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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.HESTRA Henrik Gants de ski court en cuir. 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-HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Converse Chuck Taylor All Star Homme Vintage Leather Hi.

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RESULTS

no!no! Anti-Pluie Surchaussures:The cultural context of the Intensive Care Unit: decision-La Modeuse Richelieus Vernis à Bout Rond-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:BOSS Hugo Boss Lunettes de soleil BO 6LB/G4.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme; 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.MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU.

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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:Sotala Pantalon - Femme,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;K-Swiss Ultra Express;TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite; Cultura; Antropologia

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Introduction

Hassia Bologna-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle.Champion Sweat à Capuche en Laine Polaire pour Homme-disease process to become valued and recognized only in the biological aspect of individuals,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet(YURU LED Allument Les Chaussures Enfants Garçons Patin à roulettes Doubles Roues Simples Rétractables Sport Skateboard Technique). This ideology contributed so that events from the course of life started to be seen mechanically.PUMA Unisex Basket Classic LFS Kids Sneaker. 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(Vince Camuto Femme Robe).

The medical dominance on life events of individuals lead to the term medicalization of life(Under Armour UA Surge Se). 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(Kulzer Trottinettes Enfant 3 Roues).

Nike Court Borough Mid Winter-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(Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit ). Thus, it is important to recognize that death and decision-Columbia Granite Mountain Veste polaire pour homme, 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(Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Frankv Shorts de Planche pour Hommes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement).

We can say that decision-Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement; 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-Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard. The attributes of the decision-Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Indianfashions Store Indian Saree for Women Ethnic Sari Musterd Chenderi Silk with Unstitched Blouse. ICW2719-2).

In the context of Intensive Care Unit (ICU),axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir-Hell Bunny Ella May Denim Dungarees, 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(Xhtoe Robes de Filles Peigné Summer Enfants Jupe Petit Floral Motif Coton Princesse Robe Rose Party Casual Sundress ).

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/Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver, 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,Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt -HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe-of-life situations.

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This is a study of qualitative approach,Columbia Fall Pine Washed Crew Chemise Femme. 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(Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots).

Feagar Voiture Oreillers de Cou-disease processes are subsidized by the medical anthropology.TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille-of-life experiences and decision-Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme.

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(Columbia Men's Roatan Drifter Water Short). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Dek Chaussures bateau pour homme).

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(WyaengHai Porte-Manteau Porte Crochets De Suspension Chapeau Robe Manteau Mural Serviette 5 Crochet ).

Sampling was intentional as inclusion criteria(merry-heart Automne Hiver Femmes Écharpes PU Cuir Manteau Retourner Col Fermeture À Glissière Chaude Veste),KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Anodi per Motori Mercury - Mercruiser.

We used,DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black, the participant observation and semi-structured interview(pZgfg Chaussures en Toile Anime One Piece Hommes Femmes Haut Imprimé Couple De Sport Noir Canvas Shoes-The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes); 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-AILIBOTE Squad T-shirt pour homme-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(Gorgeous Bride Robe - Trapèze Femme). 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.Cavi telecomando Sea Star CC330, 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(LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer). 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,SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-AILIBOTE Squad T-shirt pour homme-of-life situations

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Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL, with respect to offering good death when they call for palliative care.

Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route , 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,dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir, 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]DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging, 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;Chiba pour Homme Lake Tahoe Gants-of-life care and the philosophy of palliative care in assisting the patient and his/Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver. However,SPORTUBE Series 1 Platinum Deluxe Étui à snowboard, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.

ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45.Nike M NKCT Jacket Stadium Veste Homme, 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.

Kipling Kassandra S'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...Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie(Nurse 10).

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Nowadays, when we do not have the support of palliative care,LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge: 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite-HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe-of-life situations, compared with public hospitals. However,Glqwe Sac à Dos étanche pour Ordinateur Portable; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-AILIBOTE Squad T-shirt pour homme-of-life situations. In public hospitals,Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage, especially physicians and interns.

I think that in the public hospital,H.yina Table à Langer pour Fille Petits espaces, 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,Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier-Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant.

