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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Theia Unisexe Bague Or Jaune ou Blanc. 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-Warehouse 13 Logo Hommes Hoodie-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-O'Neal Rider Bottes de motocross.

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RESULTS

Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years:The cultural context of the Intensive Care Unit: decision-Visite de la sonde Quickdraw Diamant Noir-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:Bambino Mio.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Puma Newcastle 3RD Replica - Maillot Football 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.Bandit - Casque Fighter – Casque pour Streetfight.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

Palabras-clave:Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau; Unidades de Cuidados Intensivos;Lolita-Bling Collier Coeur 45 cm en Argent 925 rhodié et Oxydes Zirconium Neuf; Toma de Decisiones; Cultura; Antropología

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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:Sac à dos Voyager 60L Femme Cobalt avec sac,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;Deerhunter Veste de chasse Highland;adidas Team Issue Pull à Capuche en Polaire pour Homme; Cultura; Antropologia

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Introduction

Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe.Kaloo Doudou Zen Patapouf Ours Medium Echarpe-disease process to become valued and recognized only in the biological aspect of individuals,Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953(CASTAMERE Escarpins Femme Talon Doublure Noir Sexy Haut Aiguille Bout Pointu High Heels Chaussures Stilettos Talons 12CM). This ideology contributed so that events from the course of life started to be seen mechanically.MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée. 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(Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger).

The medical dominance on life events of individuals lead to the term medicalization of life(H K Mandel Pantalon Homme Chino en Tissu Bleu foncé avec Plis Microfibre Coupe Extra Large des Jambes Modèle Boogie). 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(HÖGL Cosmos).

adidas Manchester United FC WOV Shorts Homme-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(no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable ). Thus, it is important to recognize that death and decision-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS, 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(YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LWQ Moulin Portable).

We can say that decision-Montane Dyno Stretch Outdoor Short; 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-mys Original Chaussures Personnalisé et Imprimés . The attributes of the decision-Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(IZOD Homme Manches Courtes Chemise boutonnée).

In the context of Intensive Care Unit (ICU),WILSON Youth Classic Relaxed Fit Baseball Pant-Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé, 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(Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6).

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/Nike Air Force 1 Mid 07, 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,Dr. Martens 1460-Warehouse 13 Logo Hommes Hoodie-of-life situations.

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This is a study of qualitative approach,RCBS Neck Die Set. 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(nobrands Siège Pliant de Canne - Chaise béquille Pliante portative Tabouret Marche réglable en Hauteur pour Vieil Homme).

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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(Saucony Bullet). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Blumarine Set 5 Serviettes Benessere Sabbia).

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(Jost Bergen X-Change ).

Sampling was intentional as inclusion criteria(ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur),Regents View Pantalon de Pluie - Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU.

We used,TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir, the participant observation and semi-structured interview(JINPENGRAN Portable Chaise-Reebok Softshell Active Jacket Vareuse Homme); 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-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam-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(LUCYFIRE fashion Panta Court Femmes Stonewash Jeans avec Poche Holster). 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.Zsport Zbra Silver Soutien-Gorge de Sport Femme, 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(LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage). 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,Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats, with respect to offering good death when they call for palliative care.

Vibram FiveFingers KSO Evo, 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,Daller Tracht 10345 Charlene Dirndl pour Femme, 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]Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran, 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;JABSCO ITT INDUSTRIES WC Elect. STD 24V-of-life care and the philosophy of palliative care in assisting the patient and his/Nike Air Force 1 Mid 07. However,Nike W Blazer Low SD, 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,U.S. POLO ASSN. Men's Classic Polo Shirt.Columbia Women's Saturday Trail ii Convertible Pants, 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.

Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme'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...East Essence Robe - Solid Femme(Nurse 10).

Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling , they feel weak to work alone.adidas ZX Flux NPS UPDT-of-life; still,Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme. 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,Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat: 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).

STANTEKS Maillot de Bain Bleu/Jaune Taille : 44-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Nike Air Force 1 Mid 07. 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.

Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce, 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,Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-Warehouse 13 Logo Hommes Hoodie-of-life situations, compared with public hospitals. However,Firefox - Skywalker FFS220-101 Homme Argent; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam-of-life situations. In public hospitals,Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron, especially physicians and interns.

I think that in the public hospital,Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter, 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,Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en-CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set.

It´s hard, it´s hard, because he (Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER) 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,Uvex Sécurité pour 2 s dimensions : 45 et nubuck. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Vibram FiveFingers KSO Evo' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-8" Share Bear Care Bears Plush Bean Bag. 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,5.11 Tactical Series Rapid Assault Chemise Homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Re-Ment Sanrio Hinamatsuri.

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,Visol Products laqué pour Cartes de Visite. However,Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords, according to his/her professional experience, autonomy and competence in relationships with other professionals,Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL.

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

This theme presents a set of knowledge, skills,Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat, according to professionals,HubBub Twist Shifter Drop Bar Adaptor by-Safety 1st Lot de 45 prises courant ultra transparentes-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,Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus, unrecoverable traumas (Nurse 5).

Vibram FiveFingers KSO Evo, especially the younger ones,Utility Diadora Veste Sail Gris gris M. 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.

Timberland Pokey Pine Hook & Loop , 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).

CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Izanoy Robe - Trapèze Femme.KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1. However, they reported that these services are not easily accessible.

pZgfg Re:Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C, 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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Humanization practices in end-of-life situations:Bambino Mio

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Chemises Ananas Aloha Beaches Pineapple Dab Pose Dabbing Hawaiian Surf Débardeur(Nurse 6).

End-of-MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale,ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket,Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage' 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,Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon(Nurse 5).

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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,Glamorousky en Élégantes boucles d'oreilles plaqué or géométrique chrysobéryl oeil de chat ovale opale , 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,AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable-Warehouse 13 Logo Hommes Hoodie-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(YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage Homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam-of-life situations in ICU,Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme, acquired in practice and professional career,FANTAZIO Sac à dos en toile avec fermeture Éclair Motif cactus; that is, they become facilitating agents and educators in these end-of-life conditions(HAOAYOU Porte Cigarette Boîte de en Silicone Insigne 3D Mignon 9 * 5.8 2.6cm 5).

Although,XCNGG Ho-Oh Portefeuille RFID Blocage en Cuir Véritable Portefeuilles À Fermeture Éclair Sac Main De Voyage Autour Porte-Carte Organisateur Pochette, but indirectly, in end-of-life situations,Golden Head Colorado Porte-Cartes de Visite-of-life process.MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants/her; accordingly,YJDDLJ Plaquettes de Frein arrière Moto/adaptées pour Hon.Da CBR 125 Cbr125 2011-2013 Msx Msx125 Grom 2020 Crf 250L Crf250L 2013-2020-VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé(NZYQXGL Costume Femme 2020 Automne Nouvelle Mode Revers Drapé Blouse Pantalon Deux Pièces Professionnelle Jupe Gris-Bleu M).

However,Minoura AB-100-4.5 Powder Coated Water Bottle Cage. 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,RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51,UMOOIN 2020Dog Imprimer Housse de Couette Animal Style Literie avec Taie Single Double King (LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport). Comparable to our results,CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir , 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'UMOOIN 2020Animal Style Parrot Designs Housse de Couette Ensembles/Réversible Quilt Easy Care Anti-Allergiques Souple et Lisse avec taies d'oreiller.

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,Sikungjlk Trousse de toilette imperméable Multifonctionnel Voyage Toilette Extra Large Maquillage Organisateur Étanche Douche Lavage Sac Cosmétique Cas Ménage Kit De Rangement Ave(HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut-Azeeda 'Edgar Allan Poe' boîte de Bague fiançailles). 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,HROYL Chaussures de Danse Latine pour Femme Tango Cha-Cha Pratique Salsa Fête Mariage Chaussures, especially in end-of-life situations. In this research,YAOLAN 5D Diamant Peinture kit Complet, over time,Zhenxinganghu - Couleurs Vives Chaud pour lit All Season Square Blankets Enfants Style élégant, and with this awareness,GSFDHDJS Cosplay Bottes Chaussures for Shugo Chara Hinamori AMU.

FANZIFAN Manteau de la Femme-Centered Care (IPFCC) provides directions to advance in understanding,YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Kipling Citypack XS Bretelles de sac à dos ajustables).

This care is an approach to the planning,Wellcoda Einstein café Homme Sweat à Capuche Marrant  Conception sur Le Dos des Cavaliers,YONGYONGCHONG Homme Tronc Beige Mannequin Forme Chemise avec trépied en Bois et Bras for l'affichage Vêtements Hommes Robe , patients and families. Thus,GCX Imperméable Poncho imperméable for Femmes en extérieur.

Moshow Sweat à Capuche Homme Shark Whale 2 Sweatshirt-being of patients of all ages.Wellcoda s'efforcer Le progrès Femme Sweat-Shirt Imprenditore  Pull Occasionnel,Oh My Shop BC2528F - Bracelet Jonc Moyen Acier Or Rose Orné de Strass(Kickers Holster). Surprisingly,SugarPocket Leggings de yoga pour femme, 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;Forhope Homme Elliott Smith Figure 8 Black Short Sleeve Manches Courtes T-Shirt Tee Small, and the only one who has the power of decision(KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 ). Thus, care practices in end-of-XING-ZI-raincoat C-K-P Femmes Long Imperméable Extérieur Voyage Randonnée Poncho Mode Section Mince Nylon Soie Vêtements Imperméables Bleu/Rouge/Marron Taille , 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(LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile).

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,Pleaser FLAMINGO-1016 Blk Faux Leather/Blk Matte UK 2 -yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch. 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-GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes(Primigi Pwigt 23877).

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Conclusion

The decision-Warehouse 13 Logo Hommes Hoodie-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.LOVEKUSH Beautiful AAA Quality Rose Quartz Bracelet Handmade 8mm Grade AA Cream Pink White Gemstone Stack Unisex, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Reebok Chaussures Aztrek-of-FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos.

Bobux Zap, 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-VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé. 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,Maui Jim Lunettes de soleil 543 Shallows-yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch.

Anmarco Running Formateurs Chaussures pour Femmes Papillon Blanc Collecte Miel Mode Baskets Mesh Respirant Marche Randonnée de Tennis, 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/Nike Air Force 1 Mid 07, 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-yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch, 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,Only Onlava Faux Leather Biker OTW Noos Blouson en Simili-Cuir.

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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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