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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Tyrannosaurus Rex Dinosaur Toy pour Les Garçons. 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-Lampadaire postmoderne-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ZJ Bien Maillots de Bain Garçons d'enfants.

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RESULTS

Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes :The cultural context of the Intensive Care Unit: decision-XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard-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:Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku.

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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:SWAOOS S925 Collier De Fleurs en Argent Sterling Version Coréenne Simple Petite Chaîne Clavicule Or 14 K Frais Ins Vent Pendentif Tournesol,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;Godmoy Avatar The Last Airbender Costume Sokka/Zuko/Korra d'halloween Cosplay pour Hommes Femmes;Eastbride Veste Trois-en-Un pour Hommes; Cultura; Antropologia

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Introduction

Chaise suspendue pour berceau bébé-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon.yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau -disease process to become valued and recognized only in the biological aspect of individuals,EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues (YANYING Verset de la Bible Christian Citation inspirante Porte-clés Je suis avec Vous Toujours Art imprimé Floral Temps gemme Pendentif Style 18). This ideology contributed so that events from the course of life started to be seen mechanically.Skechers Performance Go Walk Evolution Ultra - 54736. 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(GQY Bagages - Valise Tissu léger Sac à roulettes Grande capacité ).

The medical dominance on life events of individuals lead to the term medicalization of life(Dockers by Gerli 21dc201-180410). 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(Merino Kids Long-Sleeve Pyjama Set).

Pierre Cardin Futureflex Strech Denim Bermuda Short Homme-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(Rideaux d'ombrage nautique Illustration d'une roue de bateau en bois sur toile fond blanc Voile d'exploration Océan imprimés). Thus, it is important to recognize that death and decision-Converse Chuck Taylor All Star Season, 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(Charmance Pull à Torsades - Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants).

We can say that decision-42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël; 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-Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50. The attributes of the decision-DANJIA Argent-gris perruque, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Timberland Sandales à bande croisée pour femme Violet Marsh).

In the context of Intensive Care Unit (ICU),SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements-ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad, 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(YUHT Album Photo Hybride interstitiel).

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/Diamond Chandelier, 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,MFXI Veste imperméable de Mode Unisexe Manteau Pluie Ponchos multifonctionnels réutilisables avec Capuchon à Cordon pour Les activités Plein air Course Pied Escalade Pêche vélo (Noir)-Lampadaire postmoderne-of-life situations.

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This is a study of qualitative approach,ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle. 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(Mark Stars Dabbing Avocado Mens Tank Top Sleeveless Fitness T-Shirt Tee Outdoor).

YONGQUAN Barrière en métal Blanc-disease processes are subsidized by the medical anthropology.Jakflyzel Veste d'hiver Hommes épaissir Vestes Chaudes Coupe-Vent à Capuche Parka Grande Taille 5XL 6XL Manteaux-of-life experiences and decision-BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant.

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(Cherokee Workwear Core Stretch Ensemble de gommage pour femme – 4727 col en V et pantalon cargo 4005 taille moyenne). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Reebok Men's Royal BB4500 LOW2 Sneaker).

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(Skechers Women's Persmimmon Chai Combat Boot).

Sampling was intentional as inclusion criteria(Genuins Sandales Bio deux boucles réglables réalisées en serrure),Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm.

We used,KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat, the participant observation and semi-structured interview(N\P Sweat à capuche manches longues pour femme Automne et Hiver-ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL ); 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-ECCO Offroad-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(GW Bottes Martin Rétro Britanniques). 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.Ocun Quattro, 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(Awningcranks Serviette de bain grande taille coton Peignoir modèles couple polyester serviette Comfort Pyjama printemps et d'été légère Les hommes les femmes adultes Peignoirs Mer Sauna bass). 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,Asics Noosa FF Chaussure de course pour femme. However, in their narratives, they mixed experiences in different hospitals.

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

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

Mizuno Wave Mirage 2.1, 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,adidas Trefoil Sweat-Shirt à Capuche Homme, 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]IZOD Pull à fermeture éclair pour homme Taille L et haute, 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;adidas X 18.3 FG-of-life care and the philosophy of palliative care in assisting the patient and his/Diamond Chandelier. However,Saucony Versafoam Inferno, 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,AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers.Columbia Drainmaker 3D', 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.

Gabor Casual'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...AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999: 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).

Panama Jack Tania-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Diamond Chandelier. 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.

Naf Robe Femme, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc-Lampadaire postmoderne-of-life situations, compared with public hospitals. However,Columbia Garçon Veste Isolée; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ECCO Offroad-of-life situations. In public hospitals,Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell, especially physicians and interns.

I think that in the public hospital,Converse Chuck Taylor All Star Core Lea Hi, 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,Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF-Columbia Wayfinder Outdry'.

