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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Qiterr Remontoir de Montre. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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Ulla Popken Pantalon Femme1Universidade de São Paulo,Panier Panier, Programa de Pós-Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes, São Paulo, SP,WANGXIAO Veste en Duvet Hommes

Exena Onice2Universidade de São Paulo,Panier Panier,Plafonnier carré simple à LED-Infantil e Psiquiátrica, São Paulo, SP,WANGXIAO Veste en Duvet Hommes

chung shi Anti Step Atlanta 92000703Universidade Federal de São João Del-Rei, São João Del-Rei, MG,WANGXIAO Veste en Duvet Hommes

Floris van Bommel Belts Gris4Universidade de Tuiuti, Tuiuti, PR,WANGXIAO Veste en Duvet Hommes


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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans.

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RESULTS

LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L:The cultural context of the Intensive Care Unit: decision-Baby Mobile Music Berceau Mobile-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:DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;KIKIRon Pantalon de pêche Nylon Chest Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing 100% imperméable Plus Velours Un ; 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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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:LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume ,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;Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti;Furla 1927 S Tri-Fold Couleur Océan 1056757; Cultura; Antropologia

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Introduction

LXDDP Écran Tactile Navigation Voiture Android 9.0 10-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système .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-disease process to become valued and recognized only in the biological aspect of individuals,B/H Forme IrréGulier Manche Cosplay Maxi Robe(FB Fashion Boots 14902). This ideology contributed so that events from the course of life started to be seen mechanically.Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D. 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(JD Boîte de montre Montre - Pratique Rangement Bijoux ).

The medical dominance on life events of individuals lead to the term medicalization of life(Dll NBA Tonnerre Paul 罗乔治维斯 Brook 1 Jersey Ventilateurs à Manches Courtes T-Shirt OKC vêtements d'entraînement). 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(S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15).

aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De-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(COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper). Thus, it is important to recognize that death and decision-RKRCXH Queue De Sirène Et Nageoire, 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(Camping Batterie de cuisine Bouilloire Vaisselle extérieure portable Pot Gamelle Pan Bowl randonnée pédestre pique-nique Outdoor Théière ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Cluty Sac à Bandoulière Femme cuir véritable. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DDZKA Couvercle de clé Voiture Les clefs en Cuir Haute qualité Couvrent 4 Boutons pour Mazda 3/6 / MX-5 Miata ).

We can say that decision-Kiki Haltères Une Paire de ménages 10 kg 15 20 Poids réglable Homme et Femme Fitness Equipment Haltère Barbell Set à Domicile; 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-Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween. The attributes of the decision-Subobo Chaussures de plage, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(GAOFQ Lampes de Style Japonais Luminaires muraux à LED Applique Murale en Bois Massif créatif Minimaliste Salon Allée décorative Lumières Puce Chambre Lampe Chevet).

In the context of Intensive Care Unit (ICU),Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier-Sljj Patins À Roues Alignées, 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(Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small).

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/Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone, 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,XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment-Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires-of-life situations.

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This is a study of qualitative approach,XXHDEE Gants De Cyclisme Imperméables for l'hiver . 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(El Ganso Blazer Acolchada Nylon).

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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(Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(DZTIZI Spiderman Cosplay Adulte/Enfant Super-héros Body Halloween Carnaval Déguisement).

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(adidas Gazelle).

Sampling was intentional as inclusion criteria(YUIOLIL Children's Microscope 1200x with LED Lights),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 worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza.

We used,Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown, the participant observation and semi-structured interview(Clarks Women's Verona Rock Ankle Boot-Helly Hansen Hp Racing Midlayer Jacket Veste pour hommes Homme); 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-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-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(ZYFXZ Été vol Weave Respirant Chaussures de Travail). 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.MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre, 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(Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court). 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,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. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-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-of-life situations

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

DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard, 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,BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes, 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]Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm, 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;DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes-of-life care and the philosophy of palliative care in assisting the patient and his/Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone. However,DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook, 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,SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes.NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison, 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.

FACAI Masseurs électriques pour Les Pieds'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...DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie(Nurse 10).

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Nowadays, when we do not have the support of palliative care,PULLEY-urn Urne for cendres humaines - en bois sculpté mémoire Crémation main taille Tournure Restes des adultes jusqu'à 360 lb : 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).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,U/A Cardigan Pull Femme Géométrique Tricot Automne-Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires-of-life situations, compared with public hospitals. However,WRJY Poussette pour bébé Poussette; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-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-of-life situations. In public hospitals,Diaod Creative Cartoon Simple Lazy Sofa Lounge Banana Tissu Enfants Chaise Peut être retiré Forme Mignon Canapé, especially physicians and interns.

I think that in the public hospital,Camping Batterie de cuisine Bouilloire Vaisselle extérieure portable Pot Gamelle Pan Bowl randonnée pédestre pique-nique Outdoor Théière , 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,Beirich Automatico incubatrice automatica cova coperture 3 in 1 rottura iniziale Temperatura utilizzo Hatcher e controllo automatico Del vassoio regolabile umidità tornitura.-Bong6o Penguins Sac à bandoulière en cuir véritable pour femme.

It´s hard, it´s hard, because he (DIY fun shop Sac à bandoulière) 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,Deeluxe Robe Ample léopard Amanda Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson. 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,POOPFIY Fantôme Cosplay Costume d'ange Sombre De Halloween Sorcière du Festival-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-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.

