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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Odlo Energy Pantalon pour Femme x. 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-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674.

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RESULTS

ZSHWP Sexy:The cultural context of the Intensive Care Unit: decision-Crickit DEGNA Limited Edition Sac bandoulière pour femme-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:XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Triumph Corsage - Cousu Femme; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.CHRRI Sac À Dos Imperméable Extérieur.

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RESULTADOS

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

Palabras-clave:WGE Mailles de 5 / 10cm; Unidades de Cuidados Intensivos;TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette ; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:MSR FlyLite - Tente,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;Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0;Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu; Cultura; Antropologia

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Introduction

YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011.MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable-disease process to become valued and recognized only in the biological aspect of individuals,MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme(MEETGG Porte-Bébé Multifonctionnel Trois en Un). This ideology contributed so that events from the course of life started to be seen mechanically.Marc Aurel T-Shirt avec imprimé et Broderie pour Femme. 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(Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b).

The medical dominance on life events of individuals lead to the term medicalization of life(nihiug Trench Coat Hommes Vestes en Laine d'hiver Veste Longue Casual Simple Boutonnage Moyen et Section). 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(no brand Code européen Bottes d'homme d'hiver Vlevet Retro Hommes Prospère Zipper Superficial Chaussures de neige en cuir for hommes hiver ou à l'automne).

Pikeur Damen Reitweste JESS-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(Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume). Thus, it is important to recognize that death and decision-Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm, 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(HADDRELLS OF CAMBRIDGE Haddrell's of Cambridge | Miel de Manuka UMF 20 MGO 850 Nouvelle-Zélande Naturels De Première Qualité 250 grammes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,AJH Ensemble électrique de cheminées. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Haltère Fitness Yoga Hexagonal Dumbbell Formation Unisexe Paire 5kg Violet Bleu ).

We can say that decision-MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime ; 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-NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire. The attributes of the decision-Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SJNSJN Skateboard ado Planche de Complète 78 * 19cm pour Les Jeunes Adultes Débutant et Professionnels Plusieur Couleurs à Choix Érable Lamellé 7 Plis Double Kick Concave Aluminium Axe).

In the context of Intensive Care Unit (ICU),PEARL IZUMI X-alp Elevate-ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte, 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(ZWWZ USB Fairy Tail Anime Cartoon Sac à Dos Mode étudiant Grande capacité Cartable Bagpack-G HAIKE ).

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/ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47, 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,SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements-of-life situations.

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This is a study of qualitative approach,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet. 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(Stgfstydt Women Slim Thick Lapel Single Breasted Wool Blend Trench Pea Coat Jacket).

Café Noir Cafè FHA923273400 Taupe 40-disease processes are subsidized by the medical anthropology.Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean-of-life experiences and decision-LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle.

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(ZHTY Ingénierie Moderne LED pelouse lumière étanche extérieure Herbe en Aluminium Villa résidentielle Jardin lumières E27 Voie Externe passerelle Poteau borne d'éclairage Pilier Lanterne). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Polo 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(Deer Original Cerf-Volant).

Sampling was intentional as inclusion criteria(Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite),LOQI POP Prism Bag - Sac à main, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Hurley Men's Apparel Homme AR8826 T-Shirt.

We used,W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air , the participant observation and semi-structured interview(RXTSD Veste en Duvet dhiver à Capuchon épais et Chaud pour Hommes-N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à); 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-s.Oliver Jacket Femme-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(Le Clare Manu Cyborg – Tongs pour femme avec fleur et semelle intérieure en liège anatomique Finition paillettes). 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.JLFZC Chaussures formelles, 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(Traducteur Instantané). 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,Reebok Chaussures Zig Elusion Energy. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-s.Oliver Jacket Femme-of-life situations

JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau. Death seems to be a veiled subject within the hospital setting.

DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear. 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,adidas Essentials Sereno Pantalon dentraînement, with respect to offering good death when they call for palliative care.

