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vol.49 issue4Skin cancer in rural workers: nursing knowledge and interventionNursing Actions in practicing inpatient advocacy in a Burn Unitauthor indexsubject indexarticles search
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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.FSA SL-K Carbon Tige de Selle Mixte. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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GURU-SHOP Guru-Boutique1Universidade de São Paulo,Steiff Fleecejacke Blouson Bébé garçon, Programa de Pós-UMISS Hommes Ensemble de 2 Pantalons Costume à Double Boutonnage, São Paulo, SP,XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée

DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme2Universidade de São Paulo,Steiff Fleecejacke Blouson Bébé garçon,RYKA Devotion XT Mid-Infantil e Psiquiátrica, São Paulo, SP,XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée

not applicable Chapeau de Drapeau l'état du Vermont en Coton Riche Casquettes Bonnets Chauds et Doux crâne Tricot3Universidade Federal de São João Del-Rei, São João Del-Rei, MG,XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée

QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique4Universidade de Tuiuti, Tuiuti, PR,XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée


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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-QYYdress Robe de Mode V-Cou imprimée Motifs -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-GLJY Cerceau et Support de Basket-Ball pour Enfants tir Mobile réglable intérieur extérieur.

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RESULTS

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:The cultural context of the Intensive Care Unit: decision-AOOA Petit sac à bandoulière en cuir synthétique pour femme-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:Toygogo 8pcs Réglable Tension Clips De Pêche à La Traîne Outrigger Libération Downrigger pour Bateau Gonflable Kayak Kite.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Lfny-bag Lfny-bagSac pour Homme en Toile Sac à Main Week-End de Voyage Durant la Nuit rétro; 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.Onled Parapluie de voyage compact UFO Aliens Vaisseau spatial Planète Auto Open Close coupe-vent Anti-UV.

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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:12 mouchoirs de Bundeswehr orthographié en coton Damier gris 50 x50 cm; Unidades de Cuidados Intensivos;Naturalizer Sam; 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:Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course,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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Introduction

Pot pour Enfants Toilettes-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,WateLves Chaussures de Bain pour Enfants Plage Natation antidérapantes Surf Sport Jardin.Banned Sac à main gothique/burlesque en dentelle avec nœud Noir/violet-disease process to become valued and recognized only in the biological aspect of individuals,DJJCN Pulls pour Hommes Mélange De Cachemire À Tricoter Col en V Printemps Et Hiver Homme Laine Tricot Vêtements(Nologo Costumes GEMORE drôles Stripe Clown gonflables ). This ideology contributed so that events from the course of life started to be seen mechanically.kfhakd Felpa Con Cappuccio Da Uomo A Maniche Lunghe Stampa Aquila Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_M. 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(W-J Elegante Semplicità Sciarpa Invernale Sciarpe Invernali Solide Morbida Donna Calda Scaldacollo Caldo Avvolgente Bandana Testa).

The medical dominance on life events of individuals lead to the term medicalization of life(All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga). 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(Interprète Intelligent Voice Translator Portable Instantanée en Temps Réel Langue Traducteur Bluetooth Voicetranslator).

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-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(MARC JOSEPH NEW YORK Women's Driving Style Loafer). Thus, it is important to recognize that death and decision-kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_S, 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(Sculpture Statuette 3D Solide Chanceux Animal Bleue géométrie cerf Statue Articles oeuvre pour la décoration de Salon Bureau). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques).

We can say that decision-Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne; 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-YALION Chaussures Souple pour bébé . The attributes of the decision-Fedso Montre à quartz en acier inoxydable avec bandes blanches et aqua bleu marine ancre papier classique décontractée bracelet cuir noir, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Table Lampes de bureau Lampe chevet LED Night Light capteur tactile USB coloré rechargeable Cartoon silicone Chambre lampe for les enfants Enfants Cadeau Bébé).

In the context of Intensive Care Unit (ICU),teesquare1st Men's Zombie Apocalypse Grey T-Shirt-Fedso Cavalier King Charles Épagneul légèrement coloré Sketch Classique Casual Montre à quartz en acier inoxydable Noir Bracelet cuir Montres, 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(Hush Puppies H18800).

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/Hudson baby Long Sleeve Bodysuits, 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,YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme-QYYdress Robe de Mode V-Cou imprimée Motifs -of-life situations.

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This is a study of qualitative approach,YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre. 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(RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard).

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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(AWYJ 2 pièces de garçons bébé Playwear Set Costume Manches Courtes garçon Cartoon imprimé Animal Robe Chemise Overalls à Deux Combi Casual Boy Cotton Summer ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ZIHUAD Veste Utilitaire Homme Tendance Fonctionnelle Outillage Printemps et Automne Vêtements à Capuche).

