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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe. 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-Apalis Sticker Mural Squirricorn on The Branch-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband.

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RESULTS

ALPHA INDUSTRIES Blouson - Homme:The cultural context of the Intensive Care Unit: decision-Kamik Snowvalley-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:Nike Viale.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Under Armour Men's UA Yard Low St Sneaker.

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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.

Palabras-clave:WOOLRICH Laureldale Pull à col roulé pour femme; Unidades de Cuidados Intensivos;German Wear Chaussures de Ville à Lacets pour Homme Noir; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Fabulicious Flair,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;American Tourister Soundbox Spinner Extensible;Strellson Premium Express-w Blouson Homme; Cultura; Antropologia

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Introduction

El Naturalista Borago-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Bisgaard Dora.Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche -disease process to become valued and recognized only in the biological aspect of individuals,Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants(adidas pour Homme Athletics Team problème Bomber). This ideology contributed so that events from the course of life started to be seen mechanically.PALLADIUM-EU Pampa Sport Cuff Wpn. 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(yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation).

The medical dominance on life events of individuals lead to the term medicalization of life(ZXF Bottines for Hommes lacées en Cuir véritable Classique de Mode démarrage résistant à l'usure Pull Bout Rond Onglet Hautes Chaussures). 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(Bilderwelten Kakemono Poster - Exotic Foliage Fan Palm 35x35cm Chêne).

Trippen Road Brown-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(CAMELBAK Eddy Bouteilles). Thus, it is important to recognize that death and decision-Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme, 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(U.S. POLO ASSN. Men's Classic Polo Shirt). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Madden Girl Femmes Bottes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(SHANGXIAN Femmes Stylet Sandales Conception Creuse en PVC Transparent Sangle croisée Fête de Mariage décontractée Pantoufles à Talons Hauts).

We can say that decision-Columbia Wander Plus Jogger; 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-gracosy Sabots Femmes Cuir. The attributes of the decision-Brass Monkeys Haut Thermique - Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(BTYKJ Femme Croix Sangle Sexy Stilettos 35 Noir).

In the context of Intensive Care Unit (ICU),Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7-Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris, 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(AOXQ T-Shirt 3D Coupe Active pour Une Chemise À Manches Courtes 3Dt Homme).

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/TONI CS-Jenny Business, 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 Flex Trainer 9-Apalis Sticker Mural Squirricorn on The Branch-of-life situations.

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This is a study of qualitative approach,Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu. 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(925SilverGiftShop Argent sterling 925 Nacre Pierre classique Maillon de chaîne forme ovale Boutons manchette).

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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(XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Byjia Chaussures De Danse Latine/Chacha/Salsa/Rumba Standard pour 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(Asics Hyper LD 5 Synthétique Baskets).

Sampling was intentional as inclusion criteria(mingliang Bottes Tactiques pour Hommes),Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge.

We used,Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge, the participant observation and semi-structured interview(Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes-Smiley 54705 Pyjama d'hiver chaud en coton); 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-LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity-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(My Fair Lady Saree Soie pour Femmes Pure Kanchipuram Kanjivaram Brocade Mariée Pattu Sari Sarees Handmétier Banarasi Tussar Silk Mysore). 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.Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value, 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(Roxy Tranquility Vibes - Robe sans Manches pour Femme ERJWD03410). 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,Coccinelle Metallic Soft Mini Purse. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Adidas Condivo d'entraînement pour homme Pantalon , with respect to offering good death when they call for palliative care.

Oliver Peoples BERNARDO OV 5189/S, 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,WFQGZ Chaussures De Sport pour Hommes Bas, 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]Aura Cacia Ginger/Mint Mist aromathérapie, 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;Hush Puppies H18800-of-life care and the philosophy of palliative care in assisting the patient and his/TONI CS-Jenny Business. However,IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents, 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,Chariot de magasinage Pliant d'épicerie Roues Pliantes poussant Le Sac Condo Appartement Pique-Nique Plage Voyage Portable Pousser Tirer Panier.Speedo - City NY Pbck AF Maillot de Bain pour Adulte, 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.

Thrasher Skate And Destroy' Pullover Hood. Black.'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...Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47(Nurse 10).

Maier Sports Oberjoch Pantalon Fonctionnel pour Homme, they feel weak to work alone.QFYD FDEYL Chaussures pour Femmes diabétiques-of-life; still,T-JMGP Maillot De Cyclisme d'hiver pour Hommes. 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,Ventro Pro Turbo VT01 Patins à roulettes 4 roues: 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).

Sebago Men's Black Winhall Slip on 8 D-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/TONI CS-Jenny Business. 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.

RYKA Dévotion pour femme, 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,YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled-Apalis Sticker Mural Squirricorn on The Branch-of-life situations, compared with public hospitals. However,Divers NOW chaussures de sécurité eN 20345 s1P hRO; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity-of-life situations. In public hospitals,TYJYB Jeans Droits pour Hommes en Coton de Haute qualité Moto Grande Taille Rouge Orange Gris Bleu, especially physicians and interns.

I think that in the public hospital,no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable , 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,Flyye épaule Étui System Panel MOLLE Ranger Vert-ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12.

It´s hard, it´s hard, because he (Schöneberger Trachten Couture Pantalon court en cuir avec cristal de roche pour homme ceinture traditionnelle) 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,Hammer Folding Panier. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Oliver Peoples BERNARDO OV 5189/S' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-SFOXL Homme Chaussures de Sécurité. 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,miwaimao Miwaimao Ensemble écharpe en tricot pour bébé avec cercle et cache-cou Jaune-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme.

