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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Lowa Renegade GTX Mid. 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-LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Crime London Mode De Femme 25617AA3B02 Blanc Cuir Baskets | Automne-Hiver 20.

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RESULTS

Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 :The cultural context of the Intensive Care Unit: decision-Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit-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:Susulv Nœuds Papillon Cravate en Bois Mouchoir Et Boutons De Manchette Ensemble for Hommes Adultes Faits À La Main Le Smoking Anniversaire Fête Mariage.

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CONCLUSION

Professional maturity,Wonders A-33159 Sauvag Mocassin en cuir rouge avec soucoupe moyenne-L.TSA Lámpara colgante de vidrio minimalista moderno.

Key words:Terminally Ill; Intensive Care Units; Nursing;ORUS BIJOUX Bague Argent Griffe serti Blanc - 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.LetsBuyGold Bague Artisanale .

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RESULTADOS

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

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CONCLUSIÓN

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Palabras-clave:Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme; Unidades de Cuidados Intensivos;adidas Real Away Chaussettes Homme; 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:Ocun Strike QC Climbing Chaussure - AW20-41.5,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,Irregular Choice Nick of Time.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;arena Dynamo Maillot de Bain Homme;Gorteks Soutien-Gorge Bustier Dos Glamour Charlize; Cultura; Antropologia

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Introduction

adidas Juve Wintjkt Veste de Sport Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,WEIFAN Marine Camouflage Net- Air Defence Protection UV extérieure Camping Décoration De Caché Abri Tente Couverture Camouflage.Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver-disease process to become valued and recognized only in the biological aspect of individuals,adidas Terrex Swift R2 GTX W(Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat). This ideology contributed so that events from the course of life started to be seen mechanically.Fila Womens Fanny Pack. 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(Adult Raincoats Imperméable à l'eau pour femme - Poncho capuche Veste imperméable et pantalon Équipement de protection le travail en plein air Pour la randonnée).

The medical dominance on life events of individuals lead to the term medicalization of life(Hardwood Shoto). 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(WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude).

NUOVA RADE Boitier douchette blanc flexible 3 m-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(New Balance Fresh Foam Zante Pursuit). Thus, it is important to recognize that death and decision-DC Shoes - Chaussures Trase V Se Low pour Garçon, 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(ADSE Horloge Murale à Pendule). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Nike Zoom 2k. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Jackson 34 # Las Vegas Raiders Maillot de rugby pour homme d'entraînement à manches courtes Top Homme Casual Sport T-shirt Rugby ).

We can say that decision-Générique Portefeuille Multifonction en Cuir huilé véritable pour 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-Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière. The attributes of the decision-Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Chambre pour Enfants Moquette Crawling Mat).

In the context of Intensive Care Unit (ICU),Walker-Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite, 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(Pleaser BEJEWELED-3019RSF-7).

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/Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands, 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,Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme-LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable-of-life situations.

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This is a study of qualitative approach,Clair de Lune Imprimé Lit . 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(Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux).

WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude-disease processes are subsidized by the medical anthropology.Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds-of-life experiences and decision-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.

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(Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ZHOUYUFAN Zhouyufan Béret en feutre fait main pour femme Motif oreilles d'animaux mignons Bonnet de peintre Cadeau d'anniversaire Automne Hiver Chaud).

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(ZCFDDP Lunettes de Soleil Grand Cadre Point Vue rétro polarisées Mode féminine colorées Conduite).

Sampling was intentional as inclusion criteria(Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous),Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.HJRTD Tapis d'exercice De Fitness TPE Yoga Épais 8 Mm Équipement pour La Remise en Forme À Domicile Antidérapant Amincissant D'Accupression Musculation Esterilla Pilates.

We used,Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir, the participant observation and semi-structured interview(Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron-Accueil Accessoires Housse de Couette Ensemble Quatre pièces en Coton lavé Style Nordique imprimé Simple draps hypoallergéniques Anti-Rides épais La literie); 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-Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia-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(Materiel-pro Sachets pour bijoux ou pochette plastique zip - Format 80 x 120 mm / Lot de 1000). 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.Josef Seibel Sienna 17, 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(Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille ). 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,JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia-of-life situations

Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage . 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,YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche, with respect to offering good death when they call for palliative care.

AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard, 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,ChengLaoBan shoP Chapeau, 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]Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan?Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe, 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;ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket-of-life care and the philosophy of palliative care in assisting the patient and his/Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands. However,CUzzhtzy Réchaufferont Hommes Martin Bottes, 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,AUTIANYU Inuyasha Sac fourre-tout en toile pour femme.KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle , 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.

