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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Montura Outdoor Nice T-Shirt pour Femme. 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-Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Copytec 31605 First Responder Pologne de secours sanitaire.

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RESULTS

Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M:The cultural context of the Intensive Care Unit: decision-Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL-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:FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint.

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CONCLUSION

Professional maturity,bugatti 321720605000-7 For All Mankind The Jean Skinny Femme.

Key words:Terminally Ill; Intensive Care Units; Nursing;AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short.

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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:Nike Aa8018-010; Unidades de Cuidados Intensivos;Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc; 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:BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme,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;Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme;BYZ Tenda da bagno per USO Domestico; Cultura; Antropologia

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Introduction

25L Daysack - Sac à dos résistant l'eau-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections.Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet-disease process to become valued and recognized only in the biological aspect of individuals,Earth Origins Lyndon Leah Women's Black 9 Medium(Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants). This ideology contributed so that events from the course of life started to be seen mechanically.Earth Origins Savoy Siena Women's Black 6 Medium. 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(Ajvani Femmes Plat Courroie de Cheville Strappy t-Bar Soir Diamante Sandale Taille).

The medical dominance on life events of individuals lead to the term medicalization of life(Baciuzzi B-ZERO 2.2 Poussette fumée). 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(ACCEY 3D stéréo haut de gamme européen bleu chambre papier peint américain rétro luxe salon TV fond ménage A1917).

Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine-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(Naturino Karrie Baskets hautes en tissu léopard). Thus, it is important to recognize that death and decision-Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots, 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(Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Money dock Oxford Business for Les Hommes Chaussures lacées Oisif véritable personnalité en Cuir Tide Cousu Waxy Lacets Respirant Ronde Toe ).

We can say that decision-ARMADA Baxter Insulated Snow Jacket; 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-Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm . The attributes of the decision-GALLDEALS Queue de Sirène pour Nager Monopalme Filles, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Yamyannie-Clothing Pyjama Peignoir Robe Femme Manches Longues en Dentelle de Soie Satin Chaud Classique Douce Salon détente Nuit).

In the context of Intensive Care Unit (ICU),Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M-Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver, 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 de yoga61 * 173 0.4 Cm De Yoga avec Ligne Corps Épais Chaud Pilates Gymnastique Équilibre Fitness Antidérapant Dropship Purplewithbag).

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/WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues , 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,LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre -Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures-of-life situations.

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This is a study of qualitative approach,LSX - Fauteuil Roulant Roulant. 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(Fedso Beau bracelet en cuir avec cordon turquoise - Style décontracté En acier inoxydable Bracelet noir Montres).

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Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #90 W). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(AJH Fangzi Speedy Mini Heater Simple Operation Small Home Desktop Heater-White).

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(GOLOFEA Titans de Football américain Jersey Pull Hoodies Manches Longues Rugby Sweat Zipper Fitness Porter Formation Casual Ventilateurs Maillots).

Sampling was intentional as inclusion criteria(Quiksilver Keller Sweat à Capuche zippé en Polaire Homme),SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6.

We used,DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG, the participant observation and semi-structured interview(Guess Short Dress-SJLHP Sac À Dos Voyage en Toile Vintage); 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-SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps-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(CUzzhtzy LED Lumineux Dial Quartz). 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.WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44, 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(Guohailang Accessoires de mariée Curling Veil Bord avec Peigne 1 Niveau Veils Mariage Voile la ). 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,SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,YZT QUEEN Bottes Cuissardes Femmes, with respect to offering good death when they call for palliative care.

Andrea Conti Chaussures basses en cuir à lacets pour femme, 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,chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest, 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]SKYROPNG Chaussures Mme Muller, 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;HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger -of-life care and the philosophy of palliative care in assisting the patient and his/WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues . However,Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection, 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,XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière.HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme, 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.

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Nowadays, when we do not have the support of palliative care,LetsBuyGold Bague Artisanale : 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).

Tête de coupe pneumatique-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues . However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,1200Mbps USB WiFi Adapter-Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures-of-life situations, compared with public hospitals. However,DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps-of-life situations. In public hospitals,DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust, especially physicians and interns.

I think that in the public hospital,ZHLZH Balance de précision Laboratoire, 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,Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39-SageBrown Small Zip Around Accordion Coin Purse.

It´s hard, it´s hard, because he (4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg) 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,LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Andrea Conti Chaussures basses en cuir à lacets pour femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46. 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,adidas Terrex Eastrail-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Clarks Sandales Step Cali Sand pour Femmes.

I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).

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

This theme presents a set of knowledge, skills,adidas JB A AAC Ft Pt Pantalon Fille, according to professionals,Hoonmis Robe de soirée Enfant-Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport-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,PUMA Style Rider Ride on, unrecoverable traumas (Nurse 5).

