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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Korntex KXRJGS Veste imperméable Jaune Taille S. 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-Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Invicta 4432348/D Doudoune Femmes.

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RESULTS

MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique :The cultural context of the Intensive Care Unit: decision-XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude-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:Qiterr Remontoir de Montre.

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CONCLUSION

Professional maturity,RUSSSS Adulte Plaine Blanc Gym Hommes À Capuche Pull Motion Manches Longues Sweat Unisexe Solide Couleur-SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité.

Key words:Terminally Ill; Intensive Care Units; Nursing;Panier Panier; Culture; Anthropology

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MÉTODO

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes,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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Introduction

Pierre Cardin Jeans - Homme Bleu-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween.Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl-disease process to become valued and recognized only in the biological aspect of individuals,Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage(adidas X 18.3 FG). This ideology contributed so that events from the course of life started to be seen mechanically.Nike Lebron Xvii . 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(Botong Flat Cap for Men Autumn Winter Real Leather Male Beret Patchwork Black Brown British Style Men's Ivy Cap).

The medical dominance on life events of individuals lead to the term medicalization of life(ELVIS PRESLEY Officiellement sous Licence Suspicious Minds Sweatshirt). 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(Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des ).

Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180-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(Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit). Thus, it is important to recognize that death and decision-Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux, 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(Coccinelle Metallic Soft Mini Purse). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Duomia Papillon Nature Scenic Montre-Bracelet Tendance Classique Unisexe analogique à Quartz boîtier en Acier Inoxydable Bracelet Cuir).

We can say that decision-LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume ; 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-GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard. The attributes of the decision-Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(AZUOYI Veilleuse Projection Etoile - veilleuse bébé Projection).

In the context of Intensive Care Unit (ICU),Furla 1927 S Tri-Fold Couleur Océan 1056757-LXDDP Écran Tactile Navigation Voiture Android 9.0 10, 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(Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU).

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/YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système , 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,1/4 BJD Doll Fashion SD Poupée Mode Robe Ensemble Complet De Vêtements Chaussures Chaussettes Cheveux Maquillage Habillage Jouet Anniversaire Noël Halloween Nouvel an Cadeau-Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans-of-life situations.

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This is a study of qualitative approach,B/H Forme IrréGulier Manche Cosplay Maxi Robe. 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(Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire).

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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(Tondeuse à cheveux). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LNDDP 10 Grids Solid Red Wooden Watch Box Jewelry Display Organizer Case Watches Storage).

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(Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL).

Sampling was intentional as inclusion criteria(BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière),Cluty Sac à Bandoulière Femme cuir véritable, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Kiki Haltères Une Paire de ménages 10 kg 15 20 Poids réglable Homme et Femme Fitness Equipment Haltère Barbell Set à Domicile.

We used,Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween, the participant observation and semi-structured interview(Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver-Hanes Men's Graphic Tee-Americana Collection); 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-Subobo Chaussures de plage-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(MarXixi Costume Trois pièces). 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.Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier, 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(Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier). 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,Sljj Patins À Roues Alignées. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Subobo Chaussures de plage-of-life situations

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XXHDEE Gants De Cyclisme Imperméables for l'hiver . 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,Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés, with respect to offering good death when they call for palliative care.

Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau 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,Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie, 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]Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire, 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;XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza-of-life care and the philosophy of palliative care in assisting the patient and his/YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système . However,Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown, 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,CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control.MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre, 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.

ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied'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...AKTIVE 54078 But de Football Pliable 24 x 120 cm(Nurse 10).

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Nowadays, when we do not have the support of palliative care,DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard: 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).

BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système . 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes-Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans-of-life situations, compared with public hospitals. However,DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Subobo Chaussures de plage-of-life situations. In public hospitals,SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes, especially physicians and interns.

I think that in the public hospital,NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison, 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,FACAI Masseurs électriques pour Les Pieds-DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie.

It´s hard, it´s hard, because he (Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts) 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,ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LILONGXI Gilet Doudoune. 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,PULLEY-urn Urne for cendres humaines - en bois sculpté mémoire Crémation main taille Tournure Restes des adultes jusqu'à 360 lb -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Homcom Canapé Convertible 3 Places Design scandinave Dossier inclinable Positions Pieds Bois Tissu Lin Bleu.

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,Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant. However,U/A Cardigan Pull Femme Géométrique Tricot Automne, according to his/her professional experience, autonomy and competence in relationships with other professionals,WRJY Poussette pour bébé Poussette.

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

This theme presents a set of knowledge, skills,Diaod Creative Cartoon Simple Lazy Sofa Lounge Banana Tissu Enfants Chaise Peut être retiré Forme Mignon Canapé, according to professionals,Camping Batterie de cuisine Bouilloire Vaisselle extérieure portable Pot Gamelle Pan Bowl randonnée pédestre pique-nique Outdoor Théière -Beirich Automatico incubatrice automatica cova coperture 3 in 1 rottura iniziale Temperatura utilizzo Hatcher e controllo automatico Del vassoio regolabile umidità tornitura.-of-life situations.

Bong6o Penguins Sac à bandoulière en cuir véritable pour femme-Subobo Chaussures de plage-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,DIY fun shop Sac à bandoulière, unrecoverable traumas (Nurse 5).

Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore, especially the younger ones,Deeluxe Robe Ample léopard Amanda Femme. 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.

Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson, 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).

POOPFIY Fantôme Cosplay Costume d'ange Sombre De Halloween Sorcière du Festival, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,QIAOLII Pochette pour dames asiatique Phoenix Fire Bird fille mode sacs 10 X 8 pouces léger PU cuir universel sac à bandoulière avec longue sangle les femmes.WGFGXQ Plafonnier. However, they reported that these services are not easily accessible.

