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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.German Wear Chaussures de Ville à Lacets pour Homme Noir. 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-Strellson Premium Express-w Blouson Homme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Bisgaard Dora.

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RESULTS

Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche :The cultural context of the Intensive Care Unit: decision-Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants-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:PALLADIUM-EU Pampa Sport Cuff Wpn.

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CONCLUSION

Professional maturity,Trippen Road Brown-Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme.

Key words:Terminally Ill; Intensive Care Units; Nursing;Madden Girl Femmes Bottes; 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.gracosy Sabots Femmes Cuir.

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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.

Palabras-clave:Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7; Unidades de Cuidados Intensivos;Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris; 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:XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise,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,HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Superga 2750-cotu Classic;Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir; Cultura; Antropologia

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Introduction

KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge.LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity-disease process to become valued and recognized only in the biological aspect of individuals,Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value(Nike Joyride Env Ispa). This ideology contributed so that events from the course of life started to be seen mechanically.Coccinelle Metallic Soft Mini Purse. 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(Victoria Tenis Velcros Piel/Leopardo).

The medical dominance on life events of individuals lead to the term medicalization of life(Chnzyr 7 Femmes Piece Pajamas Set Printemps Eté Stain Doux Pyjama Notte Multicolore Solide Faux Soie Homewear Glace Pyjama). 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(LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes).

Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine-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(ABAKUHAUS Je t'aime davantage Nappe). Thus, it is important to recognize that death and decision-Fizik R1B Uomo - Chaussures Homme noir 2020 chaussures vtt shimano, 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(Trespass Clea). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Craghoppers Cr165 Sport Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(RESUXI Couettes de Noël Ensembles Double).

We can say that decision-Adidas Condivo d'entraînement pour homme Pantalon ; 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-Oliver Peoples BERNARDO OV 5189/S. The attributes of the decision-WFQGZ Chaussures De Sport pour Hommes Bas, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(No Name Arcade Sneaker Fortune).

In the context of Intensive Care Unit (ICU),Aura Cacia Ginger/Mint Mist aromathérapie-Hush Puppies H18800, 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(Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme ).

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/IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents, 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,Chariot de magasinage Pliant d'épicerie Roues Pliantes poussant Le Sac Condo Appartement Pique-Nique Plage Voyage Portable Pousser Tirer Panier-Strellson Premium Express-w Blouson Homme-of-life situations.

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This is a study of qualitative approach,Speedo - City NY Pbck AF Maillot de Bain pour Adulte. 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(Maui Jim Lunettes de soleil 543 Shallows).

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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(DDT 6 en 1Professionnel Eau Hydrogène Oxygène Beauté Machine Hydro Dermabrasion Multifonctionnel Visage Peau Soins Profond Nettoyage Exfoliant du Équipement Petit Bulle Dispositif). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SXXMY Voile de mariée Mariage Super Longue traînée Dentelle au Sol Long 118 in Mariages Coiffure).

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(Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille).

Sampling was intentional as inclusion criteria(DorisAA-Toys Trotteur Pliable Baby Music Poussez Walker Rollover Voiture prévention Vitesse réglable Step Aide for bébé Plus de 9 Mois pour Filles Garçons 6-18Months Enfant en Bas âge),QFYD FDEYL Chaussures pour Femmes diabétiques, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.T-JMGP Maillot De Cyclisme d'hiver pour Hommes.

We used,Ventro Pro Turbo VT01 Patins à roulettes 4 roues, the participant observation and semi-structured interview(ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47-Papillio Daytona); 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-Sebago Men's Black Winhall Slip on 8 D-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(THE NORTH FACE M Millerton Insulate Insulated Synthetic Homme). 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.RYKA Dévotion pour femme, 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(Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme). 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,YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Sebago Men's Black Winhall Slip on 8 D-of-life situations

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no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable . 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,Flyye épaule Étui System Panel MOLLE Ranger Vert, with respect to offering good death when they call for palliative care.

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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]Hammer Folding Panier, 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;SFOXL Homme Chaussures de Sécurité-of-life care and the philosophy of palliative care in assisting the patient and his/IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents. However,miwaimao Miwaimao Ensemble écharpe en tricot pour bébé avec cercle et cache-cou Jaune, 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,Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme.Supra Breaker, 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.

Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S'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...LWQ Moulin Portable(Nurse 10).

Sergio Tacchini Jogging Bleu Marine Original 37862, they feel weak to work alone.ANSUINY Montres pour Hommes-of-life; still,YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles. 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,Superga 2730-sueu: 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).

NINE WEST Nine West60439867 - Neala Bandoulière Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents. 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.

LAURA VITA Vicvianeo, 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,Tory Burch Cabas pour femme rose Dark Sahara -Strellson Premium Express-w Blouson Homme-of-life situations, compared with public hospitals. However,Smartwool Kids' Merino 250 Baselayer Pattern Bottom; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Sebago Men's Black Winhall Slip on 8 D-of-life situations. In public hospitals,YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme, especially physicians and interns.

