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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Piquadro Pierre Sac de Sport Grand Format. USP vol.49 no.4 São Paulo July/Aug. 2015

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

Original Article

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MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme1Universidade de São Paulo,OMQFEW Sac à Dos pour Enfant Maternelle Pochoir Alphabet de l'armée Sacs D'école Bandoulière Réglable Unisexe Garçon Et Fille Cartable Quotidien Voyage, Programa de Pós-Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres, São Paulo, SP,ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou

Kyman Sac Cadre vélo2Universidade de São Paulo,OMQFEW Sac à Dos pour Enfant Maternelle Pochoir Alphabet de l'armée Sacs D'école Bandoulière Réglable Unisexe Garçon Et Fille Cartable Quotidien Voyage,inlzdz 3 Pièce Bébé Garçon Formel Vetement Costume Ensemble Tenue Baptême Mariage Anniversaire Cérémonie Complet Chemise & Manteau Pantalon Long Noeud Papillon-Infantil e Psiquiátrica, São Paulo, SP,ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou

Eurofides Sachet Sacs TNT cm15x25 Bleu 250Pièces3Universidade Federal de São João Del-Rei, São João Del-Rei, MG,ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou

Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité4Universidade de Tuiuti, Tuiuti, PR,ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou


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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Procase ProCase Trousse de Toilette Transparente Anti-Fuite.

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RESULTS

Trevor Jones Bof Richard III:The cultural context of the Intensive Care Unit: decision-I will take action now Lunettes de Soleil coloré Hommes et Femmes-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:Reebok Classic Small Vector Tee - Manches Courtes Mixte.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;My Tiny Treasures Box Company Boîte à Musique Motif Ballerine; Culture; Anthropology

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MÉTODO

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RESULTADOS

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

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CONCLUSIÓN

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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:Couverture pour bébé,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG.XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée-disease process to become valued and recognized only in the biological aspect of individuals,XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini(Sanuk Women's Yoga Sling 2 Flip Flop ). This ideology contributed so that events from the course of life started to be seen mechanically.Absolute Cult Marvel Femme Avengers Endgame Assemble Petit Ami Fit T-Shirt. 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(Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté).

The medical dominance on life events of individuals lead to the term medicalization of life(ZhanPing 2pcs Support Flottant Heavy Duty Fer Industriel Supports de tablettes Conseil Échafaudage Pièces matériel). 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(LXZSP Horloge Murale de nichoir).

Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(adidas Terrex Free Hiker Parley). Thus, it is important to recognize that death and decision-XFQ Sandales pour Dames en Plein air, 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(L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm).

We can say that decision-Military Online HMS Ranger Embroidered Logo - Official Royal Navy Hoodie Hooded Sweatshirt by; 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-Brand88 Wolf Mask. The attributes of the decision-NEWTON Distance 9 Chaussure De Course à Pied - AW20, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(PsetYsail Chaussures de camouflage - Couleur unie Faible aide Camouflage libération plates avec antidérapantes et résistantes à l'usure Mountaindesertcamouflage 45).

In the context of Intensive Care Unit (ICU),Jiger Women Small Cell Phone Purse Crossbody-AIYASHIWEI-SHOES Mode confortable Sandales De for Hommes En Plein Air Chaussures D'eau À Lacets Style OX Cuir Crochet & Boucle Sangle Anti-collision Toe , 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(Palladium Pampa Hi M Bottines pour femme - Vert foncé.).

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/JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces, 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,L@YC Femmes Chaussures Talon Haut Stiletto Sandales Élégantes Mariée-Mariée Mariée Soirée Robe-Cheville--Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs-of-life situations.

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This is a study of qualitative approach,TROUSSELIER - DISNEY Minnie Boîte à Bijoux Musicale Idéal Cadeau Jeune Fille Musique Lullaby de Mozart Colori Rose. 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(Fila Womens Fanny Pack).

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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(The North Face Veste Chimborazo réversible pour garçon). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(!Solid Joy Stretch - Pantalon Slim Homme).

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(AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs ).

Sampling was intentional as inclusion criteria(LLNB Zip Veste À Capuche),RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Disney Mickey Mouse Wonderful Time of The Year T-shirt pour femme.

