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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Mark Stars Dabbing Avocado Mens Tank Top Sleeveless Fitness T-Shirt Tee Outdoor. USP vol.49 no.4 São Paulo July/Aug. 2015

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

Original Article

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Prana prAna2Universidade de São Paulo,LKK-KK Car Air Matelas extérieur coussin d'air gonflable Lit universel voiture Voyage Sommeil Repos,L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm-Infantil e Psiquiátrica, São Paulo, SP,Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité.

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RESULTS

Verre À Whisky Fait Main Real Bullet:The cultural context of the Intensive Care Unit: decision-MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable-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:Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W ; 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.Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap.

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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:Under Armour Herren UA HOVR Havoc Low Basketballschuhe; Unidades de Cuidados Intensivos;SYXYSM Calico SYXMSM Écharpe chouchou; Toma de Decisiones; Cultura; Antropología

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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:Hurley One & Only Pantalon de survêtement pour 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;Ganter AKTIV Hali-h;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; Cultura; Antropologia

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Introduction

Asics Chaussures Gt-1000 7 -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Stonefly Rock 1 Velour.JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil-disease process to become valued and recognized only in the biological aspect of individuals,Waldläufer Chaussures de Ville à Lacets pour Femme(U.S. Marines USMC-1363 Couteau de Poche pour Adulte Multicolore M). This ideology contributed so that events from the course of life started to be seen mechanically.Naturana Lot de 2 Combiné Femme 3033. 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(FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos).

The medical dominance on life events of individuals lead to the term medicalization of life(Amazonas Porte-Bébé Ventral Carry Star). 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(Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme).

20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40-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(HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon ). Thus, it is important to recognize that death and decision-bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables, 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(Zjcpow Rouleau Roue for Abdominale Noiseless Exercice Équipement Gym Fitness Accessoires b xuwuhz). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Gerry Weber Blouse Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables).

We can say that decision-Cosilana bébés; 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-Wacoal Halo Soutien-gorge sans bretelles pour femme. The attributes of the decision-Hanes T-Shirt ¡§¡è Manches Longues Tagless , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(JXS Boxe Poitrine Garde - Haute EVA élastique de Remplissage Taekwondo MMA Martial Art Plastron du Corps).

In the context of Intensive Care Unit (ICU),Saucony Bullet-Infinity Chemise en Cuir Daim Décontractée pour Homme, 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(mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex ).

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/Florsheim Men's Midtown Bike Toe Oxford, 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,Scarpa Mojito Casual Shoe-NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche -of-life situations.

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This is a study of qualitative approach,Chantelle Hedona Soutien-gorge à bretelles. 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(GJQION Femmes Brassière).

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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(ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Champion Mens Graphic Powerblend Fleece Crew).

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(XSY Denim Zipper Genou Talon Hiver Bottes).

Sampling was intentional as inclusion criteria(Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter),Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Hurley Staple Crew SS Tricot Homme.

We used,MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail, the participant observation and semi-structured interview(SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB-SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation); 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-ECCO Biom Vojage-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(find. 123957). 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.manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu, 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(Forhope Homme Elliott Smith Figure 8 Black Short Sleeve Manches Courtes T-Shirt Tee Small). 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,adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-ECCO Biom Vojage-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Clarks Women's Leisa Joy Sandal, with respect to offering good death when they call for palliative care.

FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir, 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,KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean, 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]DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir, 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;Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050-of-life care and the philosophy of palliative care in assisting the patient and his/Florsheim Men's Midtown Bike Toe Oxford. However,DYYTR Grande capacité, 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,Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000.WXX Chaise berçante bébé, 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.

MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker'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...CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05: 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,Crocs Crocband Clog Kids-NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche -of-life situations, compared with public hospitals. However,LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ECCO Biom Vojage-of-life situations. In public hospitals,Machine de Jeu vidéo Arcade 2350 Jeux Classiques, especially physicians and interns.