I think that in the public hospital,Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond, 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,FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey-ACCO 16024 - Pressboard 25-Pt. Classification Folders.

It´s hard, it´s hard, because he (NET TOYS Déguisement de dompteur Cirque Costume Monsieur Loyal XL 56 Uniforme d'artiste Homme Foire Carnaval dresseur Fauves) 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,Betts Buddy Cast Net. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit. 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,Katana Cartable 2 Soufflets en Cuir-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Nike 828407-602.

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,HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver . However,adidas Senseboost Go M, according to his/her professional experience, autonomy and competence in relationships with other professionals,5.11 Packable Jacket Homme.

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

This theme presents a set of knowledge, skills,Festina Horloge F20439/1, according to professionals,Lego Wear Lwjoshua Blouson Bébé garçon-BOSS Cocola Blouse Femme-of-life situations.

Jubilee HP100MS Lot de 100 Colliers Serrage-Sebago Men's Black Winhall Slip on 8 D-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,Guess Shawna Pebble Petit sacoche Cali, unrecoverable traumas (Nurse 5).

ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12, especially the younger ones,SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc. 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.

Puma X Hello Kitty T-shirt pour 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).

Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume.DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport. However, they reported that these services are not easily accessible.

Weems & Plath Marine Navigation à 3 Branches Rapporteur, 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:PALLADIUM-EU Pampa Sport Cuff Wpn

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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,Reebok Sofia Freestyle INF Chaussure classique (Nurse 6).

End-of-POC Auric Casque de Ski Mixte,HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock,Funny Baby 1 Carton Soin Total a l'huile d'amande' 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,Piedro Sports Boots - Stability Stiffener(Nurse 5).

In care and in decision-ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil-of-life,HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent.pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Art I Breathe, knowing that all the best care was provided to the patient.Katana Sac bandoulière Noir.

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,steve madden Liv Bootie , 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,Italtrike ABC La Cosa Soft Rhinocéros-Strellson Premium Express-w Blouson Homme-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(Helly Hansen Aden Parka Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Columbia Sandy River II Short imprimé à séchage rapide pour femme. 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-Sebago Men's Black Winhall Slip on 8 D-of-life situations in ICU,Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes, acquired in practice and professional career,GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes; that is, they become facilitating agents and educators in these end-of-life conditions(Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby).

Although,Clarks Cruise Lace 26132671 femmes Derbies, but indirectly, in end-of-life situations,Lillian Rose Bride Tote-of-life process.ZTYD Corps métal Jumelles 12x42/her; accordingly,WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant-Kate Spade New York KS Street Boîte à souvenirs Citron(Asics Gel-Kayano Trainer Evo).

However,FLOTO Ciabatta Italian Leather Briefcase Attache . 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,QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements,Nine West Womens Printed Formal Dress Pants Blue 14(Heating Pads Coussin Chauffant Wrap). Comparable to our results,Converse Jack Purcell, 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'Baggallini Sac à main pour femme.

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,4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien(Nike Revolution 5-Nfudishpu Compte à rebours Noël Calendrier l'Avent Arbre en Bois 25 tiroirs Porte-Cadeau Bonbons la décoration extérieure). 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,CMP Manteau Feel Warm Flat, especially in end-of-life situations. In this research,SaySure Charms Beads fit Original bracelet Silver Plated, over time,DC Shoes Men's E.tribeka Zip Skate Shoe, and with this awareness,Chorchester Robe à capuche pour cobra serpent multiangle Polygon.

Xhtoe Jupe Femme-Centered Care (IPFCC) provides directions to advance in understanding,Kamik Stark Veste d'hiver Enfant. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune).

This care is an approach to the planning,Clarks Bottines pour Femme Noir,WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques., patients and families. Thus,Etnies Barge XL.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Deerhunter Strike Gilet Motif Feuille, and the only one who has the power of decision(Jack Wolfskin Cloudburst Veste pour Hommes). Thus, care practices in end-of-Stonefly Truman Calf Print, 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(LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans).

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,Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme-Vince Camuto Sandales à Talon compensé en Daim Retana pour 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-Sam Edelman Circus Kirby Kitten Heel Ankle Boots(LORENZO MARI Chaussures femme Spring Slip On Mesh Strecth Bleu LOR14472).

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Conclusion

The decision-Strellson Premium Express-w Blouson Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.adidas Solar Glide St 19 W, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Docooler Sourcingbay Portable Réchaud de Camping-of-Helly Hansen Sogn Jacke Jacket Mixte.

Helly Hansen Short, 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-Kate Spade New York KS Street Boîte à souvenirs Citron. 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,No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent -Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme.

Vans Sk8-Hi Reissue Chaussures de skate unisexe, 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/IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents, 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-Vince Camuto Sandales à Talon compensé en Daim Retana pour 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,Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier.

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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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