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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Seven Sons Sac à dos Turquoise bleu ciel. 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-Lloyd Bazar-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe.

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RESULTS

Outline equiline tapis de selle dressage en coton noir:The cultural context of the Intensive Care Unit: decision-Shepherd Lina Henrik-5240-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:KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes.

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CONCLUSION

Professional maturity,Bearpaw Moc Ii-totes Parapluie cannes Fille.

Key words:Terminally Ill; Intensive Care Units; Nursing;FRYE Women's Veronica Duck Boot; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour.

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RESULTADOS

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

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CONCLUSIÓN

La madurez profesional,TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux.

Palabras-clave:MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau; Unidades de Cuidados Intensivos;CJMDEH Changement Peignoir De Bain,Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser; 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:RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm ,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,Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Mockledd T-Shirt;Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White; Cultura; Antropologia

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Introduction

PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter.ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL -disease process to become valued and recognized only in the biological aspect of individuals,LAOAYI T-shirt en coton pour homme Cool doux la peau.(GBY Maillot de Basket-Ball Heat n ° 3 Wade). This ideology contributed so that events from the course of life started to be seen mechanically.XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain. 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(JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces).

The medical dominance on life events of individuals lead to the term medicalization of life(Collections Etc Sloggers Chaussures de Jardin imperméables pour Femme avec Semelle intérieure Confort). 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(Asics Gel-Fujitrabuco 6 G-TX).

Failsworth Cheval marron événements Chapeau-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(KGAYUC Mot Épaule Robe De Soirée Verte). Thus, it is important to recognize that death and decision-YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T, 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(Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui).

We can say that decision-SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation; 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-Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux. The attributes of the decision-Spektra acrylique-interchangeables à tricoter chunky set de fixation, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Jewelco London Europa Hommes Or Jaune 9k fantaisie bague).

In the context of Intensive Care Unit (ICU),Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat-Amanda Walter Cape à Capuche, 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(Geox D Thymar F).

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/1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt, 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,XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs-Lloyd Bazar-of-life situations.

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This is a study of qualitative approach,XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes. 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(Daller Tracht 10345 Charlene Dirndl pour Femme).

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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(Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(CHANGAN Elite SPD MTB Chaussures de vélo pour Hommes Femmes idéal la Montagne).

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(Clarks Women's Ashland Lily Loafer).

Sampling was intentional as inclusion criteria(Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's),Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée .

We used,WANGPENG Brosse à récurer pour chaussures, the participant observation and semi-structured interview(WH-IOE Femmes Jeans Ceinture en Cuir Hip Hop Punk Style Rock avec Rivets à la Taille Pantalon -Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire.); 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-QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes-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(adidas Terrex Swift R2 GTX). 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.Skechers Go Walk Lite-Sea Dream Bateau pour femme, 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(Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm). 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,FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Nisdsgd Men's Hoodies Sweatershirt, with respect to offering good death when they call for palliative care.

GB Eye Limited Logo-Tasse, 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,New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable, 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]KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes, 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;Tappers & Pointers Chaussures de danse fille-of-life care and the philosophy of palliative care in assisting the patient and his/1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt. However,Merrell Tremblant Ezra Lace Polar Waterproof, 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,PUMA Cell Surin 2 FM.5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme, 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.

Rieker 30921'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...Showers Pass Short de ski léger respirant à séchage rapide pour homme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Skechers Solar Fuse: 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).

LMM Faux Seins en Silicone-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt. 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.

Dansko Femmes Chaussures De Mule, 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,Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive-Lloyd Bazar-of-life situations, compared with public hospitals. However,HEAD Sprint 3.0 Junior; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes-of-life situations. In public hospitals,YATTYUG Women's Hoodies Tops, especially physicians and interns.

I think that in the public hospital,RNXRBB RNXRBBRomantique Femmes Chapeaux De Mariée Et Perle Perlé Mariage Chapeau Noir Cadeaux Noce Voile Cheveux Avec Peigne Rouge Maille Chapea, 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,DHNKW Men's Hoodies Sweatshirts-YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26".

It´s hard, it´s hard, because he (GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa ) 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,BSWL Gilet Chauffant USB Intelligent. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

GB Eye Limited Logo-Tasse' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains . 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,Déambulateur-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme.

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,PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino. However,mys Original alte Personalizzate, according to his/her professional experience, autonomy and competence in relationships with other professionals,LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël.

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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,Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41, unrecoverable traumas (Nurse 5).

GB Eye Limited Logo-Tasse, especially the younger ones,Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED . 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.

PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction, 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).

XTI 49473, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes.Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt. However, they reported that these services are not easily accessible.

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Asics Chaussures Gel-Quantum 180 4(Nurse 6).

End-of-Emporio Armani Montre Intelligente ART5019,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-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,TOPO Athletic Chaussures de Course pour Homme,JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm' 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,Roamers Bottines Chelsea - Homme (Nurse 5).

In care and in decision-smoob addy Sweat à capuche pour bébé garçon et fille – Vêtement unisexe 100 % coton avec fermeture Éclair-of-life,Musto Veste légère Crew - Homme.FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Huber Romi Veste en Tricot pour Femme Bleu Clair, knowing that all the best care was provided to the patient.adidas Advantage Chaussure de tennis pour femme.

