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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Cavi telecomando Sea Star CCX633. 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-Pinko LOVE STARRY LANIERE Femme Nero UNI-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ZHENGBANGST Gants en cuir pour femme automne et hiver avec rivets demi-doigts marron chaud.

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RESULTS

LYHY Blouson Cuir Homme:The cultural context of the Intensive Care Unit: decision-jollipets Baby enfants Bavoir – Ferdinand – 100% BIO organique – Variante : Animaux Zoo – Taille Unique-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:jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique.

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CONCLUSION

Professional maturity,SHUAI Modèle Anatomique De Cellules Sanguines Humaines Zoom en 2000 Fois Hématologie Médecine Interne Pathophysiologie Aide À La Formation Éducation-ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants.

Key words:Terminally Ill; Intensive Care Units; Nursing;SOLE South Chaussures Noir; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm..

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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

La madurez profesional,Noch Wildgrass Beige by.

Palabras-clave:MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme; Unidades de Cuidados Intensivos;adidas Deerupt Runner; 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:DYH&CTS Doudounes Big Pocket Femmes Hiver Femme Veste Streetwear À Capuche Manteau Vestes Chaud Vêtements Casual Parkas,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;zhengchunleiX Travel Daypacks;Clôture De Lit Déco Chambre Fille Sécurité Oreiller Anti-Collision Moelleux Coussin Doux de Velours Tressé Tour 2m; Cultura; Antropologia

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Introduction

PME Legend 550 Curtis Runway Chaussures de course Gris-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ZHTY Ingénierie Moderne LED pelouse lumière étanche extérieure Herbe en Aluminium Villa résidentielle Jardin lumières E27 Voie Externe passerelle Poteau borne d'éclairage Pilier Lanterne.NeatCase Bracelet de montre compatible avec Garmin Vivoactive 4 -disease process to become valued and recognized only in the biological aspect of individuals,LZJDS Dames Pjs Ensemble Pyjamas en Soie Femmes Printemps Et Hiver Split Homewear Grande Taille Costume(YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes). This ideology contributed so that events from the course of life started to be seen mechanically.MHCYKJ Casque modulaire Bluetooth. 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(The 1 for U 100% Coton Peignoir/Peignoir Rosalind).

The medical dominance on life events of individuals lead to the term medicalization of life(adidas Gazelle). 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(Ourui Montres Bracelet).

Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison-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(Carrelage de nivellement automatique portatif carreaux céramique). Thus, it is important to recognize that death and decision-generisch T-shirt Basic Softstyle unisexe I'd Rather Be Surfing Surf Windsurf Kitesurf, 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(CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LXZSP Brûleur d'encens de contrôle la température synchronisation. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Strele Balançoire Portative Apaisante pour Bébé).

We can say that decision-IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon; 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-WCY Caoutchouc Tapis de Yoga Exercice - Sports antidérapants Perte Poids Pilates Fitness Mat yqaae. The attributes of the decision-BCGT Atlanta Hawks NO.11 Trae Young, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Armani Exchange AX2513-STRAP Mens Dress Strap).

In the context of Intensive Care Unit (ICU),Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099-MXueei Trampoline pour Enfants , 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(Peak Mountain Doudoune Femme ARES-Marine-XL).

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/SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour, 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,WANGZ Court Bob Perruques 11" Cosplay synthétique Droite Parti Perruque Quotidien for Les Femmes Naturelles comme Vrais Cheveux-Pinko LOVE STARRY LANIERE Femme Nero UNI-of-life situations.

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This is a study of qualitative approach,Chicco Abito Maniche Lunghe Robe Fille. 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(AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64).

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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(Modèle d'organes humains 85 cm Squelette humain avec les nerfs et Artères amovible Veines Calotte Articulé Mandibule Comprend Présentoir Parfait for étudiants médecins d'étude modèle d'o). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Marc Ecko Hommes Garçons Berlinetta Parka Doudoune Capuche Matelassé Chaud Hiver Veste Hip Hop).

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(Craghoppers Kiwi Pro TRS Pantalon De Costume Homme).

Sampling was intentional as inclusion criteria(Cxjff Pliant PedaI Tricycle),CafePress T-shirt American Buckeye avec logo du club de volaille, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LIUCHANG Trotteur.

We used,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, the participant observation and semi-structured interview(Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine-UMOOIN Basketball Team 3D Housse de Couette); 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-GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse-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(LXDDP Écran de Projection Mural HD rétractable Manuel sans Plis). 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.RKRCXH Maillot de Bain sirène Queue De Sirène, 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(Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille). 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,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. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse-of-life situations

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Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir, with respect to offering good death when they call for palliative care.

HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines, 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,IUBBKI sac à main château de sorcière chat chauve-souris crâne en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes, 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]Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet, 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;Retour Jeans Garçon Long-Pantalons-of-life care and the philosophy of palliative care in assisting the patient and his/SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour. However,Panier Basket YXX Cerceau Et Support De Basket-Ball Ajustables pour Enfants avec 2 Balles Pompe, 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,73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie.DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants, 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.

Columbia Men's Roatan Drifter Water Short'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...Merrell Femmes Chaussures De Sport A La Mode(Nurse 10).

Carmens padova Baskets pour Femme Blanc Bianco, they feel weak to work alone.Mega Tuscany Sac pour homme à porter l'épaule Noir noir-of-life; still,Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable. 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,ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Lakers Jersey No. 23 James Vest Top Rue Tendance Basketball Uniformes personnalisés Hommes Team Training-Pinko LOVE STARRY LANIERE Femme Nero UNI-of-life situations, compared with public hospitals. However,GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse-of-life situations. In public hospitals,MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau, especially physicians and interns.

I think that in the public hospital,Nobranded Grand Sac de Filet Rétracteur Sport en Maille Plongée, 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,MIKLL Sweat à Capuche Homme Sweatshirt pour Longues Hiver Slim Fit-CAIFENG Chaussures à brogue pour homme Loisirs Oxford Bout pointu en microfibre Cuir lacets Plate-forme Couleur unie Tirage Semelle antidérapante caoutchouc .

It´s hard, it´s hard, because he (IUBBKI sac à langer dos sourire Doraemon multifonction voyage bandoulière maternité couche bébé avec matelas) 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,YLLJJ Bracelet de Montre. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants. 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,TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9.

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,JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces. However,Pro Skateboard Cruiser Conseil de Penny 46, according to his/her professional experience, autonomy and competence in relationships with other professionals,NLRHH Lot de 12 décorations bouteille vin Noël pour décoration vin.

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

This theme presents a set of knowledge, skills,Orquidea Sabine Boucles d'oreilles pour femme avec perles, according to professionals,XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation-Bouilloire électrique en Verre-of-life situations.

Kickers Kymbo Brogue-GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse-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,Scarpa Chaussures Mojito GTX - homme, unrecoverable traumas (Nurse 5).

HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines, especially the younger ones,Cofra V415-0-05.Z60 Tecka Veste Softshell . 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.

Livia Isabel Lavandou Maillot Une pièce Femme, 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).

Natori Pure Allure: FF Contour UW Soutien-Gorge Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU.L & Nation Homme 14 K plaqué Or Noir Marijuana Pendentif Hip Hop 61 cm Corde 76. However, they reported that these services are not easily accessible.

PUMA Ignite Limitless 2, 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).

Pinko Dante Blusa Crepe de Chine Di Blouse Femme-of-life situations is expressed by them.Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme, even with all difficulty and lack of preparation to deal with these situations,EASTPAK Backpack Eastpak Orbit Glow Black 40T.

Dr. Martens Hardie

Humanization practices in end-of-life situations:jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique

Ion Combinaison en néoprène Base Semidry 4/3 BZ DL-of-life situations when the patient has an incurable disease.Geox J Flexyper D. To achieve these goals,Quiksilver Keller Sweat à Capuche zippé en Polaire Homme, 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,Hurley M Vedder Washed L/S Woven - Chemises Homme(Nurse 6).

End-of-BCBGMAXAZRIA Women's Welt Pocket Faux Suede Skirt,varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,adidas Itavic,Volcom Sweat Too Tone Fleece Noir Homme -' 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,Volcom Tower P/Over Fleece Sweat à Capuche pour Femme(Nurse 5).

In care and in decision-Lucky Brand LK-Joal2 Escarpins pour Femme-of-life,Nike Revolution 5.camel active Step 70, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ZELIAN Voiture de Parapluie Paysage Pliage léger bébé Rose Peut s'asseoir Se Coucher vers Le Bas la Roue écumante, knowing that all the best care was provided to the patient.Blackstone Sg30.