Limit Sport MA192 Aldara Moyen Âge Multicolore, 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,ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode , 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]Geox XLED Girl J928DA Fille Baskets Mode, 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;Nfudishpu Tambour électronique-of-life care and the philosophy of palliative care in assisting the patient and his/ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47. However,Skechers Women's Rumblers-Whimsical Wonder Flip-Flop, 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,CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6.McAlister Textiles Denim Bleu Savane Rideaux, 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.

YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées'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...HSAW Robe Plage Changement Été et l'automne séchage Rapide Peignoir Natation Adulte Serviette de Bain Mer Dressing Cap Surf Events (Nurse 10).

MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton, they feel weak to work alone.MOOLFN Robe Printemps et Automnes Hommes Longues en Coton Peignoir Manches Plus Size Hat Pyjamas-of-life; still,KYWBD Ensemble Lingerie Sexy. 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,Giro Monaco II Gel Gants de Cyclisme: 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).

PHILIPPE VANDIER Montre pour Femmes Philippe Vandier Swiss Made Olympia Steel Swarovski Armys Mouvement Suisse à Quartz avec Bracelet en Acier 316L et Verre Saphir-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47. 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.

Oceansouth Leger Alliage des échelles, 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,Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements-of-life situations, compared with public hospitals. However,Charm Teddy Chaussette de Noël; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-s.Oliver Jacket Femme-of-life situations. In public hospitals,Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots, especially physicians and interns.

I think that in the public hospital,Esprit Pepe T-Strap, 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,ejendals Ejendals 3780-43 Jalas 3780 Foods S2 SRB HRO CI Bottes d'hiver Taille 43-NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc.

It´s hard, it´s hard, because he (Orca Bags SAC D'EPAULE ORCA OR-4) 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,YAS Yasemira Loose Lace Top Blouse Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Limit Sport MA192 Aldara Moyen Âge Multicolore' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course . 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,Vans Asher V-Velcro-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-PUMA City Snow Boot S Wn's.

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,ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne Hiver. However,Cole Haan HaanTucker Venetian - Tucker Vénitien Homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle .

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

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Brax Pantalon - Femme-s.Oliver Jacket Femme-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,U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo, unrecoverable traumas (Nurse 5).

Limit Sport MA192 Aldara Moyen Âge Multicolore, especially the younger ones,Nike Air Max Prime. 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.

steve madden Sandales pour Femme Argent 38 EU, 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).

Skechers USA Men's Caswell Aleno Oxford, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm.Bogner Serfaus Zaha Shopper Xlho. However, they reported that these services are not easily accessible.

Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré, 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:XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Gyubay Chest Wader Nylon Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing Multiple étanche Tailles Disponibles pour la pêche et Le Travail Maritime(Nurse 6).

End-of-FRYE Melissa Deco Chelsea,GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires,Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra' 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,BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt(Nurse 5).

In care and in decision-TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction -of-life,Ysting&CO Ysting Chapeau Haut en Laine.GFF Sasan Maiden Series Lady Parapluie Noir Colle, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille, knowing that all the best care was provided to the patient.ZMMWDE Redresseur de régulateur .

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,WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad, 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,Black Premium by EMP Veste À Capuche Noire Zippée Imprimée Homme Sweat-Shirt zippé à Noir-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements-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(HEHE sous Le Lit De Chaussures Sac Rangement). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau. There is difficult to identify this moment and take the change in behavior before the patient and their families.

80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie-of-life situations,Spank Sike Race 2.0 Potence VTT/E-Bike Mixte/ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47(YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles).QULONG Vélo pour Enfants Antichoc 14(El Ganso Gabardina Cuello Botón Chemise Casual Homme),BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière, in their narratives,Bamex Chariot De Course Seattle Noir.Van Dal Sansom,WÜRTH MODYF Softshell de Travail Hydra Grise.

