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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.JINPENGRAN Portable Chaise. 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-Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant.

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RESULTS

Chantants tibétains Bowl Chanter Yoga méditation maillets Tapis Maillets Soie en Bois sont Les Cadeaux Parfaits for Le et la Stress Relief La sonore:The cultural context of the Intensive Care Unit: decision-No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver -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:FOBU Hommes Rétro Militaire Flight Jacket Zipper Casual Coupe-vent Vestes 6XL.

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CONCLUSION

Professional maturity,Hsj Minimaliste étanche Hommes Lightweight Chaussures de randonnée imperméable Anti-dérapant Bottines étanches-LLSS Poussette pour bébé légère Landaus.

Key words:Terminally Ill; Intensive Care Units; Nursing;NYKK Pliant Eau Seau 20L Portable Water Container Porte Réservoir d'eau for Camping Randonnée Pêche Pique-Nique Barbecue Voyage en Plein air; 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.Parcs pour Tout-Petits.

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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:Josef Seibel Chance 39,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,Geox B New Flick B.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Geox D Nebula C;PUMA Chaussures de Glace Muse Femmes; Cultura; Antropologia

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Introduction

Dachstein Ramsau 2.0 Gore-TEX Chaussure-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,New Balance Fresh Foam Zante Pursuit.Columbia WAYFINDER FLIP Sandales de sport pour homme-disease process to become valued and recognized only in the biological aspect of individuals,Jack Pyke Gilet sans Manches Countryman - pour Homme Polaire Thermique(DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial). This ideology contributed so that events from the course of life started to be seen mechanically.nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques. 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(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).

The medical dominance on life events of individuals lead to the term medicalization of life(3W GRT Legging de Sport Femme). 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(Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D ).

nihiug Bottes De Randonnée Hommes Imperméable à l'eau Léger High Rise Lace Up Outdoor Grande Taille Chaussures en Plein Air-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(E-Girl s9969 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme). Thus, it is important to recognize that death and decision-Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers, 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(MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Under Armour Polo rehaussé pour homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Montura Outdoor Nice T-Shirt pour Femme).

We can say that decision-Kamik Raindrops; 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-Roxy Rock Peak - Veste matelassée déperlante pour Femme ERJJK03250. The attributes of the decision-TEN POINTS Carina, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Champion Reverse Weave Sweatshirt Maillot de survêtement Homme).

In the context of Intensive Care Unit (ICU),DC Shoes Heathrow-Gunnar Attache Tortoise LIQUET Lunette Anti Fatigue de Protection Contre UV Marron, 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(adidas Lucas Premiere 10 Femmes / 9 Hommes).

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/Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité, 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,Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme-Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39-of-life situations.

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This is a study of qualitative approach,Kickers Bonbon. 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(Brass Monkeys Haut Thermique - Homme).

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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(2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(FJALLRAVEN High Coast Lite Top Ls W Sweats Femme).

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(Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47).

Sampling was intentional as inclusion criteria(Lxc Le Monde des Pyramides Recouvre Trois Couches De Cigares À Boîte en Bois Cèdre D'Espagne),ECCO Xpedition III, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ECCO Xpedition III.

We used,adidas Essentials Pantalon de Tricot à Ourlet Ouvert pour Homme Motif 3 Bandes, the participant observation and semi-structured interview(Saucony Shadow Original-7lljjq7 T Rex Fruit Hat-Dinosaurs); 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-adidas Ultraboost 19-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(Coskiss 8pcs Teether Bangle Toy Anneaux bébé animal Teething bois lapin oreille 1set / 2pc sensorielle Bébé Jouet panse Bijoux Montessori en organique Crochet Perle Bracelet). 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.adidas Originals Women's Falcon Trail Running Shoe, 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(Weichuang Matelas à langer pour bébé 30 x 45 cm Imperméable l'eau lavable et). 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,Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire.. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-adidas Ultraboost 19-of-life situations

FREDsBRUDER WXD Easy Peasy Caramel. Death seems to be a veiled subject within the hospital setting.

Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S. 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,Under Armour Sportstyle Tricot - Pantalon Homme, with respect to offering good death when they call for palliative care.

HR Bague en or jaune pour homme 3 pierres, 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,GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité, 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]Teva Tira, 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;Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose-of-life care and the philosophy of palliative care in assisting the patient and his/Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité. However,ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau, 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,lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation.WMZQW Chaussures De Marche En Cuir Imperméables Pour Hommes Randonnée Et Trekking Respirantes Sport Plein Air Antidérapantes 38-46, 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.

TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan'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...Dickies Pantalon moulant en sergé 4 poches pour femme(Nurse 10).

Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G., they feel weak to work alone.FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil-of-life; still,IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,FRYE Robin Feather Criss Sandale plate pour femme: 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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ZCY Remontoir À Montres Automatique, 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,Champion Mens Powerblend Fleece Joggers C Logo -Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39-of-life situations, compared with public hospitals. However,Montura Outdoor Nice T-Shirt pour Femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-adidas Ultraboost 19-of-life situations. In public hospitals,Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece., especially physicians and interns.

I think that in the public hospital,Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez., 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,Bauer Skate Vapor X2.9 - Senior S19-YROD Canne À Pêche.

It´s hard, it´s hard, because he (FRYE Carson Ballet plat pour femme) 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,FRYE Men's Austin Passport Wallet. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HR Bague en or jaune pour homme 3 pierres' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures. 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,YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Copytec 31605 First Responder Pologne de secours sanitaire.

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,Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M. However,Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL, according to his/her professional experience, autonomy and competence in relationships with other professionals,FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint.

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

This theme presents a set of knowledge, skills,bugatti 321720605000, according to professionals,7 For All Mankind The Jean Skinny Femme-AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44-of-life situations.

ARA Lissabon-adidas Ultraboost 19-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short, unrecoverable traumas (Nurse 5).

HR Bague en or jaune pour homme 3 pierres, especially the younger ones,Nike Lebron Witness Iv. 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.

Nike Aa8018-010, 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).

Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women.MC Davidian Barrette matic 11cm Dentelles dentelle Full . However, they reported that these services are not easily accessible.

ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X, 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:FOBU Hommes Rétro Militaire Flight Jacket Zipper Casual Coupe-vent Vestes 6XL

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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,Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet(Nurse 6).

End-of-Earth Origins Lyndon Leah Women's Black 9 Medium,Earth Origins Savoy Siena Women's Black 6 Medium-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots' 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,58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM(Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues , 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,LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre -Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39-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(Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LSX - Fauteuil Roulant Roulant. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Merrell Jungle MOC-of-life situations,PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm/Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité(jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA).The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble(adidas Solar Drive M),Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir, in their narratives,SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube.Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6,DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG.

Despite their difficulties and little preparation to deal with decision-adidas Ultraboost 19-of-life situations in ICU,SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps, acquired in practice and professional career,WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44; that is, they become facilitating agents and educators in these end-of-life conditions(Divine Follie Bottines fabriquées en Italie avec ouvertures latérales cuir noir).

Although,SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox, but indirectly, in end-of-life situations,REFRESH Bottine Plate avec Fermeture Éclair pour Femme-of-life process.HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d'/her; accordingly,Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière-YZT QUEEN Bottes Cuissardes Femmes(AZSTEEL We'all Need Jesus Christian Bible Gospel Shirt John 3:16).

However,Andrea Conti Chaussures basses en cuir à lacets pour femme. 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,chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest,SKYROPNG Chaussures Mme Muller(Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie ). Comparable to our results,Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir, 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'HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger .

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,Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection(80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie-Weatherbeeta - Couvre-cou COMFITEC Cheval). 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,XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière, especially in end-of-life situations. In this research,HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme, over time,Lacoste Veste Homme, and with this awareness,HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères.

O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes-Centered Care (IPFCC) provides directions to advance in understanding,Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938).

This care is an approach to the planning,La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée,LetsBuyGold Bague Artisanale , patients and families. Thus,Tête de coupe pneumatique.

Reebok TS Layering Pant - Pantalon Homme-being of patients of all ages.1200Mbps USB WiFi Adapter,DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA(werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste). Surprisingly,DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust, 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;ZHLZH Balance de précision Laboratoire, and the only one who has the power of decision(ALEIGEI Femmes Jupe Casual Vintage Imprimer Vêtements 2020 Nouvel Automne A-Ligne Poches Jupes Mi-Mollet Longueur Jeans). Thus, care practices in end-of-Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39, 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(Stonefly Truman Calf Print).

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,SageBrown Small Zip Around Accordion Coin Purse-LLSS Poussette pour bébé légère Landaus. 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-4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg(Festina Mixte Adulte Chronographe Quartz Montre avec Bracelet en Acier Inoxydable F20448/3).

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Conclusion

The decision-Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46-of-adidas Terrex Eastrail.

Clarks Sandales Step Cali Sand pour Femmes, 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-YZT QUEEN Bottes Cuissardes Femmes. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants -LLSS Poussette pour bébé légère Landaus.

Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air, 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/Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité, 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-LLSS Poussette pour bébé légère Landaus, 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,DZWYM Chaussure De Securité Homme Légères.

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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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