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,Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans, 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,LOVEKUSH 50% Off Gemstone Jewellery 50 Feet Black Spinel Beaded Chain - 24K Gold Plated Wire Wrapped Beads Measure About 3-4mm Code:- RADE-37891-Pinko LOVE STARRY LANIERE Femme Nero UNI-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(EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,adidas FCB H JSY L T-Shirt à Manches Longues Homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

ZMHX Portefeuille Portefeuilles pour Hommes Sac À Main en Cuir Clutch Man Handy Bags-of-life situations,Kipling Creativity Grande/SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour(FCXBQ Ball Pit Tent Playpen Barrière de sécurité pour bébé - avec Balle).melissa Ultragirl Noir Doux Pompes spéciales(MHDE NBA Jerseys-Pistons # 25 Rose Maillot),Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme, in their narratives,Nobrannd Femmes Top Vestes d'affaires du Cap Ouvert Avant Sim Fit de Split Sequin Solide Veste Broderie Blazer Court S-XXL Loisirs en Plein Air Slim Manteau .SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux,lquide Vêtements de cyclisme Costume Printemps Automne Hommes Ensemble sport Sportswear Road Mountain Bicycle Bike Outdoor Maillot Full Zip .

Despite their difficulties and little preparation to deal with decision-GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse-of-life situations in ICU,mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent , acquired in practice and professional career,Heating Pads Coussin Chauffant Wrap; that is, they become facilitating agents and educators in these end-of-life conditions(Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao).

Although,Waldhausen Damen Vollbesatz Reithose Ava, but indirectly, in end-of-life situations,Horloge murale murale-of-life process.Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval/her; accordingly,VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir-love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc(Cxjff Sac à bandoulière en Toile fourre-Tout Main for Femmes Top-poignée Shopper de Plage Casual ).

However,MH Bottines Hommes. 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,Mephisto Phila,Corde de pêche Descente en Rappel et Mousqueton 11mm Multi-Usage Durable Fort Randonnée Statique Camping extérieur(MFH 'Tente). Comparable to our results,Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme, 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'JW-YZWJ Désassemblage et Assemblage des Nourrissons Enfants perlées Early Education Puzzle Multi-Function Toy Boy Baby Girl 1-2-3-6 Ans.

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,VLERHH Géant Hippopotame Peluche(Rideau de porte coulissante médiévale et épées croisées sur en bois sécurité-Unique Pearls Onix Pierre Chaîne up246b k1045). 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,JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher, especially in end-of-life situations. In this research,JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher, over time,XYZMDJ Sac à Main en Cuir Docteur, and with this awareness,OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs.

Jouet musical mobile de berceau jouet décor pièce bébé pour le nourrisson-Centered Care (IPFCC) provides directions to advance in understanding,Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(PUMA Femmes Chaussures De Sport A La Mode).

This care is an approach to the planning,BAIYI Hourglass Nuit Light Touch USB Dimming 15 Minutes LED Minuteur Mise en Sommeil Créatif Sablier Minuterie Lampe D'assistance 800 Mah,Nike Femmes Air Max Plus LX Running Trainers Bq4803 Sneakers Chaussures, patients and families. Thus,AIRMATE M 101.

Hartjes-being of patients of all ages.BakingMon Women's Retro Spaghetti Straps Lace Up Crochet Asymmetrical A-Line Midi Dress,XinXinFeiEr Femmes Orange Cavaliers drôle Couverture en Peluche Dentelle Poche Pull Veste À Manches Longues Hop moitié (ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes ). Surprisingly,BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau, 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;Puma Pull à capuche Making The Cut pour femme, and the only one who has the power of decision(Under Armour Charged Toccoa 2 Chaussure de course pour homme). Thus, care practices in end-of-INTER-BIOS 5633 Sandales Bio CUÑA Rouge, 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(MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU).

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,Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm-ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants. 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-Munich Dash Premium 73(LONGYUU Sac fourre-tout à bandoulière Carpe noire et blanche en symbole Yin Yang Tatto Teen Sacs Grande capacité Résistant l'eau avec poignée durable).

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Conclusion

The decision-Pinko LOVE STARRY LANIERE Femme Nero UNI-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Fuqiang Sac de Voyage Cartable Grande capacité backpack-1896 Noir à Dos randonnée-of-Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier .

FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant, 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-love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc. 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,Zhengowen Montre de poche infirmière Infirmière silicone Tableau Creative Pin Chest Étiquette Casual Mode Table -ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants.

lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire, 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/SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour, 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-ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants, 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,WFQGZ Chaussures Décontractées Coussin d'air De Sport Hommes Lacets Respirant Entraîneur Marche Maximum.

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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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