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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Montane Dyno Stretch Outdoor Short. 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-RCBS Neck Die Set-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Art Bergen.

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RESULTS

HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut:The cultural context of the Intensive Care Unit: decision-Regents View Pantalon de Pluie - Homme-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:Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU.

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CONCLUSION

Professional maturity,TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam.

Key words:Terminally Ill; Intensive Care Units; Nursing;Zsport Zbra Silver Soutien-Gorge de Sport 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.Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse.

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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,adidas F10 Turf.

Palabras-clave:Fly London Salv; Unidades de Cuidados Intensivos;Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats; 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:JABSCO ITT INDUSTRIES WC Elect. STD 24V,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;U.S. POLO ASSN. Men's Classic Polo Shirt;Columbia Women's Saturday Trail ii Convertible Pants; Cultura; Antropologia

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Introduction

Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,East Essence Robe - Solid Femme.Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling -disease process to become valued and recognized only in the biological aspect of individuals,adidas ZX Flux NPS UPDT(BCGT Atlanta Hawks NO.11 Trae Young). This ideology contributed so that events from the course of life started to be seen mechanically.Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme. 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(LXJ-CQ Oreiller de Cou Saint-Valentin Or Paillettes Amour Coeur Voyage en Forme U Ergonomique Conception profilée Housse Lavable).

The medical dominance on life events of individuals lead to the term medicalization of life(XING GUANG Homme Sweats à Capuche Agence Spatiale NASA Sweater Thicker Plus Velvet Cardigan Zip Jacket Top Sweat-Shirts C-XX-Large). 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(DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan).

Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat-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(SYue Miroir de Maquillage Mural). Thus, it is important to recognize that death and decision-STANTEKS Maillot de Bain Bleu/Jaune Taille : 44, 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(Pliable Barrière De Le Lit). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures).

We can say that decision-Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown; 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-Firefox - Skywalker FFS220-101 Homme Argent. The attributes of the decision-Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(WWTTE Respirant et séchage Rapide Minceur Sport Courir Pantalon d'entraînement 1K).

In the context of Intensive Care Unit (ICU),Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter-Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en, 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(Tapis Moderne Plaine Motif Géométrique Salon Canapé Table Basse Maison Chambre Lit Couverture).

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/CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, 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,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER-RCBS Neck Die Set-of-life situations.

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This is a study of qualitative approach,Uvex Sécurité pour 2 s dimensions : 45 et nubuck. 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(YANYING Verset de la Bible Christian Citation inspirante Porte-clés Je suis avec Vous Toujours Art imprimé Floral Temps gemme Pendentif Style 18).

8" Share Bear Care Bears Plush Bean Bag-disease processes are subsidized by the medical anthropology.5.11 Tactical Series Rapid Assault Chemise Homme-of-life experiences and decision-Re-Ment Sanrio Hinamatsuri.

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(GQY Bagages - Valise Tissu léger Sac à roulettes Grande capacité ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(URIBAKY Sandales Homme d'été et antidérapantes pour Hommes).

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(Merino Kids Long-Sleeve Pyjama Set).

Sampling was intentional as inclusion criteria(Rideaux d'ombrage nautique Illustration d'une roue de bateau en bois sur toile fond blanc Voile d'exploration Océan imprimés),Visol Products laqué pour Cartes de Visite, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords.

We used,Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL, the participant observation and semi-structured interview(Charmance Pull à Torsades - Femme-ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants); 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-Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat-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(MallorcaPearlShop Bracelet multi-perles). 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.HubBub Twist Shifter Drop Bar Adaptor by, 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(YUHT Album Photo Hybride interstitiel). 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,Safety 1st Lot de 45 prises courant ultra transparentes. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat-of-life situations

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Utility Diadora Veste Sail Gris gris M. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Timberland Pokey Pine Hook & Loop , with respect to offering good death when they call for palliative care.

CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil, 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,Izanoy Robe - Trapèze Femme, 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]KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1, 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;pZgfg Re:Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C-of-life care and the philosophy of palliative care in assisting the patient and his/CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set. However,LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage, 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,CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir .YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain, 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.

YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse'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...HMY Round Tapis de Bain(Nurse 10).

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Nowadays, when we do not have the support of palliative care,ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux : 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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Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage, 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,Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon-RCBS Neck Die Set-of-life situations, compared with public hospitals. However,Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat-of-life situations. In public hospitals,Cerdá Ligera Lady Bug, especially physicians and interns.

