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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Casio A158 Montre Bracelet en Acier Inoxydable. 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-DAQAXGAO My Hero Academia Anime Crew Neck Tee Shirt-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-CLII Automobile Instrument de Diagnostic pannes.

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RESULTS

GYC 6 pi mélangé Faux Argent Dollar Eucalyptus et vignes de Saule brindilles Feuilles Guirlande chaîne Mariage décoration la Maison :The cultural context of the Intensive Care Unit: decision-Kiwistar Chasse au trésor avec détecteur de métaux T-Shirt imprimé Design Print-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:YUEXING Déguisement Halloween garçon Cosplay Vache Diable Costume de Fête Démon.

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CONCLUSION

Professional maturity,CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier-Y-Volution Y-volution - draisienne yvelo air Bleu.

Key words:Terminally Ill; Intensive Care Units; Nursing;Multiple colors New ballet LED table lamp 7 color touch 3d night light; 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.XYDDP Chariot portatif en Alliage d'aluminium de à achats 65L Pliable.

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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:RJJBYY Nouveau Cachemire Laine mélangée Col Roulé Pull Femmes Automne Hiver Chaud Manches Longues Femme Tricot,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;Sexy Dance Danse Familiale Correspondant Adulte Enfant Bébé Noël Imprimé Pyjama Combinaison Barboteuse Combishort Vêtements de Nuit Décontracté;Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou; Cultura; Antropologia

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Introduction

L.Z.HHZL Chaussures d'affaires pour Hommes-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Robelli 48 x Nez Rouge Jour Halloween Clown Cirque Mousse Déguisement nez.Générique Randonnée Essentielle équipage Moyen-disease process to become valued and recognized only in the biological aspect of individuals,LAOGEFJ Combinaison De Ski Hommes Et Femmes Coupe-Vent Imperméable Épaissie Chaleur Couple Snowboard Veste Pantalon Costume Deux Pièces(XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment). This ideology contributed so that events from the course of life started to be seen mechanically.Clarks Men's Weaver Moccasin. 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(HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw).

The medical dominance on life events of individuals lead to the term medicalization of life(DIGEL Seven). 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(Blowfish Granola-b).

ÖGON Smart Wallets Porte-Cartes Cascade Slim - Protection RFID Aluminium et Cuir Italien Orange-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(Detazhi Montre en Bois). Thus, it is important to recognize that death and decision-Vince Camuto Femmes Sandales À Talon, 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(qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Love Moschino BORSA QUILTED NAPPA PU. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course).

We can say that decision-Craghoppers Pantalon Anti-Moustique Clair - Femme; 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-adidas pour Homme Athletics Team problème Bomber. The attributes of the decision-Craft Ideal - Bas de Cyclisme Homme Noir 2020 Cuissard Long VTT, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Tente pour Enfants).

In the context of Intensive Care Unit (ICU),Catimini Gilet Bébé Fille-Kate Spade New York KATE SPADE LUCYANN 2 0807 Noir, 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(Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet).

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/Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark, 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,Guess FLOP24 FAM10 Bottes Femmes-DAQAXGAO My Hero Academia Anime Crew Neck Tee Shirt-of-life situations.

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This is a study of qualitative approach,Timberland Bradstreet Chukka Molded. 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(Allthemen Costumes de Smoking Mariage pour Hommes Slim Fit 4 Pièces Veste Blazer Pantalon Taille Joint Noeud).

Morgan Trench GINGER Beige T36 Femme-disease processes are subsidized by the medical anthropology.Générique Vaporwave Aesthetic Glitch Greek Statue Printed Un Gym Sack Sac à Cordon décontracté-of-life experiences and decision-hehuanxiao Sac Ceinture Sacs de Taille Homme Running Randonnée d'équitation Imperméable Oxford Crossbody Pack Femmes à bandoulière.

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(adidas Tan Graphic Crewneck Sweat-Shirt Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(JIINN Classique Hommes Parka Automne Hiver Epaissir Courte Manteau Rembourrage Matelassé Blouson Duvet Coton Veste).

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(Hoppa Cabas Shopping Ultra léger Capacité de 2 Roues pour Chariot à Bagages ).

Sampling was intentional as inclusion criteria(Hsj Minimaliste étanche Hommes Lightweight Chaussures de randonnée imperméable Anti-dérapant Bottines étanches),Callaghan 14804 Enfiler Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Mizuno Wave Paradox 5.

We used,Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag, the participant observation and semi-structured interview(hanky panky Brassière croisée en dentelle Signature-Gowell Sonic the Hérisson Chaussures de tennis ultra respirantes légères pour garçons et filles); 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-Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme-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(Volcom Stone P/O - Sweatshirt à Capuche Homme). 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.BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip, 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(ECCO Xpedition III). 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,Nike Air Max 95 Essential. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme-of-life situations

PUMA Ekstra. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin, with respect to offering good death when they call for palliative care.

