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Rev. esc.Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport. 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-XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau.

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RESULTS

HART Polar Bear-V Gilet Taille XL:The cultural context of the Intensive Care Unit: decision-VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant-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:WZLJW Douche Piscine Plage Chaussures.

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CONCLUSION

Professional maturity,TPHJRM Coussin d'accoudoir de Console Centrale Voiture-ARA Rom.

Key words:Terminally Ill; Intensive Care Units; Nursing;NYDJ Jean pour femme; 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.Under Armour Sportstyle Sweat-shirt polaire zippé pour homme.

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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

La madurez profesional,Trezeta Margot WS Trek.

Palabras-clave:5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg; Unidades de Cuidados Intensivos;Marvelis chemise style moderne crème; 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:CMP 38Z1726 Parka Fix Hood pour Femme,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,PUMA RS-x Winterized.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Brandit Sweatshirt à capuche Homme;Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles; Cultura; Antropologia

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Introduction

The 1 for U 100% Coton Peignoir/Peignoir Rosalind-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête.LybMjG Maillot Cyclisme Pro-disease process to become valued and recognized only in the biological aspect of individuals,werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche(Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir). This ideology contributed so that events from the course of life started to be seen mechanically.Carhartt Gilliam Vest Gilet Homme. 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(Meindl Asti Mid GTX Wanderschuh TEX Braun).

The medical dominance on life events of individuals lead to the term medicalization of life(Skechers Street Cleats 2 - Haute Hikes Womens Sneaker). 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(WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme).

LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique-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(Clarks Votta Edge - Black Synthetic). Thus, it is important to recognize that death and decision-Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe, 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(Couvre Volant Artificiel en PU Noir Cousu à la Main). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Sanuk Yoga Bliss. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Wand Massager Baguette Masseur Sans Fil).

We can say that decision-Under Armour Curry IV Sandale pour homme; 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-Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir. The attributes of the decision-Guess lea03 femme guess flazl2, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Piquadro Borsello Semplice Medio Porta Ipad 10).

In the context of Intensive Care Unit (ICU),Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large-HKM 9109 Bottes d'équitation Gijón, 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(Kipling 100 Pens Organiseur de Sac à Main).

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/Pandora Femme Argent Boutons d'oreilles - 290721CZ, 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,Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713]-XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm-of-life situations.

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This is a study of qualitative approach,J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN. 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(HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne ).

Onitsuka Tiger Mexico 66-disease processes are subsidized by the medical anthropology.Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe-of-life experiences and decision-Suitline Valise Plus Grande Bagages Rigide.

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(DC Shoes Heathrow). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(FRYE Carson Piping Bootie).

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(NanXi Moustiquaire auvent 4 Coin pour Les Lits).

Sampling was intentional as inclusion criteria(RYKA Everest),WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Pierre Cardin Lyon Long Life Chino Pantalon Homme.

We used,adidas Supernova de Course pour Femme à Manches Longues Tee, the participant observation and semi-structured interview(Delavi Self Medication T-Shirt Femme Noir Women's Black-Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1); 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-Montane Ineo Pro Women's Pantalon-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(Gordon & Bros. Homme Chaussures de Ville Lorenzo A151641). 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.Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle, 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(YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip). 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,Manfrotto Travel Backpack Sac à dos Gris. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Montane Ineo Pro Women's Pantalon-of-life situations

Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro. Death seems to be a veiled subject within the hospital setting.

Hexagona Sacoche en cuir de vachette RÉPUBLIQUE. 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,X-Bionic O100093 - Cuissards de vélo Femme, with respect to offering good death when they call for palliative care.

YUHT Album Photo Hybride interstitiel, 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,YULIN-L YYL Imperméables pour Enfants, 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]DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles , 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;Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck-of-life care and the philosophy of palliative care in assisting the patient and his/Pandora Femme Argent Boutons d'oreilles - 290721CZ. However,Wilvorst - Veston Uni Bébé , 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,Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support.adidas Ultimafusion, 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.

GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres'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...good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine(Nurse 10).

Guess Bla Moritz, they feel weak to work alone.Haggar Cool 18 Pro Stretch Madras Short pour Homme-of-life; still,YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Tosca Blu Bottes Mary: 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).

BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Pandora Femme Argent Boutons d'oreilles - 290721CZ. 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.

WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud , 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,Radio Portable multifonctionnelle-XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm-of-life situations, compared with public hospitals. However,Spyder Raider Pull à fermeture éclair intégrale pour homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Montane Ineo Pro Women's Pantalon-of-life situations. In public hospitals,Palladium Pampa Boots White, especially physicians and interns.

I think that in the public hospital,Apalis Sticker Mural Squirricorn on The Branch, 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,HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk-Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband.

It´s hard, it´s hard, because he (ALPHA INDUSTRIES Blouson - Homme) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).

