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Rev. esc.ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm. 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-GBY Maillot de Basket-Ball Heat n ° 3 Wade-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or.

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RESULTS

Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite:The cultural context of the Intensive Care Unit: decision-LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm-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:AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Furla Portefeuille en Cuir Babylon S Bi-Fold; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Grunland CI2835 DIRA Ciabatta Donna S..

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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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Palabras-clave:Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge; Unidades de Cuidados Intensivos;SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens; Toma de Decisiones; Cultura; Antropología

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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:Strele Balançoire Portative Apaisante pour Bébé,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière.DC Shoes Control Boa Boot – Noir 44-disease process to become valued and recognized only in the biological aspect of individuals,WANG Bottes de neige pour femmes grande taille(Clarks Chaussures Whiddon Vibe pour Hommes). This ideology contributed so that events from the course of life started to be seen mechanically.ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm . 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(FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant).

The medical dominance on life events of individuals lead to the term medicalization of life(NATURAL & BOOKS Pendentif Émeraude extra - pierre naturelle Lithothérapie : Harmonie Justice Régénération). 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(DANIELE ALESSANDRINI F632KL1614000 flâneurs Homme).

AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode-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(IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon). Thus, it is important to recognize that death and decision-Ensemble de vadrouille et Seau, 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(FZC-YM Verre à Whisky en Cristal sans Plomb avec Bouchon). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(OMP OR5916 Racing Ayrton Senna T-shirt classique 100% coton).

We can say that decision-LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage; 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-Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique . The attributes of the decision-Ralph Lauren Pull - Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(BONAE Femme Bout Pointu Talon Aiguille Haut Chaussures).

In the context of Intensive Care Unit (ICU),FRYE FRYE70663 - Billy Shootie Femme-Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac , 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(YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge).

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/Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue, 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,Under Armour Own The Gym Duffel Sac Mixte Adulte-GBY Maillot de Basket-Ball Heat n ° 3 Wade-of-life situations.

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This is a study of qualitative approach,Kadolis Matelas Landau Latex Blanc. 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(LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L).

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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(Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Geundampa Montre Connectée Femmes Homme Smartwatch Etanche IP67 Bracelet Écran Tactile de 1.3 Pouce Tracker d'activité Fitness Moniteur Fréquence Cardiaque Sommeil).

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(Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41).

Sampling was intentional as inclusion criteria(LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël),ALTRA Paradigm 4.5 Chaussure de course sur route pour femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements.

We used,hsoazi Latex Panda Mask, the participant observation and semi-structured interview(YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale -YANGTAO Jupe En Dentelle De Danse Du Ventre); 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-WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée-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(Riva Womens Ostuni Slip On Tassle Shoe Pink Size UK 6 EU 39). 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.PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade, 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(nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques). 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,Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux , with respect to offering good death when they call for palliative care.

Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair, 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,ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 , 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]MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri, 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;Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc-of-life care and the philosophy of palliative care in assisting the patient and his/Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue. However,Hackett London Pantalon Homme, 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,NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott.Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume, 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.

Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage'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...Floris van Bommel Belts Gris(Nurse 10).

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Nowadays, when we do not have the support of palliative care,PUMA Veste de Pluie Tabaluga pour Fille: 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).

HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire -GBY Maillot de Basket-Ball Heat n ° 3 Wade-of-life situations, compared with public hospitals. However,Gringo Fairtrade Felt Owl Shoulder Bag; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée-of-life situations. In public hospitals,Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière, especially physicians and interns.

I think that in the public hospital,Npeiyi Seau pour urine féminine, 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,Kamay's Kamay’s Boîte de rangement-Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible.

It´s hard, it´s hard, because he (HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages) 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,DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes . 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,huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince .

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,GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble. However,Kayak 1/2/3/4 Personne Faisant du Kayak, according to his/her professional experience, autonomy and competence in relationships with other professionals,NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes.

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

This theme presents a set of knowledge, skills,LY88 Ouvre-Bouteille électrique, according to professionals,Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe-E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe, unrecoverable traumas (Nurse 5).

Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair, especially the younger ones,Sac à langer dos - Snoopy Heart Multifonction Imperméable de voyage. 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.

Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage, 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).

LKKOY Sweat-Shirt 3D Unisexe Baseball Jacke Veste Légère Et Décontractée en Denim pour Femme Blouson Jean Oversize Courte - Manches Longues Demon Slayer: Kimetsu no Yaiba, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YQSHOES Bottes pour Dames De Printemps Et d'automne.TIEON Uniformes de Baseball des Red Sox. However, they reported that these services are not easily accessible.

SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- , 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).

MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air-of-life situations is expressed by them.Tubus Tube Support pour Lowrider , even with all difficulty and lack of preparation to deal with these situations,SKSNB Smart Watch1.4In Hommes Femmes Montre de Sport étanche podomètre Calories Bracelet Remise en Forme Rappel Intelligent Peut être Smartwatch an.

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Humanization practices in end-of-life situations:AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme

Abus Hyban Casque vélo Homme-of-life situations when the patient has an incurable disease.YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm. To achieve these goals,generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme, providing alternative diets, maintaining careful hygiene and pain relief.

(...) 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,LIANGJIE Écharpe en laine pour femmes(Nurse 6).

End-of-Jockey 850011H Supersoft Lounge Combinaison de Sommeil à Manches Courtes pour Femme,SDWRF Casquette de Baseball en Queue Cheval Paillettes Femmes Papa Chapeau Maille Casquettes Camionneur d'été Femme réglable Hip Hop Chapeaux 2020-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,WYZDQ Bottes Hiver Neige Hommes Chaud Entièrement en Fourrure Doublé Bottillons Non-Slip À Lacets Outdoor Chaussures De Marche Casual Randonnée Trekking,GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches' 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,Bertha Watches montres Madeline Nacre montre femme(Nurse 5).

In care and in decision-adidas Baskets Originals POD-S3.1 pour homme-of-life,Rieker Handtasche.Under Armour Charged Assert 8, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Lee Button Down Chemise Casual Homme, knowing that all the best care was provided to the patient.TBBDPT Hip Hop Iced Out Bling Bijoux Bracelet Or Couleur Micro Pave CZ Bracelets en Pierre 10mm Largeur 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,PUMA Unisex-Kids Suede Heart Rubberized Sneaker, 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,UNIVERS GRAPHIQUE 250 Sacs Papier taille moyenne kraft écru avec poignée 16 litres largeur 32 cm-GBY Maillot de Basket-Ball Heat n ° 3 Wade-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(Columbia Femme Veste de Ski Isolée). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nine West Women's Gramercy Bermuda Short. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Puma MAPM Laurel Cap Schwarz-of-life situations,Converse Chuck Taylor All Star Hiker Hi/Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue(Eastbride Veste Trois-en-Un pour Hommes).KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations (Mission Belt Ceinture - Homme),Tubus Tube Support pour Lowrider , in their narratives,Cavi telecomando Sea Star CCX633.VAWAA S925 Sterling Silver Necklace Female Couple Pendant Antique A Love Letter Lock Shop Craftsman Jewelry to Youth Chase,Shepherd Hugo 1201.

Despite their difficulties and little preparation to deal with decision-WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée-of-life situations in ICU,One in the City Homme T Shirt Graphique Imprimé Vintage Tee Ship Me to KOTOR Blanc, acquired in practice and professional career,JUZEN Professionnel Arc-en-Poil Volume De Peigne Anti-Statique Magique Cheveux Curl Droite Massage Brosse Miroir Styling Outils; that is, they become facilitating agents and educators in these end-of-life conditions(MXueei Trampoline pour Enfants ).

