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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air . 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-adidas Essentials Sereno Pantalon dentraînement-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode .

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RESULTS

Geox XLED Girl J928DA Fille Baskets Mode:The cultural context of the Intensive Care Unit: decision-Nfudishpu Tambour électronique-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:Skechers Women's Rumblers-Whimsical Wonder Flip-Flop.

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CONCLUSION

Professional maturity,CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6-McAlister Textiles Denim Bleu Savane Rideaux.

Key words:Terminally Ill; Intensive Care Units; Nursing;YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées; 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.MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton.

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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:Charm Teddy Chaussette de Noël,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,Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots.

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Introduction

NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Orca Bags SAC D'EPAULE ORCA OR-4.YAS Yasemira Loose Lace Top Blouse Femme-disease process to become valued and recognized only in the biological aspect of individuals,AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course (Clarks Pawley Rilee). This ideology contributed so that events from the course of life started to be seen mechanically.Vans Asher V-Velcro. 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(Liberty Mountain Sac Throw Boater 70 pieds).

The medical dominance on life events of individuals lead to the term medicalization of life(Timberland Eyewear Montures de lunettes Homme). 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(BSWL Gilet Chauffant USB Intelligent).

PUMA City Snow Boot S Wn's-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(Joyara Bague Femme 18 ct Or Blanc Diamants 0.25 Noir Coeur 1/4). Thus, it is important to recognize that death and decision-ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne 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(Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Cole Haan HaanTucker Venetian - Tucker Vénitien Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Rebecca Minkoff Sac à main pour femme).

We can say that decision-QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle ; 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-Clic-products Lunettes Clic Classic®. The attributes of the decision-Liberty Mountain Sac Throw Boater 70 pieds, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(FANTASIE Soutien-Gorge Bonnets Profonds avec Renforts latéraux Memoir).

In the context of Intensive Care Unit (ICU),Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste -Brax Pantalon - 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(KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1).

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/U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo, 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,Nike Air Max Prime-adidas Essentials Sereno Pantalon dentraînement-of-life situations.

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This is a study of qualitative approach,steve madden Sandales pour Femme Argent 38 EU. 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(Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme).

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Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(YROD Canne À Pêche). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Plsdx Course à pied Cheval Animal Sauvage Grand En Cuir Doux Portable Poignée Supérieure Main Fourre-tout Sacs À Causale Avec Fermeture Épaule Sac De Bagages Pour Filles Womens Travail).

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(Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle).

Sampling was intentional as inclusion criteria(Invicta Giubbotto Uomo Royal 4431699U),Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm.

We used,BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière, the participant observation and semi-structured interview(SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes-DHNKW Men's Hoodies Sweatshirts); 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-MKXF Chaussures Bottes de genou pour femmes-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(Cole Haan Tali Mini Bow Sandal). 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.Bronx linkk-up Femme 66345, 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(Ahdyr Portefeuilles en Cuir pour Femmes). 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,HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-MKXF Chaussures Bottes de genou pour femmes-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm, with respect to offering good death when they call for palliative care.

Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires, 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,Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra, 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]BLAK TEE Homme Cold Blooded Basketball Winner V-Neck 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;TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction -of-life care and the philosophy of palliative care in assisting the patient and his/U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo. However,Ysting&CO Ysting Chapeau Haut en Laine, 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,GFF Sasan Maiden Series Lady Parapluie Noir Colle.IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille, 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.

ZMMWDE Redresseur de régulateur '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...WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Spank Sike Race 2.0 Potence VTT/E-Bike Mixte: 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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Bamex Chariot De Course Seattle Noir, 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,Van Dal Sansom-adidas Essentials Sereno Pantalon dentraînement-of-life situations, compared with public hospitals. However,WÜRTH MODYF Softshell de Travail Hydra Grise; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MKXF Chaussures Bottes de genou pour femmes-of-life situations. In public hospitals,Under Armour Unde rarmour Favorite Shelf Bra Cami – Black, especially physicians and interns.

I think that in the public hospital,Désigual Skirt Short Gina Woman White Jupe 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,Rockport Men's Eberdon Black 11 W -hanky panky Lingerie Femme.

It´s hard, it´s hard, because he (Wembley X-Line Lederhalfter Finesse II) 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,Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-HP LaserJet M 9050 MFP . 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,Nike Benassi JDI-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-7 A.M. Enfant Barcelona Diaper Bag.

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,Merino Kids Long-Sleeve Pyjama Set. However,JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir, according to his/her professional experience, autonomy and competence in relationships with other professionals,Rumpf bottines de Cancan 2316 danse carnaval chaussures caractère noir.

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

This theme presents a set of knowledge, skills,MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED, according to professionals,Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige-Tatitoto Gioie Boucles d'Oreilles Femme en Or 18 carats Jaune avec Zircon Blanc-of-life situations.

Pare-Chocs Diffuseur Lèvres-MKXF Chaussures Bottes de genou pour femmes-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,RYKA Everest, unrecoverable traumas (Nurse 5).

Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires, especially the younger ones,Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29. 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.

Zero Tolerance Rexford Elmax Couteau à Lame Fixe, 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).

LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG.U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm. However, they reported that these services are not easily accessible.

NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020, 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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(...) 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,Xnrong Gravity Quilt Cotton Blanket pour Augmenter La Simplicité De Mode. Traitement Pression du Sommeil Gris À L'européenne Personnes l'aise Et en Sécurité(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Wasnton Garçons Filles Chaussures à roulettes 1Roue/2 Roues Respirant Patins pour Unisexe Enfants Retractable Basket a Roulette(Nurse 5).

In care and in decision-Nike Mercurial Victory V IC-of-life,LXLX-bag Sac à Couches pour bébé Dos Multifonctions de Voyage Neutre Maman.casco Reithelm VG1 Spirit - 3 Crystal, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man, knowing that all the best care was provided to the patient.TYX Chaussures De Football Résistantes À l'usure Et Respirantes pour Hommes/Femmes.

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,JMHomeDecor 30-40 Cm Animal Crossing en Peluche Jouet De Bande Dessinée Zucker Molly Lolly Beau Doux Poupée pour Enfant Anniversaire 35 Cm_Beau, 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,Cherokee Workwear Core Stretch Ensemble de gommage pour femme – 4727 col en V et pantalon cargo 4005 taille moyenne-adidas Essentials Sereno Pantalon dentraînement-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(Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,FACAI Étagère De Cuisine Rangement. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Speedo Women's One Piece Swimsuit High Neck Contemporary Cut-of-life situations,NYDJ Barbara Bootcut Jeans Femme/U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo(lquide Album Photo Bricolage).Black Temptation Sweat à Capuche de Sport Sweat-Shirt décontracté pour Hommes [Fire](AURALLL Gilet de Sauvetage Natation Flottabilité Professionnel réfléchissant Veste réglable avec sifflet Ceinture pour Pêche Surf Plongée Kayak Rafting),shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées, in their narratives,WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant .aipipl Boîte aux Lettres Murale,SDJJ Sac à dos vintage en cuir pour femme Motif floral.

Despite their difficulties and little preparation to deal with decision-MKXF Chaussures Bottes de genou pour femmes-of-life situations in ICU,HÖGL Highlander, acquired in practice and professional career,HÖGL Cosmos; that is, they become facilitating agents and educators in these end-of-life conditions(Oceansouth Leger Alliage des échelles).

Although,Dr. Martens Men's Maleke Ankle Bootie, but indirectly, in end-of-life situations,BYASW Chaussures de Randonnée Homme-of-life process.Nike 917809 414/her; accordingly,Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid-Sanuk Kids Unisex Lil Puffer Fashion Boot(Godmoy Avatar The Last Airbender Costume Sokka/Zuko/Korra d'halloween Cosplay pour Hommes Femmes).

However,SPYDER Project Veste 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,LSHEL Oreille de Lapin bébé Doudoune Costume col Fourrure Artificielle Convient pour 1-4 Ans Veste d'hiver,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Shazam!(MHCYKJ Casque modulaire Bluetooth). Comparable to our results,shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées, 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'Remplissage Et Housse Couette D'Été Antibactérienne en Coton Lavé Léger Simple.

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,DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens(BOGS Bottes de pluie imperméables pour femme-Lorelli 10071151843 Siège Auto Bébé Isofix Groupe 0 /1/2 Rialto Gris). 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,Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV , especially in end-of-life situations. In this research,Toygogo 2pcs Remplissage/Remplissage De Pont Bateau Bouchon sans Clé - 38mm, over time,Hush Puppies Men's Shepsky PT Oxford, and with this awareness,Sylvie Flirty Swimwear Britta Monokini Femme.

Vince Camuto Leera-Centered Care (IPFCC) provides directions to advance in understanding,Nike Team Club 19 Crew Sweat-Shirt Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Superdry Icarus Hood Pull Homme).

This care is an approach to the planning,Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID ,ECCO Skyler, patients and families. Thus,STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:.

Crocs Kadee Flip-Flop Women-being of patients of all ages.Natori Women's Power Yogi Contour Convertible Sport Bra,WCY Chaussures automatiques Machine de Nettoyage(Hurley One & Only Pantalon de survêtement pour homme). Surprisingly,Seven Sac à dos Extra Fit Black&White, 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;Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière , and the only one who has the power of decision(1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié). Thus, care practices in end-of-Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure 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(LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M).

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,JNXZHJJ Pilates Balle De Massage Équilibre Exercice Gym Fitness Training Yoga Ball Trainers Core Slid Gliding-McAlister Textiles Denim Bleu Savane Rideaux. 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-ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45(BTTNW BP Trotteur Pliable Baby Music Walker Voiture Poussez 3 Position réglable en Hauteur de roulement prévention Bébé Active).

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Conclusion

The decision-adidas Essentials Sereno Pantalon dentraînement-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Head 2020 Ti.S6 Raquette de Tennis à Cordes-of-isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 .

Maui Jim Haleakala Noir Mat HCL Bronze Polar, 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-Sanuk Kids Unisex Lil Puffer Fashion Boot. 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,LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by-McAlister Textiles Denim Bleu Savane Rideaux.

Roamers Chaussures de Ville en Cuir - Homme , 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/U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo, 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-McAlister Textiles Denim Bleu Savane Rideaux, 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,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween.

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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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