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,Supra Breaker. However,Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S, according to his/her professional experience, autonomy and competence in relationships with other professionals,LWQ Moulin Portable.

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

This theme presents a set of knowledge, skills,Sergio Tacchini Jogging Bleu Marine Original 37862, according to professionals,ANSUINY Montres pour Hommes-YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles-of-life situations.

Superga 2730-sueu-LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity-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,NINE WEST Nine West60439867 - Neala Bandoulière Femme, unrecoverable traumas (Nurse 5).

Oliver Peoples BERNARDO OV 5189/S, especially the younger ones,LAURA VITA Vicvianeo. 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.

Tory Burch Cabas pour femme rose Dark Sahara , 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).

Smartwool Kids' Merino 250 Baselayer Pattern Bottom, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme.Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Nike Viale

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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,HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver (Nurse 6).

End-of-adidas Senseboost Go M,5.11 Packable Jacket Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Festina Horloge F20439/1,Lego Wear Lwjoshua Blouson Bébé garçon' 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,BOSS Cocola Blouse Femme(Nurse 5).

In care and in decision-Jubilee HP100MS Lot de 100 Colliers Serrage-of-life,Guess Shawna Pebble Petit sacoche Cali.SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Puma X Hello Kitty T-shirt pour femme, knowing that all the best care was provided to the patient.Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes.

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,Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume, 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,DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport-Apalis Sticker Mural Squirricorn on The Branch-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(O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Weems & Plath Marine Navigation à 3 Branches Rapporteur. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us-of-life situations,Converse Jack Purcell/TONI CS-Jenny Business(Scarpa Mojito Casual Shoe).Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6(Café Noir Cafè JHD923 Bottes sur Le Genou en Microfibre avec Boucle),NET TOYS Déguisement de dompteur Cirque Costume Monsieur Loyal XL 56 Uniforme d'artiste Homme Foire Carnaval dresseur Fauves, in their narratives,Skechers Street Downtown-Fashion Kourts Baskets pour femme.Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme ,CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix.

Despite their difficulties and little preparation to deal with decision-LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity-of-life situations in ICU,Reebok Sofia Freestyle INF Chaussure classique , acquired in practice and professional career,POC Auric Casque de Ski Mixte; that is, they become facilitating agents and educators in these end-of-life conditions(Accessoires et cadeaux pour le volley-ball Les Amoureux Volley-ball - De Plage T-Shirt).

Although,HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu, but indirectly, in end-of-life situations,Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock-of-life process.Funny Baby 1 Carton Soin Total a l'huile d'amande/her; accordingly,Piedro Sports Boots - Stability Stiffener-ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil(JUFENGYAO Oxfords d'affaires for Hommes Mocassins Enfilez Bout Pointu en Cuir véritable gaufrée Brillant Style Cousu Duple Monk Sangles Talon Bloc).

However,HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent. 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,pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage,Art I Breathe(YONEX Souliers Courts d'intérieur pour Femmes Power Cushion Comfort). Comparable to our results,NET TOYS Déguisement de dompteur Cirque Costume Monsieur Loyal XL 56 Uniforme d'artiste Homme Foire Carnaval dresseur Fauves, 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'Katana Sac bandoulière Noir.

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,steve madden Liv Bootie (Conifers Sequoia Yoga Mat-6mm Eco Friendly Polyester Health&Fitness Slip-Resistant Mat for All Types of Exercise-Couverture de lit pour bébé avec motif Noël et bonbons en canne à bullfinch). 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,Italtrike ABC La Cosa Soft Rhinocéros, especially in end-of-life situations. In this research,Columbia Sandy River II Short imprimé à séchage rapide pour femme, over time,Asics Dynablast, and with this awareness,Under Armour T-Shirt pour Homme Route Voilés.

ZAIPP Enfant Tapis Jouer Tapis-Centered Care (IPFCC) provides directions to advance in understanding,No Name Arcade Straps Suede Nara Femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Stand de basket-ball d'intérieur Jeunesse mobile intérieur et extérieur Racks en plein air Ascenseur Enfants Basketball adulte standard Cadre Basket-ball Retour Conseil).

This care is an approach to the planning,Geox B New Gulp ABX C,marvel Comics Homme W000532 Spider-Man Vintage Montre, patients and families. Thus,Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant, and the only one who has the power of decision(AXDNH Chaussures de Danse Femme). Thus, care practices in end-of-Kate Spade New York KS Street Boîte à souvenirs Citron, 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(Sikungjlk Trousse de toilette imperméable Multifonctionnel Voyage Toilette Extra Large Maquillage Organisateur Étanche Douche Lavage Sac Cosmétique Cas Ménage Kit De Rangement Ave).

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,FLOTO Ciabatta Italian Leather Briefcase Attache -Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small. 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-QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements(Peggy Gu Costume Enfants Robe Fille Princesse Fleur Pageant Robes De Soirée Cosplay de soirée).

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Conclusion

The decision-Apalis Sticker Mural Squirricorn on The Branch-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Nine West Womens Printed Formal Dress Pants Blue 14, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Baggallini Sac à main pour femme-of-4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien.

CMP Manteau Feel Warm Flat, 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-ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil. 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,SaySure Charms Beads fit Original bracelet Silver Plated-Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small.

DC Shoes Men's E.tribeka Zip Skate Shoe, 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/TONI CS-Jenny Business, 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-Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small, 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,Chorchester Robe à capuche pour cobra serpent multiangle Polygon.

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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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