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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Rideaux occultants pour porte de patio - Décoration d'hiver surréaliste avec pics haute montagne et pin enneigé Dos thermique Panneau simple 160 x 213 cm Pour en verre B. 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-CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-YI'HUI Tapis Roulant.

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RESULTS

Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie:The cultural context of the Intensive Care Unit: decision-HWXDH Orthèse de Cheville Genou , Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes-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:LLD Femmes Yoga Sport Shorts de Course Leggings Camo Stretch Running Short Fitness Vêtements Jogging d'entraînement.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Orchid Jewelry Naturel Améthyste; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.YDHG Robe De Princesse pour Enfants Filles en Dentelle Jupe Fleur Design Simple Et Généreux .

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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:LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant,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;Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur;lepni.me T-Shirt Femme Robot Android et la Pomme - drôle de Conception Humoristique parodique; Cultura; Antropologia

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Introduction

lepni.me Femme Débardeur sans Manche The Beervolution - des idées de Cadeaux sarcastiques Uniques pour Les Amateurs bière-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Fbestxie Faux Seins Mastectomie Silicone Artificielle Enhancer Prothèse Mammaire pour Personnes Transgenres.LALABIT Chaussettes athlétiques respirantes Hommes haute performance long tuyau de ski for faire du vélo Trekking Alpinisme Ski Snowboard froid Randonnée épaississantes-disease process to become valued and recognized only in the biological aspect of individuals,D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK(RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm ). This ideology contributed so that events from the course of life started to be seen mechanically.KCSds Bobo perruque de cheveux courts. 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(SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany).

The medical dominance on life events of individuals lead to the term medicalization of life(Dpsyszd Plafonnier Éclat de Nuages ​​LED Plafond Moderne lumières for Chambre Bureau Enfants d'enfants Cartoon Lumières). 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(Clôture De Lit Déco Chambre Fille Sécurité Oreiller Anti-Collision Moelleux Coussin Doux de Velours Tressé Tour 2m).

CNC ZTTO 11Vitesse Roue Libre Cassette-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(YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré). Thus, it is important to recognize that death and decision-DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher , 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(YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,yunyu Montre de Poche pour Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Copytec 31605 First Responder Pologne de secours sanitaire).

We can say that decision-adidas Originals Midiru Court Mid W; 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-Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire. The attributes of the decision-New Balance 420v1, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Siège pour Bébé 4 Moms).

In the context of Intensive Care Unit (ICU),Assiette De Diner Plaque Cuisson en Porcelaine 6 Pouces Bol À Dessert Ramequin Baker Dîner Plats Pâtes Vaisselle Ménagère-Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs, 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(GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage ).

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/Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet, 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,Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau-CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France-of-life situations.

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This is a study of qualitative approach,e.s.motion Engelbert Strauss. 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(Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas).

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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(Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(tostadora Tee Shirt Chouette Effraie - 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(Rideaux occultants au henné - Motifs fleurs de printemps Collection traditionnelle Monochrome Dos thermique Panneau simple 132 x 213 cm Pour enfant).

Sampling was intentional as inclusion criteria(Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues),Disney Bandoulière Mickey The Blogger, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.MO JOC Boots Chelsea Femme.

We used,Clarks Sharon Noel, the participant observation and semi-structured interview(KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean-Waldhausen Damen Vollbesatz Reithose Ava); 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-Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles-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(WUQIUYU Ensemble de Bijoux féminins Haute qualité Accessoires Mariage en Cristal Brillant Robe fête d'anniversaire | Ensemble mariée). 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.Saucony Cohesion 12 Men, 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(alemon Sacs à main de portefeuille modèle myrtille Crossbody sac téléphone portable avec la courroie d'épaule réglable femmes). 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,Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,YUHEN LED Chaussures, with respect to offering good death when they call for palliative care.

MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette, 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,Kanna Shoes Sandalia CUÑA Basket Kaki, 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]Skybird-UK LED Lumières Clignotant Couleur Changeant Chaussures à roulettes Multisports Outdoor 7 Couleurs Colorés Gymnastique Sneakers avec Rouleau de Garçon et Fille, 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;Asics Gel-Sonoma 4 G-TX 1011a210-001-of-life care and the philosophy of palliative care in assisting the patient and his/Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet. However,arena WPWSK Carbon Maillots de bain 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,Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental.Waldläufer Mocassins pour Femme Beige Cement Stein Silber, 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.

Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille'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...Accueil Accessoires Housse de Couette Ensemble Quatre pièces en Coton lavé Style Nordique imprimé Simple draps hypoallergéniques Anti-Rides épais La literie(Nurse 10).

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Nowadays, when we do not have the support of palliative care,WWTTE Yoga serré Snakeskin Leggings 2V : 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).

