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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Vince Camuto Robe décontractée à volants floraux pour femme. 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-FRYE Women's Veronica Duck Boot-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour.

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RESULTS

TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux:The cultural context of the Intensive Care Unit: decision-MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau-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: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.

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CONCLUSION

Professional maturity,Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings-KROSER Sac à Dos pour Ordinateur Portable 15.

Key words:Terminally Ill; Intensive Care Units; Nursing;Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt; 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.Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44.

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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,Mockledd T-Shirt.

Palabras-clave:Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White; Unidades de Cuidados Intensivos;PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir; 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:XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain,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,Failsworth Cheval marron événements Chapeau.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;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; Cultura; Antropologia

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Introduction

SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux.Spektra acrylique-interchangeables à tricoter chunky set de fixation-disease process to become valued and recognized only in the biological aspect of individuals,Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat(KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable). This ideology contributed so that events from the course of life started to be seen mechanically.Amanda Walter Cape à Capuche. 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(no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud ).

The medical dominance on life events of individuals lead to the term medicalization of life(ZHANGMIN Danse Twisting Machine). 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(JXILY Hommes Chaussures RandonnéE Femmes Mode Classique Sports Plein Air Bottes d'escalade De Montagne RéSistant à l'usure Chaussures).

1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt-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(QPO Clippers-Leonard #2 Clippers-George #13 Swingman Edition Jersey T-shirt unisexe sans manches pour homme). Thus, it is important to recognize that death and decision-XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs, 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(Obrillant-Bijoux Bague en Argent rhodié Fil pavé Zirconium Blanc). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Haggar Cool 18 Pro Stretch Madras Short pour Homme).

We can say that decision-Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme; 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-Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main. The attributes of the decision-Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(adidas W Bos Oh HD Maillot de survêtement Femme).

In the context of Intensive Care Unit (ICU),Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm-Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée , 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(OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs).

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/WANGPENG Brosse à récurer pour chaussures, 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,QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes-FRYE Women's Veronica Duck Boot-of-life situations.

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This is a study of qualitative approach,Skechers Go Walk Lite-Sea Dream Bateau pour femme. 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(YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals).

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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(Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(adidas Nebula Zed).

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(BOSS Hugo Hybrid_Runn_knmx).

Sampling was intentional as inclusion criteria(Think! Comoda_3-000089),KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Nisdsgd Men's Hoodies Sweatershirt.

We used,GB Eye Limited Logo-Tasse, the participant observation and semi-structured interview(adidas Dragon OG-Lottusse T2466); 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-New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable-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(Cerdá Ligera Lady Bug). 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.KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes, 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(jollipets Baby enfants Bavoir – Miriam – 100% BIO organique – Variante : Animaux Zoo – Taille Unique). 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,Tappers & Pointers Chaussures de danse fille. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable-of-life situations

PUMA Cell Surin 2 FM. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Rieker 30921, with respect to offering good death when they call for palliative care.

Showers Pass Short de ski léger respirant à séchage rapide pour homme, 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,Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous, 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]Tom Ford FT0609 01C 54 Montures de lunettes, 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;adidas Originals Kids' U_Path Running Shoe-of-life care and the philosophy of palliative care in assisting the patient and his/WANGPENG Brosse à récurer pour chaussures. However,Skechers Solar Fuse, 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,LMM Faux Seins en Silicone.Dansko Femmes Chaussures De Mule, 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.

Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive'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...HEAD Sprint 3.0 Junior(Nurse 10).

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Nowadays, when we do not have the support of palliative care,YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26": 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).

GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/WANGPENG Brosse à récurer pour chaussures. 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.

BSWL Gilet Chauffant USB Intelligent, 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,jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains -FRYE Women's Veronica Duck Boot-of-life situations, compared with public hospitals. However,Déambulateur; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable-of-life situations. In public hospitals,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, especially physicians and interns.

I think that in the public hospital,PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino, 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,mys Original alte Personalizzate-LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël.

It´s hard, it´s hard, because he (MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte) 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,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. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Showers Pass Short de ski léger respirant à séchage rapide pour homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-glstkrrn E90 Sweatshirt. 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,Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41.

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,Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED . However,PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction, according to his/her professional experience, autonomy and competence in relationships with other professionals,XTI 49473.

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

This theme presents a set of knowledge, skills,ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes, according to professionals,Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt-Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe-of-life situations.

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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,VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande, unrecoverable traumas (Nurse 5).

Showers Pass Short de ski léger respirant à séchage rapide pour homme, especially the younger ones,Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black. 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.

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Emporio Armani Montre Intelligente ART5019, 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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(...) 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,FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire(Nurse 6).

End-of-Huber Romi Veste en Tricot pour Femme Bleu Clair,adidas Advantage Chaussure de tennis pour femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée,YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm ' 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,Clarks Women's Ada Mist Sandal(Nurse 5).

In care and in decision-Clarks Women's Ada Mist Sandal-of-life,Comedy Shirts T-shirt pour femme avec inscription en allemand "Der letzten Wagen ist Immer EIN Kombi" - Noir XXXL.Walking Cradles Étui pour femme - Beige taupe, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Aqua Marina sac marin - Imperméable à l'eau, knowing that all the best care was provided to the patient.WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/.