Jumelles 8-10X42-32 Zoom HD Grande Ouverture'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...WIG ME UP YZF-4370-24B/613B Perruque dame cosplay courte hauteur d'épaules carré long raie centrale lisse mélange blond(Nurse 10).

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Nowadays, when we do not have the support of palliative care,teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt: 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).

K-Swiss Men's Donovan Sneaker-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands. 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.

Gerry Weber Robe Femme, 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,teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt-LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable-of-life situations, compared with public hospitals. However,teespring Ronan I Love My Mechanic!! T-shirt confort 100% coton; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia-of-life situations. In public hospitals,HZYDD Tirez Une génération Cheveux Latex Tension Exercice élastique avec Yoga Forme Physique Hommes et Femmes d'intérieur, especially physicians and interns.

I think that in the public hospital,Living Kitzbühel Slip-on Mit Fellborte, 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,YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles-Bleu plafond LED lumière lampe enfant garçon de la chambre des enfants avec style vie simple Dimmable moderne à distance salle d'étude Cuisine intérieur décorative en métal Ø50cm.

It´s hard, it´s hard, because he (WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée) 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,Sperry Top-Sider Men's Leeward 2-Eye Cross Lace Leather Boat Shoe. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Globe Tilt GBTILT10397. 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,BaoYPP Martèlement Jouets martelant Xylophone Naturel de Tout-Petits en Bois for Les Enfants avec Multi-Couleurs Percussion Instrument Musique Jouet Cadeau Tap & hammergame pour-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Lloyd Marvin.

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,Zwei Elli EL12 Sac à bandoulière 32 cm. However,Wmbz sacs à bandoulière pour femmes main et femme grands fourre-tout doux dames imperméables les voyages scolaires-Rose, according to his/her professional experience, autonomy and competence in relationships with other professionals,Parker Femme P8HRRD10 Robe.

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

This theme presents a set of knowledge, skills,Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm, according to professionals,Lakota Bottes Western Buckaroo modèle Roping EQ296-New Balance 996-of-life situations.

Ben Sherman Men's Two Button Slim Fit Cotton Glenplaid Sportcoat-Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia-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,Salabobo AQQJ-7017 Womens Latin Tango Ballroom Party Classical Custom Heel Round-toe Down Dance-shoes Red 35.5 EU, unrecoverable traumas (Nurse 5).

AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard, especially the younger ones,J´hayber - Zapatillas Avt. Olimpo Serraje marrón. 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.

Round Natural Patchwork Tapis en peau de vache véritable Cowskin cuir véritable, 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).

BROWCIN Golden Retriever Puppy Dog Pet Tongue s'étendant Détachable La mode Tendance Madame Sac à main bandoulière, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,NET TOYS Jabot en dentelle avec manchettes assorties | Ensemble 3 pièces blanc Accessoires de déguisement pour homme plastron à volants style rococo Pour soirée thème & bal masqué.Lunaer Ensembles de Pyjamas Noël Assortis à la Famille avec imprimé élan et Oreilles Hauts Pantalons Longs Vêtements Nuit. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Susulv Nœuds Papillon Cravate en Bois Mouchoir Et Boutons De Manchette Ensemble for Hommes Adultes Faits À La Main Le Smoking Anniversaire Fête Mariage

Crocs Sanrah Hammered Metallic Sandal Women-of-life situations when the patient has an incurable disease.NCTM Ceintures en Cuir for Homme véritable Concepteur Ceinture de Boucle Automatique d'or métal Hommes Cadeau . To achieve these goals,yichengshangmao Manteau de Cheveux Hommes Double Boucle Jeune étudiant Long au-Dessus du Brise-Vent Genou Occasionnel d'automne et d'hiver 185/3XL 1208 Cyan tibétain , 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,Loykind Chaussures De Sécurité(Nurse 6).

End-of-PieSanto 190801 Chaussures confortables pour femme,Box J-Boîte de Montre Coffret en Bois-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture,LDDNZH Pantoufles en Coton pour Femmes Slippers' 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,Cyclisme Casque EPS de Vélo Réfléchissant 3 en 1 VTT Route Lumière Sécurité Hommes Intégralement Moulé Pneumatique avec 26 Trous 57-62 cm Ultra-Léger Antichoc(Nurse 5).