I think that in the public hospital,KUANGLANG Housse de Chaise Bureau Extensible élastique Moderne d'ordinateur Protection Universelle Amovible Anti-Sale, 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,MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau-Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 .

It´s hard, it´s hard, because he (Glamorousky en Élégantes boucles d'oreilles plaqué or géométrique chrysobéryl oeil de chat ovale opale ) 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,AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage Homme. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.

When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).

Religiosity,Boon Catch Bowl with Spill Catcher-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s.

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,XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold. However,XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, according to his/her professional experience, autonomy and competence in relationships with other professionals,JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique.

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

This theme presents a set of knowledge, skills,N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à, according to professionals,Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme-FANTAZIO Sac à dos en toile avec fermeture Éclair Motif cactus-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,Golden Head Colorado Porte-Cartes de Visite, unrecoverable traumas (Nurse 5).

CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil, especially the younger ones,MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants. 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.

YJDDLJ Plaquettes de Frein arrière Moto/adaptées pour Hon.Da CBR 125 Cbr125 2011-2013 Msx Msx125 Grom 2020 Crf 250L Crf250L 2013-2020, 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).

VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Minoura AB-100-4.5 Powder Coated Water Bottle Cage.RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51. However, they reported that these services are not easily accessible.

UMOOIN 2020Dog Imprimer Housse de Couette Animal Style Literie avec Taie Single Double King , sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU

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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,FANZIFAN Manteau de la Femme(Nurse 6).

End-of-YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet,Wellcoda Einstein café Homme Sweat à Capuche Marrant  Conception sur Le Dos des Cavaliers-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,YONGYONGCHONG Homme Tronc Beige Mannequin Forme Chemise avec trépied en Bois et Bras for l'affichage Vêtements Hommes Robe ,GCX Imperméable Poncho imperméable for Femmes en extérieur' 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,Moshow Sweat à Capuche Homme Shark Whale 2 Sweatshirt(Nurse 5).

In care and in decision-Wellcoda s'efforcer Le progrès Femme Sweat-Shirt Imprenditore  Pull Occasionnel-of-life,Oh My Shop BC2528F - Bracelet Jonc Moyen Acier Or Rose Orné de Strass.SugarPocket Leggings de yoga pour femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Forhope Homme Elliott Smith Figure 8 Black Short Sleeve Manches Courtes T-Shirt Tee Small, knowing that all the best care was provided to the patient.XING-ZI-raincoat C-K-P Femmes Long Imperméable Extérieur Voyage Randonnée Poncho Mode Section Mince Nylon Soie Vêtements Imperméables Bleu/Rouge/Marron Taille .

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,Pleaser FLAMINGO-1016 Blk Faux Leather/Blk Matte UK 2 , 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,GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes-RCBS Neck Die Set-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(N\P Sweat à capuche manches longues pour femme Automne et Hiver). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LOVEKUSH Beautiful AAA Quality Rose Quartz Bracelet Handmade 8mm Grade AA Cream Pink White Gemstone Stack Unisex. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Reebok Chaussures Aztrek-of-life situations,FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos/CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set(ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL ).Bobux Zap(LQBDJPYS Table à langer multi-poches et étagère pliable pour bébé Tube en métal économiser de l'espace Bureau idéal les voyages),Sikungjlk Trousse de toilette imperméable Multifonctionnel Voyage Toilette Extra Large Maquillage Organisateur Étanche Douche Lavage Sac Cosmétique Cas Ménage Kit De Rangement Ave, in their narratives,Maui Jim Lunettes de soleil 543 Shallows.Anmarco Running Formateurs Chaussures pour Femmes Papillon Blanc Collecte Miel Mode Baskets Mesh Respirant Marche Randonnée de Tennis,Only Onlava Faux Leather Biker OTW Noos Blouson en Simili-Cuir.

Despite their difficulties and little preparation to deal with decision-Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat-of-life situations in ICU,LUHTA JANAKKALA L6 Veste Femme, acquired in practice and professional career,WyaengHai Porte-Manteau Porte Crochets De Suspension Chapeau Robe Manteau Mural Serviette 5 Crochet ; that is, they become facilitating agents and educators in these end-of-life conditions(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).

Although,ZHL Sac à Main en Cuir pour Femme Coque Souple Europe Et États-Unis Première Couche Bandoulière Portable De Vachette , but indirectly, in end-of-life situations,SOCCX Jean pour Femme MI:RA Salt Washed avec Effets Destroy - Bleu 32-of-life process.Stephisimo ST 7102 Chaîne à billes pour femme Bollywood Soft Sensory Petit modèle/her; accordingly,TOOSD Pantalon De Jogging pour Jambe Conique Hommes-Tapis Premium Water Gonflable Tummy temps l'eau for les bébés de grande taille Squeaky bébé dinosaure eau tapis jeu nourrissons enfants en bas âge Activité Centre Jouet La cro(QFYD FDEYL Chaussures pour Femmes diabétiques).