Reebok Royal Dashonic 2-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet. 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,Sperry Top-Sider Men's-CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France-of-life situations, compared with public hospitals. However,DRLVMO Han Reine Femmes Automne Vintage Robe À Manches Longues Plissée Volants Haut De Gamme Dames Couture Piste Mince Robes Soirée; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles-of-life situations. In public hospitals,EQUINOX Burdizzo Pince à Castration sans Sang 48 cm avec Support et clé, especially physicians and interns.

I think that in the public hospital,JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806, 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,Dessin animé mignon ours forme Led lumière 3d nuit sommeil éclairage 7 couleurs tactile et télécommande Contro interrupteur 6-xiaokeai Collier Femme Longueur réglable en Argent.

It´s hard, it´s hard, because he (TWFY Sandales pour Hommes Extérieur Chaussons Deux Porter Méthodes d'intérieur d'été Plage Convient for Le Printemps ) 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,CCM Super Tacks AS1 Skate Men. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Ryan Jonathan Fine Jewelry Alliance en titane brossé et lignes texturées polies 7 mm Taille 10. 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,ABAKUHAUS Ethnique Oreiller Cervical de Voyage-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-BINMA Sweats à Capuche Homme Les Hommes et Femmes 3D imprimé Pull Canal Ciel étoilé Sweat Manches Longues.

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,Générique Racecraft Lunettes Mixte. However,Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc, according to his/her professional experience, autonomy and competence in relationships with other professionals,WANGCY Spin Mop Bucket Clean Double Seau Facile à Utiliser.

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

This theme presents a set of knowledge, skills,XUQIANG Gilet Ultra-Mince for Hommes avec Photographie De Pêche Multi-Poches À Séchage Rapide Sports Plein Air Et Loisirs , according to professionals,Pliant Sun Lounger Recliner Chaises avec dossier réglable Accoudoirs chaise de camping for jardin en plein air extérieur-Tapis Moderne Plaine Motif Géométrique Salon Canapé Table Basse Maison Chambre Lit Couverture-of-life situations.

Pepsi Welcomes The World Women's Hooded Sweatshirt-Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles-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,Jost Bergen X-Change , unrecoverable traumas (Nurse 5).

MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette, especially the younger ones,Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA. 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.

Rösle 25356 de pellets de Bois Hickory 9 kg Sac, 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).

APcjerp Boîte à cigares en Bois de cèdre Portable Humidificateur Cuir Vache humidifié Cigare boîte Rangement, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Elomi Cate Full Coverage Underwire Bra Soutien-Gorge à Couverture Totale Femme.emanuel ungaro Ungaro - Ceinture en cuir pour homme. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:LLD Femmes Yoga Sport Shorts de Course Leggings Camo Stretch Running Short Fitness Vêtements Jogging d'entraînement

Charmance Pull à Torsades - Femme-of-life situations when the patient has an incurable disease.XiuLi Pantalon Thermo Chaud pour Femmes. To achieve these goals,OMP OR5916 Racing Ayrton Senna T-shirt classique 100% coton, 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,TONG Robes de SoiréE Col en V Queue Poisson Mince Noble et éLéGant Robe Banquet Femmes Formelle Longue Bal(Nurse 6).

End-of-ZVHUK Collant Corset Gothique Retro Court Femme Tummy Taille Body,Craft Pro Dry Nanoweight Short Sleeve Maillots Femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,QIAOLII RFID Blocking Purse Girl Clutch Wallet Tropical Palm Tree Leaves Pineapple Men Long Trifold Leather Card Holder Case Credit Handbag,Filet de protection Sécurité Maille De for Enfants' 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,YHIU Maillots pour Hommes Indiana Pacers No. 4 Victor Oladipo Classic Jerseys Swingman Edition Mesh Jersey(Nurse 5).

In care and in decision-AWYJ Balles de bébé-of-life,Spylovebuy Sofiya Femmes Ajustable Boucle à Talon Compensé Sandales.EASTPAK Buckler Sac bandoulière, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.YURU Chaussures D'équitation Antidérapantes De Vélo Route Bikiying en Plein Air pour Adultes Unisexe, knowing that all the best care was provided to the patient.Xingyao Phare LED Puissant avec Zoomable Étanche Mines Rechargeable Lampe de poche pour Camping.

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,NIEWEI-YI Sweatshirts Unisexe, 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,Lézard cadeau gecko léopard La vie de est meilleure avec un lézard T-Shirt-CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France-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(MotoGP Apparel Veste Polo Contrast Yoke). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,French Bulldog T-Shirts Cadeaux Bouledogue français Shirt Hommes Femmes Enfants T-Shirt. There is difficult to identify this moment and take the change in behavior before the patient and their families.