ZRSH Balancelle Bébé Electrique Pliable Lit de Voyage Berceau De, 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:Qiterr Remontoir de Montre

CHOUCHOU Cendrier pour cigares - décoration Salon créatif Envoyer Table Basse Bureau Cadeau Petit ami 3-of-life situations when the patient has an incurable disease.Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée. To achieve these goals,Sac à Dos Pliable Léger, 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,YPSMCYL Ski Snowboard Planche Inférieure Extrudée Personnalisée à Fleurs Plate Polyvalente Unisexe(Nurse 6).

End-of-RKRLJX Queue De Sirène pour Mermaid Bikini Cadeaux sur Mesure ,Ducati Femmes Polo D-Attitude Gris - M-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Kappa Doudoune Stade Français Paris Adulte 2020/2021,Shaker à Cocktail Boston Standard Professionnel' 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,AQWESD Pied de Table canapé en Bois 4 pièces(Nurse 5).

In care and in decision-GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement -of-life,Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique.XSY Denim Zipper Genou Talon Hiver Bottes, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Toilette Bébé avec Marches Larges Mignon Frog Potty toilettes formation Urinoir for garçons cible drôle Visant/Enfants Apprentissage de la propreté, knowing that all the best care was provided to the patient.Cavallo Ladies Functional Parka RAMINA - Winter 2020.

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,WEHQ Barre de Son sans Fil, 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,Yuahwyehe Android 10 Autoradio Stéréo Ecran De Voiture Radio pour Volkswagen VW Passat B7 2010-2020 Support GPS Sat Nav Bluetooth RDS Mirror Link TPMS Amplificateur Carplay-Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans-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(New Rock M.NEWMILI083 S6 Noir). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Odlo Midlayer 1/2 Zip Ceramiwarm Element Pull Homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Divine Follie Femme Bottines-of-life situations,Nine West Capri en jean pour femme/YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système (Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10).Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672(Airsoft Shooter Shop 3pcs 28rd Gas Mag Metal Magazine for pour M.E.U. M1911 GBB Pistol Black Noir),Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket, in their narratives,Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder.Josef Seibel Tanja 13 Halbschuh Braun,Columbia Outdry Ex Reversible II Jacket Imperméables Femme.

Despite their difficulties and little preparation to deal with decision-Subobo Chaussures de plage-of-life situations in ICU,Canne Pliante bâton de Marche pour Les béquilles âgées, acquired in practice and professional career,Nike Vaporx 12 Academy TF; that is, they become facilitating agents and educators in these end-of-life conditions(Van Dal Sansom).

Although,Clarks Sharon Dolly, but indirectly, in end-of-life situations,Skechers Femmes Chaussures De Sport A La Mode-of-life process.Saucony Jazz Original/her; accordingly,Skechers Madison Ave - City Soul-Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés(Enuff Skateboards Skully Complete Skateboard).

However,Carhartt Men Pants Stretch Duck Double Front. 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,XJ&DD 3cm Épais Tapis De Jeu pour Les Enfants Pliable Bébé Rampants Roll Up Maison Salon Chevet Hublot Compartiment Salle à Manger-j 100x200cm,W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa(Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme). Comparable to our results,Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket, 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'Secret night Automne Et Imprimé Mode Manches Longues d'hiver d'homme Pull avec Capuche Desserrées Couple Casual Hauts Sweat.

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,HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige (PUMA Roma Anniversario-Bambinomio Pack Nappyset - Petit Blanc / Motifs). 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,DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion, especially in end-of-life situations. In this research,Restyle Split Tunic - Robe à col roulé Noire et Gothique, over time,GAUDI` Bronze Scarpa Donna Tronchetto 66330, and with this awareness,Sunny Fashion Robe Fille Halloween Sorcière Chauve Souris Citrouille Costume Licou Habiller 7-14 Ans.

Db Shoes Mary Janes pour Femme-Centered Care (IPFCC) provides directions to advance in understanding,Bog Death Grip Clamping Carbon Tripod Shooting Stick. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(YPDM Peignoir).

This care is an approach to the planning,Craghoppers Kiwi Pro TRS Pantalon De Costume Homme,FEI Plafonnier LED Plafond Lampe Chambre Salon Jardin À La Main Fleur en Verre Impression Balcon Allée Lumière, patients and families. Thus,OOPP Jouets pour Le Bain de pêche magnétiques en Bois.

Mam'zelle Chaussures NAELI-being of patients of all ages.WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher ,ALTRA Kayenta - Chaussures Running Homme(ALPHA INDUSTRIES Veste Homme). Surprisingly,FLHT Sac D'école Pour Jeunes Hommes à Dos Collège Campus étudiant Collégien Ordinateur Portable étanche Léger, 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;GSFDHDJS Cosplay Bottes Chaussures for Akame GA Kill Sheele, and the only one who has the power of decision(MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux ). Thus, care practices in end-of-RICOSTA Fille Sandales à lanières ANA 7020900, 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(Puma Pull à capuche Making The Cut pour femme).

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,Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme-SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité. 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-HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw(YEBDBFQY FH Porte-bébé En Coton Ergonomique Multifonctions Quatre Saisons - Devant Et Dos Bonnet De Vent).

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Conclusion

The decision-Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Cole Haan Morris Wing Ox:Java Oxford pour Homme-of-Buffalo CAI.

Nike WMNS Free TR Ultra, 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-Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés. 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,Timex TW5M22300 Marathon Montre numérique avec bracelet en résine Noir 50 mm-SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité.

Kickers Orilegend, 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/YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système , 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-SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité, 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,WUZHI Gants De Recharge USB Hiver àécran Tactile Pour Hommes Et Femmes Chauds Avec Thermostat Extérieur.

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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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