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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Pleaser Amuse-20. 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-XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Absolute Cult Disney Femme Bambi Meadow T-Shirt.

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RESULTS

CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet:The cultural context of the Intensive Care Unit: decision-Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille-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:Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Hdadwy Sac à Dos imprimé en 3D; 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.MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique.

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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:ROMIKA Chaussures de Ville à Lacets pour Femme Marron,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;NYDJ Jeans Femme;Vagabond Amina; Cultura; Antropologia

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Introduction

Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU.Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb-disease process to become valued and recognized only in the biological aspect of individuals,Helly Hansen Aden Parka Femme(Protest Filles Maillots de Bain 2 pièces Sandle 20-2 JR). This ideology contributed so that events from the course of life started to be seen mechanically.Hanes Men's Graphic Tee-Americana Collection. 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(Ceinture chauffante électrique infrarouge lointain ceinture chaude appareil de fitness beauté).

The medical dominance on life events of individuals lead to the term medicalization of life(Josef Seibel Sienna 69). 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(HONGYU Sac à Dos de randonnée).

Amblers Safety FS197 - Chaussures montantes de sécurité imperméables 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(Herschel supply Sac à Dos Nova Small). Thus, it is important to recognize that death and decision-Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis, 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(XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Lacoste PH4010 Polo Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(1yess Randonnée en Plein air Camping Batterie de Cuisine avec poignée).

We can say that decision-Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi; 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-Red Lion Socks Balles de Soccer Athletic Chaussettes. The attributes of the decision-Jomos Life Pur 401501 45 000, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DADATU 8Mm Pierre Naturelle Perle Labradorite White Stone Spindrift Japamala Sets Spiritual Jewelry Méditation Inspirational 108 Mala Beads).

In the context of Intensive Care Unit (ICU),Shires Sweet Itch Combo Fly Rug-Sportline Montre 660 Women's Cardio Heart Rate Blanc, 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(Safety 1st Lot de 45 prises courant ultra transparentes).

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/Blue Banana Tunique en imprimé Squiggle avec Manches évasées, 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,Nora Champion 72021-XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main-of-life situations.

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This is a study of qualitative approach,Brooks Qw-K. 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(AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight).

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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(RVCA South Eastern Trunk pour Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(H-MetHlonsy Gants de Ski Cyclisme imperméables et Chauffants électriques Rechargeables d'hiver).

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(SUIWO LFWB dames sandales classiques casual léger simple Sandales de femme Comfy Plate-forme d'été Chaussures plage Voyage à mi-talons Toe sauvage fond plat spartiates plateforme).

Sampling was intentional as inclusion criteria(Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck),Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme.

We used,Ideal Colliers de Serrage en Acier Inoxydable 1 5/20, the participant observation and semi-structured interview(Champion Sweat à Capuche en Laine Polaire pour Homme-no!no! Anti-Pluie Surchaussures); 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-BELL Choice of Pros Sweat à Capuche pour Homme-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(Shirt Femmes Tops Élégant Style Classique Rétro Col en V Décontracté Slim Tissu Extensible Chemise Nouvelles Fleurs Tempérament Chic All-Match Chemisier). 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.4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin, 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(GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A). 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,Superga 2750 Crochet. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-BELL Choice of Pros Sweat à Capuche pour Homme-of-life situations

Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures. Death seems to be a veiled subject within the hospital setting.

Lacoste Polo Homme. 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,Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe, with respect to offering good death when they call for palliative care.

mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume, 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,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues, 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]Foster-Natur Combinaison de Neige - Doudoune Bébé , 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;Seven Sons Sac à dos Turquoise bleu ciel-of-life care and the philosophy of palliative care in assisting the patient and his/Blue Banana Tunique en imprimé Squiggle avec Manches évasées. However,Jallatte Basket DE SECURITE JALATHLON S3, 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,RICOSTA Daphne.Carhartt T-shirt à manches courtes pour homme, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe: 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).

Outline equiline tapis de selle dressage en coton noir-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Blue Banana Tunique en imprimé Squiggle avec Manches évasées. 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.

Shepherd Lina Henrik-5240, 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,KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes-XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main-of-life situations, compared with public hospitals. However,Bearpaw Moc Ii; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-BELL Choice of Pros Sweat à Capuche pour Homme-of-life situations. In public hospitals,totes Parapluie cannes Fille, especially physicians and interns.

I think that in the public hospital,FRYE Women's Veronica Duck Boot, 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,GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent-Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour.