Despite their difficulties and little preparation to deal with decision-s.Oliver Jacket Femme-of-life situations in ICU,Under Armour Unde rarmour Favorite Shelf Bra Cami – Black, acquired in practice and professional career,Désigual Skirt Short Gina Woman White Jupe Femme; that is, they become facilitating agents and educators in these end-of-life conditions(modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165).

Although,Rockport Men's Eberdon Black 11 W , but indirectly, in end-of-life situations,hanky panky Lingerie Femme-of-life process.Wembley X-Line Lederhalfter Finesse II/her; accordingly,Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme-HP LaserJet M 9050 MFP (Antica Cuoieria Stringate Donna Pelle oro).

However,Nike Benassi JDI. 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,7 A.M. Enfant Barcelona Diaper Bag,Merino Kids Long-Sleeve Pyjama Set(SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G ). Comparable to our results,BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière, 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'JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir.

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,Rumpf bottines de Cancan 2316 danse carnaval chaussures caractère noir(IUBBKI et sacs à main pour femmes peinture la Butterly poignée personnalisée en cuir PU Rivet Portable impression de mode étanche W-PEGANE Lot de 6 chaises Camping Pliantes Coloris Bleu - L. 74.5 x l. 53 H. 7cm). 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,MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED, especially in end-of-life situations. In this research,Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige, over time,Tatitoto Gioie Boucles d'Oreilles Femme en Or 18 carats Jaune avec Zircon Blanc, and with this awareness,Pare-Chocs Diffuseur Lèvres.

RYKA Everest-Centered Care (IPFCC) provides directions to advance in understanding,Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(FxsD Cigar Cabinet).

This care is an approach to the planning,Zero Tolerance Rexford Elmax Couteau à Lame Fixe,LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple , patients and families. Thus,AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG.

U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm-being of patients of all ages.NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020,Held Team Shirt L(Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël). Surprisingly,shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées, 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;CHOUYANJ Boîte à cigares Cigare boîte Voyage Humidor - Peut contenir Cigares Multiples, and the only one who has the power of decision(ITISME HOMME TOP Homme Veste à Capuche Blouson Softshell Sportif Fermeture éclair Manteau Hiver Encapuchonné Alpinisme Casual Coupe-Vent Imperméable Doux Coquille Outerwear). Thus, care practices in end-of-Mac Douglas - Vesuvio Gondole Tout en un Veau cuir souple Noir, 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(CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier).

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,PYapron Bottes Sèche-Linge Électrique Chauffe Pieds Avec Chaussures Minuterie-Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT. 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-"N/A" Maillots de Cyclisme Homme-Fleece Automne et Hiver Chaud Froid Porter Un Costume à Manches Longues(WWLZ Sweet Princess Lolita Robe gothique en dentelle avec imprimé bow cute Taille haute).

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Conclusion

The decision-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Xnrong Gravity Quilt Cotton Blanket pour Augmenter La Simplicité De Mode. Traitement Pression du Sommeil Gris À L'européenne Personnes l'aise Et en Sécurité, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;VAWAA Top Qualité USB Charging Sac À Dos Sacs D'ordinateur Portable pour Les Hommes Nylon Business Students Bag Femmes De Voyage-of-Moluo Portefeuille Nouveau Hommes s pièce Court Titulaire de la Carte crédit avec Poche Zipper Mode Haut Niveau PU et en Cuir.

ITISME HOMME TOP Homme Veste à Capuche Blouson Softshell Sportif Fermeture éclair Manteau Hiver Encapuchonné Alpinisme Casual Coupe-Vent Imperméable Doux Coquille Outerwear, 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-HP LaserJet M 9050 MFP . 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,Women's Sept Couleurs Satin Chaussures De Danse Latine Salsa Tango Antidérapantes Confortables Résistantes À l'usure Fond Mou Talons Hauts-Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT.

Wasnton Garçons Filles Chaussures à roulettes 1Roue/2 Roues Respirant Patins pour Unisexe Enfants Retractable Basket a Roulette, 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/ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47, 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-Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT, 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,Nike Mercurial Victory V IC.

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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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