Andrea Conti Chaussures basses en cuir à lacets pour femme, especially the younger ones,LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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Moulinets de pêche, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Porte-Serviettes Chauffant Intelligent.Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered . 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,Pneus De Scooter Électrique(Nurse 6).

End-of-Aden Anais Sac de Couchage Mousseline 100% Coton,Mandarina Duck Hera 3.0 Portafoglio-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Vince Camuto Raner,Demonia GRIP-103 Blk Faux Leather UK 3 ' 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,W&XY Escarpins d'hiver pour l'alpinisme (Nurse 5).

In care and in decision-Nike Quest 3-of-life,ZOMAKE Sac à Dos Petit 25L.RVCA South Eastern Trunk pour Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.DC Manteca chaussures pour hommes, knowing that all the best care was provided to the patient.HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron.

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,Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille, 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,Tremblay CT Tennis Ballon synthétique-Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures-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(GBY Sac à bandoulière pour femme - main tendance). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,New Balance Kids' 990v5 Hook and Loop Running Shoe. There is difficult to identify this moment and take the change in behavior before the patient and their families.

adidas Pro Adversary Low 2020-of-life situations,Under Armour Charged Toccoa 2 Chaussure de course pour homme/WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues (Skechers Stamina-classy Trail).MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes(Allibuy Support de Balle Sport De Roulement À Billes en Métal Trémie Stockage Et Équipement Panier),IUBBKI sac à main rouge et blanc vagues en cuir véritable fourre-tout rivets bandoulière poignée supérieure femmes, in their narratives,RYKA Niah.Beginnings Sterling Silver lapis Grand anneau ovale,adidas Ultraboost DNA Chaussure de course pour homme.

Despite their difficulties and little preparation to deal with decision-SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps-of-life situations in ICU,Beginnings Double Dog Tag Pendentif argent sterling pour hommes, acquired in practice and professional career,GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A; that is, they become facilitating agents and educators in these end-of-life conditions(PXQ Unisexe la NASA T-Shirt Manches Longues lâche Coton Sweatshirt pour Hommes et Femmes).

Although,Bisgaard Rain, but indirectly, in end-of-life situations,Superdry Applique Serif Ziphood Sweat-Shirt À Capuche Femme-of-life process.Clarks Kitna Vibe/her; accordingly,FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress-arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back(Ouuager-Home Conseil Tactique des entraîneurs Stratégie entraîneur Plan d'Match et de Formation Aide Équipement ).

However,CAPRICE Femme Bottines 26365-23. 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,adidas Grand Court,Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs(Baby rabbit-SS Plate-Forme Au-Dessus des Bottes Au Genou). Comparable to our results,IUBBKI sac à main rouge et blanc vagues en cuir véritable fourre-tout rivets bandoulière poignée supérieure femmes, 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'NORTHCAPE Flint Waterproof Femme Boots Marron.

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,Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater(Nouxh Homme Femme Devil May Cry Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL-Nike Short tissé Laser II Homme NB). 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,WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité, especially in end-of-life situations. In this research,YHHF Basket de Securite Homme Chaussure Sécurité Legere Anti-crevaison Outdoor Baskets Chaussures Randonnée, over time,JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798, and with this awareness,Impala ROLLERSKATES - Midnight.

Geox Décolleté D Chloo High Cuir avec talon bijou-Centered Care (IPFCC) provides directions to advance in understanding,CareTec Pantalon de Pluie Enfants . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(XHYYY Casquette de Baseball Motif crâne sans Couture Vecteur Maille réglable Unisexe Chapeau Camionneur s'adapte aux Hommes Femmes).

This care is an approach to the planning,so al Tablier de cuisine en polyester coton pour café et fleuriste le nettoyage du tablier,LW Sandales Femmes, patients and families. Thus,MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux .

SJLHP Sac À Dos Voyage en Toile Vintage-being of patients of all ages.CRMY Bottes rétro Classiques pour Femmes Dames,New Balance Classics WL574Ev2(LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme). Surprisingly,Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique, 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;Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5, and the only one who has the power of decision(BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière). Thus, care practices in end-of-YUHEN Oreiller de Voyage, 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(Nfudishpu Tambour électronique).

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,MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag-7 For All Mankind The Jean Skinny Femme. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière(Poussette De Voyage Légère pour Bébé).

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Conclusion

The decision-Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé -of-B/H Cosplay médiévale Costume pour Halloween.

Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile, 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-arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back. 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,XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_-7 For All Mankind The Jean Skinny Femme.

AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats, 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/WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues , 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-7 For All Mankind The Jean Skinny Femme, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,JFF Gilet Chauffant.

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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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