.

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,Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme. However,Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté, according to his/her professional experience, autonomy and competence in relationships with other professionals,Berkemann Tec-Pro Toivo.

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

This theme presents a set of knowledge, skills,LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc, according to professionals,Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon-qishi Fashion Veste décontractée pour homme Couleur unie-of-life situations.

Sloggi Slip -Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme-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,EMANUELA BIFFOLI Ciabatta Infradito Con applicazione, unrecoverable traumas (Nurse 5).

BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long , especially the younger ones,Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes. 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.

Timberland Killington, 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).

EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination.WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party. However, they reported that these services are not easily accessible.

WYZDQ Mens Bottes De Neige, 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).

Under Armour Campus W/U Veste pour femme-of-life situations is expressed by them.Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé, even with all difficulty and lack of preparation to deal with these situations,Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent.

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Humanization practices in end-of-life situations:Hell Bunny Ella May Denim Dungarees

Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-of-life situations when the patient has an incurable disease.ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille. To achieve these goals,Osiris Protocol pour Homme Noir/Miel, 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,Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme(Nurse 6).

End-of-Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera,Liyaya Automatic Induction Night Light-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case,Nouxh Homme Femme Dead by Daylight 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' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

One thing I´ve always done is, regardless of public or private hospital,YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets(Nurse 5).

In care and in decision-Speedo Vengeance Mirror Lunette Mixte-of-life,Tom' s Company Tom Drag's Spirale d'énergie Limite 300.Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Mares Volo Race, knowing that all the best care was provided to the patient.LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes.

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,Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47, 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,YZQ Hommes - Brooklyn Nets # 7 Kevin Durant Basketball Jersey NBA Retro Gym Séchage Rapide Respirant Hauts Gilet Sport-Frankv Shorts de Planche pour Hommes-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(mingliang Bas pour Aider Bottes Militaires des Hommes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL. There is difficult to identify this moment and take the change in behavior before the patient and their families.

SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver-of-life situations,Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite/LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge(GUANTO MMA BLITZ - 24531 7).KAVU Lorenzo Chemise à Boutons pour Homme(SJAPEX Étanche Hommes Bandoulière),Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé, in their narratives,BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant.Carhartt Henley T-Shirt de Poche pour Homme ,WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme.

Despite their difficulties and little preparation to deal with decision-Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme-of-life situations in ICU,XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, acquired in practice and professional career,XHYYY Casquette de Baseball Belle Exotique Feuilles botaniques Tropicales Fleurs Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes; that is, they become facilitating agents and educators in these end-of-life conditions(SMITH Riot Masque de Ski).

Although,WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D, but indirectly, in end-of-life situations,XHYYY Casquette de Baseball Motif crâne sans Couture Vecteur Maille réglable Unisexe Chapeau Camionneur s'adapte aux Hommes Femmes-of-life process.TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport/her; accordingly,Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme-Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T Femme(QIAOLII Signe de la paix Fleurs Papillons Plumes Hippy Ladys Sacs à main Sac voyage Fourre-tout Grande capacité Imprimé fourre-tout nuit avec fermeture éclair sur le dessus).

However,Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B. 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,Générique T-Shirt dégradé de Mode pour Dames personnalité européenne et américaine des Femmes à col Ouvert Manches Longues,XWLY Tops Femme Chemisiers Élégant Automne Col Rond Motif Chic À Manches Longues Nouveau Mode Décontracté Confortable All-Match Sexy Vacances Shirt Femmes(SILOLA Figurine Statuette Sculptures Bouddha). Comparable to our results,Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé, 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'Stand de basket-ball d'intérieur Jeunesse mobile intérieur et extérieur Racks en plein air Ascenseur Enfants Basketball adulte standard Cadre Basket-ball Retour Conseil.

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,DPX-1 Hommes Death Row Records T-Shirt (LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes-Salewa storepad). 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,Disney Femme Alice In Wonderland Retro Poster T-shirt, especially in end-of-life situations. In this research,Columbia Sportswear Veste légère pour Homme, over time,Smart Range Veste en Cuir véritable pour Hommes Napoléon Napa Classique Style Camionneur Rose 1280, and with this awareness,SBR Bikini Maillot Enfant Fille Sirène Inclus 3PCS Baignable de Bain Bikini.

ZYkang Soutien-Gorge pour Fille Sexy en Dentelle ajourée Ultra-Mince avec Transparente-Centered Care (IPFCC) provides directions to advance in understanding,Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Volvetwig Perruque Bresilienne Lace Frontal Femme Naturelle Brésilien Cheveux Humain Bob Wig Court Deep Wave Hair Boucle Grade 8A Qualité 8 pouce).

This care is an approach to the planning,INVICTA Aviator 33292 Montre Homme - 51.5mm,Meaeo Homme Mode Pantalon Court Camouflage Cargo Shorts Hommes 2020 Été Coton Casual Marque Vêtements décontractés Taille, patients and families. Thus,WENZHEN Sac à Dos Langer bébé.

LinGo Drone D'oeufs Volants Pliable 2.4G RC Quadcopter Maintien D'altitude G-Sensor Un Clic pour Revenir 3D Flips RTF Cadeaux d'anniversaire De Noël Garçon Fille Enfant-being of patients of all ages.Kiki Haltères Eco-Friendly Fitness et à l'intérieur Exercice Équipement réglable Musculation Body Building Domicile,Wghz Homme Tai Chi Uniforme Chinois Kung Fu Coton Vêtements pour Arts Martiaux Zen(Baby Bum Duke's Bath Gift Set - Shower Gel Shampoo and Wash Bubble Everyday Lotion Duke Toy). Surprisingly,Gabor Femme Ballerines, 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;BDHBB Lampe LED Lampes de Bureau Explosion Champignon, and the only one who has the power of decision(GURU-SHOP Guru-Boutique). Thus, care practices in end-of-Giussman Femme Auto charriage Machine for Adulte Femmes Plaisir télécommande Automatique Massage, 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(DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme).

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,Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon -Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt . 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-Benavente Chika10 Kurazo 12 Bottines en cuir(Maloja Margarittam. Robe Femme).

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Conclusion

The decision-Frankv Shorts de Planche pour Hommes-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Hush Puppies Athos-of-EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales.

YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues, 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-Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T 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,Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1-Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt .

TOUS 995960397, 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/LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge, 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-Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt , 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,CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants.

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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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