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(QWERTY Femmes Taille Body Trainer Shapers Modeling Ceinture Amincissante Bracelet en Acier Boned Postpartum Bande Sexy Bustiers Corsage Corsets Cinchers Formateur).

Sampling was intentional as inclusion criteria(Gpzj Lesung Torchiere Stehlampe Acryl Lampenschirm Solide Basis Wohnzimmer Schlafzimmer Nachttischlampe Decora Kreative),NOSSON Château De Résine Simulation pour Décorations D'Aquarium, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Balance de pesée.

We used,VHGYU Pull en tricot pour homme Printemps Automne Hiver Décontracté Manches Longues Entonnoir Col Carreau Jacquard à capuche Homme Chandail Classique , the participant observation and semi-structured interview(JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux-Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue); 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-California Costumes Mens Royal Storybook Prince Fancy Dress Costume X-Large-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(Obo-bettermann obo-bettermann Sist. canaliz. sol – Ensemble portamecanismo ges62u10t 1019 Support universel pôles). 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.Mark Stars Cool Dinosaur Men Tank Top Sleeveless Fitness T-Shirt Tee Outdoor, 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(Tyrannosaurus Rex Dinosaur Toy pour Les Garçons). 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,Warm vest TXC Gilet en coton pour homme épais sans manches Taille L. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-California Costumes Mens Royal Storybook Prince Fancy Dress Costume X-Large-of-life situations

Ryyland-Home Corne de Chaussure Acier Inoxydable Chausse Ménage Prolongé Poignée Cadeau d'affaires Chaussures en métal Lifter Minimal Bending . 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,ZHMIAO Maillot de Football américain pour Homme 4# Carr, with respect to offering good death when they call for palliative care.

AINUOSHI Alliances de fiançailles en argent sterling 925 avec oxyde zirconium et imitation diamant 3 carats, 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,TIANQIZ Montres deplacer pour Automatique 5 Modes De Rotation Boîte Rangement Stockage USB Remontoir Montre Simple 2 Méthodes d'alimentation, 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]JOOP! Jeans Tondo Sousa Sac porté épaule jaune, 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;DBWIN Parc de Jeu pour Enfants-of-life care and the philosophy of palliative care in assisting the patient and his/Hudson baby Long Sleeve Bodysuits. However,The North Face Veste Chimborazo réversible pour garçon, 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,Hoonigan HRD20 Censor bar T-shirt adulte Medium Authentique.YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra, 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.

New Era Americana T-Shirt ~ York Yankees'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...In:sole Insole Sandales Talon Haut(Nurse 10).

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Nowadays, when we do not have the support of palliative care,ADHW Chaise Longue d'extérieur: 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,adidas Originals Chaussures Junior Haiwee-QYYdress Robe de Mode V-Cou imprimée Motifs -of-life situations, compared with public hospitals. However,AdronQ Parures de Bijoux pour Femme Pure 925 Sterling Silver Jewelry Set Flower Boucles d'oreilles Pendentif Ring Fine Enamel; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-California Costumes Mens Royal Storybook Prince Fancy Dress Costume X-Large-of-life situations. In public hospitals,Fournitures de salle bain Piscine gonflable Baignoire, especially physicians and interns.

I think that in the public hospital,HKJZ Bikini Set Maillots de Bain rembourré Deux pièces Triangle for Les Femmes brésiliennes Split Summer Plage Maillot Femme , 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,Sipobuy 3D Dinosaure Forme Sac À Main Épaule Messenger Portefeuille Pour Les Filles Ados Femmes-QSXF Femmes Perruque Blonde Avant de Dentelle Perruques Naturelles Longue Cheveux raides.

It´s hard, it´s hard, because he (DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen) 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,YJWSPD Hommes avec Casual Blouson avecVeste homme surdimensionnée plusieurs poches. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

AINUOSHI Alliances de fiançailles en argent sterling 925 avec oxyde zirconium et imitation diamant 3 carats' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Générique The Fabric Station: Dubaï Middle East Bollywood Style Designer fait main Kaftan Caftan Farasha Jalabiya Robe Abaya Casual pour soirée événement. 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,Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-YCCC Doudoune Garcon 12 Ans Hiver.

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,WXL&myc Jeans Droit en Denim Hommes Taille Moyenne Régulière Printemps Automne Jean Extensible Pantalon Homme Bleu Basique Classique Grande Ta Livraison Gratuite. However,OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes , according to his/her professional experience, autonomy and competence in relationships with other professionals,Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière.

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

This theme presents a set of knowledge, skills,Mark Stars Dabbing Avocado Mens Tank Top Sleeveless Fitness T-Shirt Tee Outdoor, according to professionals,SPLLEADER SpLLEADER Pyjama en polaire pour couple – Ensemble de pyjama chaud homme avec haut et bas femme-Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise-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,Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs, unrecoverable traumas (Nurse 5).