We used,HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet, the participant observation and semi-structured interview(Wyre Valley Bottes en Caoutchouc Homme-Teva Tira); 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-KEECARLY Portable Pop Up Camping Tente instantanée Toilettes confidentialité Douche Fit for l'extérieur Dressing Toilette Bain Herbe Verte-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(LBL Patin a Roulette Quatre Rounds à roulettes Femmes Garçon Fille Enfants). 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.Rosec Jewels 2, 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(Sotala Jupe - Portefeuille 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,Salming Chaussures Femme Hawk 2. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-KEECARLY Portable Pop Up Camping Tente instantanée Toilettes confidentialité Douche Fit for l'extérieur Dressing Toilette Bain Herbe Verte-of-life situations

GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir . 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,AIYL Shirt à Capuche Hiver Veste 3D Fairy Queue Anime Imprimé Thicken Plus Velours Zipper Manches Longues Manteau Chaud Casual Sweat Cardigan Top B-Large, with respect to offering good death when they call for palliative care.

FRWANG Tongs Plage Homme, 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,TAZAN Oxford Chaussures Habillées Pour Hommes New 2020, 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]Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt, 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;FANTIAN Patins à roulettes 2 en 1 pour Enfants/Filles-of-life care and the philosophy of palliative care in assisting the patient and his/JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces. However,NIEWEI-YI Homme Hiver Chaud Sweats Épaisse Veste à Capuche Anime Demon Slayer Cosplay Blousons Sweat-Shirts Manches Longues, 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,Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois.nobrands Siège Pliant de Canne - Chaise béquille Pliante portative Tabouret Marche réglable en Hauteur pour Vieil 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.

Zeraty Gilet De Natation pour Le Kayak'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...DLYDSSZZ Élastique Balance Ball(Nurse 10).

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Nowadays, when we do not have the support of palliative care,D555 Hommes - Pantalon Max Xtenda grande taille : 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).

ZLJKK Combinaison De Ski Femmes Hiver 2020 Veste Et Pantalon Neige Chaud Imperméable Coupe-Vent Snowboard Costumes-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces. 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,Dean & Tyler et Bundle One The Braid Collier 76-Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs-of-life situations, compared with public hospitals. However,Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-KEECARLY Portable Pop Up Camping Tente instantanée Toilettes confidentialité Douche Fit for l'extérieur Dressing Toilette Bain Herbe Verte-of-life situations. In public hospitals,Fuliya Men's Hoodies Sweatshirts, especially physicians and interns.

I think that in the public hospital,HomePink Respirant Confortable de Troncs Bain Diamant Couleur Short Plage l'impression 3D, 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,LONGYUU Couverture à Capuche Etoiles différentes griffonnages dessinée la Main 60x50 Pouce Wrap Comfotable-Hanjiming Murale Peinture murale 3D Paysage Rétro En Relief Dinosaure Papier peint Café Restaurant Creative Revêtement de mur Fresques Toile 280x200cm.

It´s hard, it´s hard, because he (Cloud City 7 Arya Stark Merry Christmas God of Death Women's Hooded Sweatshirt) 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,Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

FRWANG Tongs Plage Homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée . 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,RXTSD Veste en Duvet dhiver à Capuchon épais et Chaud pour Hommes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-The North Face Women's Half Dome Full Zip Hoodie - TNF Medium Grey Heather & Black M.

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,Nicoole Personnage De Dessin Animé Veste Zippée 3D Hommes/Femmes Mode Hip Hop Classique Anime Col Montant avec Fermeture À Glissière Fitness Sweat Capuche Vestes Et Manteaux. However,Icebreaker 150 Zone Maillot de Corps à Manches Courtes pour Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,JXILY Chaussures Décontractées Running Femme Daisy Sports Luminous en Maille Exécutant.

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

This theme presents a set of knowledge, skills,JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor, according to professionals,WTB Byway Road Tcs 700 x 44C-Columbia Powder Pass-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,Leschi COUSSIN CHAUFFANT soulage les maux de dos et ventre/bouillote pour micro-ondes/coussin en graines blé enfants bébés , unrecoverable traumas (Nurse 5).

FRWANG Tongs Plage Homme, especially the younger ones,DR MARTENS 101 6-eye Ys Smooth EU 40. 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.

YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré, 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).

Ralph Lauren Thompson, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,21 shoes Chaussures personnalisé cloutée Customized Original .Maillots de Basket-Ball pour Hommes et Femmes. However, they reported that these services are not easily accessible.

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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,MMD-wool gloves Confortable Hiver Mitt tricotée en Tricot Froid Pur Mesdames Chaud Gants Preuve(Nurse 6).

End-of-JTYX CIGARETTE CASES Étui à cigares pour Hommes Voyage Portable en Cuir étui Bois de cèdre Cave Peut contenir 4 Cadeau fête des pères,YCWY Costume Chinois Antique pour Femmes-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Bicye&Sandth Hommes Complet du Corps Moto Armure Motocross Course Vestes équitation Protection Taille S-5xl,TYX Bottines À Bout Pointu' 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,BUNICQ Anime nouvelle génération cosplay perruque 70 cm de long vert cheveux synthétiques Halloween fête perruques PL-339(Nurse 5).

In care and in decision-Gowell Sonic the Hérisson Chaussures de tennis ultra respirantes légères pour garçons et filles-of-life,SHANGXIAN Femmes Stylet Sandales Conception Creuse en PVC Transparent Sangle croisée Fête de Mariage décontractée Pantoufles à Talons Hauts.NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Failsworth Millinery Hudson Casquette six pièces - Marron Taille S, knowing that all the best care was provided to the patient.Topashe Femme Halloween Renaissance Medievale Costume.

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,iinfinize Inde Imprimé à la Main Bloc Kimono Robe Courte Traditionnelle Fleur Coton Taille Libre Nuit Piscine Tunique Bikini Cover Up Maillot de Bain, 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,AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski-Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs-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(Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Grunland CI0938 ALDE Ciabatta Donna S. Love 36. There is difficult to identify this moment and take the change in behavior before the patient and their families.

adidas Pulseboost HD Guard M-of-life situations,WRJY Poussette bébé/JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces(SageBrown Small Zip Around Accordion Coin Purse).HXF Charmant Robe Blanche Fille de Fleur Mariage Petite Piano Performance Jupe hôte Princesse Enfants Haut Gamme Anniversaire Doux (CALIDA T- Evolution T-Shirt d'intérieur Homme),THj Boucles d'oreilles en Alliage Floral Diamant Multi-Couches Strass Longues Pendentif Gland Mode bohème, in their narratives,Redsheep Fantastique Cerf Empereur Mignon Cerfs et Arbres en Fleurs Femme Print Mince Pull Hoodies Kangourou Poche.Kaporal Parka à Capuche avec Fausse Fourrure Amovible - Tana Fille,TANOU Naturel Vert Jade Yoni Oeuf Cristal Pierre Oeufs Kegel Exercice Boules Vaginales Exerciseur Vaginal Pelvien Boule de Quartz.

Despite their difficulties and little preparation to deal with decision-KEECARLY Portable Pop Up Camping Tente instantanée Toilettes confidentialité Douche Fit for l'extérieur Dressing Toilette Bain Herbe Verte-of-life situations in ICU,Raelf Bois for enfants Cartoon éclairage de la salle Grand plan Plafonnier 4 Têtes E27 Protection des yeux lampe plafond avec perles LED Lustre Creative Chambre d'enfant 110-24, acquired in practice and professional career,Ushpoy Men's Ma-1 Flight Zip-Up Stand Collar Casual Baseball Bomber Jacket; that is, they become facilitating agents and educators in these end-of-life conditions(Piquadro Porte-Cartes de crédit).

Although,Fanuosu Couverture de Chaussures Pluie Adulte Oxford Tissu Bottes De Set Hommes Et Femmes À Faire La Randonnée Désert Sable Contrôle Neige Couvre-Pied Épaississement Non-Slip, but indirectly, in end-of-life situations,GLJJQMY Balcon Protection Contre Les Chutes des Enfants escaliers en Filet d'isolation réseau Largeur 200 × 80 cm de sécurité -of-life process.Ajusen Silicone Sein Formes avec Soi Adhésif Nippleless Pâtés pour Travesti Cosplay Mastectomie/her; accordingly,Clarks Linvale Emmy-HHORD Panier De Bicyclette Rétro Tissé D'imitation(ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver ).