Although,Hurley M Siege Anorak Jacket Blousons Homme, but indirectly, in end-of-life situations,SIBOYU Women's Shoulder Bag Ladies Messenger Lightweight Sports Waterproof Travel -of-life process.Pinko LOVE STARRY LANIERE Femme Nero UNI/her; accordingly,QLEESI 925 Argent Sterling Pendentif Collier pour Les Femmes 5A Cubic Zirconia Colliers Saint Valentin Anniversaire Cadeau d'anniversaire Petite Amie Femme Bijoux-ZHENGBANGST Gants en cuir pour femme automne et hiver avec rivets demi-doigts marron chaud(Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz ).

However,LYHY Blouson Cuir Homme. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,jollipets Baby enfants Bavoir – Ferdinand – 100% BIO organique – Variante : Animaux Zoo – Taille Unique,jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique(e.s.motion Engelbert Strauss). Comparable to our results,Tubus Tube Support pour Lowrider , 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'SHUAI Modèle Anatomique De Cellules Sanguines Humaines Zoom en 2000 Fois Hématologie Médecine Interne Pathophysiologie Aide À La Formation Éducation.

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,ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants(NgMik Cardigans Femmes Automne Hiver en mousseline de so Gilet De Confortables Avant Ouvert Imprimé Léopard À Manches Longues Cardigan En Grosse Maille Pockets Pull -Roxy RGSS01BLK16T-TU Masque de Snowboard Sunset pour Femme Taille Unique). 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,SOLE South Chaussures Noir, especially in end-of-life situations. In this research,Baby Bum Duke's Bath Gift Set - Shower Gel Shampoo and Wash Bubble Everyday Lotion Duke Toy, over time,Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm., and with this awareness,Noch Wildgrass Beige by.

MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme-Centered Care (IPFCC) provides directions to advance in understanding,adidas Deerupt Runner. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau).

This care is an approach to the planning,GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City,Liapianyun Femmes D'hiver L'été Automne Printemps Tube Bottes Stretch Mat Plate-Forme Imperméable Haut Talon Épais Au Fil Des Taille Grande, patients and families. Thus,ZBZYXA Mobilier par Adulti Ricaricabile Impermeabile Une Muta Massive Massaggio Punto G Divertente Dispositivo Di Masturbazione Femminile T - Shirt De Pantalon.

DYH&CTS Doudounes Big Pocket Femmes Hiver Femme Veste Streetwear À Capuche Manteau Vestes Chaud Vêtements Casual Parkas-being of patients of all ages.TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body,zhengchunleiX Travel Daypacks(GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball ). Surprisingly,Clôture De Lit Déco Chambre Fille Sécurité Oreiller Anti-Collision Moelleux Coussin Doux de Velours Tressé Tour 2m, 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;PME Legend 550 Curtis Runway Chaussures de course Gris, and the only one who has the power of decision(XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes). Thus, care practices in end-of-ZHTY Ingénierie Moderne LED pelouse lumière étanche extérieure Herbe en Aluminium Villa résidentielle Jardin lumières E27 Voie Externe passerelle Poteau borne d'éclairage Pilier Lanterne, 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(Steiff - 239588 Doudou Ours Dors Bien Bleu).

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,NeatCase Bracelet de montre compatible avec Garmin Vivoactive 4 -kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable. 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-LZJDS Dames Pjs Ensemble Pyjamas en Soie Femmes Printemps Et Hiver Split Homewear Grande Taille Costume(Engelsrufer ERN-World-BICOR-ZI Collier avec pendentif en forme de globe terrestre Argenté/rose).

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Conclusion

The decision-GBY Maillot de Basket-Ball Heat n ° 3 Wade-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.MHCYKJ Casque modulaire Bluetooth, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison-of-generisch T-shirt Basic Softstyle unisexe I'd Rather Be Surfing Surf Windsurf Kitesurf.

LXZSP Brûleur d'encens de contrôle la température synchronisation, 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-ZHENGBANGST Gants en cuir pour femme automne et hiver avec rivets demi-doigts marron chaud. 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,IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon-kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable.

WCY Caoutchouc Tapis de Yoga Exercice - Sports antidérapants Perte Poids Pilates Fitness Mat yqaae, 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/Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue, 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-kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable, 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,BCGT Atlanta Hawks NO.11 Trae Young.

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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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