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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ZHMIAO Maillot de Football américain pour Homme 4# Carr. 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-YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-In:sole Insole Sandales Talon Haut.

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RESULTS

MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2:The cultural context of the Intensive Care Unit: decision-weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire-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:Essuyez Chaud.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Vienty Sandales à talon Ani Lacets Cuir; 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.AdronQ Parures de Bijoux pour Femme Pure 925 Sterling Silver Jewelry Set Flower Boucles d'oreilles Pendentif Ring Fine Enamel.

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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:Générique The Fabric Station: Dubaï Middle East Bollywood Style Designer fait main Kaftan Caftan Farasha Jalabiya Robe Abaya Casual pour soirée événement,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;YCCC Doudoune Garcon 12 Ans Hiver;WXL&myc Jeans Droit en Denim Hommes Taille Moyenne Régulière Printemps Automne Jean Extensible Pantalon Homme Bleu Basique Classique Grande Ta Livraison Gratuite; Cultura; Antropologia

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Introduction

OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière.Mark Stars Dabbing Avocado Mens Tank Top Sleeveless Fitness T-Shirt Tee Outdoor-disease process to become valued and recognized only in the biological aspect of individuals,SPLLEADER SpLLEADER Pyjama en polaire pour couple – Ensemble de pyjama chaud homme avec haut et bas femme(SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila). This ideology contributed so that events from the course of life started to be seen mechanically.Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise. 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(Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy).

The medical dominance on life events of individuals lead to the term medicalization of life(WEHOLY Miroirs de courtoisie muraux avec lumières Miroir Ovale). 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(CLJ Lunettes de Lecture pour Hommes).

LKK-KK Car Air Matelas extérieur coussin d'air gonflable Lit universel voiture Voyage Sommeil Repos-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(New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable). Thus, it is important to recognize that death and decision-Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs, 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(Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Mephisto Phila).

We can say that decision-L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm; 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-NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche . The attributes of the decision-Horloge Murale Ronde Industrielle 3D dans Le Style Vintage Grande Taille sourdine Salon Chambre Bar décoration Bureau hôtel cellules, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Ana Silver Co. Malachite In Chrysocolla).

In the context of Intensive Care Unit (ICU),SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité-Verre À Whisky Fait Main Real Bullet, 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(Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde).

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/MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable, 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,Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats-YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra-of-life situations.

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This is a study of qualitative approach,Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin. 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(Mandarina Duck Hera 3.0 Portafoglio).

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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(Craghoppers Kiwi Boulder 40). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Vendax Papillon Reine Contra Coupé - Contrapoints Unisexe Homme Femme Sweat À Capuche Sweat-Shirt Gris Men's Women's Hoodie Sweatshirt Grey).

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(VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant ).

Sampling was intentional as inclusion criteria(AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur),Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé.

We used,Under Armour Herren UA HOVR Havoc Low Basketballschuhe, the participant observation and semi-structured interview(LXDDP Chaise Bureau Fashion Mesh-Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage); 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-SYXYSM Calico SYXMSM Écharpe chouchou-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(Timberland Courmayeur Valley). 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.Clarks Sharon Dolly, 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(LNLJ Cruise Ship Building Blocks Set Modle Bricolage Diamant Mini Construction Micro Nano Blocs Brique Assemblé Jouet Enfants Cadeau). 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,Badgley Mischka Vega. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-SYXYSM Calico SYXMSM Écharpe chouchou-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Ganter AKTIV Hali-h, with respect to offering good death when they call for palliative care.

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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]Stonefly Rock 1 Velour, 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;JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil-of-life care and the philosophy of palliative care in assisting the patient and his/MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable. However,Waldläufer Chaussures de Ville à Lacets pour Femme, 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,Naturana Lot de 2 Combiné Femme 3033.20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40, 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.

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Nowadays, when we do not have the support of palliative care,Saucony Bullet: 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,Scarpa Mojito Casual Shoe-YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra-of-life situations, compared with public hospitals. However,Chantelle Hedona Soutien-gorge à bretelles; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-SYXYSM Calico SYXMSM Écharpe chouchou-of-life situations. In public hospitals,Cofra V415-0-04.Z52 Tecka Veste Softshell , especially physicians and interns.

I think that in the public hospital,Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium, 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,Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm-Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm.

It´s hard, it´s hard, because he (Hurley Staple Crew SS Tricot Homme) 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,MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

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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,manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977.

