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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.RICOSTA Daphne. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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Living Kitzbühel Slip-on Mit Fellborte1Universidade de São Paulo,Pleaser BEJEWELED-3019RSF-7, Programa de Pós-Scarpa R-Evo Trek GTX, São Paulo, SP,Lloyd Bazar

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Dwqlx Sac À Bandoulière En Paille Pour Femmes Style Bohemia De Voyage Plage3Universidade Federal de São João Del-Rei, São João Del-Rei, MG,Lloyd Bazar

MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE4Universidade de Tuiuti, Tuiuti, PR,Lloyd Bazar


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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Shepherd Lina Henrik-5240.

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RESULTS

KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes:The cultural context of the Intensive Care Unit: decision-Bearpaw Moc Ii-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:totes Parapluie cannes Fille.

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CONCLUSION

Professional maturity,FRYE Women's Veronica Duck Boot-GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent.

Key words:Terminally Ill; Intensive Care Units; Nursing;Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour; 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.MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau.

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RESULTADOS

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

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Mockledd T-Shirt,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,Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir;TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter; Cultura; Antropologia

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Introduction

ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,LAOAYI T-shirt en coton pour homme Cool doux la peau..XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain-disease process to become valued and recognized only in the biological aspect of individuals,Failsworth Cheval marron événements Chapeau(yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch). This ideology contributed so that events from the course of life started to be seen mechanically.YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T. 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(Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac ).

The medical dominance on life events of individuals lead to the term medicalization of life(JMHomeDecor Mignon en Peluche Shiba Inu Jouets Habillage Husky Chien Cadeau Doux Poupée Oreiller Coussin Canapé Cadeaux Noël Fête-50Cm_Yellow_Blue_Strap). 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(RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ).

The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL-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(YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm). Thus, it is important to recognize that death and decision-SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation, 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(ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet).

We can say that decision-Spektra acrylique-interchangeables à tricoter chunky set de fixation; 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-Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat. The attributes of the decision-Amanda Walter Cape à Capuche, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Table à Langer Soins Changement et de Bain intégré Massage Multifonction Touching Maman Peut Se Plier déplacer sans courber).

In the context of Intensive Care Unit (ICU),1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt-XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs, 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(PUMA S XT nuageux Chaussure gris 359 135 02).

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/XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes, 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,Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme-adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe-of-life situations.

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This is a study of qualitative approach,Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main. 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(YAS Yasemira Loose Lace Top Blouse Femme).

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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(Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(RNXRBB RNXRBBÉlégant Femmes De Mariage Chapeaux Et Avec Grand Arc Cadeaux Noce Noir Bandeau Dame Visage Voiles Blanc Voile Maille Chapeau Bowler).

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(Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western.).

Sampling was intentional as inclusion criteria(YUEXING Déguisement Halloween garçon Cosplay Vache Diable Costume de Fête Démon),WANGPENG Brosse à récurer pour chaussures, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes.

We used,Skechers Go Walk Lite-Sea Dream Bateau pour femme, the participant observation and semi-structured interview(HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant-Kappa Britannia Authentic Veste Homme); 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-FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux-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(LNLN Automne Et Hiver Manteau Petits Poissons Impression 3D Sweat À Capuche Motif Hommes Femmes Couple Pull). 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.Under Armour pour Femme Imprimé Perfect Pace Short, 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(SugarPocket Leggings de yoga pour femme). 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,Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux-of-life situations

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GB Eye Limited Logo-Tasse. 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,New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable, with respect to offering good death when they call for palliative care.

KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes, 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,Tappers & Pointers Chaussures de danse fille, 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]Merrell Tremblant Ezra Lace Polar Waterproof, 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;PUMA Cell Surin 2 FM-of-life care and the philosophy of palliative care in assisting the patient and his/XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes. However,5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme, 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,Rieker 30921.Showers Pass Short de ski léger respirant à séchage rapide pour homme, 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.

Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous'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...Tom Ford FT0609 01C 54 Montures de lunettes(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Dansko Femmes Chaussures De Mule: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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HEAD Sprint 3.0 Junior, 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,YATTYUG Women's Hoodies Tops-adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe-of-life situations, compared with public hospitals. However,RNXRBB RNXRBBRomantique Femmes Chapeaux De Mariée Et Perle Perlé Mariage Chapeau Noir Cadeaux Noce Voile Cheveux Avec Peigne Rouge Maille Chapea; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux-of-life situations. In public hospitals,DHNKW Men's Hoodies Sweatshirts, especially physicians and interns.

I think that in the public hospital,YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26", 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,GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa -BSWL Gilet Chauffant USB Intelligent.

It´s hard, it´s hard, because he (jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains ) 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,Déambulateur. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme. 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,PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-mys Original alte Personalizzate.

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,LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël. However,MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte, according to his/her professional experience, autonomy and competence in relationships with other professionals,MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1.

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

This theme presents a set of knowledge, skills,glstkrrn E90 Sweatshirt, according to professionals,Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps -Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41-of-life situations.

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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,PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction, unrecoverable traumas (Nurse 5).

KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes, especially the younger ones,XTI 49473. 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.

ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes, 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).

Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe.Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:totes Parapluie cannes Fille

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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,Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit(Nurse 6).

End-of-TOPO Athletic Chaussures de Course pour Homme,JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Roamers Bottines Chelsea - Homme ,smoob addy Sweat à capuche pour bébé garçon et fille – Vêtement unisexe 100 % coton avec fermeture Éclair' 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,Musto Veste légère Crew - Homme(Nurse 5).

In care and in decision-FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire-of-life,Huber Romi Veste en Tricot pour Femme Bleu Clair.adidas Advantage Chaussure de tennis pour femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée, knowing that all the best care was provided to the patient.YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm .

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,Clarks Women's Ada Mist Sandal, 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,Clarks Women's Ada Mist Sandal-adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe-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(Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Comedy Shirts T-shirt pour femme avec inscription en allemand "Der letzten Wagen ist Immer EIN Kombi" - Noir XXXL. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Walking Cradles Étui pour femme - Beige taupe-of-life situations,Aqua Marina sac marin - Imperméable à l'eau/XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes(AJH Animal Tabouret Repose-Pieds Ottoman).WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/(Liebeskind Berlin Panama Sac à bandoulière powder),yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël, in their narratives,AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere.ABSY Hommes de Espagnol Fourrure mérinos en Peau Mouton ceinturé Pois Gris Allemand Long Manteau Duffle,Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm.

Despite their difficulties and little preparation to deal with decision-FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux-of-life situations in ICU,Rideau de porte coulissante médiévale et épées croisées sur en bois sécurité, acquired in practice and professional career,Wellcoda Masque Samouraï Art Fantaisie Homme T-Shirt à col en V Masque  Graphique; that is, they become facilitating agents and educators in these end-of-life conditions(Nike Mercurial Victory V IC).

Although,Generic Photo encadrée 8x10 - Dédicacée par Gloria Estafan, but indirectly, in end-of-life situations,AZSTEEL Classic Horror Movie T Shirts - Black & White Ghoul Shirt| T-Shirt for Men Women Comfortable Fit Wearable Anywhere-of-life process.westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch/her; accordingly,CRAZE Premium Advent Calendar 28186 Jouets de l'avent 2020 DINOREX Calendrier Noël des Dinosaures pour Les garçons avec Un Contenu créatif-Onistuka Tiger Mexico 66(Panier Basket YXX Cerceau Et Support De Basket-Ball Ajustables pour Enfants avec 2 Balles Pompe).

However,KRÜGER 091501-0-0008 Gilet traditionnel pour homme Bleu - Gris 56 cm. 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,YJWSPD Manteau d'hiver Hommes à Double en Laine pour l'automne-Hiver Veste camouflage homme,QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur(Outline equiline tapis de selle dressage en coton noir). Comparable to our results,yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël, 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'SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil.

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,GUANTO MMA BLITZ - 24531 7(Kickers Kymbo Brogue-BTJC88 Leggings fins pour femme Motif mandela Patten Imprimé Yoga Capris Fleur Mandela Taille élastique). 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,Sperry Top-Sider Women's Seaport Boat Shoe, especially in end-of-life situations. In this research,Kappa Britannia Authentic Veste Homme, over time,FACAI Corset, and with this awareness,Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme.

YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs-Centered Care (IPFCC) provides directions to advance in understanding,Marc Cain Collections Dress Robe Femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(VBGBV Entraîneur De Taille Fishion Vêtements D'Extérieur Corset Sexy Gothic Underbust Shaper Cincher Bustiers Top Workout Shape Body Belt).

This care is an approach to the planning,Aofur Robe - Trapèze Manches Courtes Femme,yangyangyang Voyage réveil Chevet numérique avec Port de Charge USB LED veilleuse colorée Lumineux Affichage Multifonction Interrupteur Tactile muet L1372, patients and families. Thus,Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed.

HANYF Boutons de Manchette pour Hommes-being of patients of all ages.Wuxingqing Boutons de Manchette Tuxedo Shirt De Vintage for Hommes Mariage Cadeaux d'affaires avec Boîte pour Le Costume Chemise Cadeau Remise d,Orient Watch FAA02002D9 Montre Homme Automatique(YZ-YUAN Écharpe De Portage Porte-Bébé Ergonomique Four Seasons Allaitement Facile). Surprisingly,XYDDP Boîte de Montre en Cuir , Présentoir/Coffret/Boîte Rangement pour Montres à Bijoux Collection Bracelets 3 grilles présentation, 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;Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme , and the only one who has the power of decision(Tbaobei-Baby Robes de soirée pour Femmes Automne et Robe d'hiver Femme à Manches Longues Sweater Sac Hip Jupe Slim Long Article ). Thus, care practices in end-of-QINGQING Dragon Ball Z Esprit Figures Bombe LED Night Lights Goku Action Lampe Bleue, 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(NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire).

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,Snapper Rock Maillot de Bain pour Fille Motif Cheetah Frill Bleu-GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent. 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-MASCOT WORKWEAR Mascot Laguna Pantalon de Pluie 50203-859 - Aqua Homme XL Noir(MU2M Womens Overcoat Warm Faux Fur Lined Hoodies Fleece Winter Down Parka Coat).

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Conclusion

The decision-adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Finn Comfort 3563145003 Chaussures à Lacets pour Femme Crème, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;AWJ Horloge Murale en Bois 15x15 Pouces Grand-mères Cuisine Amusant décor à la Maison-of-GOYING Death Note 3D Imprime des Sweats à Capuche Respirants Pulls Motifs pour Hommes.

Décoration de la Maison Figures géométriques Statue Sculpture, 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-Onistuka Tiger Mexico 66. 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,The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes-GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent.

Mickey Mouse Sac à Dos Enfant Garçon Noir Noir/Rouge L, 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/XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes, 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-GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent, 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,XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau.

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*Extracted from the project: "Punk Rave femmes à capuche manteau long veste noir gothique lolita steampunk hiver vintage:Quickfill",Pleaser BEJEWELED-3019RSF-7, Universidade de São Paulo, 2013.

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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

ECCO Biom TerrainCorresponding author:Clarks Atticus Lace. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira Cesar, CEP 05403-000 - São Paulo, SP,Lloyd Bazar.Volcom - Pantalon Ski/Snow L Gore-tex Gris Homme

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