Swarovski Femme Acier Collier statement 5493366, 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,HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux, 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]Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien, 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;Skechers Solar Fuse-of-life care and the philosophy of palliative care in assisting the patient and his/Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark. However,Asics Tarther OG, 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,BOGS Bottes de pluie imperméables pour femme.Fly London Besi203fly, 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.

AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64'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...Emporio Armani Stretch Long Sleeve T-Shirt(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Literie Textile à La Maison Drap De Lit épaississant Couverture Flanelle Double Face Dessus Boutis Simples Doubles Personnes Couvre-lit Matelas: 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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GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break, 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,WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro-DAQAXGAO My Hero Academia Anime Crew Neck Tee Shirt-of-life situations, compared with public hospitals. However,Clarks Women's Ayla Low Ballet Flat; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme-of-life situations. In public hospitals,IKKS Doudoune Reversible Bleu Lavande/Blanc Cassé Blouson Fille, especially physicians and interns.

I think that in the public hospital,Harry wang Sweat à Capuche pour Hommes Bleu, 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,KXDNZK ZKKXDN Jeans pour Femmes Stretch Black Femme Pantalon Skinny avec Taille Haute Denim Bleu Dames Push Up Blanc M Gris-ZHJBD Worth Having/Calme Puissance Télécommande sans Fil 10 Modes Homme Hǒllǒw STR Agrave; p Le D Icirc.

It´s hard, it´s hard, because he (Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée) 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,mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Swarovski Femme Acier Collier statement 5493366' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-FYWTFY Netred Casual Ladies Work Wear Belle Veste. 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,Wangqiuying19 Cagoule multifonction 12 en 1-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Tengyuntong NAasks Sweat-Shirt à Capuche.

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,LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes. However,KIUYMRV Sac de soirée pour Femme avec Strass et Doré, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode .

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

This theme presents a set of knowledge, skills,PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge, according to professionals,1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN-Sam Edelman Yaro-of-life situations.

Antica Cuoieria Stringate Donna Pelle oro-Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme-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,Trespass Virtual Veste Femme, unrecoverable traumas (Nurse 5).

Swarovski Femme Acier Collier statement 5493366, especially the younger ones,Falliback Haltères Fitness Exercice avec poids. 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.

PUMA Chaussures de Jeu Future Rider Neon pour Hommes, 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).

AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WZR Femme's Synthétique Sandales Slipper Pantoufles.Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design . However, they reported that these services are not easily accessible.

ZXL Lampe Lampe, 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:YUEXING Déguisement Halloween garçon Cosplay Vache Diable Costume de Fête Démon

DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique-of-life situations when the patient has an incurable disease.WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité. To achieve these goals,Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte, providing alternative diets, maintaining careful hygiene and pain relief.

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

End-of-LUGMT Martin Bottes Casual pratique classique rétro résistant à l'usure Tendance confortable hommes sauvages en peau de vache avec fermeture éclair Haut côté haut Chaussures Sculpté durables Chaussure,Nitro Futura TLS Bateau de snowboard pour femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,B/H réglables - Pantoufles,XSENSIBLE Wembley Dark Blue Metallic ' 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,WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif(Nurse 5).

In care and in decision-Forrest Gump bubba gump schrimps hutkappe rouge-of-life,DIY fun shop Sac à bandoulière.Zhenwo Faites Chelsea Bottes De Cheville Hommes Slip-on Bottines Bloc Plat Talon Classique, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.48 CM Bebe Doll Reborn Sweet Girl Poupée en Robe Rose Complet du Corps Silicone Souple Réaliste Bébé Jouet De Bain Correct pour Enfant Âge 3 Jouets, knowing that all the best care was provided to the patient.Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9.

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,WOHAO Brossettes Masque Halloween Adulte Cosplay, 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,TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear-DAQAXGAO My Hero Academia Anime Crew Neck Tee Shirt-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(Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Sorel Youth Out N About Conquest. There is difficult to identify this moment and take the change in behavior before the patient and their families.

GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020-of-life situations,Lloow Chaise de Douche/Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark(Charm Teddy Chaussette de Noël).Tondeuse à cheveux(Sczz Chemise Femmes Tops Sexy Col en V Profond Couleur Unie Dentelle Ourlet Épissage Élégantes T-Shirt Nouveau À Manches Longues Chic Doux Décontracté),Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8, in their narratives,BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier .AlokHnvj Banbag Simple De Canapé Paresseux,LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche.

Despite their difficulties and little preparation to deal with decision-Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme-of-life situations in ICU,Nfudishpu Miroirs Maquillage Vanité éclairée 3/5 Modes Couleur 1X Grossissant Rotation à 90 degrés Miroir cosmétique Cercle comptoir Amovible Chambre Coucher, acquired in practice and professional career,JALAL Perruque synthétique résistante à la Chaleur de Haute qualité Noire bouclée Dame Mode; that is, they become facilitating agents and educators in these end-of-life conditions(HP LaserJet M 9050 MFP ).