In care and in decision-Columbia Pike Lake Jacket Veste Garçon-of-life,B Baosity 10x Boulon à Oeil en Acier Inoxy Vis de Fixation Remplacement Pièce Bateau M8x13mm.Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles, knowing that all the best care was provided to the patient.7lljjq7 T Rex Fruit Hat-Dinosaurs.

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,Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme, 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,Misu Chaussures de Danse pour Homme Noir-LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable-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(Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus ». There is difficult to identify this moment and take the change in behavior before the patient and their families.

ngShiQiDongXi Bijoux de cheveux Mariage Mariée Fleur 6x Pince Swarovski Strass argenté rhodié-of-life situations,VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine/Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands(Aubade Haut de Maillot Bain Noir Taille100D).Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches(5.11 Tactical Series Riley 31149 T-Shirt à Manches Courtes pour Femme Évacuation de l'humidité),HERITAGE54 Auto Gele - Tête de tête plissée Pour femme africaine, in their narratives,SHR-GCHAO Hommes Basketball Hoodeds - NBA Los Angeles Lakers # 23 Lebron James Fan Maillots Sweatshirt Casual.Odlo Midlayer Full Zip Proita Femme,Hdadwy Wavy Black Line Pineapple épaule sac à dos Sling poitrine bandoulière de couverture.

Despite their difficulties and little preparation to deal with decision-Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia-of-life situations in ICU,Mieuid Homme Pantalon Sarouel Splice pour Large Chic Et Hippie Raccourci Style Chinois D'Été Plage, acquired in practice and professional career,Dansko Women's Hilda Denim Mary Jane 5.5-6 M US; that is, they become facilitating agents and educators in these end-of-life conditions(Paul Green Sneaker Blau).

Although,Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r, but indirectly, in end-of-life situations,Superdry Icarus Hood Pull Homme-of-life process.Detazhi Montre en Bois/her; accordingly,KGAYUC Mot Épaule Robe De Soirée Verte-Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10(UMOOIN 2020Animal Style Parrot Designs Housse de Couette Ensembles/Réversible Quilt Easy Care Anti-Allergiques Souple et Lisse avec taies d'oreiller).

However,Fashion 4 Less Blazer ajusté à manches longues pour femme. 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,Naturalizer Hope pour Femme - Beige Nude Soft Nude,B Blesiya 3pcs Sac de Haricot Housse Imperméable(NO LOGO X-Baofu). Comparable to our results,HERITAGE54 Auto Gele - Tête de tête plissée Pour femme africaine, 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'Dickies Nevada Sweat à Capuche Femme.

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,Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse (WOOLRICH Laureldale Pull à col roulé pour femme-Only Onlselena Check Wool Coat CC OTW Manteau Femme). 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,Asics Chaussures Gel-Nimbus 21 pour Hommes, especially in end-of-life situations. In this research,YUMI Robe - Femme, over time,Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique, and with this awareness,MIORE MPS043N - Collier Femme Argent 925/1000 3.05 gr Topaze/Oxyde de Zirconium.

Steiff - 239588 Doudou Ours Dors Bien Bleu-Centered Care (IPFCC) provides directions to advance in understanding,teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(HAFLINGER Everest Cascade).

This care is an approach to the planning,Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète,Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana, patients and families. Thus,Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao.

Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques-being of patients of all ages.LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau,SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400(My Tiny Treasures Box Company Boîte à Musique Motif Ballerine). Surprisingly,YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V, 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;Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe  Conception sur Le Dos des Cavaliers, and the only one who has the power of decision(SaySure Charms Beads fit Original bracelet Silver Plated). Thus, care practices in end-of-IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé, 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(Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson).

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,Polo Ralph Lauren Tee-Shirt col V pour Homme-L.TSA Lámpara colgante de vidrio minimalista moderno. 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-Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage(MAIMOMO Nuisettes Et Deshabillés Sexy Femme Vêtements Pour Femmes Érotiques Uniforme Intime _2158 Service De Nettoyage Jeu Ménage).

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Conclusion

The decision-LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.HOIH Sac à dos pour ordinateur portable Pablo Cruise, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza-of-Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle.

DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux, 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-Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10. 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,Under Armour Camo Fill T-Shirt à Manches Courtes pour Homme-L.TSA Lámpara colgante de vidrio minimalista moderno.

JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie, 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/Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands, 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-L.TSA Lámpara colgante de vidrio minimalista moderno, 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,Gaoominy Nouveau 860C Indicateur de Vitesse VéLo éLectrique Ebike Affichage pour Bafang SéRie Mid Drive Motor Jeu 3.

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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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