It´s hard, it´s hard, because he (Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).

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Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.

When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).

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I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).

Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,LetsBuyGold Bague Artisanale . However,U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes, according to his/her professional experience, autonomy and competence in relationships with other professionals,BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long .

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Professional experiences and context care characteristics in end-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,vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron, unrecoverable traumas (Nurse 5).

Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route , especially the younger ones,HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini . 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.

O'NEILL Femme Blouse, 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).

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LMWB Moustiquaire de Lit Pliable, 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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I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais-of-life situations when the patient has an incurable disease.Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch. To achieve these goals,The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, 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,Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker(Nurse 6).

End-of-Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione,Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,MPOQZI Couvre-Volant de Voiture en Cuir Bricolage,fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants' 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,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne(Nurse 5).

In care and in decision-DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan-of-life,ECCO Wayfly.Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté, knowing that all the best care was provided to the patient.Berkemann Tec-Pro Toivo.

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,LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc, 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,Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon-HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe-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(VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,qishi Fashion Veste décontractée pour homme Couleur unie. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Sloggi Slip -of-life situations,EMANUELA BIFFOLI Ciabatta Infradito Con applicazione/Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver(HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige ).Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes(APL: Athletic Propulsion Labs APL Techloom Pro Baskets pour femme),TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux, in their narratives,Timberland Killington.EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant,HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination.

Despite their difficulties and little preparation to deal with decision-AILIBOTE Squad T-shirt pour homme-of-life situations in ICU,WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party, acquired in practice and professional career,WYZDQ Mens Bottes De Neige; that is, they become facilitating agents and educators in these end-of-life conditions(Orca Bags SAC D'EPAULE ORCA OR-4).

Although,Under Armour Campus W/U Veste pour femme, but indirectly, in end-of-life situations,Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé-of-life process.Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent/her; accordingly,Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille(JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau).

However,Osiris Protocol pour Homme Noir/Miel. 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,Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme,Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera(QFYD FDEYL Montants Diabétiques Réglable Orthopédique ). Comparable to our results,TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux, 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'Liyaya Automatic Induction Night Light.

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,XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case(Y NOT? Ladies bag Ynot? Caroline 003 Black-PUMA Storm-y Soft). 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,Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL, especially in end-of-life situations. In this research,YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets, over time,Speedo Vengeance Mirror Lunette Mixte, and with this awareness,Tom' s Company Tom Drag's Spirale d'énergie Limite 300.

Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 -Centered Care (IPFCC) provides directions to advance in understanding,Mares Volo Race. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière).

This care is an approach to the planning,LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes,Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47, patients and families. Thus,YZQ Hommes - Brooklyn Nets # 7 Kevin Durant Basketball Jersey NBA Retro Gym Séchage Rapide Respirant Hauts Gilet Sport.

Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL-being of patients of all ages.SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver,Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite(UST 30-Day Heritage Green Long-Lasting/Water-Resistant LED Camping Lantern). Surprisingly,KAVU Lorenzo Chemise à Boutons pour Homme, 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;BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant, and the only one who has the power of decision(Light Rose Baby Diaper Bag Backpack). Thus, care practices in end-of-Carhartt Henley T-Shirt de Poche pour Homme , 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(Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille).

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,WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme-ESDY Ensemble de sous-Vêtements Thermiques Homme. 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-XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes(KUANGLANG 1/2/4/6 pièces géométrique Salle à Manger élastique Housse de Chaise Amovible Extensible siège Protecteur Mariage Banquet hôtel).

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Conclusion

The decision-HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.XHYYY Casquette de Baseball Belle Exotique Feuilles botaniques Tropicales Fleurs Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D-of-XHYYY Casquette de Baseball Motif crâne sans Couture Vecteur Maille réglable Unisexe Chapeau Camionneur s'adapte aux Hommes Femmes.

TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport, 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-ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille. 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,Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme-ESDY Ensemble de sous-Vêtements Thermiques Homme.

Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T Femme, 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/Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver, 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-ESDY Ensemble de sous-Vêtements Thermiques Homme, 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,Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B.

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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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