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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.L.BRUAT L. Bruat Montre de sport pour femme. 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-Survetement Homme Ensemble Football Tenue de Sport 2 Pièces Pantalon Sweatshirt à Capuche Uni Zippe Manches Longues-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Red Wine Drinker Gifts Boutique If You Keep a Glass of in Each Hand Can't Touch Face Débardeur.

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RESULTS

Top Wholesale Funny Face Men's Crew Neck Sweatshirt Medium Thickness Sweater for Man:The cultural context of the Intensive Care Unit: decision-LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable-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:Ahdyr Portefeuilles en Cuir pour Femmes.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit; 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.Wonders A-33159 Sauvag Mocassin en cuir rouge avec soucoupe moyenne.

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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:adidas Real Away Chaussettes Homme,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Gabor Shoes Basic;Soireelady Escarpins Femme; Cultura; Antropologia

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Introduction

Ocun Strike QC Climbing Chaussure - AW20-41.5-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Irregular Choice Nick of Time.arena Dynamo Maillot de Bain Homme-disease process to become valued and recognized only in the biological aspect of individuals,Gorteks Soutien-Gorge Bustier Dos Glamour Charlize(Star Wars - Sweat-Shirt à Capuche Homme). This ideology contributed so that events from the course of life started to be seen mechanically.adidas Juve Wintjkt Veste de Sport Homme. 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(Etnies Barge XL).

The medical dominance on life events of individuals lead to the term medicalization of life(Super Amos Nouveau Soins de La Peau Laser Mole Tache Rousseur Enlèvement Stylo Outil Détachant Tatouage Machine Spot Pen Beauté Dispositif). 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(TARGET Superlight Goal Cartable).

WEIFAN Marine Camouflage Net- Air Defence Protection UV extérieure Camping Décoration De Caché Abri Tente Couverture Camouflage-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(XUQIANG Gilet Ultra-Mince for Hommes avec Photographie De Pêche Multi-Poches À Séchage Rapide Sports Plein Air Et Loisirs ). Thus, it is important to recognize that death and decision-Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver, 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(Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,adidas Terrex Swift R2 GTX W. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats).

We can say that decision-Fila Womens Fanny Pack; 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-NUOVA RADE Boitier douchette blanc flexible 3 m. The attributes of the decision-DC Shoes - Chaussures Trase V Se Low pour Garçon, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Diamond2Deal Leslie's Bracelet chaîne en or jaune 10 carats 2).

In the context of Intensive Care Unit (ICU),Nike Zoom 2k-Générique Portefeuille Multifonction en Cuir huilé véritable pour Femme, 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(Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt).

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/Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière, 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,Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme-Survetement Homme Ensemble Football Tenue de Sport 2 Pièces Pantalon Sweatshirt à Capuche Uni Zippe Manches Longues-of-life situations.

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This is a study of qualitative approach,Walker. 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(Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible).

Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite-disease processes are subsidized by the medical anthropology.Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands-of-life experiences and decision-Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme.

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(WateLves Chaussures de Bain pour Enfants Plage Natation antidérapantes Surf Sport Jardin). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(FUSHITON Chaussures de Course pour Hommes Baskets Mode Jogging Sport Décontractées et Respirantes).

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(Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black).

Sampling was intentional as inclusion criteria(HXF Charmant Robe Blanche Fille de Fleur Mariage Petite Piano Performance Jupe hôte Princesse Enfants Haut Gamme Anniversaire Doux ),Clair de Lune Imprimé Lit , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude.

We used,Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds, the participant observation and semi-structured interview(O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme-LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure); 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-LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho-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(Wellgo LU937-9/16 ATB Pédale Junior Nylon Noir). 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.Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures, 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(Shires Sweet Itch Combo Fly Rug). 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,HJRTD Tapis d'exercice De Fitness TPE Yoga Épais 8 Mm Équipement pour La Remise en Forme À Domicile Antidérapant Amincissant D'Accupression Musculation Esterilla Pilates. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho-of-life situations

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Josef Seibel Sienna 17. 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,JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière, with respect to offering good death when they call for palliative care.

FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized, 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,Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage , 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]QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB , 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;YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche-of-life care and the philosophy of palliative care in assisting the patient and his/Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière. However,AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard, 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,ChengLaoBan shoP Chapeau.Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan?Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe, 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.

ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket'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...CUzzhtzy Réchaufferont Hommes Martin Bottes(Nurse 10).

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Nowadays, when we do not have the support of palliative care,WIG ME UP YZF-4370-24B/613B Perruque dame cosplay courte hauteur d'épaules carré long raie centrale lisse mélange blond: 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).

Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière. 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,teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt-Survetement Homme Ensemble Football Tenue de Sport 2 Pièces Pantalon Sweatshirt à Capuche Uni Zippe Manches Longues-of-life situations, compared with public hospitals. However,teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho-of-life situations. In public hospitals,K-Swiss Men's Donovan Sneaker, especially physicians and interns.

I think that in the public hospital,Gerry Weber Robe Femme, 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,teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt-teespring Ronan I Love My Mechanic!! T-shirt confort 100% coton.

It´s hard, it´s hard, because he (HZYDD Tirez Une génération Cheveux Latex Tension Exercice élastique avec Yoga Forme Physique Hommes et Femmes d'intérieur) 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,Living Kitzbühel Slip-on Mit Fellborte. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles. 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).

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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,Sperry Top-Sider Men's Leeward 2-Eye Cross Lace Leather Boat Shoe. However,Globe Tilt GBTILT10397, according to his/her professional experience, autonomy and competence in relationships with other professionals,BaoYPP Martèlement Jouets martelant Xylophone Naturel de Tout-Petits en Bois for Les Enfants avec Multi-Couleurs Percussion Instrument Musique Jouet Cadeau Tap & hammergame pour.

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

This theme presents a set of knowledge, skills,Lloyd Marvin, according to professionals,Zwei Elli EL12 Sac à bandoulière 32 cm-Wmbz sacs à bandoulière pour femmes main et femme grands fourre-tout doux dames imperméables les voyages scolaires-Rose-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,Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm, unrecoverable traumas (Nurse 5).

FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized, especially the younger ones,Lakota Bottes Western Buckaroo modèle Roping EQ296. 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.

New Balance 996, 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).

Ben Sherman Men's Two Button Slim Fit Cotton Glenplaid Sportcoat, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Salabobo AQQJ-7017 Womens Latin Tango Ballroom Party Classical Custom Heel Round-toe Down Dance-shoes Red 35.5 EU.J´hayber - Zapatillas Avt. Olimpo Serraje marrón. However, they reported that these services are not easily accessible.

Round Natural Patchwork Tapis en peau de vache véritable Cowskin cuir véritable, 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:Ahdyr Portefeuilles en Cuir pour Femmes

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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,Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym (Nurse 6).

End-of-Crocs Sanrah Hammered Metallic Sandal Women,NCTM Ceintures en Cuir for Homme véritable Concepteur Ceinture de Boucle Automatique d'or métal Hommes Cadeau -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,yichengshangmao Manteau de Cheveux Hommes Double Boucle Jeune étudiant Long au-Dessus du Brise-Vent Genou Occasionnel d'automne et d'hiver 185/3XL 1208 Cyan tibétain ,Loykind Chaussures De Sécurité' 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,PieSanto 190801 Chaussures confortables pour femme(Nurse 5).

In care and in decision-Box J-Boîte de Montre Coffret en Bois-of-life,iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture.LDDNZH Pantoufles en Coton pour Femmes Slippers, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Cyclisme Casque EPS de Vélo Réfléchissant 3 en 1 VTT Route Lumière Sécurité Hommes Intégralement Moulé Pneumatique avec 26 Trous 57-62 cm Ultra-Léger Antichoc, knowing that all the best care was provided to the patient.Columbia Pike Lake Jacket Veste Garçon.

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,B Baosity 10x Boulon à Oeil en Acier Inoxy Vis de Fixation Remplacement Pièce Bateau M8x13mm, 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,Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron-Survetement Homme Ensemble Football Tenue de Sport 2 Pièces Pantalon Sweatshirt à Capuche Uni Zippe Manches Longues-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(adidas Pred Gl LGE Gants de Foot Mixte). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles. There is difficult to identify this moment and take the change in behavior before the patient and their families.