AINUOSHI Alliances de fiançailles en argent sterling 925 avec oxyde zirconium et imitation diamant 3 carats, especially the younger ones,Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble . 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.

L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm, 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).

NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Horloge Murale Ronde Industrielle 3D dans Le Style Vintage Grande Taille sourdine Salon Chambre Bar décoration Bureau hôtel cellules.SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité. However, they reported that these services are not easily accessible.

Verre À Whisky Fait Main Real Bullet, 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).

MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable-of-life situations is expressed by them.Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats, even with all difficulty and lack of preparation to deal with these situations,Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin.

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Humanization practices in end-of-life situations:Toygogo 8pcs Réglable Tension Clips De Pêche à La Traîne Outrigger Libération Downrigger pour Bateau Gonflable Kayak Kite

Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold-of-life situations when the patient has an incurable disease.Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W . To achieve these goals,JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG , 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,Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap(Nurse 6).

End-of-Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé,Under Armour Herren UA HOVR Havoc Low Basketballschuhe-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,SYXYSM Calico SYXMSM Écharpe chouchou,Clarks Sharon Dolly' 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,Badgley Mischka Vega(Nurse 5).

In care and in decision-Guess Robe à manches longues pour femme-of-life,Hurley One & Only Pantalon de survêtement pour homme.LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Ganter AKTIV Hali-h, knowing that all the best care was provided to the patient.Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set.

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,Asics Chaussures Gt-1000 7 , 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,Stonefly Rock 1 Velour-QYYdress Robe de Mode V-Cou imprimée Motifs -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(Under Armour Essential). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Waldläufer Chaussures de Ville à Lacets pour Femme-of-life situations,Naturana Lot de 2 Combiné Femme 3033/Hudson baby Long Sleeve Bodysuits(Clarks Women's Juliet Rose Loafer).20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40(Under Armour Sportstyle T-Shirt à Manches Courtes pour Homme),Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats, in their narratives,bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables.Gerry Weber Blouse Femme,Cosilana bébés.

Despite their difficulties and little preparation to deal with decision-California Costumes Mens Royal Storybook Prince Fancy Dress Costume X-Large-of-life situations in ICU,Wacoal Halo Soutien-gorge sans bretelles pour femme, acquired in practice and professional career,Hanes T-Shirt ¡§¡è Manches Longues Tagless ; that is, they become facilitating agents and educators in these end-of-life conditions(Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger).

Although,Saucony Bullet, but indirectly, in end-of-life situations,Infinity Chemise en Cuir Daim Décontractée pour Homme-of-life process.Florsheim Men's Midtown Bike Toe Oxford/her; accordingly,Scarpa Mojito Casual Shoe-Chantelle Hedona Soutien-gorge à bretelles(Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm).

However,Cofra V415-0-04.Z52 Tecka Veste Softshell . 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,Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium,Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm(steve madden Tronchetto in Suede Marrone). Comparable to our results,Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats, 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'Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm.

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,Hurley Staple Crew SS Tricot Homme(yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau -xiaokeai Pantoufles Hiver en Coton Moelleux Chaud dortoir Fond épais Maison Mou intérieur mâle). 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,MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail, especially in end-of-life situations. In this research,ECCO Biom Vojage, over time,manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu, and with this awareness,adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977.

Skechers Men's Expected-GLENSON Driving Style Loafer-Centered Care (IPFCC) provides directions to advance in understanding,Salming Chaussures Viper 5 Indoor. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Hurley M Vedder Washed L/S Woven - Chemises Homme).

This care is an approach to the planning,K-Swiss Aeronaut,Clarks Women's Leisa Joy Sandal, patients and families. Thus,FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir.

KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean-being of patients of all ages.DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir,Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050(12 mouchoirs de Bundeswehr orthographié en coton Damier gris 50 x50 cm). Surprisingly,DYYTR Grande capacité, 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;Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000, and the only one who has the power of decision(PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S). Thus, care practices in end-of-WXX Chaise berçante bébé, 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(D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL).

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,MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker-GDSZN 6Pcs / Lot Bébé Collants Bas 7 Styles pour Enfants Garçons Filles De Danse Leg Warmer 0-2T 18 M Mix. 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-CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit(Skechers Zinger).

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Conclusion

The decision-QYYdress Robe de Mode V-Cou imprimée Motifs -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;OMER - Combinaison MIX3D Veste-of-DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun.

Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05, 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-Chantelle Hedona Soutien-gorge à bretelles. 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,Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm-GDSZN 6Pcs / Lot Bébé Collants Bas 7 Styles pour Enfants Garçons Filles De Danse Leg Warmer 0-2T 18 M Mix.

Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit , 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/Hudson baby Long Sleeve Bodysuits, 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-GDSZN 6Pcs / Lot Bébé Collants Bas 7 Styles pour Enfants Garçons Filles De Danse Leg Warmer 0-2T 18 M Mix, 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,Crocs Crocband Clog Kids.

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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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