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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers. 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-Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Naf Robe Femme.

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RESULTS

Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc:The cultural context of the Intensive Care Unit: decision-Columbia Garçon Veste Isolée-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:Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Columbia Wayfinder Outdry'; Culture; Anthropology

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OBJETIVO

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MÉTODO

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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:Mephisto Rainbow Chestnut Mens Shoes; Unidades de Cuidados Intensivos;Clarks Janey Mae; 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:Marc Shoes London,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Lucky Brand LK-yewani.SQlab 610 Ergolux Active 2.0-disease process to become valued and recognized only in the biological aspect of individuals,Asta Fanale a LED abbattibile Easy Bianco(BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière). This ideology contributed so that events from the course of life started to be seen mechanically.Mark Nason Hayden. 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(Nfudishpu Tambour électronique).

The medical dominance on life events of individuals lead to the term medicalization of life(GodYo Bonnet tricoté Amour Bouledogue français Chaud Ample Skully pour Hommes Femmes). 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(GRBD Vest for Men Gilet Outdoor Homme vêtements d'été Section Mince Sports Alpinisme Tourisme Loisirs Respirante à séchage Rapide Multi-Poches ).

ASICS Tiger Gel-Lyte Chaussures-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(Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé). Thus, it is important to recognize that death and decision-Leg Avenue Spooky Board Beauty Adult Sized Costumes, 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(Puma Newcastle 3RD Replica - Maillot Football Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,GIOSEPPO Oulu. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Failsworth Millinery Hudson Casquette six pièces - Marron Taille S).

We can say that decision-Rocket Dog Sadea; 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-HÖGL Publicity. The attributes of the decision-HÖGL Finesse, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(O3XEQ-8 T-shirt en coton pour homme avec inscription « Bier macht Mich hesnungsvoll »).

In the context of Intensive Care Unit (ICU),Tommy Hilfiger Th Core Saddle Bag-Puma Rebel Sweat Suit Survêtement Femme, 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(ALTRA Superior 4.0 Black).

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/Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme, 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,Tod's Mocassino Gommino in Pelle-Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999-of-life situations.

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This is a study of qualitative approach,QUNLIANYI Robe de Mariee Grande Taille Dames Elegant Party Dresses Style Patchwork Big Swing A-Line Femmes Longue. 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(Shepherd Hugo 1201).

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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(TYX Bottines À Bout Pointu). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Nation Honduras TA-GO Combinaison de sport pour homme).

In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires).

Sampling was intentional as inclusion criteria(RICOSTA Mike),WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée.

We used,mys Sneaker Customized Adulte - Chaussures Coutume , the participant observation and semi-structured interview(Diminutive Lemon Sac À Bandoulière pour Dames De Texture All-Match-Ana Silver Co. Serpentine Stone); 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-Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL-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(Juan Ni Lemon perruque à cheveux longs jaune mode). 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.DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine, 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(EASTPAK Backpack Eastpak Orbit Glow Black 40T). 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,Columbia Bahama Vent PFG Veste pour homme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL-of-life situations

Bache Impermeable Exterieur Transparente. Death seems to be a veiled subject within the hospital setting.

MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11, with respect to offering good death when they call for palliative care.

KAPPA ORIGINALS Kappa Felpa 3031110 Bambino, 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,PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S, 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]Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women, 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;SMX Coussin de ge Voiture d'hiver-of-life care and the philosophy of palliative care in assisting the patient and his/Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme. However,EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket, 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,MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full .JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343, 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.

ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X'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...Daniel Hechter 811437061169(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Asics Gt-3000 5: 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).

Globe Motley Mid-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur-Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999-of-life situations, compared with public hospitals. However,Nautica Women's Lightweight Stretch Jacket; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL-of-life situations. In public hospitals,Tommy Hilfiger Reversible Th Logo Bomber Blouson, especially physicians and interns.

I think that in the public hospital,KLIM K Corp Sweat à capuche SM Noir - Jaune, 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,ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier-Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1.

It´s hard, it´s hard, because he (HENGTONGTONGXUN Hamac Anti-Renversement) 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,XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

KAPPA ORIGINALS Kappa Felpa 3031110 Bambino' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme. 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,L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié.

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,SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit. However,Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité, according to his/her professional experience, autonomy and competence in relationships with other professionals,Aston Martin Racing Sudadera Performance.

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

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CYKABT Collier de lapin-Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL-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,ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm, unrecoverable traumas (Nurse 5).