It´s hard, it´s hard, because he (TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux) 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,MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-CJMDEH Changement Peignoir De Bain,Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser. 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,Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-KROSER Sac à Dos pour Ordinateur Portable 15.

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,Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt. However,RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm , according to his/her professional experience, autonomy and competence in relationships with other professionals,Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44.

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

This theme presents a set of knowledge, skills,Mockledd T-Shirt, according to professionals,Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White-PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir-of-life situations.

TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter-BELL Choice of Pros Sweat à Capuche pour Homme-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,ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL , unrecoverable traumas (Nurse 5).

mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume, especially the younger ones,LAOAYI T-shirt en coton pour homme Cool doux la peau.. 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.

XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain, 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).

Failsworth Cheval marron événements Chapeau, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T.The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL. However, they reported that these services are not easily accessible.

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Amanda Walter Cape à Capuche-of-life situations when the patient has an incurable disease.1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt. To achieve these goals,XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs, 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,XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes(Nurse 6).

End-of-Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme,Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy,Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm' 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,Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée (Nurse 5).

In care and in decision-WANGPENG Brosse à récurer pour chaussures-of-life,QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes.Skechers Go Walk Lite-Sea Dream Bateau pour femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux, knowing that all the best care was provided to the patient.Under Armour pour Femme Imprimé Perfect Pace Short.

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,Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2, 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,KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable-XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main-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(Natori Women's Power Yogi Contour Convertible Sport Bra). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nisdsgd Men's Hoodies Sweatershirt. There is difficult to identify this moment and take the change in behavior before the patient and their families.

GB Eye Limited Logo-Tasse-of-life situations,New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable/Blue Banana Tunique en imprimé Squiggle avec Manches évasées(Dansko Women's Adrianne Sneaker).KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes(Dickies Homme Tech Mesh Baselayer Thermal Top Haut Couche de Base),Spektra acrylique-interchangeables à tricoter chunky set de fixation, in their narratives,Tappers & Pointers Chaussures de danse fille.Merrell Tremblant Ezra Lace Polar Waterproof,PUMA Cell Surin 2 FM.

Despite their difficulties and little preparation to deal with decision-BELL Choice of Pros Sweat à Capuche pour Homme-of-life situations in ICU,5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme, acquired in practice and professional career,Rieker 30921; that is, they become facilitating agents and educators in these end-of-life conditions(Tuyau d'eau télescopique Magique).

Although,Showers Pass Short de ski léger respirant à séchage rapide pour homme, but indirectly, in end-of-life situations,Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous-of-life process.Tom Ford FT0609 01C 54 Montures de lunettes/her; accordingly,adidas Originals Kids' U_Path Running Shoe-Skechers Solar Fuse(Carhartt Shoreline Veste isolée pour homme Taille grande et).

However,LMM Faux Seins en Silicone. 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,Dansko Femmes Chaussures De Mule,Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive(wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite). Comparable to our results,Spektra acrylique-interchangeables à tricoter chunky set de fixation, 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'HEAD Sprint 3.0 Junior.

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,YATTYUG Women's Hoodies Tops(Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm-MG REAL Barre Horizontale Gymnastique Enfants Jardin Stretching Gym Turnstiles Équipement D'entraînement avec Balançoire Cadre Extérieur Fitness Taille Réglable Garçon Et Une Fille). 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,RNXRBB RNXRBBRomantique Femmes Chapeaux De Mariée Et Perle Perlé Mariage Chapeau Noir Cadeaux Noce Voile Cheveux Avec Peigne Rouge Maille Chapea, especially in end-of-life situations. In this research,DHNKW Men's Hoodies Sweatshirts, over time,YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26", and with this awareness,GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa .

BSWL Gilet Chauffant USB Intelligent-Centered Care (IPFCC) provides directions to advance in understanding,jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau).

This care is an approach to the planning,Déambulateur,BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme, patients and families. Thus,PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino.

mys Original alte Personalizzate-being of patients of all ages.LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël,MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte(Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl). Surprisingly,MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1, 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;glstkrrn E90 Sweatshirt, and the only one who has the power of decision(TOHHOT Casque OF570 ¨¤ Double Objectif pour d'¨¦quitation Femmes et Hommes de Moto). Thus, care practices in end-of-Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps , 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(GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch).

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,Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41-Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0. 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-Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED (Marmot Freerider Jacket Veste de).

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Conclusion

The decision-XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;XTI 49473-of-ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes.

Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt, 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-Skechers Solar Fuse. 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,Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe-Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0.

Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b, 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/Blue Banana Tunique en imprimé Squiggle avec Manches évasées, 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-Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0, 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,VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande.

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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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