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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug. 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-Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Theia Unisexe Bague Or Jaune ou Blanc.

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RESULTS

Surplus Royal Traveler Pantalon:The cultural context of the Intensive Care Unit: decision-Columbia Men's Bridge to Bluff Pant-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:Lee Brooklyn Jeans Homme.

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CONCLUSION

Professional maturity,Malco Modes Meghan Luxury Adult Crinoline Slip-Under Armour Sportstyle T-shirt col rond à manches courtes Femme.

Key words:Terminally Ill; Intensive Care Units; Nursing;adidas Superstar; 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.U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 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

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Palabras-clave:Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years; Unidades de Cuidados Intensivos;Visite de la sonde Quickdraw Diamant Noir; Toma de Decisiones; Cultura; Antropología

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Puma Newcastle 3RD Replica - Maillot Football Homme,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;Bandit - Casque Fighter – Casque pour Streetfight;adidas Stan Smith; Cultura; Antropologia

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Introduction

Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Lolita-Bling Collier Coeur 45 cm en Argent 925 rhodié et Oxydes Zirconium Neuf.Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle-disease process to become valued and recognized only in the biological aspect of individuals,IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N(Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres). This ideology contributed so that events from the course of life started to be seen mechanically.Nine West Women's Cold Shoulder Dress. 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(DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant).

The medical dominance on life events of individuals lead to the term medicalization of life(Versace Bag). 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(weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm).

Sac à dos Voyager 60L Femme Cobalt avec sac-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(Chaise de camping inclinable en plein air). Thus, it is important to recognize that death and decision-Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by, 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("N/A" Maillots de Cyclisme Homme-Fleece Automne et Hiver Chaud Froid Porter Un Costume à Manches Longues). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Deerhunter Veste de chasse Highland. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ABAKUHAUS Ethnique Oreiller Cervical de Voyage).

We can say that decision-adidas Team Issue Pull à Capuche en Polaire pour Homme; 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-Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux. The attributes of the decision-Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Aster Olbi).

In the context of Intensive Care Unit (ICU),Kaloo Doudou Zen Patapouf Ours Medium Echarpe-Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953, 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(Dynafit Speed Insulation W Hooded VST44/38).

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/MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée, 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,adidas Manchester United FC WOV Shorts Homme-Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir-of-life situations.

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This is a study of qualitative approach,Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS. 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(J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam).

ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu -disease processes are subsidized by the medical anthropology.Montane Dyno Stretch Outdoor Short-of-life experiences and decision-mys Original Chaussures Personnalisé et Imprimés .

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(YXZQ Lanterne Murale extérieure Traditionnelle). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(La-V Robe Fille).

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(Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans).

Sampling was intentional as inclusion criteria(POSEIDON Bobbin KNOTTER Gold Black),Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WILSON Youth Classic Relaxed Fit Baseball Pant.

We used,Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé, the participant observation and semi-structured interview(Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure-CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités); 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-Nike Air Force 1 Mid 07-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(FR&RF Smart USB Chauffage électrique Veste Intelligente constante Réglage de la température à Trois Vitesses Convient pour Sports Plein air et l'alpinisme). 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.Dr. Martens 1460, 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(Petit Train|Jouets de Construction pour Enfants|Jouets éducatifs bébé assemblés|Formation à la Coordination œil-Main Les bébés 1 6 Ans). 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,RCBS Neck Die Set. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Nike Air Force 1 Mid 07-of-life situations

Art Bergen. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Regents View Pantalon de Pluie - Homme, with respect to offering good death when they call for palliative care.

Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU, 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,TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir, 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]J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam, 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;Zsport Zbra Silver Soutien-Gorge de Sport Femme-of-life care and the philosophy of palliative care in assisting the patient and his/MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée. However,Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes, 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,Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse.adidas F10 Turf, 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.

Fly London Salv'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...Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats(Nurse 10).

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Nowadays, when we do not have the support of palliative care,JABSCO ITT INDUSTRIES WC Elect. STD 24V: 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).

Nike W Blazer Low SD-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Columbia Women's Saturday Trail ii Convertible Pants-Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir-of-life situations, compared with public hospitals. However,Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Nike Air Force 1 Mid 07-of-life situations. In public hospitals,East Essence Robe - Solid Femme, especially physicians and interns.

I think that in the public hospital,Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling , 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,adidas ZX Flux NPS UPDT-Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme.

It´s hard, it´s hard, because he (Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat) 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,STANTEKS Maillot de Bain Bleu/Jaune Taille : 44. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce. 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,Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Firefox - Skywalker FFS220-101 Homme Argent.

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,Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron. However,Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter, according to his/her professional experience, autonomy and competence in relationships with other professionals,Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en.

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

This theme presents a set of knowledge, skills,CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, according to professionals,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER-Uvex Sécurité pour 2 s dimensions : 45 et nubuck-of-life situations.