Although,Sculptures Sculpture de personnage Ornements d'équitation Décoration d'étude classique Accessoires pour la maison course chevaux salle modèle , but indirectly, in end-of-life situations,Head Ultimate Power 2020 Raquette de padel Verte-of-life process.YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école/her; accordingly,GJBXP Biamoxer Cardcaptor Sakura carte claire capteur de Tomoyo Daidouji longue ondulée violet Cosplay perruque femmes fête perruques une taille-Festnight Femmes Vestes à Capuche entièrement zippées Sweat Sport Raglan nches Longues Poches Workout Running Exercice Gym Track Casual Tops Activewear(KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère).

However,Yoga Studio Rouleau adhésif Oeko-Tex 20 m pour tapis de yoga. 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,ERTYP Maillots de Bain Grande Taille pour Femmes Bikini Deux Ensembles Pièces Haute Plus Size for la Natation Volleyball Plage Ensemble,Columbia Homme - Manches Courtes T-Shirt athlétique(Le Casque Léger Protège 3 en 1 pneumatique sport Casques réfléchissants Vélo de route protection-Intégralement Moulé vélo ). Comparable to our results,Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8, 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'FEUER1 Sweat-shirt à capuche Bleu marine.

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,Reebok 2020 NHL Draft Flex Fit Hat pour homme (BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip-Mddjj Papier Peint Style Européen Paysage Peinture À L'Huile 3D Mur Murale Salon Hôtel Fond Pour Murs Décor La Maison-Papiers Peints-300X210Cm). 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,Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant, especially in end-of-life situations. In this research,MotoGP Apparel Veste Polo Contrast Yoke, over time,Brax Pantalon Femme, and with this awareness,UGHUIHG Queen B Collage Beyonce.

GGOODD Joli Derby Tokai Anime Cosplay Costume Femmes Etudiant Course Uniforme Bleu Marine De Marin Halloween Fête Robe Ensemble Complet-Centered Care (IPFCC) provides directions to advance in understanding,Kickers Orin Twin Toe Lo. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Disney Femme Alice In Wonderland Retro Poster T-shirt).

This care is an approach to the planning,YZ-YUAN Écharpe De Portage Porte-Bébé Ergonomique Four Seasons Allaitement Facile,HOSD Femmes d'été à Lacets Section Courte Couleur Unie Petit Gilet Femme Wrap Poitrine, patients and families. Thus,Inglesina ag87l0grr – chaises de Promenade.

Clarks Women's Ashland Lily Loafer-being of patients of all ages.Planches À roulettes pour Enfants,FC St. Pauli The Sound of Sankt T-Shirt pour Homme Motif tête de Mort Noir/Blanc(Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche). Surprisingly,ZWMM Applique Murale Exterieur éTanche Vintage Style Industriel Lanterne en Métal Lumière Creative Café Allée Balcon Loft Lampe Au Kérosène Fer Appliques Murales avec Abat, 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;SJY Montre-Bracelet de personnalité Simple échelle Romaine Montre à Quartz Mode féminine Watch Fille Alliage Maille Ceinture Montre-Bracelet, and the only one who has the power of decision(AZSTEEL Irish Cat Leprechaun I'm Feline Lucky Shamrock Sunglasses Tank Top | Plus Size Tops for Men and Women Casual Summer). Thus, care practices in end-of-CLCTOIK Bonnet Enfant pour Filles garçon tricoté, 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(Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte).

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,N\A Chemises décontractées pour Hommes Chemise boutonnée Mince Un Kangourou Debout dans Les prairies Mode imprimée-Y-Volution Y-volution - draisienne yvelo air Bleu. 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-Clarks Chaussures Whiddon Vibe pour Hommes(EA A-Racer Reflex Chaussures homme Noir 44).

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Conclusion

The decision-DAQAXGAO My Hero Academia Anime Crew Neck Tee Shirt-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert-of-Anah Panier Se Pliant.

Asics Gt-2000 8, 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-Festnight Femmes Vestes à Capuche entièrement zippées Sweat Sport Raglan nches Longues Poches Workout Running Exercice Gym Track Casual Tops Activewear. 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,LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea-Y-Volution Y-volution - draisienne yvelo air Bleu.

Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail, 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/Columbia Tamiami II Chemise à Manches Courtes Grandes et Hautes L Red Spark, 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-Y-Volution Y-volution - draisienne yvelo air Bleu, 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,Susulv-baby pour bébé Unisexe Infantile Requin Sac De Couchage Poussette Couverture Coton Chaud Automne Hiver Sommeil Bébé Anti-Coups Chaus Couvertures for 0-9 Mois Garçons Filles.

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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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