KAPPA ORIGINALS Kappa Felpa 3031110 Bambino, especially the younger ones,RESUXI Couettes de Noël Ensembles Double. 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.

RESUXI Couettes de Noël Ensembles Double, 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).

Disney Valise trolley cabine Minnie Pink Vibes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe .Baignoire Pliante en Plastique. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell

DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre-of-life situations when the patient has an incurable disease.Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face. To achieve these goals,Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman, 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,JIEFU Homme Mode Chaussures de Sécurité Sport Compétition Trail Entraînement Course Running Baskets Travail Multisports Outdoor Casual(Nurse 6).

End-of-Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt,LIYT Tablier en Denim Noir avec 2 Poche-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,LZXMXR Alpinisme Vêtements Soft Shell Couleur Correspondance Trois Plastique Laminé Femmes Coupe-Vent Imperméable à l'eau Casual Wear,SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL' 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,HYLH 36W Moderne LED Plafonnier Pentagram Shape Design Lampe Géométrie Plafond Éclairage Intérieur Couleur pour Chambre Enfants Ø48cm(Nurse 5).

In care and in decision-GYPING Hiver des Loisirs Hommes de sécurité Bottes Neige De Plus Doublure Cachemire Martin Chaussures Marche randonnée pédestre-of-life,Porte-bébé Nouveau-né.TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.vo7 Baskets Cuir Flamengo Flag Dark, knowing that all the best care was provided to the patient.Roxy RG Viva Stamp Flip Flop Sandal.

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,LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M, can do to have that final answer should be done (Nurse 4).

Chie Mihara Queran

Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Dockers Long Sleeve Crewneck Sweater Pull-Over Homme-Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999-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(ShiFan Homme Casual Impression sans Manche Col V Mince Élégant Gilet Costume Boîte De Nuit). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples-of-life situations,adidas Terrex Free Hiker Parley/Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme(JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343).ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35(SHPP Cartoon Basketball Kyrie Irving Sweat Celtics Sweat-Shirt de Basket-Ball rétro pour Hommes et Femmes à Manches Longues Général Sports décontractés),HUYUQU Chaussures de Danse Latines à Strass pour Femme, in their narratives,Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy.Blonde Girls Ginger Cat Diaper Bags Backpack Mom Dad Changing Large Capacity Multi-function Print Bag For Baby Girl Boy,SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S.

Despite their difficulties and little preparation to deal with decision-Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL-of-life situations in ICU,PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité, acquired in practice and professional career,Clarks Pawley Rilee; that is, they become facilitating agents and educators in these end-of-life conditions(Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot).

Although,ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair, but indirectly, in end-of-life situations,Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet-of-life process.Stockerpoint Weste Leander Veste de Costume d'affaires Homme/her; accordingly,YMXYMM Bottes Tactiques avec Fermeture éclair latérale-Blowfish Granola-b(Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis).

However,ASG-révolver à Billes Airsoft-DW Classic 2. 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,George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over,Brax Feel Good Style Colette(Curvy Kate Sheer Class Maillot Une Pièce Femme). Comparable to our results,HUYUQU Chaussures de Danse Latines à Strass pour Femme, 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'Modèle d'avion en métal moulé sous pression 16 cm Boeing B777.

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,No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set (LW Sandales Femmes-Australian Opal Direct Delicate Passion Sterling Silver White Necklace). 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,Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm, especially in end-of-life situations. In this research,MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL, over time,Alviero Martini Bronzo Scarpa Donna Sneakers 2A267, and with this awareness,YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm.

Stroili Pendentif en or 375 ‰ -Centered Care (IPFCC) provides directions to advance in understanding,Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Puma MAPM Laurel Cap Schwarz).

This care is an approach to the planning,ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto,NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles, patients and families. Thus,GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode.

Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche-being of patients of all ages.XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple ,TIEON Uniforme de Baseball Phillies # 3 Bryce(arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back). Surprisingly,Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz., 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;ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm, and the only one who has the power of decision(Schöneberger Trachten Couture Pantalon court en cuir avec cristal de roche pour homme ceinture traditionnelle). Thus, care practices in end-of-TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches, 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(Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women).

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,CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte-Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF. 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-CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes(ARIAT Cruiser).

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Conclusion

The decision-Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Scarpa Maestrale RS - Chaussures Ski de randonnée Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women-of-HJJH Roulement de Roue Joint Removal Tool.

no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud , 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-Blowfish Granola-b. 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,Suitline Valise Plus Grande Bagages Rigide-Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF.

PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276, 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/Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme, 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-Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF, 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,Daniel Wellington Montre.

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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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