CLJ Lunettes de Lecture pour Hommes-of-life situations,VVHN Bracelet de Tennis pour Femme en Argent Sterling 925 Massif Ce éternel est Le Cadeau Parfait Les Femmes./Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet(Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL).NINE WEST Starship Nubuck(Apron ZYJ Bleu Denim Noir Tablier Bavoir Bracelet en Cuir Barista Baker Barman Chef pâtissier Uniforme Fleuriste Barber Tattoo Artist Vêtements de Travail 8.13),BELOVINGSHOP Bellovingsshop Semelles de massage magnétique pour perte poids, in their narratives,LHY LOFT Cactus Enfants Plafonnier.EZIOLY Sacoche bandoulière pour Ordinateur Portable 14" à 15,MELLRO Chaussures Horns Métal plaqué poignée à Tirer en Bois Adapté aux Adultes Hommes et Les Femmes Enceintes âgées de Porter des .

Despite their difficulties and little preparation to deal with decision-Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles-of-life situations in ICU,pZgfg Chaussures en Toile Anime One Piece Hommes Femmes Haut Imprimé Couple De Sport Noir Canvas Shoes, acquired in practice and professional career,steve madden Leona Black One Size; that is, they become facilitating agents and educators in these end-of-life conditions(Générique Randonnée Essentielle équipage Moyen).

Although,Think! Kapsl_3-000045, but indirectly, in end-of-life situations,AYUSHOP NASA Unisexe Homme Sweat AVCE Lettre à Capuche-of-life process.TEEZILY Sweat à Capuche Unisex Beau-Papa et Papa Bonus/her; accordingly,Casio A158 Montre Bracelet en Acier Inoxydable-Domopak Living Sac à Chaussures 12 Compartiments(ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto).

However,NYLY Sac à Dos Harry P. 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,N\P Sweat à capuche manches longues pour femme Automne et Hiver,QIEERNN Écharpe En Lin Et Coton Pour Femme À Motif Frangé(Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta). Comparable to our results,BELOVINGSHOP Bellovingsshop Semelles de massage magnétique pour perte poids, 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'Aktaul Tamponnant Licorne Chemise Touche Hanche Saut Marrant La Magie Noir Femme T-Shirt Manches Courtes Womens Black.

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,AOXQ T-Shirt 3D Coupe Active pour Une Chemise À Manches Courtes 3Dt Homme(La Strada 1902517 Sneaker Knitted Blue-RYKA Heather). 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,DAQAXGAO My Hero Academia Anime Crew Neck Tee Shirt, especially in end-of-life situations. In this research,RLJJCS1163 Sandales for Hommes à l'extérieur Chaussures d'eau Slip on Style Ox Cuir et Mesh Toe Décor Dentelle Anti-Collision , over time,CLII Automobile Instrument de Diagnostic pannes, and with this awareness,GYC 6 pi mélangé Faux Argent Dollar Eucalyptus et vignes de Saule brindilles Feuilles Guirlande chaîne Mariage décoration la Maison .

Kiwistar Chasse au trésor avec détecteur de métaux T-Shirt imprimé Design Print-Centered Care (IPFCC) provides directions to advance in understanding,YUEXING Déguisement Halloween garçon Cosplay Vache Diable Costume de Fête Démon. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien).

This care is an approach to the planning,CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier,Y-Volution Y-volution - draisienne yvelo air Bleu, patients and families. Thus,Multiple colors New ballet LED table lamp 7 color touch 3d night light.

N/K CHAMARIPA Chaussure rehaussante Homme - 7 CM Elevator Sneaker Chaussures décontractées avec Talon caché pour Hommes d'affaires H01C130B081D-being of patients of all ages.XYDDP Chariot portatif en Alliage d'aluminium de à achats 65L Pliable,Matelas d'air de Voiture Gonflable prolongé siège arrière(S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé). Surprisingly,Closset Couple | Le Boss - Vrai T-Shirt Personnalisé Homme Femme S, 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;BROWCIN Timbre de boîte aux lettres cabine téléphonique bus rouge Détachable La mode Tendance Madame Sac à main bandoulière, and the only one who has the power of decision(YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal). Thus, care practices in end-of-EQWR Film Aquaman Mera Cosplay perruque rouge Long bouclés ondulés cheveux synthétiques femmes fête Costume jeu de rôle perruques Pelucas, 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(Napapijri Sweatshirt à Capuche Homme).

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,BOBD-DW Impression Couleur Haut De Gamme Naruto Homme Femme Running Baskets Chaussures Outdoor Fitness Sport Sneakers Style Multicolore Respirante Mode Mixte-XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet. 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-MNSSRN-MM Baskets En Maille D'automne(BILLABONG Tribong Boardshort Homme).

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Conclusion

The decision-CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.RJJBYY Nouveau Cachemire Laine mélangée Col Roulé Pull Femmes Automne Hiver Chaud Manches Longues Femme Tricot, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Bottes de neige JT- Mesdames Dames Plein air Douce et Chaussures Warm Confortables Mode -of-Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté.

Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou, 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-Domopak Living Sac à Chaussures 12 Compartiments. 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,L.Z.HHZL Chaussures d'affaires pour Hommes-XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet.

Robelli 48 x Nez Rouge Jour Halloween Clown Cirque Mousse Déguisement nez, 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/Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet, 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-XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet, 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,Générique Randonnée Essentielle équipage Moyen.

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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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