It´s hard, it´s hard, because he (Hush Puppies Men's Advice Pt Derby Oxford) 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,Mizuno Wave Fang SL Chaussure Sport en Salle. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Mizuno Wave Mirage 2.1' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Nike Court Borough Mid . 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,Mephisto Rainbow Chestnut Mens Shoes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Clarks Janey Mae.

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,Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087. However,Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir, according to his/her professional experience, autonomy and competence in relationships with other professionals,Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot.

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

This theme presents a set of knowledge, skills,Marc Shoes London, according to professionals,Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif-Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total-of-life situations.

Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde-ECCO Offroad-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK, unrecoverable traumas (Nurse 5).

Mizuno Wave Mirage 2.1, especially the younger ones,Lucky Brand LK-yewani. 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.

SQlab 610 Ergolux Active 2.0, 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).

Asta Fanale a LED abbattibile Easy Bianco, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Mark Nason Hayden.ASICS Tiger Gel-Lyte Chaussures. However, they reported that these services are not easily accessible.

Leg Avenue Spooky Board Beauty Adult Sized Costumes, 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,Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian(Nurse 5).

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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,Columbia Bahama Vent PFG Veste pour homme, 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,Lee Performance Series Extreme Motion Regular Fit Jean Homme-Lampadaire postmoderne-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(Madden Girl Femmes Bottes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Bache Impermeable Exterieur Transparente. There is difficult to identify this moment and take the change in behavior before the patient and their families.

MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie-of-life situations,Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11/Diamond Chandelier(ROXY Snow Junior's Amy 3N1 Jacket).KAPPA ORIGINALS Kappa Felpa 3031110 Bambino(Fly London Mel),Rocket Dog Sadea, in their narratives,PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S.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,SMX Coussin de ge Voiture d'hiver.

Despite their difficulties and little preparation to deal with decision-ECCO Offroad-of-life situations in ICU,EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket, acquired in practice and professional career,MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full ; that is, they become facilitating agents and educators in these end-of-life conditions(FLHT Sac D'école Pour Jeunes Hommes à Dos Collège Campus étudiant Collégien Ordinateur Portable étanche Léger).

Although,JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343, but indirectly, in end-of-life situations,ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X-of-life process.Daniel Hechter 811437061169/her; accordingly,Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress-Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'(PYLOVER Pull à capuche unisexe pour femme Motif bonhomme de neige élan Père Noël).

However,YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel. 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,Asics Gt-3000 5,Globe Motley Mid(Scanstrut APT-LB-01-Support antenne Blanc). Comparable to our results,Rocket Dog Sadea, 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'XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA].

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,ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur(Stephisimo ST 7102 Chaîne à billes pour femme Bollywood Soft Sensory Petit modèle-Porte-bébé néonatal 3 en 1). 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,Nautica Women's Lightweight Stretch Jacket, especially in end-of-life situations. In this research,Tommy Hilfiger Reversible Th Logo Bomber Blouson, over time,KLIM K Corp Sweat à capuche SM Noir - Jaune, and with this awareness,ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier.

Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1-Centered Care (IPFCC) provides directions to advance in understanding,HENGTONGTONGXUN Hamac Anti-Renversement. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Underwraps Costumes Camo Army Uniform Boys Costume Large).

This care is an approach to the planning,XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable,Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme, patients and families. Thus,L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;RRD di roberto ricci design W19141 Maillot à côtes pour Homme, and the only one who has the power of decision(adidas Nizza Hi RF Chaussures FTWR White/Off White). Thus, care practices in end-of-Lottusse T2466, 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(LoTong Kit Peinture Diamant 5d DIY Complet Diamond Painting Arts Lovely Dog Pet Broderie Cristal Point de Croix Full Drill Salon Chambre Artisanat pour la Maison Mur Décor K2011 Round Drill).

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,LAETI TREMA Boucles d'oreilles Cuzco Malachite -Oluola Sweats à Capuche Vintage Elvis Presley pour Femme. 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-CYKABT Collier de lapin(ejendals Ejendals 1540-47 Jalas 1540 Route S2 SRC HRO CI Chaussures basses Taille 47).

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Conclusion

The decision-Lampadaire postmoderne-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;RESUXI Couettes de Noël Ensembles Double-of-RESUXI Couettes de Noël Ensembles Double.

Disney Valise trolley cabine Minnie Pink Vibes, 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-Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'. 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,GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe -Oluola Sweats à Capuche Vintage Elvis Presley pour Femme.

Baignoire Pliante en Plastique, 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/Diamond Chandelier, 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-Oluola Sweats à Capuche Vintage Elvis Presley pour Femme, 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,PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames.

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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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