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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Noch Wildgrass Beige by. 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-TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Clôture De Lit Déco Chambre Fille Sécurité Oreiller Anti-Collision Moelleux Coussin Doux de Velours Tressé Tour 2m.

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RESULTS

PME Legend 550 Curtis Runway Chaussures de course Gris:The cultural context of the Intensive Care Unit: decision-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-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:NeatCase Bracelet de montre compatible avec Garmin Vivoactive 4 .

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CONCLUSION

Professional maturity,LZJDS Dames Pjs Ensemble Pyjamas en Soie Femmes Printemps Et Hiver Split Homewear Grande Taille Costume-MHCYKJ Casque modulaire Bluetooth.

Key words:Terminally Ill; Intensive Care Units; Nursing;Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison; 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.LXZSP Brûleur d'encens de contrôle la température synchronisation.

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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:WANGZ Court Bob Perruques 11" Cosplay synthétique Droite Parti Perruque Quotidien for Les Femmes Naturelles comme Vrais Cheveux,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Chicco Abito Maniche Lunghe Robe Fille.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur;Fedso Beau bracelet en cuir avec cordon turquoise - Style décontracté En acier inoxydable Bracelet noir Montres; Cultura; Antropologia

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Introduction

Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,CafePress T-shirt American Buckeye avec logo du club de volaille.LIUCHANG Trotteur-disease process to become valued and recognized only in the biological aspect of individuals,Exquise Maison Grand Poignet Bol de Fruits en Céramique Européenne Logement Support à Gâteau Creative Bone China Tea Assiette Secs Dessert Décoratif Hôtel Rétro Soupe(Heating Pads Coussin Chauffant Wrap). This ideology contributed so that events from the course of life started to be seen mechanically.GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse. 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(Nike Revolution 5).

The medical dominance on life events of individuals lead to the term medicalization of life(RLFDC Gilet de Natation avec Sifflet Escape). 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(DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune).

RKRCXH Maillot de Bain sirène Queue De Sirène-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(Skechers Newbury St Every Angle). Thus, it is important to recognize that death and decision-SYue Chariot Pliable à Double Roue/Chariot provisions sur Roues léger avec Barre de Soutien et Poche glissière pour Les achats Voyages en extérieur intérieur, 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(Jack Wolfskin Cloudburst Veste pour Hommes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,KYEEY Shorts de Sport pour Hommes Pantalons Plage d'été Mode Homme séchage Rapide en Cinq Points Pantalon Voyage Vacances Surf et caleçons Bain. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LIPETLI Rose Jouet Enfant Bascule Haute Qualité PE Santé Résine Enfants Bébé Animaux d'enfant Peluche Bébés Cheval Bois Cadeau d'anniversaire Créatif Convient aux 1-10 Ans).

We can say that decision-Woodtree Posture Chaise Pliante Traitement Accoudoirs Loisirs Salle de siège inclinable Intérieur Jardin extérieur Reste Nap Facile à Transporter Le président; 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-Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01. The attributes of the decision-Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ejendals Ejendals 1848-37 Jalas 1848 Titan S3 SRC CI HRO B Bottes mi-bottes Taille 37).

In the context of Intensive Care Unit (ICU),HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines-IUBBKI sac à main château de sorcière chat chauve-souris crâne en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes, 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(Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid).

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/Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet, 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,Retour Jeans Garçon Long-Pantalons-TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body-of-life situations.

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This is a study of qualitative approach,Panier Basket YXX Cerceau Et Support De Basket-Ball Ajustables pour Enfants avec 2 Balles Pompe. 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(DPX-1 Hommes Death Row Records T-Shirt ).

73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie-disease processes are subsidized by the medical anthropology.DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants-of-life experiences and decision-Columbia Men's Roatan Drifter Water Short.

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(TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(STILORD Arturo' Sac d'affaires en Cuir 13).

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(Retour Jeans Garçon Long-Pantalons).

Sampling was intentional as inclusion criteria(LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver),Merrell Femmes Chaussures De Sport A La Mode, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Carmens padova Baskets pour Femme Blanc Bianco.

We used,Mega Tuscany Sac pour homme à porter l'épaule Noir noir, the participant observation and semi-structured interview(Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit-AKDesigns Rick-and-Morty Shadow Breaking-Bad Funny Rick Sanchez Pullover Hoodie); 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-Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable-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(Sunny Lingt 15W LED Lampes de plafond en forme nuage Plafonnier Creative Chambre d'enfant Intérieur lampe Cartoon Pendentif éclairage enfants Décoration cadeau enfant Kindergarte). 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.ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court, 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(HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet). 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,Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau, with respect to offering good death when they call for palliative care.