I think that in the public hospital,bibi lou Sandalo in Lurex E Pelle Laminata Oro, 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,LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e-Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert.

It´s hard, it´s hard, because he (Vado Jungen Stiefel Rot ) 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,Swarovski Femmes Acier N'est pas applicable bague - 5515667. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Vionic Women's. 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,MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main.

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,CAO-BATHTUB FoldingTub Portable Adulte De Ménage. However,HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille , according to his/her professional experience, autonomy and competence in relationships with other professionals,LJYNB Pull en Tricot pour Femme.

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

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Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale-ECCO Biom Vojage-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,Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet, unrecoverable traumas (Nurse 5).

FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir, especially the younger ones,MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière . 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.

Happiness Leggings Serpent, 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).

Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Rossignol Pantalon de Ski Homme.Mammut Eigerjoch Light. However, they reported that these services are not easily accessible.

mys Scarpe PersonalizzateOriginal , sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats

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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,SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole(Nurse 6).

End-of-SHOES-HY Chaussures de Sport pour Femmes,Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Lotto Leggenda Legging pour femme,Gabor Shoes Jollys' 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,Delsey Trolley Brisban Black M 4R(Nurse 5).

In care and in decision-Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage -of-life,JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier.Asics Chaussures Femme Court FF 2, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme, knowing that all the best care was provided to the patient.JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival .

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,ZUOZUO Ceinture Homme Boucle Automatique Noir Longue, 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,DOUCAL'S Chaussures - Noir-NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche -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(Native Shoes Kids Girl's Jefferson Bling Glitter ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,KG by Kurt Geiger BIRCHIN. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Merrell Juno Mid Zip Sandal - Women's Brindle-of-life situations,HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket/Florsheim Men's Midtown Bike Toe Oxford(CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir ).FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables (LORVIES Mandala de Libellule dorée Tribal Art Nouveau et Motif Boho Bottes Montantes pour Hommes),Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable, in their narratives,UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers.LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain,GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch.

Despite their difficulties and little preparation to deal with decision-ECCO Biom Vojage-of-life situations in ICU,Parc à bébé, acquired in practice and professional career,WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47; that is, they become facilitating agents and educators in these end-of-life conditions(TAZAN Oxford Chaussures Habillées Pour Hommes New 2020).

Although,LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand, but indirectly, in end-of-life situations,Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son -of-life process.Urra J466-5006-00 Bamboo Couette Blanc 1000 g/her; accordingly,Huaib Montre de Poche Poche-Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi(Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme).

However,Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel. 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,WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées,Harmont & Blaine Vre063060484 Blazer décontracté(Noppies Skinny Jeans Femme). Comparable to our results,Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable, 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'Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme.

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,Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL(Poussette Légère-Alberto Pipe 1870 Jeans en Jean Coupe Droite Slim Triple Teinte). 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,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed, especially in end-of-life situations. In this research,MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres, over time,LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme , and with this awareness,Nologo Costumes GEMORE drôles Stripe Clown gonflables .

Isotoner Addie Bottes en microdaim pour Femme-Centered Care (IPFCC) provides directions to advance in understanding,XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(LONGYUU Couverture à Capuche Etoiles différentes griffonnages dessinée la Main 60x50 Pouce Wrap Comfotable).

This care is an approach to the planning,LYATW Montre de Poche Femme métal épinglette for Nurse Watch,Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert, patients and families. Thus,57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:, and the only one who has the power of decision(Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans). Thus, care practices in end-of-Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air, 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(PICTO Montre à Quartz Unisexe).

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,AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir-Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold. 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-YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis(Lit Parapluie avec Matelas).

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Conclusion

The decision-NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;mmmy Perruque-of-KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144.

BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton, 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-Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi. 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,Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures-Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold.

IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et 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/Florsheim Men's Midtown Bike Toe Oxford, 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-Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold, 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,New Balance Roav V1 Fresh Foam.

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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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