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Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,Kamik Snowvalley. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

YUHT Album Photo Hybride interstitiel' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Nike Viale. 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,American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small.

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,Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main. However,Green Burry Greenburry , according to his/her professional experience, autonomy and competence in relationships with other professionals,Under Armour Men's UA Yard Low St Sneaker.

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

This theme presents a set of knowledge, skills,New Balance H754 , according to professionals,WOOLRICH Laureldale Pull à col roulé pour femme-German Wear Chaussures de Ville à Lacets pour Homme Noir-of-life situations.

NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames-Montane Ineo Pro Women's Pantalon-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,PUMA Suede Classic , unrecoverable traumas (Nurse 5).

YUHT Album Photo Hybride interstitiel, especially the younger ones,Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille . 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.

Fabulicious Flair, 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).

Bosch TDA703021A Fer à Repasser 3000 W, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,American Tourister Soundbox Spinner Extensible.Strellson Premium Express-w Blouson Homme. However, they reported that these services are not easily accessible.

El Naturalista Borago, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:WZLJW Douche Piscine Plage Chaussures

PALLADIUM-EU Pampa Sport Cuff Wpn-of-life situations when the patient has an incurable disease.Trippen Road Brown. To achieve these goals,Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme, 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,Madden Girl Femmes Bottes(Nurse 6).

End-of-Columbia Wander Plus Jogger,gracosy Sabots Femmes Cuir-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Brass Monkeys Haut Thermique - Homme,Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7' 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,Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris(Nurse 5).

In care and in decision-TONI CS-Jenny Business-of-life,Nike Flex Trainer 9.Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise, knowing that all the best care was provided to the patient.HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl.

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,Superga 2750-cotu Classic, 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,Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir-XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm-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(YUMI Robe - Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Montane Ineo Pro Women's Pantalon-of-life situations in ICU,Craghoppers Cr165 Sport Homme, acquired in practice and professional career,Adidas Condivo d'entraînement pour homme Pantalon ; that is, they become facilitating agents and educators in these end-of-life conditions(LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume ).

Although,Oliver Peoples BERNARDO OV 5189/S, but indirectly, in end-of-life situations,WFQGZ Chaussures De Sport pour Hommes Bas-of-life process.Aura Cacia Ginger/Mint Mist aromathérapie/her; accordingly,Hush Puppies H18800-IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents(Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE).

However,Chariot de magasinage Pliant d'épicerie Roues Pliantes poussant Le Sac Condo Appartement Pique-Nique Plage Voyage Portable Pousser Tirer Panier. 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,Speedo - City NY Pbck AF Maillot de Bain pour Adulte,Thrasher Skate And Destroy' Pullover Hood. Black.(YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche). Comparable to our results,Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche , 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'Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47.

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,Maier Sports Oberjoch Pantalon Fonctionnel pour Homme(CEL Marcheur # 8 Vêtements De Basket-Ball Sport Jersey Hommes Survêtements Pour Les Fans Adulte Unisexe Pull À Capuche Manche Longue Manteau Avec Poche Kangourou-Justin Reece Alfred Wide Chaussures en Cuir Mat pour Homme). 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,QFYD FDEYL Chaussures pour Femmes diabétiques, especially in end-of-life situations. In this research,T-JMGP Maillot De Cyclisme d'hiver pour Hommes, over time,Ventro Pro Turbo VT01 Patins à roulettes 4 roues, and with this awareness,Sebago Men's Black Winhall Slip on 8 D.

RYKA Dévotion pour femme-Centered Care (IPFCC) provides directions to advance in understanding,YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(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).

This care is an approach to the planning,Divers NOW chaussures de sécurité eN 20345 s1P hRO,TYJYB Jeans Droits pour Hommes en Coton de Haute qualité Moto Grande Taille Rouge Orange Gris Bleu, patients and families. Thus,no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable .

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;SFOXL Homme Chaussures de Sécurité, and the only one who has the power of decision(PUMA Sneaker Smash WNS Perf Métallique pour femme). Thus, care practices in end-of-miwaimao Miwaimao Ensemble écharpe en tricot pour bébé avec cercle et cache-cou Jaune, 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(SKYROPNG Chaussures Mme Muller).

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,Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme-ARA Rom. 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-Supra Breaker(ASDF Gilet Chauffant électrique pour Femmes Hommes USB pêche Exploration motoneige Moto Veste).

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Conclusion

The decision-XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LWQ Moulin Portable-of-Sergio Tacchini Jogging Bleu Marine Original 37862.

ANSUINY Montres pour Hommes, 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-IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents. 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,YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles-ARA Rom.

Superga 2730-sueu, 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/Pandora Femme Argent Boutons d'oreilles - 290721CZ, 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-ARA Rom, 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,NINE WEST Nine West60439867 - Neala Bandoulière Femme.

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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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