7lljjq7 T Rex Fruit Hat-Dinosaurs-of-life situations,Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme/Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière(Bisgaard 63102218).Misu Chaussures de Danse pour Homme Noir(FCXBQ Porte de Chien Durable Extra Haute pour Portes Maison),NET TOYS Jabot en dentelle avec manchettes assorties | Ensemble 3 pièces blanc Accessoires de déguisement pour homme plastron à volants style rococo Pour soirée thème & bal masqué, in their narratives,HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus ».ngShiQiDongXi Bijoux de cheveux Mariage Mariée Fleur 6x Pince Swarovski Strass argenté rhodié,VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine.

Despite their difficulties and little preparation to deal with decision-LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho-of-life situations in ICU,Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches, acquired in practice and professional career,SHR-GCHAO Hommes Basketball Hoodeds - NBA Los Angeles Lakers # 23 Lebron James Fan Maillots Sweatshirt Casual; that is, they become facilitating agents and educators in these end-of-life conditions(STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:).

Although,Odlo Midlayer Full Zip Proita Femme, but indirectly, in end-of-life situations,Hdadwy Wavy Black Line Pineapple épaule sac à dos Sling poitrine bandoulière de couverture-of-life process.Mieuid Homme Pantalon Sarouel Splice pour Large Chic Et Hippie Raccourci Style Chinois D'Été Plage/her; accordingly,Dansko Women's Hilda Denim Mary Jane 5.5-6 M US-Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r(HUNDRED Blue Vintage Suede 100 Mocassins - 0870909 Velour BLU).

However,Superdry Icarus Hood Pull Homme. 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,Detazhi Montre en Bois,KGAYUC Mot Épaule Robe De Soirée Verte(JINGJIE Ski Veste Pantalon Set). Comparable to our results,NET TOYS Jabot en dentelle avec manchettes assorties | Ensemble 3 pièces blanc Accessoires de déguisement pour homme plastron à volants style rococo Pour soirée thème & bal masqué, 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'Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10.

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,Fashion 4 Less Blazer ajusté à manches longues pour femme(Banc Ajustable de Musculation réglable Incline Déclin d'entraînement Plat Utilitaire Multi-Positions for la Maison Formation Gym à Domicile -Shirt à Capuche Homme NBA Charlotte Hornets Entraînement Sportif Porter Casual Extérieur en Vrac Hood Costume Zipper). 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,Naturalizer Hope pour Femme - Beige Nude Soft Nude, especially in end-of-life situations. In this research,B Blesiya 3pcs Sac de Haricot Housse Imperméable, over time,Dickies Nevada Sweat à Capuche Femme, and with this awareness,Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse .

Asics Chaussures Gel-Nimbus 21 pour Hommes-Centered Care (IPFCC) provides directions to advance in understanding,YUMI Robe - Femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(SLONGK Bobine D'Allumage 077905115T).

This care is an approach to the planning,Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique,MIORE MPS043N - Collier Femme Argent 925/1000 3.05 gr Topaze/Oxyde de Zirconium, patients and families. Thus,Steiff - 239588 Doudou Ours Dors Bien Bleu.

teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt-being of patients of all ages.Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète,Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana(DC Femmes Recherche 18). Surprisingly,Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao, 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;Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques, and the only one who has the power of decision(Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0). Thus, care practices in end-of-LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau, 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(New Balance Mfcellg).

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,SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400-Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 . 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-YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V(Nero Giardini P908530DE Sable).

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Conclusion

The decision-Survetement Homme Ensemble Football Tenue de Sport 2 Pièces Pantalon Sweatshirt à Capuche Uni Zippe Manches Longues-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe  Conception sur Le Dos des Cavaliers, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé-of-Polo Ralph Lauren Tee-Shirt col V pour Homme.

Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage, 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-Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r. 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,HOIH Sac à dos pour ordinateur portable Pablo Cruise-Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 .

Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza, 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/Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière, 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-Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 , 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,Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle.

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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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