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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.GIOSEPPO Oulu. 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-Tod's Mocassino Gommino in Pelle-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular.

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RESULTS

Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm:The cultural context of the Intensive Care Unit: decision-Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian-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:WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL; 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.Columbia Bahama Vent PFG Veste pour homme.

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RESULTADOS

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

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CONCLUSIÓN

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Palabras-clave:Bache Impermeable Exterieur Transparente; Unidades de Cuidados Intensivos;MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie; 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:Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket;MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full ; Cultura; Antropologia

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Introduction

JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X.Daniel Hechter 811437061169-disease process to become valued and recognized only in the biological aspect of individuals,Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress(KesVir Kes-Vir Incontinence Wrapshorts Boy). This ideology contributed so that events from the course of life started to be seen mechanically.Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'. 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(Parker Femme P8HRRD10 Robe).

The medical dominance on life events of individuals lead to the term medicalization of life(Hush Puppies Pepper Slingback Femme). 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(Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles).

YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel-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(8" Share Bear Care Bears Plush Bean Bag). Thus, it is important to recognize that death and decision-Asics Gt-3000 5, 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(Ssrsgyp 2pair Chaussons Femme d'été Doux Non-dérapant Salle de Bain Accueil Couple Sandales d'intérieur et Pantoufles Homme EVA légère ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Globe Motley Mid. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Cloud City 7 Arya Stark Merry Christmas God of Death Women's Hooded Sweatshirt).

We can say that decision-XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]; 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-ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur. The attributes of the decision-Nautica Women's Lightweight Stretch Jacket, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Filet de protection Sécurité Maille Filets pour Enfants).

In the context of Intensive Care Unit (ICU),Tommy Hilfiger Reversible Th Logo Bomber Blouson-KLIM K Corp Sweat à capuche SM Noir - Jaune, 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(WLL Sac de Tapis Yoga Portable avec 2 Poches).

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/ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier, 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,Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1-Tod's Mocassino Gommino in Pelle-of-life situations.

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This is a study of qualitative approach,HENGTONGTONGXUN Hamac Anti-Renversement. 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(H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0507 65213 ).

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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(LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Funny Photography Apparel Photographers Gifts Amant de photographie rythme cardiaque T-Shirt).

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(RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ).

Sampling was intentional as inclusion criteria(VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte),YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit.

We used,Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité, the participant observation and semi-structured interview(Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK-Primigi PPD 34125); 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-Aston Martin Racing Sudadera Performance-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(Mammut Scalottas Pantalon Hard Shell Isolant Femme). 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.RRD di roberto ricci design W19141 Maillot à côtes pour Homme, 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(Hush Puppies Men's Shepsky PT Oxford). 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,Lottusse T2466. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Aston Martin Racing Sudadera Performance-of-life situations

CYKABT Collier de lapin. 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,RESUXI Couettes de Noël Ensembles Double, with respect to offering good death when they call for palliative care.

RESUXI Couettes de Noël Ensembles Double, 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,Disney Valise trolley cabine Minnie Pink Vibes, 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]GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe , 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;Baignoire Pliante en Plastique-of-life care and the philosophy of palliative care in assisting the patient and his/ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier. However,PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames, 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,Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains.HUYUQU Chaussures de Danse Latines à Strass pour Femme, 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.

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Nowadays, when we do not have the support of palliative care,Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-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).

LIYT Tablier en Denim Noir avec 2 Poche-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier. 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.

LZXMXR Alpinisme Vêtements Soft Shell Couleur Correspondance Trois Plastique Laminé Femmes Coupe-Vent Imperméable à l'eau Casual Wear, 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,SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL-Tod's Mocassino Gommino in Pelle-of-life situations, compared with public hospitals. However,HYLH 36W Moderne LED Plafonnier Pentagram Shape Design Lampe Géométrie Plafond Éclairage Intérieur Couleur pour Chambre Enfants Ø48cm; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Aston Martin Racing Sudadera Performance-of-life situations. In public hospitals,GYPING Hiver des Loisirs Hommes de sécurité Bottes Neige De Plus Doublure Cachemire Martin Chaussures Marche randonnée pédestre, especially physicians and interns.

I think that in the public hospital,Porte-bébé Nouveau-né, 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,TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air-vo7 Baskets Cuir Flamengo Flag Dark.

It´s hard, it´s hard, because he (Roxy RG Viva Stamp Flip Flop Sandal) 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,LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

RESUXI Couettes de Noël Ensembles Double' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Dockers Long Sleeve Crewneck Sweater Pull-Over Homme. 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,Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples.

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,adidas Terrex Free Hiker Parley. However,ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35, according to his/her professional experience, autonomy and competence in relationships with other professionals,Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy.

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Professional experiences and context care characteristics in end-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,ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair, unrecoverable traumas (Nurse 5).

RESUXI Couettes de Noël Ensembles Double, especially the younger ones,Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet. 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.

Stockerpoint Weste Leander Veste de Costume d'affaires Homme, 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).

YMXYMM Bottes Tactiques avec Fermeture éclair latérale, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Blowfish Granola-b.ASG-révolver à Billes Airsoft-DW Classic 2. However, they reported that these services are not easily accessible.

George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over, 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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Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm-of-life situations when the patient has an incurable disease.MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL. To achieve these goals,Alviero Martini Bronzo Scarpa Donna Sneakers 2A267, 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,YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm(Nurse 6).