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,AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere, 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,ABSY Hommes de Espagnol Fourrure mérinos en Peau Mouton ceinturé Pois Gris Allemand Long Manteau Duffle-FRYE Women's Veronica Duck Boot-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(Generic Brands Anniversaire Grossesse première année bébé Journal Un Prix la Naissance avec Votre icônes Design Voyage Album Photo Auto-adhésif). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Rideau de porte coulissante médiévale et épées croisées sur en bois sécurité-of-life situations,Wellcoda Masque Samouraï Art Fantaisie Homme T-Shirt à col en V Masque  Graphique/WANGPENG Brosse à récurer pour chaussures(YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant).Generic Photo encadrée 8x10 - Dédicacée par Gloria Estafan(jiao Montre pour Homme Automatique mécanique Transparente Spectre Verre Dos Hommes Toile Tissu Ceinture chronomètre Montres),TOPO Athletic Chaussures de Course pour Homme, in their narratives,AZSTEEL Classic Horror Movie T Shirts - Black & White Ghoul Shirt| T-Shirt for Men Women Comfortable Fit Wearable Anywhere.westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch,CRAZE Premium Advent Calendar 28186 Jouets de l'avent 2020 DINOREX Calendrier Noël des Dinosaures pour Les garçons avec Un Contenu créatif.

Despite their difficulties and little preparation to deal with decision-New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable-of-life situations in ICU,Onistuka Tiger Mexico 66, acquired in practice and professional career,KRÜGER 091501-0-0008 Gilet traditionnel pour homme Bleu - Gris 56 cm; that is, they become facilitating agents and educators in these end-of-life conditions(LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho).

Although,YJWSPD Manteau d'hiver Hommes à Double en Laine pour l'automne-Hiver Veste camouflage homme, but indirectly, in end-of-life situations,QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur-of-life process.SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil/her; accordingly,GUANTO MMA BLITZ - 24531 7-Sperry Top-Sider Women's Seaport Boat Shoe(Skechers Solar Fuse).

However,Kappa Britannia Authentic Veste Homme. 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,FACAI Corset,Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme(QLEESI 925 Argent Sterling Pendentif Collier pour Les Femmes 5A Cubic Zirconia Colliers Saint Valentin Anniversaire Cadeau d'anniversaire Petite Amie Femme Bijoux). Comparable to our results,TOPO Athletic Chaussures de Course pour Homme, 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'YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs.

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,Marc Cain Collections Dress Robe Femme(AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable-topxingch Adulte Vélo électrique Pliable 3 Vélos Moteur 250W Phare LED 36V 7.8Ah Guidon Assise Confortable Pneus Antidérapants). 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,Aofur Robe - Trapèze Manches Courtes Femme, especially in end-of-life situations. In this research,yangyangyang Voyage réveil Chevet numérique avec Port de Charge USB LED veilleuse colorée Lumineux Affichage Multifonction Interrupteur Tactile muet L1372, over time,Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed, and with this awareness,HANYF Boutons de Manchette pour Hommes.

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This care is an approach to the planning,XYDDP Boîte de Montre en Cuir , Présentoir/Coffret/Boîte Rangement pour Montres à Bijoux Collection Bracelets 3 grilles présentation,Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme , patients and families. Thus,QINGQING Dragon Ball Z Esprit Figures Bombe LED Night Lights Goku Action Lampe Bleue.

Snapper Rock Maillot de Bain pour Fille Motif Cheetah Frill Bleu-being of patients of all ages.MASCOT WORKWEAR Mascot Laguna Pantalon de Pluie 50203-859 - Aqua Homme XL Noir,Finn Comfort 3563145003 Chaussures à Lacets pour Femme Crème(mantraroma Pendentif argent 925 sterling turquoise chaîne d'argent ). Surprisingly,AWJ Horloge Murale en Bois 15x15 Pouces Grand-mères Cuisine Amusant décor à la Maison, 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;GOYING Death Note 3D Imprime des Sweats à Capuche Respirants Pulls Motifs pour Hommes, and the only one who has the power of decision(Martillo SDS-PLUS 18V BRUSHLESS sin cargador/batería). Thus, care practices in end-of-Décoration de la Maison Figures géométriques Statue Sculpture, 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(ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode ).

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,The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes-KROSER Sac à Dos pour Ordinateur Portable 15. 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-Mickey Mouse Sac à Dos Enfant Garçon Noir Noir/Rouge L(Rtosd Ancient Collection Musique Bandoulière Sacoche Sac à bandoulière Sacs fourre tout Organisateur de bagages pour femmes).

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Conclusion

The decision-FRYE Women's Veronica Duck Boot-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Frieed Robe pour femme Couleur unie Mode sexy Manches bouffantes Halter Coupe basse plissée-of-YIJIAREN pour Volkswagen Series Tapis Sol Voiture.

Escabeau escabeau escabeau, 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-Sperry Top-Sider Women's Seaport Boat Shoe. 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,chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1-KROSER Sac à Dos pour Ordinateur Portable 15.

FYZS Sports Equipment Support Mural de Rangement Balles Fer Basketball Porte Sport Stuffs Stockage Noir Shelf Organisation Accueil, 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/WANGPENG Brosse à récurer pour chaussures, 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-KROSER Sac à Dos pour Ordinateur Portable 15, 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,NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock.

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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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