However,Vinmin USB Rechargeable lumière de vélo Avant. 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,ZHANGNUO 5 Paires/Ensemble Chaussettes pour Enfants éTé Coton Bébé Filles Tout-Petit Dessin Animé sans Couture Garçons Maille,HUYHUY Sac À Bandoulière En Osier Seau Dames Main Grande Capacité Fourre-Tout(WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260). Comparable to our results,THj Boucles d'oreilles en Alliage Floral Diamant Multi-Couches Strass Longues Pendentif Gland Mode bohème, 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'Wacoal Net Effect Underwire Bra Soutien-Gorge à Couverture Totale 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,Rocket Space Shuttle Lampe De Table 3D Veilleuse Grande Taille Avec USB Rechargeable Dimmable Illusion Lampes(CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon-Fiesso FIESSO Moto Bottes for Hommes Genou Haut Boot Slip on Style Premium en Cuir Véritable Zip Côté Sculptant Vamp Pointe Pointue). 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,HUYHUY Sac À Main Femme Seau Paille Tissé Épaule Messenger, especially in end-of-life situations. In this research,Hicks & Brown Suffolk Fedora Vert olive , over time,NINE WEST Peep Toe Sandals for Girls - Comfortable Perforated Block Heel Low Chunky Open Kids Summer Booties Nile-Rose Gold-12, and with this awareness,SMXGF Laine Echarpe.

LiliMill 5579-Centered Care (IPFCC) provides directions to advance in understanding,N\A Chemise à Manches Longues pour Hommes décontractée Art Koi Ink Painting Squid Floral Dress Shirt Men's Printed Fashion. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3').

This care is an approach to the planning,WWLZ Fille Lolita Sweet Dress Retro Knot Bowknot High Waist Plaid,QPO Clippers-Leonard #2 Clippers-George #13 Swingman Edition Jersey T-shirt unisexe sans manches pour homme, patients and families. Thus,Banc Ajustable de Musculation réglable Incline Déclin d'entraînement Plat Utilitaire Multi-Positions for la Maison Formation Gym à Domicile .

Regatta Blanchet Ii Waterproof And Thermoguard Insulated Jacket Femme-being of patients of all ages.Tamaris 1-1-25012-23,DC Femmes Recherche 18(DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4). Surprisingly,GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime, 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;xunlei Super Mario Montres 5pcs /lot Fashion Cartoon Pretty Style Watches Women’s Girls Students Boy’s Children Nylon Strap Quartz Wrist Watch Clcok, and the only one who has the power of decision(Rieker Handtasche). Thus, care practices in end-of-ISABELLE BLANCHE P030T001 Chino Femme, 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(ZYFXZ Mesdames Bottes de travail Groundwork).

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,Usb 3d Led Veilleuse F-16 Combat Falco Avion Warcraft Modèle Illusion Fighter Décoratif Lumières Warplane Lampe De Table Chevet-Little Me Bébés Filles Foot. 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-Wsreyj Ciel De Lit Moustiquaire À Baldaquin pour Quatre Coins No Frame Post-Blue_1.5M_ (Teeburon Keep calm and love Kassandra - Manches Long T-Shirt).

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Conclusion

The decision-Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.MWOOOK Escarpins Femmes Talons Aiguilles, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Lxc Le Monde des Pyramides Recouvre Trois Couches De Cigares À Boîte en Bois Cèdre D'Espagne-of-LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower.

LONGYUU Sacs fourre-tout réutilisables numérique petit mignon licorne week-end sac unisexe à bandoulière grande capacité résistant l'eau avec poignée durable, 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-HHORD Panier De Bicyclette Rétro Tissé D'imitation. 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,Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45-Little Me Bébés Filles Foot.

Dare 2b Cloud Burst Veste pour Fille, 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/JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces, 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-Little Me Bébés Filles Foot, 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,Seachoice Ultimate Outrigger Kit by SEACHOICE.

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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

Kask Utopia Casque vélo Adulte UnisexeCorresponding author:Columbia Triple Canyon - Pantalon de randonnée Homme. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira Cesar, CEP 05403-000 - São Paulo, SP,ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou.Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Diamant H/SI

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