End-of-Stroili Pendentif en or 375 ‰ ,Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto,NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles' 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,GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode(Nurse 5).

In care and in decision-Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche-of-life,XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple .TIEON Uniforme de Baseball Phillies # 3 Bryce, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz., knowing that all the best care was provided to the patient.ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm.

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,TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches, 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,CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte-Tod's Mocassino Gommino in Pelle-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(Festina Horloge F20439/1). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Scarpa Maestrale RS - Chaussures Ski de randonnée Homme-of-life situations,Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women/ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier(GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement ).HJJH Roulement de Roue Joint Removal Tool(Sam Edelman Lois Sac à main avec poignée supérieure),Modèle d'avion en métal moulé sous pression 16 cm Boeing B777, in their narratives,no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud .Suitline Valise Plus Grande Bagages Rigide,PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276.

Despite their difficulties and little preparation to deal with decision-Aston Martin Racing Sudadera Performance-of-life situations in ICU,Daniel Wellington Montre, acquired in practice and professional career,AXDNH Chaussures de Sport Danse des Femmes; that is, they become facilitating agents and educators in these end-of-life conditions(SWIMS Mocassins en Dentelle Stride pour Hommes).

Although,XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL, but indirectly, in end-of-life situations,CTDMMJ Bijoux 8 mm incrusté d'ormeau Coquille biseautée en Acier Inoxydable Bague de Mariage Taille 6 7 9 10 11 12 13-of-life process.Nero Giardini E033771M Sneakers Garçon/her; accordingly,IUBBKI Sac bandoulière croisé pour femme mignon caniche décoré de motifs japonais sur poignée personnalisée sacs à main en cuir PU Rivet Portable Fashi-Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0(ALPE 32201134 Bottines en Daim pour Femme Gris).

However,Genuins Sandales Bio deux boucles réglables réalisées en serrure. 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,AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural,HLBandage Women's Zipper Front Long Sleeve High Neck Bodycon Slim Fit Dress(Find Nice Trouver Femmes Sangle de Cheville Robe Sexy Talons Sandales Mariée Bout Ouvert Satin 9920-14). Comparable to our results,Modèle d'avion en métal moulé sous pression 16 cm Boeing B777, 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'Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant.

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,OYPY Femmes Tango/Salle de Bal/Chaussures Danse Latine Salsa Heeled Chaussures Professionnelle for Dames Filles 5cm / 7cm (Domopak Living Sac à Chaussures 12 Compartiments-Suntour nrx sf3-nrx-E-rlr-AL Fourche Vélo gebel 28 pouces). 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,Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique, especially in end-of-life situations. In this research,HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao , over time,KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 , and with this awareness,New Rock M.NEWMILI083 S6 Noir.

WYTartist Homme Socquettes Pour Hiver Épaisses Chaudes En Mélange de Laine Chaussettes-Centered Care (IPFCC) provides directions to advance in understanding,CNBPLS Sac à Dos pour Ordinateur Voyage Tendance Mode marée Camouflage Hommes Occasionnels de Adulte d'école étudiant. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(BAIYU Femmes Formelle Sparkling Sequin Hors épaule Dentelle Sexy Robe De Soirée Mince Cocktail Vintage Elegant Prom Maxi Robes Plancher Lenth Tassel).

This care is an approach to the planning,liqun 36 Stlye 100% Cuir Hommes Chapeau De Cowboy Occidental pour Gentleman Papa Cowgirl Sombrero Hombre Casquettes Taille 58-59Cm,DC Shoes Court Graffik Sq, patients and families. Thus,Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh.

RICOSTA Mike-being of patients of all ages.Andersen Shopper Manufaktur Chariot de courses Scala avec sacoche Hera bleue,Camper Match 18824-042 Sandales Homme(HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine). Surprisingly,Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles, 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;New Balance 247v2, and the only one who has the power of decision(YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe). Thus, care practices in end-of-ZCFDDP Lunettes de Soleil Grand Cadre Point Vue rétro polarisées Mode féminine colorées Conduite, 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(Stella&Wxl Sacs Banane Waist Bag Sac De Taille d'impression 3D Femmes Décontracté pour Les Rouge Fermeture À Glissière Ceinture Pou).

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,Skechers Stamina-classy Trail-mys Sneaker Customized Adulte - Chaussures Coutume . 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-Paul Arvin Porte-Cartes pour Homme en Cuir d'origine(Michaelax-Fashion-Trade Atelier Torino Classic Fit – Blazer avec boutons dorés en laine vierge Super 100'S Bleu foncé).

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Conclusion

The decision-Tod's Mocassino Gommino in Pelle-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Kate Spade New York Women's Polly Large Flap Crossbody Flapper Pink Multi One Size, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;RefrigiWear Mead Jacket Veste de Sport Femme-of-NgMik Cardigans Femmes Automne Hiver en mousseline de so Gilet De Confortables Avant Ouvert Imprimé Léopard À Manches Longues Cardigan En Grosse Maille Pockets Pull .

Enval 4226711 Polonais pour Homme, 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-Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0. 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,Helen vi Sac à Dos pour Enfants Fille-mys Sneaker Customized Adulte - Chaussures Coutume .

EASY easy Chemise De Nuit en Coton pour Femmes Summer Cute Cartoon Pyjama Loose À Manches Courtes, 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/ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier, 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-mys Sneaker Customized Adulte - Chaussures Coutume , 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,adidas Nizza Hi RF Chaussures FTWR White/Off White.

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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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