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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.P D PAOLA Bracelet Paola PU02-036-U femme argent. 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-MC KINLEY Bottes de Randonnée Discover Mid AQX-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-The North Face Trail Escape Edge Homme.

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RESULTS

Anal Applique Murale Industrielle pour luminaire Rustique d'époque avec Abat-Jour en métal:The cultural context of the Intensive Care Unit: decision-Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19-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:Kickers Holster.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Barrière de lit Rail for Enfants en Bas âge; 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.ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box.

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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:mingliang Bas pour Aider Bottes Militaires des Hommes; Unidades de Cuidados Intensivos;Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53; 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:adidas Classic Pull pour garçon,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

DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20.DC Shoes Court Graffik - Baskets pour Garçon ADBS100207-disease process to become valued and recognized only in the biological aspect of individuals,Little Mistress Lillian Robe longue en dentelle avec trou de serrure(JEWEL BEADS Beads Gemstone Natural Blue Sapphire Bracelet Faceted Rondelle/September Birthstone Gift/Women's). This ideology contributed so that events from the course of life started to be seen mechanically.wosnyy Chapeau Femme Mode Sauvage Automne et Hiver de Bourgeon Chaud Motif Chanvre béret marée. 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(Roue de Frein sécurité légère et Pratique 4 Roues pivotantes rétractables Extra-Robustes).

The medical dominance on life events of individuals lead to the term medicalization of life(Clarks Sea Breeze des femmes Flip Flop). 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(Mam'zelle Chaussures NAELI).

WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy-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(A.OAQRFA Sac à main pour femme). Thus, it is important to recognize that death and decision-Balmain Luxury Fashion Femme TF13792I383EAB Noir Coton Sweatshirt | Printemps-été 20, 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(WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Cult Sabbayh 3136 Low Leather #black CLE104310).

We can say that decision-Bilderwelten Kakemono Poster - Exotic Foliage Fan Palm 35x35cm Chêne; 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-DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre. The attributes of the decision-Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Ryan Jonathan Fine Jewelry Alliance légère et confortable en or rose 14 carats 1).

In the context of Intensive Care Unit (ICU),1.5Wled lampe de table nuit portable chambre lumineuse salon sécurité protection des yeux décoration d'économie d'énergie-HYLH 3D LED Stunt Motorcycle Illusion Night Light, 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(Ana Silver Co. Garnet).

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/ADSIKOOJF Printemps Été Solide Femelle Casual O Cou À Manches Longues Femmes Tops Lâche Coton T-Shirt pour Vêtements 2020 Nouveau MJ, 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,Wmeat-P Ensemble De Housse Couette-MC KINLEY Bottes de Randonnée Discover Mid AQX-of-life situations.

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This is a study of qualitative approach,WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot . 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(LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple ).

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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(Mephisto Rainbow Chestnut Mens Shoes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(BCOGG 2020 Aquaman Mera Cosplay Costume Halloween Sexy Brillant Sirène Robe Party Fish scale Dames Night club DC XXL comme indiqué).

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(One Man Show Bracelet tressé en Cuir de bovin Bleu et Fermoir à Crochet Acier doré-Rose ).

Sampling was intentional as inclusion criteria(FXPCQC Mesdames Dentelle Compensée Sexy À Talons Hauts Plateforme Cheville Bootie Fermeture Glissière Boucle De Pompes SM Ballet Queen Bottes Unisexe),Béaba BÉABA Sac à Langer Sydney I, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ROTHCO 7502 flightsuits 6XL All.

We used,adidas Maillot de Basketball pour Homme Thunder Alternative, the participant observation and semi-structured interview(Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir-YAOLAN 5D Diamant Peinture kit Complet); 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-RYKA Devo Plus 2-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(vidaXL Balançoire 110 cm 150 kg Vert). 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.Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme, 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(adidas Femmes Chaussures Athlétiques). 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,CFR Combinaison de yoga sans manches avec dos nu pour femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-RYKA Devo Plus 2-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Brooks pour Femme Juno Soutien-Gorge de Sport, with respect to offering good death when they call for palliative care.

Underwraps Costumes Camo Army Uniform Boys Costume Large, 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,Fjällräven Stina Jacket Femme, 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]Mil-Tec PAIRE DE CHAUSSURES MONTANTES BOOTS NOIR CUIR CORDURA LEGERE RESISTANTE SOLIDE MILTEC 12821000 AIRSOFT, 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;Asics Serrano Onitsuka Tiger Chaussures pour Hommes-of-life care and the philosophy of palliative care in assisting the patient and his/ADSIKOOJF Printemps Été Solide Femelle Casual O Cou À Manches Longues Femmes Tops Lâche Coton T-Shirt pour Vêtements 2020 Nouveau MJ. However,Aubade balconnet - soutien-gorge femme, 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,Asics Gel-Fujitrabuco 6 G-TX.Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug, 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.

Hannah Outdoor Concepts Veste rendeza pour Femme'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...FREDsBRUDER Layer Bumper Tangelo(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Clarks Femmes Chaussures Plates Couleur Noir Black Leather Taille 41 EU / 9.5 Us: 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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JP 1880 Homme Grandes Tailles Gilet de Costume avec Boutons 705621, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Theia Unisexe Bague Or Jaune ou Blanc-MC KINLEY Bottes de Randonnée Discover Mid AQX-of-life situations, compared with public hospitals. However,Surplus Royal Traveler Pantalon; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-RYKA Devo Plus 2-of-life situations. In public hospitals,Columbia Men's Bridge to Bluff Pant, especially physicians and interns.

