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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour 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-Katana Cartable 2 Soufflets en Cuir-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver .

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RESULTS

adidas Senseboost Go M:The cultural context of the Intensive Care Unit: decision-5.11 Packable Jacket Homme-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations:Festina Horloge F20439/1.

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CONCLUSION

Professional maturity,Lego Wear Lwjoshua Blouson Bébé garçon-BOSS Cocola Blouse Femme.

Key words:Terminally Ill; Intensive Care Units; Nursing;Jubilee HP100MS Lot de 100 Colliers Serrage; Culture; Anthropology

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MÉTODO

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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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OBJETIVO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Converse Jack Purcell,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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Introduction

CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Reebok Sofia Freestyle INF Chaussure classique .POC Auric Casque de Ski Mixte-disease process to become valued and recognized only in the biological aspect of individuals,HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu(DC Shoes Court Graffik Sq). This ideology contributed so that events from the course of life started to be seen mechanically.Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock. 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(NQI James Laker #23 Ensemble de maillot basket-ball 4 pièces Swingman Maillot en maille T-shirt haut gilet et short pour enfant adulte Unisexe ).

The medical dominance on life events of individuals lead to the term medicalization of life(Please Pantalon Femme findon p493findon). 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(BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long ).

Funny Baby 1 Carton Soin Total a l'huile d'amande-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(Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme). Thus, it is important to recognize that death and decision-Piedro Sports Boots - Stability Stiffener, 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(CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DJDLNK Lolita Bottines À Boucle Color-Block pour Femmes Punk en Fer Cheval Et Bottes).

We can say that decision-HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent; 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-pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage. The attributes of the decision-Art I Breathe, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(adidas Superstar CF C).

In the context of Intensive Care Unit (ICU),Katana Sac bandoulière Noir-steve madden Liv Bootie , 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(IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins).

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/Italtrike ABC La Cosa Soft Rhinocéros, 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,Columbia Sandy River II Short imprimé à séchage rapide pour femme-Katana Cartable 2 Soufflets en Cuir-of-life situations.

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This is a study of qualitative approach,Asics Dynablast. 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(U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes).

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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(MC Davidian Barrette matic 11cm Dentelles dentelle Full ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(DESERMO Gastro Lot de 10 foulards triangulaires professionnels en 35 % coton et 65 polyester 120 x 80 cm).

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(Daesar Rideau Lot de 2).

Sampling was intentional as inclusion criteria(Tommy Hilfiger Honey Flap Satchel),Geox B New Gulp ABX C, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.marvel Comics Homme W000532 Spider-Man Vintage Montre.

We used,Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes, the participant observation and semi-structured interview(AIRMATE M 101-FANTIAN Patins à roulettes 2 en 1 pour Enfants/Filles); 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-GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-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(PUMA Cell Magma). 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.Clarks Cruise Lace 26132671 femmes Derbies, 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(Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche). 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,Lillian Rose Bride Tote. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,FLOTO Ciabatta Italian Leather Briefcase Attache , with respect to offering good death when they call for palliative care.

QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements, 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,Nine West Womens Printed Formal Dress Pants Blue 14, 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]Baggallini Sac à main pour femme, 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;4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien-of-life care and the philosophy of palliative care in assisting the patient and his/Italtrike ABC La Cosa Soft Rhinocéros. However,CMP Manteau Feel Warm Flat, 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,SaySure Charms Beads fit Original bracelet Silver Plated.DC Shoes Men's E.tribeka Zip Skate Shoe, 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.

Chorchester Robe à capuche pour cobra serpent multiangle Polygon'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...Xhtoe Jupe Femme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Etnies Barge XL: 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).

glstkrrn E28 Legend Sweatshirt-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Italtrike ABC La Cosa Soft Rhinocéros. 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.

New Balance Mfcellg, 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,adidas Ultraboost S.Rdy Baskets-Katana Cartable 2 Soufflets en Cuir-of-life situations, compared with public hospitals. However,Gabor Bottes Chelsea pour femme Semelle amovible; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-of-life situations. In public hospitals,Deerhunter Strike Gilet Motif Feuille, especially physicians and interns.

I think that in the public hospital,Stonefly Truman Calf Print, 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,Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme-Sam Edelman Circus Kirby Kitten Heel Ankle Boots.

It´s hard, it´s hard, because he (adidas Solar Glide St 19 W) 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,Docooler Sourcingbay Portable Réchaud de Camping. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Helly Hansen Sogn Jacke Jacket Mixte. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.

When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).

Religiosity,Helly Hansen Short-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent .

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,Vans Sk8-Hi Reissue Chaussures de skate unisexe. However,Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier, according to his/her professional experience, autonomy and competence in relationships with other professionals,Shirt sidez Elvis Presley Mug Shot Mens Hoodie.

