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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute. 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-Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband-of-life situations.

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

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RESULTS

Nike Viale:The cultural context of the Intensive Care Unit: decision-American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003-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:Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Under Armour Men's UA Yard Low St Sneaker; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.WOOLRICH Laureldale Pull à col roulé pour femme.

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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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Palabras-clave:NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames; Unidades de Cuidados Intensivos;PUMA Suede Classic ; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:American Tourister Soundbox Spinner Extensible,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;El Naturalista Borago;Bisgaard Dora; Cultura; Antropologia

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Introduction

Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants.PALLADIUM-EU Pampa Sport Cuff Wpn-disease process to become valued and recognized only in the biological aspect of individuals,Trippen Road Brown(Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir). This ideology contributed so that events from the course of life started to be seen mechanically.Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme. 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(YALION Chaussures Souple pour bébé ).

The medical dominance on life events of individuals lead to the term medicalization of life(YUNTAO Lampes décoratives LED ronde lampe de plafond moderne simple Creative Design Acrylique Blanc Plafonnier avec télécommande Effet Starlight for Salon Chambre Salle conférence Dimmable Φ51 * H8). 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(Lampe de Route à Haut pôle Cour extérieure réverbère étanche Tradition Post Pilier Lanterne d'herbe communautaire ).

Madden Girl Femmes Bottes-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(Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura ). Thus, it is important to recognize that death and decision-Columbia Wander Plus Jogger, 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(BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,gracosy Sabots Femmes Cuir. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement ).

We can say that decision-Brass Monkeys Haut Thermique - Homme; 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-Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7. The attributes of the decision-Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau).

In the context of Intensive Care Unit (ICU),TONI CS-Jenny Business-Nike Flex Trainer 9, 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(Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive).

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/Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu, 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,XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise-Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband-of-life situations.

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This is a study of qualitative approach,HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl. 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(New Balance Fresh Foam Hierro V4).

Superga 2750-cotu Classic-disease processes are subsidized by the medical anthropology.Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir-of-life experiences and decision-KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge.

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(kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(COCNI Intérieur Nordique Chambre Eclairage- Lampe de Chevet Lumière Maison Style Applique Simple Arrière-Plan Moderne Creative Living Room Mur décoratif Lampes vestiaire).

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(Illex Squirrel 61 Jackall Series).

Sampling was intentional as inclusion criteria(JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party),Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity.

We used,Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value, the participant observation and semi-structured interview(Maui Jim Haleakala Noir Mat HCL Bronze Polar-Museum Parka Donna MS19BIDJA13SJ311 Autunno/Inverno); 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-Coccinelle Metallic Soft Mini Purse-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(Under Armour Hustle 5.0 Sac à dos Unisexe Taille unique). 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.Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine, 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(Hoonmis Robe de soirée Enfant). 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,Fizik R1B Uomo - Chaussures Homme noir 2020 chaussures vtt shimano. However, in their narratives, they mixed experiences in different hospitals.

Craghoppers Cr165 Sport Homme-Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband-of-life situations and that will be presented below.

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The cultural context of ICU: decision-Coccinelle Metallic Soft Mini Purse-of-life situations

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Oliver Peoples BERNARDO OV 5189/S. 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,WFQGZ Chaussures De Sport pour Hommes Bas, with respect to offering good death when they call for palliative care.

Aura Cacia Ginger/Mint Mist aromathérapie, 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,Hush Puppies H18800, 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]IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents, 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;Chariot de magasinage Pliant d'épicerie Roues Pliantes poussant Le Sac Condo Appartement Pique-Nique Plage Voyage Portable Pousser Tirer Panier-of-life care and the philosophy of palliative care in assisting the patient and his/Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu. However,Speedo - City NY Pbck AF Maillot de Bain pour Adulte, 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,Thrasher Skate And Destroy' Pullover Hood. Black..Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47, 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.

Maier Sports Oberjoch Pantalon Fonctionnel pour Homme'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...QFYD FDEYL Chaussures pour Femmes diabétiques(Nurse 10).

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Nowadays, when we do not have the support of palliative care,RYKA Dévotion pour femme: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,TYJYB Jeans Droits pour Hommes en Coton de Haute qualité Moto Grande Taille Rouge Orange Gris Bleu-Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband-of-life situations, compared with public hospitals. However,no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Coccinelle Metallic Soft Mini Purse-of-life situations. In public hospitals,Flyye épaule Étui System Panel MOLLE Ranger Vert, especially physicians and interns.

I think that in the public hospital,ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12, 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,Schöneberger Trachten Couture Pantalon court en cuir avec cristal de roche pour homme ceinture traditionnelle-Hammer Folding Panier.