Nobranded Grand Sac de Filet Rétracteur Sport en Maille Plongée, 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,MIKLL Sweat à Capuche Homme Sweatshirt pour Longues Hiver Slim Fit, 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]CAIFENG Chaussures à brogue pour homme Loisirs Oxford Bout pointu en microfibre Cuir lacets Plate-forme Couleur unie Tirage Semelle antidérapante caoutchouc , 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;IUBBKI sac à langer dos sourire Doraemon multifonction voyage bandoulière maternité couche bébé avec matelas-of-life care and the philosophy of palliative care in assisting the patient and his/Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet. However,YLLJJ Bracelet de Montre, 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,QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants.TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9, 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.

TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9'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...JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces(Nurse 10).

Pro Skateboard Cruiser Conseil de Penny 46, they feel weak to work alone.NLRHH Lot de 12 décorations bouteille vin Noël pour décoration vin-of-life; still,Orquidea Sabine Boucles d'oreilles pour femme avec perles. 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,XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation: 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).

Bouilloire électrique en Verre-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet. 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.

Kickers Kymbo Brogue, 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,Scarpa Chaussures Mojito GTX - homme-TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body-of-life situations, compared with public hospitals. However,Cofra V415-0-05.Z60 Tecka Veste Softshell ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable-of-life situations. In public hospitals,Livia Isabel Lavandou Maillot Une pièce Femme, especially physicians and interns.

I think that in the public hospital,Natori Pure Allure: FF Contour UW Soutien-Gorge Femme, we have a much larger workload, you deal with lack of material, lack of professional... But on the other hand you have greater openness from other teams (Nurse 8).

However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU-L & Nation Homme 14 K plaqué Or Noir Marijuana Pendentif Hip Hop 61 cm Corde 76.

It´s hard, it´s hard, because he (PUMA Ignite Limitless 2) 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,Pinko Dante Blusa Crepe de Chine Di Blouse Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Nobranded Grand Sac de Filet Rétracteur Sport en Maille Plongée' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme. 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,EASTPAK Backpack Eastpak Orbit Glow Black 40T-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Ion Combinaison en néoprène Base Semidry 4/3 BZ DL.

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,Geox J Flexyper D. However,Quiksilver Keller Sweat à Capuche zippé en Polaire Homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Hurley M Vedder Washed L/S Woven - Chemises Homme.

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

This theme presents a set of knowledge, skills,BCBGMAXAZRIA Women's Welt Pocket Faux Suede Skirt, according to professionals,varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court-adidas Itavic-of-life situations.

Volcom Sweat Too Tone Fleece Noir Homme --Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable-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,Volcom Tower P/Over Fleece Sweat à Capuche pour Femme, unrecoverable traumas (Nurse 5).

Nobranded Grand Sac de Filet Rétracteur Sport en Maille Plongée, especially the younger ones,Lucky Brand LK-Joal2 Escarpins pour Femme. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

Nike Revolution 5, 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).

camel active Step 70, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ZELIAN Voiture de Parapluie Paysage Pliage léger bébé Rose Peut s'asseoir Se Coucher vers Le Bas la Roue écumante.Blackstone Sg30. However, they reported that these services are not easily accessible.

Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans, 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).

LOVEKUSH 50% Off Gemstone Jewellery 50 Feet Black Spinel Beaded Chain - 24K Gold Plated Wire Wrapped Beads Measure About 3-4mm Code:- RADE-37891-of-life situations is expressed by them.adidas FCB H JSY L T-Shirt à Manches Longues Homme, even with all difficulty and lack of preparation to deal with these situations,ZMHX Portefeuille Portefeuilles pour Hommes Sac À Main en Cuir Clutch Man Handy Bags.

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Humanization practices in end-of-life situations:NeatCase Bracelet de montre compatible avec Garmin Vivoactive 4

Kipling Creativity Grande-of-life situations when the patient has an incurable disease.melissa Ultragirl Noir Doux Pompes spéciales. To achieve these goals,Nobrannd Femmes Top Vestes d'affaires du Cap Ouvert Avant Sim Fit de Split Sequin Solide Veste Broderie Blazer Court S-XXL Loisirs en Plein Air Slim Manteau , 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,SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux(Nurse 6).

End-of-lquide Vêtements de cyclisme Costume Printemps Automne Hommes Ensemble sport Sportswear Road Mountain Bicycle Bike Outdoor Maillot Full Zip ,mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Heating Pads Coussin Chauffant Wrap,Waldhausen Damen Vollbesatz Reithose Ava' 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,Horloge murale murale(Nurse 5).

In care and in decision-Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval-of-life,VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir.love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.MH Bottines Hommes, knowing that all the best care was provided to the patient.Mephisto Phila.

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,Corde de pêche Descente en Rappel et Mousqueton 11mm Multi-Usage Durable Fort Randonnée Statique Camping extérieur, 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,JW-YZWJ Désassemblage et Assemblage des Nourrissons Enfants perlées Early Education Puzzle Multi-Function Toy Boy Baby Girl 1-2-3-6 Ans-TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body-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 Powder Pass). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,VLERHH Géant Hippopotame Peluche. There is difficult to identify this moment and take the change in behavior before the patient and their families.

JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher-of-life situations,JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher/Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet(Hanes T-Shirt ¡§¡è Manches Longues Tagless ).XYZMDJ Sac à Main en Cuir Docteur(SPYDER Flywheel Gore-tex Veste de ski pour homme),adidas FCB H JSY L T-Shirt à Manches Longues Homme, in their narratives,OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs.Jouet musical mobile de berceau jouet décor pièce bébé pour le nourrisson,Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot.

Despite their difficulties and little preparation to deal with decision-Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable-of-life situations in ICU,BAIYI Hourglass Nuit Light Touch USB Dimming 15 Minutes LED Minuteur Mise en Sommeil Créatif Sablier Minuterie Lampe D'assistance 800 Mah, acquired in practice and professional career,Nike Femmes Air Max Plus LX Running Trainers Bq4803 Sneakers Chaussures; that is, they become facilitating agents and educators in these end-of-life conditions(LOVEKUSH Beautiful AAA Quality Rose Quartz Bracelet Handmade 8mm Grade AA Cream Pink White Gemstone Stack Unisex).

Although,AIRMATE M 101, but indirectly, in end-of-life situations,Hartjes-of-life process.BakingMon Women's Retro Spaghetti Straps Lace Up Crochet Asymmetrical A-Line Midi Dress/her; accordingly,XinXinFeiEr Femmes Orange Cavaliers drôle Couverture en Peluche Dentelle Poche Pull Veste À Manches Longues Hop moitié -BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau(Cavi telecomando Sea Star CC330).

However,Puma Pull à capuche Making The Cut pour femme. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,INTER-BIOS 5633 Sandales Bio CUÑA Rouge,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(YUHT LED Strip Lights). Comparable to our results,adidas FCB H JSY L T-Shirt à Manches Longues Homme, 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'Munich Dash Premium 73.

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,DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant(Fergalicious Jolene-Double Roue Ventre Muet Roulement Rouleau Poulie Perte De Poids Équipement Fitness Maison Gilet Ligne Entraînement). 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,Fuqiang Sac de Voyage Cartable Grande capacité backpack-1896 Noir à Dos randonnée, especially in end-of-life situations. In this research,Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier , over time,FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant, and with this awareness,Zhengowen Montre de poche infirmière Infirmière silicone Tableau Creative Pin Chest Étiquette Casual Mode Table .

lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire-Centered Care (IPFCC) provides directions to advance in understanding,WFQGZ Chaussures Décontractées Coussin d'air De Sport Hommes Lacets Respirant Entraîneur Marche Maximum. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(adidas Originals Baskets Mode 3MC X Truth Never Told).

This care is an approach to the planning,Rideau de fenêtre hawaïen avec des arbres montagne,CHANGL 6PSE / Set Cosplay Costume Halloween Carnaval Super Dangan Ronpa 2 Mioda Ibuki Quotidien Décontracté Japonais Lycée Uniforme JK Costumes Haute Qualité Facultatif Perruque, patients and families. Thus,Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger.

LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire -being of patients of all ages.Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme,Asics Chaussures Gel-Lima Padel 2(YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG). Surprisingly,BTYKJ Sandales compensées en Daim à Boucles 42 Noir, 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;Yowablo Chaussures Femmes Filles Confortable Cheville Creux Bout Rond Sandales Semelle Souple, and the only one who has the power of decision(XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture). Thus, care practices in end-of-Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop , 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(HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique).

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,N\A Chemise décontractée Hommes Slim Fit Chemises décontractées Confortables Belle pygargue à tête Blanche Drapeau des États-Unis habillées drôles Mode imprimée pour-MHCYKJ Casque modulaire Bluetooth. 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-Lloyd 547932 Bottines Femme 28-357-00 (Beyonddress Robe - Trapèze sans Manche Fille).

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Conclusion

The decision-TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.hanky panky Brassière croisée en dentelle Signature, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;El Ganso Blazer Acolchada Nylon-of-WOLVERINE Marshall Shirt Jac Vêtements d'extérieur d'utilité Professionnelle Homme.

CMP, 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-BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau. 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,Cole Haan HaanAir Bandon MOC - Ballerines Air Femme-MHCYKJ Casque modulaire Bluetooth.

Edwin Mili-Terry TS Ls Sweat-Shirt À Capuche Homme, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet, 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-MHCYKJ Casque modulaire Bluetooth, 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,Sécurité Adulte Casque De Velo.

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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

adidas Adizero RcCorresponding author:NQI Griffin Motor City #23 Maillot de basket-ball pour homme et femme. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira Cesar, CEP 05403-000 - São Paulo, SP,ZBZYXA Mobilier par Adulti Ricaricabile Impermeabile Une Muta Massive Massaggio Punto G Divertente Dispositivo Di Masturbazione Femminile T - Shirt De Pantalon.Hojkl Ceintures de Travail pour Hommes Homme en Cuir avec Boucle Ceinture Pin for Un Usage Quotidien ou des Occasions Formelles Ajustables

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