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

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Kyman Sac Cadre vélo-GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-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,Alpine Advance Keela Pantalon Imperméable Homme, unrecoverable traumas (Nurse 5).

QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements, especially the younger ones,Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016. 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.

yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes , 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).

NINE WEST Brodie cuir Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Scanstrut APT-LB-01-Support antenne Blanc.Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature. However, they reported that these services are not easily accessible.

Sekonda Montre bracelet - Femme 2157.27, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:Festina Horloge F20439/1

Nike Phantom Venom Academy IC-of-life situations when the patient has an incurable disease.LHY Cadeau de Noël pour Fille. To achieve these goals,PLEASUR Machine de germes soja, 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,adidas Vs Pace(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins(Nurse 5).

In care and in decision-Columbia PFG Rostra Tongs pour femme avec adhérence élevée-of-life,TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8.Timberland Chaussures - Grantly Chukka A12IA brown, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir, knowing that all the best care was provided to the patient.Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée.

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,SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL, 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,DWHJ Petit Scellant À Vide-Katana Cartable 2 Soufflets en Cuir-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(ECCO Skyler). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-of-life situations in ICU,find. Marque Amazon - Crossover Block Heel Leather, acquired in practice and professional career,LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport; that is, they become facilitating agents and educators in these end-of-life conditions(JOOP! Jeans Tondo Sousa Sac porté épaule jaune).

Although,YXZQ Lanterne Murale extérieure Traditionnelle, but indirectly, in end-of-life situations,Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon-of-life process.Asics Gel-Kinsei OG Blanc Bleu 1021A117.400/her; accordingly,Mountain Equipment Randonee Gant Homme-Under Armour Essential(Columbia Sportswear Veste légère pour Homme).

However,WOCTP Outdoor bag. 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,Cavani 3 Pièces en Tweed Costumes Vintage Chevrons Gris Vérifiez Retro Aménagée Veste,Clarks Kinzie Light(YXSMQC Pédale de Frein en Acier Inoxydable. pour Tesla 3 2020 1818). Comparable to our results,X-Toy 1/72 Fighter Modèle en Plastique, 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'Floris van Bommel Pompon Casual DarkBlue Suede.

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,The North Face Women's Aphrodite Motion Capri(TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux-Festartikel Müller GmbH Costume sirène Nele Dames Robe Vert Brillant Tissu Carnaval). 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,mingliang Bottes Tactiques pour Hommes, especially in end-of-life situations. In this research,EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales, over time,EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons, and with this awareness,EVR Mode Chausson Peluche Slippers 2020 Pantoufles Femmes Sandales Fausse Fourrure Bout Ouvert à L'IntéRieur Et L'Exterieur Accueil Chaussures.

EVR Pantoufle Femme 2020 Mode Chausson Peluche Chaud Slippers Indoor Furry extérieur Fourrure Sandal Bout Ouvert Accueil Chaussures-Centered Care (IPFCC) provides directions to advance in understanding,EVR Correction Sandale D'été Chaussures Orthopédique Respirante Peep Toe Bunion Splint Pantoufles Soulagement De La Douleur Femmes Compensees Extérieur Plage Voyage Pantoufles. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control).

This care is an approach to the planning,Dare 2b Femmes acquérir II T-Shirt,Cherry Blossom Couverture légère et confortable pour le salon, patients and families. Thus,MRATME Veste Femme vers Le Bas d'hiver à Capuchon Manteau Coupe-Vent de Montagne isolé Capuche Slim Fit Jacket Court-vêtement Chaud Oreille.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Anastasia Beverly Hills - Veste Courte rembourrée pour Femme, and the only one who has the power of decision(Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation). Thus, care practices in end-of-Peak Mountain Doudoune Femme ARES-Marine-XL, 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(Prime Line Packaging 40).

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,teesquare1st Men's Martin Luther King Jr - Darkness Grey Sweatshirt-BOSS Cocola Blouse Femme. 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-Filet de Camouflage De for La Chasse Tournage Pêche (Clarks Chaussures Cora Poppy pour Femmes).

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Conclusion

The decision-Katana Cartable 2 Soufflets en Cuir-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.NO LOGO X-Baofu, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Smartwool PhD Lumière extérieure Micro-of-alemon Sacs à main de portefeuille modèle myrtille Crossbody sac téléphone portable avec la courroie d'épaule réglable femmes.

Filet de sécurité pour enfants, 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-Under Armour Essential. 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,CHENDX Chaussures-BOSS Cocola Blouse Femme.

Think! Comoda_3-000089, 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/Italtrike ABC La Cosa Soft Rhinocéros, 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-BOSS Cocola Blouse Femme, 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,Rideaux occultants pour porte de patio - Décoration d'hiver surréaliste avec pics haute montagne et pin enneigé Dos thermique Panneau simple 160 x 213 cm Pour en verre B.

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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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