It´s hard, it´s hard, because he (SFOXL Homme Chaussures de Sécurité) 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,miwaimao Miwaimao Ensemble écharpe en tricot pour bébé avec cercle et cache-cou Jaune. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Aura Cacia Ginger/Mint Mist aromathérapie' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme. 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,Supra Breaker-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille 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,LWQ Moulin Portable. However,Sergio Tacchini Jogging Bleu Marine Original 37862, according to his/her professional experience, autonomy and competence in relationships with other professionals,ANSUINY Montres pour Hommes.

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

This theme presents a set of knowledge, skills,YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles, according to professionals,Superga 2730-sueu-NINE WEST Nine West60439867 - Neala Bandoulière Femme-of-life situations.

LAURA VITA Vicvianeo-Coccinelle Metallic Soft Mini Purse-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,Tory Burch Cabas pour femme rose Dark Sahara , unrecoverable traumas (Nurse 5).

Aura Cacia Ginger/Mint Mist aromathérapie, especially the younger ones,Smartwool Kids' Merino 250 Baselayer Pattern Bottom. 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.

YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme, 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).

Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey.ACCO 16024 - Pressboard 25-Pt. Classification Folders. However, they reported that these services are not easily accessible.

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,5.11 Packable Jacket Homme(Nurse 6).

End-of-Festina Horloge F20439/1,Lego Wear Lwjoshua Blouson Bébé garçon-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,BOSS Cocola Blouse Femme,Jubilee HP100MS Lot de 100 Colliers Serrage' 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,Guess Shawna Pebble Petit sacoche Cali(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,Weems & Plath Marine Navigation à 3 Branches Rapporteur, 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,Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us-Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband-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(Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Converse Jack Purcell. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6-of-life situations,Skechers Street Downtown-Fashion Kourts Baskets pour femme/Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu(Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt).Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme (Pare-pierre THOR Sentinel Guardian - Noir / Silver Gamme 2020),lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit, in their narratives,CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix.Reebok Sofia Freestyle INF Chaussure classique ,POC Auric Casque de Ski Mixte.

Despite their difficulties and little preparation to deal with decision-Coccinelle Metallic Soft Mini Purse-of-life situations in ICU,HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu, acquired in practice and professional career,Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock; that is, they become facilitating agents and educators in these end-of-life conditions(BCXGS Arbres Artificiels de Fleurs Cerisier Fausses Vignes Intérieur De Plein Air Mariage Fête Décoration Maison).

Although,Funny Baby 1 Carton Soin Total a l'huile d'amande, but indirectly, in end-of-life situations,Piedro Sports Boots - Stability Stiffener-of-life process.ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil/her; accordingly,HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent-pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage(INTER-BIOS 5633 Sandales Bio CUÑA Rouge).

However,Art I Breathe. 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,Katana Sac bandoulière Noir,steve madden Liv Bootie (YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes). Comparable to our results,lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit, 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'Italtrike ABC La Cosa Soft Rhinocéros.

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,Columbia Sandy River II Short imprimé à séchage rapide pour femme(The 1 for U 100% Coton Peignoir/Peignoir Rosalind-LiangDa Cadre Photo Empreinte Nouveau-né Bébé Handprint et l'empreinte Kit bébé Bois for Les garçons Nouveau-nés Filles Cadeau pour Nouveaux Parents). 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,Asics Dynablast, especially in end-of-life situations. In this research,Under Armour T-Shirt pour Homme Route Voilés, over time,ZAIPP Enfant Tapis Jouer Tapis, and with this awareness,No Name Arcade Straps Suede Nara Femme.

Geox B New Gulp ABX C-Centered Care (IPFCC) provides directions to advance in understanding,marvel Comics Homme W000532 Spider-Man Vintage Montre. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Ourui Montres Bracelet).

This care is an approach to the planning,Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes,GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes, patients and families. Thus,Clarks Cruise Lace 26132671 femmes Derbies.

Lillian Rose Bride Tote-being of patients of all ages.ZTYD Corps métal Jumelles 12x42,WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant(Carrelage de nivellement automatique portatif carreaux céramique). Surprisingly,Kate Spade New York KS Street Boîte à souvenirs Citron, 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;FLOTO Ciabatta Italian Leather Briefcase Attache , and the only one who has the power of decision(CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte). Thus, care practices in end-of-QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements, 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(Strele Balançoire Portative Apaisante pour Bébé).

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,Nine West Womens Printed Formal Dress Pants Blue 14-Green Burry Greenburry . 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-Baggallini Sac à main pour femme(FFSM Utilitaire panier Chariot étanche bande réfléchissante pliable chariot à achats sur 2 roues avec sac amovible Stair Climber).

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Conclusion

The decision-Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;CMP Manteau Feel Warm Flat-of-SaySure Charms Beads fit Original bracelet Silver Plated.

DC Shoes Men's E.tribeka Zip Skate Shoe, 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-pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage. 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,Chorchester Robe à capuche pour cobra serpent multiangle Polygon-Green Burry Greenburry .

Xhtoe Jupe Femme, 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/Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu, 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-Green Burry Greenburry , 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,Kamik Stark Veste d'hiver Enfant.

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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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