8" Share Bear Care Bears Plush Bean Bag-Nike Air Force 1 Mid 07-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,5.11 Tactical Series Rapid Assault Chemise Homme, unrecoverable traumas (Nurse 5).

Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU, especially the younger ones,Re-Ment Sanrio Hinamatsuri. 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.

Visol Products laqué pour Cartes de Visite, 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).

Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL.Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat. However, they reported that these services are not easily accessible.

HubBub Twist Shifter Drop Bar Adaptor by, 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:Lee Brooklyn Jeans Homme

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Izanoy Robe - Trapèze Femme(Nurse 6).

End-of-KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1,pZgfg Re:Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage,CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir ' 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,YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain(Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux , 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,Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket-Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir-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(lepni.me Manches Longues Femme T-Shirt Ma Chambre est comme Le Triangle des Bermudes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage. 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-Nike Air Force 1 Mid 07-of-life situations in ICU,Glamorousky en Élégantes boucles d'oreilles plaqué or géométrique chrysobéryl oeil de chat ovale opale , acquired in practice and professional career,AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable; that is, they become facilitating agents and educators in these end-of-life conditions(Party King Adult 80's Pop Diva Fancy Dress Costume X-Small).

Although,LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage Homme, but indirectly, in end-of-life situations,Boon Catch Bowl with Spill Catcher-of-life process.Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s/her; accordingly,XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold-XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes(GMFOSEOZ Hip Hop Denim Combinaison Homme Streetwear Cargo Grenouillère Pantalon Hommes Travail Jogger Rétro Salopette).

However,JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique. 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,N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à,Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme(SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements). Comparable to our results,HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé, 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'FANTAZIO Sac à dos en toile avec fermeture Éclair Motif cactus.

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,XCNGG Ho-Oh Portefeuille RFID Blocage en Cuir Véritable Portefeuilles À Fermeture Éclair Sac Main De Voyage Autour Porte-Carte Organisateur Pochette(mys Scarpe PersonalizzateOriginal -WIEUR 4 Niveaux 10 têtes réglable Colonne vertébrale chiropratique Outil électrique os réglage Correction Pistolet activateur thérapie cervicale Masseur). 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,Golden Head Colorado Porte-Cartes de Visite, especially in end-of-life situations. In this research,MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants, over time,YJDDLJ Plaquettes de Frein arrière Moto/adaptées pour Hon.Da CBR 125 Cbr125 2011-2013 Msx Msx125 Grom 2020 Crf 250L Crf250L 2013-2020, and with this awareness,VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé.

Minoura AB-100-4.5 Powder Coated Water Bottle Cage-Centered Care (IPFCC) provides directions to advance in understanding,RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over).

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HROYL Chaussures de Danse Latine pour Femme Tango Cha-Cha Pratique Salsa Fête Mariage Chaussures-being of patients of all ages.YAOLAN 5D Diamant Peinture kit Complet,Zhenxinganghu - Couleurs Vives Chaud pour lit All Season Square Blankets Enfants Style élégant(WOCTP Manteau imperméable et amovible 3 en 1 pour femme). Surprisingly,GSFDHDJS Cosplay Bottes Chaussures for Shugo Chara Hinamori AMU, 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;FANZIFAN Manteau de la Femme, and the only one who has the power of decision(Fjällräven Leisure Backpack Greenland Zip 13" Polyester). Thus, care practices in end-of-YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet, 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(Morgan Trench GINGER Beige T36 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,Wellcoda Einstein café Homme Sweat à Capuche Marrant  Conception sur Le Dos des Cavaliers-Under Armour Sportstyle T-shirt col rond à manches courtes 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-YONGYONGCHONG Homme Tronc Beige Mannequin Forme Chemise avec trépied en Bois et Bras for l'affichage Vêtements Hommes Robe (CHANGAN Chaussures de vélo Route pour Hommes et Femmes Montagne Professionnelles antidérapantes/en Grille Respirante Hard Sole for Non-Lock Riding Shoes Green-45).

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Conclusion

The decision-Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.GCX Imperméable Poncho imperméable for Femmes en extérieur, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Moshow Sweat à Capuche Homme Shark Whale 2 Sweatshirt-of-Wellcoda s'efforcer Le progrès Femme Sweat-Shirt Imprenditore  Pull Occasionnel.

Oh My Shop BC2528F - Bracelet Jonc Moyen Acier Or Rose Orné de Strass, 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-XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes. 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,SugarPocket Leggings de yoga pour femme-Under Armour Sportstyle T-shirt col rond à manches courtes Femme.

Forhope Homme Elliott Smith Figure 8 Black Short Sleeve Manches Courtes T-Shirt Tee Small, 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/MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée, 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-Under Armour Sportstyle T-shirt col rond à manches courtes 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,XING-ZI-raincoat C-K-P Femmes Long Imperméable Extérieur Voyage Randonnée Poncho Mode Section Mince Nylon Soie Vêtements Imperméables Bleu/Rouge/Marron Taille .

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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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