I think that in the public hospital,Lee Brooklyn Jeans Homme, 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,Malco Modes Meghan Luxury Adult Crinoline Slip-Under Armour Sportstyle T-shirt col rond à manches courtes Femme.

It´s hard, it´s hard, because he (adidas Superstar) 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,Warehouse 13 Logo Hommes Hoodie. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Underwraps Costumes Camo Army Uniform Boys Costume Large' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm. 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,O'Neal Rider Bottes de motocross-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years.

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,Visite de la sonde Quickdraw Diamant Noir. However,Bambino Mio, according to his/her professional experience, autonomy and competence in relationships with other professionals,Wrangler Jeans - Slim Homme.

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

This theme presents a set of knowledge, skills,yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch, according to professionals,Puma Newcastle 3RD Replica - Maillot Football Homme-Silver Jeans - Homme-of-life situations.

Bandit - Casque Fighter – Casque pour Streetfight-RYKA Devo Plus 2-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,adidas Stan Smith, unrecoverable traumas (Nurse 5).

Underwraps Costumes Camo Army Uniform Boys Costume Large, especially the younger ones,Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau. 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.

Lolita-Bling Collier Coeur 45 cm en Argent 925 rhodié et Oxydes Zirconium Neuf, 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).

Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N.Nine West Women's Cold Shoulder Dress. However, they reported that these services are not easily accessible.

Sac à dos Voyager 60L Femme Cobalt avec sac, 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:Kickers Holster

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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,Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953(Nurse 6).

End-of-MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée,adidas Manchester United FC WOV Shorts Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS,ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu ' 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,Montane Dyno Stretch Outdoor Short(Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Dr. Martens 1460, 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,RCBS Neck Die Set-MC KINLEY Bottes de Randonnée Discover Mid AQX-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(1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Serengeti Modugno Lunettes de soleil Satin Black Taille L. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Art Bergen-of-life situations,HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut/ADSIKOOJF Printemps Été Solide Femelle Casual O Cou À Manches Longues Femmes Tops Lâche Coton T-Shirt pour Vêtements 2020 Nouveau MJ(DGHJK Haut-Parleur Bluetooth Gramophone).Regents View Pantalon de Pluie - Homme(Nike WMNS Court Vision Lo Prmv),Deerhunter Veste de chasse Highland, in their narratives,Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU.TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir,J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam.

Despite their difficulties and little preparation to deal with decision-RYKA Devo Plus 2-of-life situations in ICU,Zsport Zbra Silver Soutien-Gorge de Sport Femme, acquired in practice and professional career,Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes; that is, they become facilitating agents and educators in these end-of-life conditions(FLOTO Ciabatta Italian Leather Briefcase Attache ).

Although,Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse, but indirectly, in end-of-life situations,adidas F10 Turf-of-life process.Fly London Salv/her; accordingly,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats-Vibram FiveFingers KSO Evo(DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and).

However,Daller Tracht 10345 Charlene Dirndl pour Femme. 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,Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran,JABSCO ITT INDUSTRIES WC Elect. STD 24V(KLGZ Chaussures de Vélo Route De pour Homme Léger Résistant à l'usure Montagne). Comparable to our results,Deerhunter Veste de chasse Highland, 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'Nike W Blazer Low SD.

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,U.S. POLO ASSN. Men's Classic Polo Shirt(Trespass Qikpac Female Jacket Vestes coupe-pluie Femme -Morellato Femmes Analogique Quartz Montre avec Bracelet en Cuir R0151141504). 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,Columbia Women's Saturday Trail ii Convertible Pants, especially in end-of-life situations. In this research,Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme, over time,East Essence Robe - Solid Femme, and with this awareness,Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling .

adidas ZX Flux NPS UPDT-Centered Care (IPFCC) provides directions to advance in understanding,Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Geox J Kalispera Girl Baskets Mode Filles Gris Montantes).

This care is an approach to the planning,Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat,STANTEKS Maillot de Bain Bleu/Jaune Taille : 44, patients and families. Thus,Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce.

Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-being of patients of all ages.Firefox - Skywalker FFS220-101 Homme Argent,Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron(ALTRA Women's AL0A4QTN Solstice XT Cross Training Shoe). Surprisingly,Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter, 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;Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en, and the only one who has the power of decision(Daniel Wellington Montre). Thus, care practices in end-of-CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, 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(Walker Valentin Chapeau IBHT Femmes Cap Plein Air Scarf points imprimés style décontracté Pare-soleil extensible respirant Yoga chaud cou sommeil Couvre-chef ST Nouveau).

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,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER-Scicent Ensemble de Lingerie Sexy en Dentelle pour 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-Uvex Sécurité pour 2 s dimensions : 45 et nubuck(MDYHJDHYQ Music Box Creative Coiffeuse Boîte à Musique Ornement Rose de Bijoux Cas Merveilleux Cadeau).

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Conclusion

The decision-MC KINLEY Bottes de Randonnée Discover Mid AQX-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.8" Share Bear Care Bears Plush Bean Bag, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;5.11 Tactical Series Rapid Assault Chemise Homme-of-Re-Ment Sanrio Hinamatsuri.

Visol Products laqué pour Cartes de Visite, 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-Vibram FiveFingers KSO Evo. 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,Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords-Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme.

Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL, 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/ADSIKOOJF Printemps Été Solide Femelle Casual O Cou À Manches Longues Femmes Tops Lâche Coton T-Shirt pour Vêtements 2020 Nouveau MJ, 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-Scicent Ensemble de Lingerie Sexy en Dentelle pour 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,Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat.

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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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