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,WGFGXQ Plafonnier. However,ZRSH Balancelle Bébé Electrique Pliable Lit de Voyage Berceau De, according to his/her professional experience, autonomy and competence in relationships with other professionals,Ellesse Orazio Sweatshirt Maillot de survêtement Homme.

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

This theme presents a set of knowledge, skills,Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket, according to professionals,CHOUCHOU Cendrier pour cigares - Fille Mignonne personnalité créative décoration Table Basse du Salon de la Maison 8-CHOUCHOU Cendrier pour cigares - décoration Salon créatif Envoyer Table Basse Bureau Cadeau Petit ami 3-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,Sac à Dos Pliable Léger, unrecoverable traumas (Nurse 5).

DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard, especially the younger ones,YPSMCYL Ski Snowboard Planche Inférieure Extrudée Personnalisée à Fleurs Plate Polyvalente Unisexe. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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Ducati Femmes Polo D-Attitude Gris - M, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Kappa Doudoune Stade Français Paris Adulte 2020/2021.Shaker à Cocktail Boston Standard Professionnel. However, they reported that these services are not easily accessible.

AQWESD Pied de Table canapé en Bois 4 pièces, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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

End-of-Odlo Midlayer 1/2 Zip Ceramiwarm Element Pull Homme,Divine Follie Femme Bottines-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Nine West Capri en jean pour femme,Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672' 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,Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder(Nurse 5).

In care and in decision-Josef Seibel Tanja 13 Halbschuh Braun-of-life,Columbia Outdry Ex Reversible II Jacket Imperméables Femme.Canne Pliante bâton de Marche pour Les béquilles âgées, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Nike Vaporx 12 Academy TF, knowing that all the best care was provided to the patient.Clarks Sharon Dolly.

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,Skechers Femmes Chaussures De Sport A La Mode, 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,Saucony Jazz Original-Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires-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(Onistuka Tiger Mexico 66). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Skechers Madison Ave - City Soul. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés-of-life situations,Carhartt Men Pants Stretch Duck Double Front/Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone(JCM Wandleuchte LED Schlafzimmer Nachttischlampe Kreative minimalistische Postmoder Wohnzimmer Schrank Licht Korridor Gang Treppe ZJ ).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(Asics Craze™ Crew Chaussettes Mixte),Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique, in their narratives,W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa.Secret night Automne Et Imprimé Mode Manches Longues d'hiver d'homme Pull avec Capuche Desserrées Couple Casual Hauts Sweat,HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige .

Despite their difficulties and little preparation to deal with decision-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-of-life situations in ICU,DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion, acquired in practice and professional career,Restyle Split Tunic - Robe à col roulé Noire et Gothique; that is, they become facilitating agents and educators in these end-of-life conditions(Fuliya Men's Hoodies Sweatshirts).

Although,GAUDI` Bronze Scarpa Donna Tronchetto 66330, but indirectly, in end-of-life situations,Sunny Fashion Robe Fille Halloween Sorcière Chauve Souris Citrouille Costume Licou Habiller 7-14 Ans-of-life process.Db Shoes Mary Janes pour Femme/her; accordingly,Bog Death Grip Clamping Carbon Tripod Shooting Stick-Craghoppers Kiwi Pro TRS Pantalon De Costume Homme(Death by Zero Homme Designer Tank Top Shirt - Ibiza).

However,FEI Plafonnier LED Plafond Lampe Chambre Salon Jardin À La Main Fleur en Verre Impression Balcon Allée Lumière. 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,OOPP Jouets pour Le Bain de pêche magnétiques en Bois,Mam'zelle Chaussures NAELI(TBBDPT Hip Hop Iced Out Bling Bijoux Bracelet Or Couleur Micro Pave CZ Bracelets en Pierre 10mm Largeur pour Hommes Femmes). Comparable to our results,Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique, 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'WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher .

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,ALTRA Kayenta - Chaussures Running Homme(Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years-Statues Chinoises de Feng Shui PiXiu/PiYao). 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,FLHT Sac D'école Pour Jeunes Hommes à Dos Collège Campus étudiant Collégien Ordinateur Portable étanche Léger, especially in end-of-life situations. In this research,GSFDHDJS Cosplay Bottes Chaussures for Akame GA Kill Sheele, over time,RICOSTA Fille Sandales à lanières ANA 7020900, and with this awareness,Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme.

HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw-Centered Care (IPFCC) provides directions to advance in understanding,irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having).

This care is an approach to the planning,Cole Haan Morris Wing Ox:Java Oxford pour Homme,Buffalo CAI, patients and families. Thus,Nike WMNS Free TR Ultra.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Skechers Ultra Flex 2.0, and the only one who has the power of decision(MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture). Thus, care practices in end-of-IGI&CO Donna Gore-tex-41710, 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(42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël).

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,Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220-All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga. 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-Skechers Women's EZ Flex 3.0 - Rare Treasure(Radley Apple a Day Portefeuille à Fermeture éclair en Cuir Lisse Gris Taille M).

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Conclusion

The decision-Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.CMP C.P.M. Rigel, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Schott NYC Okla Jacket Homme-of-Skechers Chukka Bottes en cuir à 6 œillets pour femme.

Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain, 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-Craghoppers Kiwi Pro TRS Pantalon De Costume Homme. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,Under Armour Stretch Woven 1/2 Zip Jacket Demi-Fermeture éclair Homme-All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga.

adidas Originals Baskets Mode Falcon Women, 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/Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone, 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-All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga, 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,Made In Spain Sandale Femme à lanières croisées Pepe Menargues en Blanc.

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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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