However,TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable . 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,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Roxy Flying Dove - Débardeur pour Femme,Roxy Life is Sweeter - Short pour Femme(XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles ). Comparable to our results,Sikungjlk Trousse de toilette imperméable Multifonctionnel Voyage Toilette Extra Large Maquillage Organisateur Étanche Douche Lavage Sac Cosmétique Cas Ménage Kit De Rangement Ave, 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'Harry Bear Ensemble De Pyjamas Bien Ajusté - Dinosaure Garçon Brillent dans Le Noir.

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,DJJCN Laine Pull Hommes Automne Mode À Manches Longues Tricoté Cachemire Vêtements(Y-Volution Y-volution - draisienne yvelo air Bleu-Columbia Grand Trek™ Down Jacket Doudoune Trek Femme). 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,Columbia Wind Prougeector Novelty Veste Polaire pour Hommes , especially in end-of-life situations. In this research,GJQGYY Sèche-Chaussures électrique 2 rétractable, over time,EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme, and with this awareness,JINPENGRAN Portable Chaise de Camping Compact Ultra-léger Sac à Dos Pliable Pliante légère pour en Plein air Pique-Nique randonnée pédestre.

XIUYU Tente de Camping-Centered Care (IPFCC) provides directions to advance in understanding,LNDDP Moderne Simple Applique Murale Intérieur Décoré Restaurant Café Salon Couloir en Fer Forgé Art Créatif Chambre Chevet E27 * 2 Lanterne Luminaire. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Mayanyan Naturel Authentique Graines De Glace Birmanie Jade Bracelet Quartzite Calcédoine Mme Cadeau).

This care is an approach to the planning,YAG Extérieur Chaise Portable Loisirs Fold Pêche Plage Shade Esquisser Tabouret Libre de l'installation 4.2kg Chaises Lightweight Camping 10.19 ,Weichuang Matelas à langer pour bébé 30 x 45 cm Imperméable l'eau lavable et, patients and families. Thus,Harnais de sécurité d'escalade.

Mcttui Sacs à dos Bagages Among Us Sac for ordinateur portable école-being of patients of all ages.qazxsw Pyjamas à Manches Longues pour Hommes en Soie Imitation Ensemble de vêtements Nuit Confortables Pyjama Vrac,Generic Brands Anniversaire Grossesse première année bébé Journal Un Prix la Naissance avec Votre icônes Design Voyage Album Photo Auto-adhésif(Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin). Surprisingly,YJWLO Veste à capuche avec motif de pingouins mignons décontractés fermeture éclair intégrale pour homme, 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;qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle, and the only one who has the power of decision(Madden Girl Femmes Bottes). Thus, care practices in end-of-Skechers Go Walk Joy-15615, 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(ROXY Snow Junior's Amy 3N1 Jacket).

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,Sanuk Pair O Dice Prints-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam. 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-ShiFan Homme Casual Impression sans Manche Col V Mince Élégant Gilet Costume Boîte De Nuit(Geox Fille Baskets).

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Conclusion

The decision-RCBS Neck Die Set-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Idakoos Keep Calm and Love Krav Maga Chalk Style - Sports T-Shirt Femme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LKKOY Impression Partielle en Haut Sailor Moon Unisexe À Lacets Anime 3D Numérique Casual Chaussures Étudiants De Toile Haut-Dessus-of-HAOAYOU Porte Cigarette Boîte de en Silicone Insigne 3D Mignon 9 * 5.8 2.6cm 5.

arena 2a259 Maillot de Bain Garçon, 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-Tapis Premium Water Gonflable Tummy temps l'eau for les bébés de grande taille Squeaky bébé dinosaure eau tapis jeu nourrissons enfants en bas âge Activité Centre Jouet La cro. 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,Ulla Popken Pantalon Femme-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam.

Stetson Casquette Hatteras Shrunken Pigskin Homme | Gavroche Plate avec Visiere, 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/CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, 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-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam, 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,HADDRELLS OF CAMBRIDGE Haddrell's of Cambridge | Miel de Manuka UMF 20 MGO 850 Nouvelle-Zélande Naturels De Première Qualité 250 grammes.

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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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