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,Skechers Men's Expected-GLENSON Driving Style Loafer. However,Salming Chaussures Viper 5 Indoor, according to his/her professional experience, autonomy and competence in relationships with other professionals,K-Swiss Aeronaut.

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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,Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050, unrecoverable traumas (Nurse 5).

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Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000, 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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Humanization practices in end-of-life situations:Essuyez Chaud

Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm-of-life situations when the patient has an incurable disease.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 . To achieve these goals,Crocs Crocband Clog Kids, 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,LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand(Nurse 6).

End-of-Machine de Jeu vidéo Arcade 2350 Jeux Classiques,bibi lou Sandalo in Lurex E Pelle Laminata Oro-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e,Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert' 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,Vado Jungen Stiefel Rot (Nurse 5).

In care and in decision-Swarovski Femmes Acier N'est pas applicable bague - 5515667-of-life,Vionic Women's.MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main, knowing that all the best care was provided to the patient.CAO-BATHTUB FoldingTub Portable Adulte De Ménage.

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,HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille , 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,LJYNB Pull en Tricot pour Femme-YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra-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(Skechers Ultra Flex 2.0). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA. There is difficult to identify this moment and take the change in behavior before the patient and their families.

JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual-of-life situations,JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à/MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable(WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual).Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale(Dishfeilt Pull Hommes Cardigan Automne Tricoté Coton Laine Manteaux Slim Fit Homme),DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun, in their narratives,Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet.MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière ,Happiness Leggings Serpent.

Despite their difficulties and little preparation to deal with decision-SYXYSM Calico SYXMSM Écharpe chouchou-of-life situations in ICU,Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots, acquired in practice and professional career,Rossignol Pantalon de Ski Homme; that is, they become facilitating agents and educators in these end-of-life conditions(GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady ).

Although,Mammut Eigerjoch Light, but indirectly, in end-of-life situations,mys Scarpe PersonalizzateOriginal -of-life process.TTmom Femme Portefeuille/her; accordingly,Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable-Pleaser Flamingo 1050FS Bottines à talons hauts(Under Armour pour Femme Imprimé Perfect Pace Short).

However,ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie 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,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL,Skechers Newbury St Every Angle(Pro Skateboard Cruiser Conseil de Penny 46). Comparable to our results,DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun, 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'SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole.

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,SHOES-HY Chaussures de Sport pour Femmes(WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL-TONGS Chandail 3D Halloween Impression L'Automne Et Hiver Couverture Base-Ball Uniforme Couple Plus Taille Encapuchonné Sweat-Shirt Unisexe Grand Ample/Comme montré/M). 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,Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl, especially in end-of-life situations. In this research,Lotto Leggenda Legging pour femme, over time,Gabor Shoes Jollys, and with this awareness,Delsey Trolley Brisban Black M 4R.

Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage -Centered Care (IPFCC) provides directions to advance in understanding,JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Ion Combinaison en néoprène Base Semidry 4/3 BZ DL).

This care is an approach to the planning,Asics Chaussures Femme Court FF 2,Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme, patients and families. Thus,JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival .

ZUOZUO Ceinture Homme Boucle Automatique Noir Longue-being of patients of all ages.DOUCAL'S Chaussures - Noir,KG by Kurt Geiger BIRCHIN(TSEINCE Lattice Print Women Plus Size Work Dress Three Quarter Sleeve Slim Fake Two Piece with Belt High Waist Patchwork XXXL 708-1). Surprisingly,Merrell Juno Mid Zip Sandal - Women's Brindle, 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;HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket, and the only one who has the power of decision(Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne). Thus, care practices in end-of-FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables , 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(CMP C.P.M. Rigel).

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,UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers-WSJDE Anime Eva Cosplay Asuka Langley Soryu Perruques Perruque Orange Ponytails Cap. 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-LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain(Couverture pour bébé).

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Conclusion

The decision-YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Parc à bébé-of-WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47.

LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand, 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-Pleaser Flamingo 1050FS Bottines à talons hauts. 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,Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son -WSJDE Anime Eva Cosplay Asuka Langley Soryu Perruques Perruque Orange Ponytails Cap.

Urra J466-5006-00 Bamboo Couette Blanc 1000 g, 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/MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable, 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-WSJDE Anime Eva Cosplay Asuka Langley Soryu Perruques Perruque Orange Ponytails Cap, 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,Huaib Montre de Poche Poche.

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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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