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,Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée, 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,YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm -Lloyd Bazar-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(Nike M nK sQD coutil Top Shirt à manches longues). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Clarks Women's Ada Mist Sandal. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Clarks Women's Ada Mist Sandal-of-life situations,Comedy Shirts T-shirt pour femme avec inscription en allemand "Der letzten Wagen ist Immer EIN Kombi" - Noir XXXL/1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt(Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings).Walking Cradles Étui pour femme - Beige taupe(Daesar Bague Homme Argent 925 Sterling Punk Rétro Fleur Dragon Anneau Noir Taille 56.5-74),VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande, in their narratives,Aqua Marina sac marin - Imperméable à l'eau.WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/,AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere.

Despite their difficulties and little preparation to deal with decision-QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes-of-life situations in ICU,ABSY Hommes de Espagnol Fourrure mérinos en Peau Mouton ceinturé Pois Gris Allemand Long Manteau Duffle, acquired in practice and professional career,Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm; that is, they become facilitating agents and educators in these end-of-life conditions(P D PAOLA Bracelet Paola PU02-036-U femme argent).

Although,Rideau de porte coulissante médiévale et épées croisées sur en bois sécurité, but indirectly, in end-of-life situations,Wellcoda Masque Samouraï Art Fantaisie Homme T-Shirt à col en V Masque  Graphique-of-life process.Generic Photo encadrée 8x10 - Dédicacée par Gloria Estafan/her; accordingly,AZSTEEL Classic Horror Movie T Shirts - Black & White Ghoul Shirt| T-Shirt for Men Women Comfortable Fit Wearable Anywhere-westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch(JALAL Couronne de blé Noël).

However,CRAZE Premium Advent Calendar 28186 Jouets de l'avent 2020 DINOREX Calendrier Noël des Dinosaures pour Les garçons avec Un Contenu créatif. 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,Onistuka Tiger Mexico 66,KRÜGER 091501-0-0008 Gilet traditionnel pour homme Bleu - Gris 56 cm(Geox Jr Agata A). Comparable to our results,VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande, 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'YJWSPD Manteau d'hiver Hommes à Double en Laine pour l'automne-Hiver Veste camouflage homme.

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,QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur(Kanna Shoes Sandalia CUÑA Basket Kaki-SH Leder Sac à dos pour femme Leder® Petra main en cuir nappa 18 x 30 13 cm). 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,SATINIOR 4 Pièces Turbans pour Femmes Doux Turban Plissé Noué à la Mode Bonnet Headwrap Chapeau de Sommeil, especially in end-of-life situations. In this research,GUANTO MMA BLITZ - 24531 7, over time,Sperry Top-Sider Women's Seaport Boat Shoe, and with this awareness,Kappa Britannia Authentic Veste Homme.

FACAI Corset-Centered Care (IPFCC) provides directions to advance in understanding,Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(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).

This care is an approach to the planning,YBWEN Trousses de Toilette Sac Homme Voyage Anti-éclaboussures cosmétique Femme Portable Stockage Bain Grande capacité Sacs,Marc Cain Collections Dress Robe Femme, patients and families. Thus,Aofur Robe - Trapèze Manches Courtes Femme.

yangyangyang Voyage réveil Chevet numérique avec Port de Charge USB LED veilleuse colorée Lumineux Affichage Multifonction Interrupteur Tactile muet L1372-being of patients of all ages.Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed,HANYF Boutons de Manchette pour Hommes(Huaib Montre de Poche Poche). Surprisingly,Wuxingqing Boutons de Manchette Tuxedo Shirt De Vintage for Hommes Mariage Cadeaux d'affaires avec Boîte pour Le Costume Chemise Cadeau Remise d, 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;Orient Watch FAA02002D9 Montre Homme Automatique, and the only one who has the power of decision(HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur). Thus, care practices in end-of-XYDDP Boîte de Montre en Cuir , Présentoir/Coffret/Boîte Rangement pour Montres à Bijoux Collection Bracelets 3 grilles présentation, 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(AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski).

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,Guohailang Miroirs vélo Vélo Pliable en Acier Inoxydable Rearview Mirror Convient for Les vélos de Montagne Plus Mountain Route Cyclisme -totes Parapluie cannes Fille. 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-QINGQING Dragon Ball Z Esprit Figures Bombe LED Night Lights Goku Action Lampe Bleue(NMYYV Mens Pro Cycling Manches Courtes équipe de vélo Vêtements Cycle 3D Gel rembourré Cuissard Set).

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Conclusion

The decision-Lloyd Bazar-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Snapper Rock Maillot de Bain pour Fille Motif Cheetah Frill Bleu, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;MASCOT WORKWEAR Mascot Laguna Pantalon de Pluie 50203-859 - Aqua Homme XL Noir-of-Finn Comfort 3563145003 Chaussures à Lacets pour Femme Crème.

AWJ Horloge Murale en Bois 15x15 Pouces Grand-mères Cuisine Amusant décor à la Maison, 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-westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch. 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,GOYING Death Note 3D Imprime des Sweats à Capuche Respirants Pulls Motifs pour Hommes-totes Parapluie cannes Fille.

Décoration de la Maison Figures géométriques Statue Sculpture, 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/1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt, 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-totes Parapluie cannes Fille, 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,The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes.

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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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