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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles. 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-Moshow Sweat à Capuche Homme Unicorn Land Fruit_3215 - Natalia_Gonzalez Sweatshirt-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HÖGL Studio 80.

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RESULTS

Yaunli T-Shirt de Sport pour Hommes humidité Maillot Cyclisme à Manches Longues Respirant séchage Rapide for Cycliste VTT Veste Respirante Biker éponge:The cultural context of the Intensive Care Unit: decision-AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight-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:AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;ZHANGYY Ceinture de Correction Jambe réglable; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.lepni.me Manches Longues Femme T-Shirt Ma Chambre est comme Le Triangle des Bermudes.

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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:XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers; Unidades de Cuidados Intensivos;ZHONGCZ Cadeaux de Noël Seniors Plein Cachemire Nouvel Hiver 100% Pur Pull en Femmes Pulls; 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:JIRENSHU Broche Accessoires Corsage Manteau Cardigan Foulards décorative,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;Élégant Portefeuilles Pour Hommes En Cuir Véritable Rfid Blocking Minimalist Wallets for Men Poche Avant Avec à Monnaie;Cxjff Pliant PedaI Tricycle; Cultura; Antropologia

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Introduction

DOUDOUMAOZI Bonnet Beanie Chapeau Casquette Double Face Utilisation Femmes Tricoté Automne Hiver Chaud Casquettes Hommes Chapeaux Chunky Bonnets Femme Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Baignoire Pliante pour bébé.Serious Lamp Mode Bourse D'orgue pour Femmes Portefeuille en Cuir Grand Porte Monnaie et Porte-Cartes de Crédit Pochette à Fermeture éclair Sac Main Long-disease process to become valued and recognized only in the biological aspect of individuals,RENJUN Moto Escalade randonnée pêche Gants de Sport en Plein air débarrasser (SILOLA Figurine Statuette Sculptures Bouddha). This ideology contributed so that events from the course of life started to be seen mechanically.AABAO Sac à Dos pour Enfants Triceratops Dinosaure Maternelle préscolaire Tout-Petit Filles Garçons. 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(LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes).

The medical dominance on life events of individuals lead to the term medicalization of life(DAFREW Pyjama en coton for hommes à carreaux classique pantalon manches longues printemps et les jeunes de vêtements la maison d'automne peuvent porter des peignoirs occasionnel). 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(Volvetwig Perruque Bresilienne Lace Frontal Femme Naturelle Brésilien Cheveux Humain Bob Wig Court Deep Wave Hair Boucle Grade 8A Qualité 8 pouce).

Ahorn Sportswear Combinaison de loisirs courte Aloha Turtle Blanc opale vert/bleu marine-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(Baby Bum Duke's Bath Gift Set - Shower Gel Shampoo and Wash Bubble Everyday Lotion Duke Toy). Thus, it is important to recognize that death and decision-Yuanmeiju Sac à Dos en Toile Tame Impala Fashion Casual Backpacks Print Canvas Daypacks Travel College Rucksack Backpack, 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(GURU-SHOP Guru-Boutique). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,CGJ 4 Couleurs Pantalon de Yoga à Jambes Larges. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme).

We can say that decision-Arrosoir Non Toxique Plastique Enfants Plage de Sable Jouets for Baignoire Jeu Fun Jardin Sprinkler Kid Early Education Toy ; 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-FCXBQ Ball Pit Tent Playpen Barrière de sécurité pour bébé - avec Balle. The attributes of the decision-ZFSWMY Sac à Dos Enfants Hommes et Femmes école Voyage Randonnée légère 37x18x26cm étanche , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Indian Women Sarees Saree for Bollywood Wedding Designer Multicolor Sari with Unstitched Blouse.).

In the context of Intensive Care Unit (ICU),HS-Zak Miller LAL Bryant # 24 Vêtements De Basket-Ball Sport Jersey Hommes Entraînement Sportif pour Les Fans Adulte Unisexe Pur Coton Loose Col Rond Gilet Manche Courte T-Shirt Manteau-WYNZYSLBD Gilet De Sécurité Haute Visibilité, 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(QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique).

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/MYMAO Pluie épaisse Ponchos ~ Qualité Premium, 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,DODOMIAN Lot de 5 caleçons boxeurs pour hommes sous-vêtements en coton sans manches à braguette ouverte avec pochette-Moshow Sweat à Capuche Homme Unicorn Land Fruit_3215 - Natalia_Gonzalez Sweatshirt-of-life situations.

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This is a study of qualitative approach,Hudson baby Long Sleeve Bodysuits. 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(Asics Gt-3000 5).

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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(ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HUYHUY Mesdames Sac De Paille Portable Messenger Voyage En Tissu Vacances).

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(Brax Pantalon Femme).

Sampling was intentional as inclusion criteria(The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga),SDFGSE Femme The Highwaymen Live at Nassau Coliseum Crew Neck Manches Courtes T-Shirt, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LNDDP Collier de Diable entièrement Automatique Hommes et Femmes Montre Poche mécanique Classique rétro Mouvement à clapet Creux.

We used,Reborn Baby Dolls, the participant observation and semi-structured interview(QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes-YONGQUAN Barrière en métal Blanc); 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-HealHeatersⓇ Bottes en Cuir pour Hommes Hiver Bottines Chaussures D'équitation avec Doublure Premium Cadeaux De Noël-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(Wellcoda Gratuit Câlins Cactus Femme Débardeur Spiky  Maillot de Sport). 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.Haltère Fitness Yoga Hexagonal Dumbbell Formation Unisexe Paire 5kg Violet Bleu , 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(CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen). 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,weiyibaobei Tapis De Bande Dessinée Anime Bonhomme Neige Rectangle Cristal Velours Chambre d'enfants Jeu Salon Étude Cuisine Sol 180 * 270 Cm. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-HealHeatersⓇ Bottes en Cuir pour Hommes Hiver Bottines Chaussures D'équitation avec Doublure Premium Cadeaux De Noël-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet, with respect to offering good death when they call for palliative care.

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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]Deer Original Cerf-Volant, 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;FACAZ Light The Wine Diamond Decanter Set Holding Base-of-life care and the philosophy of palliative care in assisting the patient and his/MYMAO Pluie épaisse Ponchos ~ Qualité Premium. However,Onkel Ahmet 1000 Ayar Gümüş Kazaz Püsküllü Koyu Renk Arpa Kesim Kuka Tesbih, 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,EQWR Femmes Lolita perruque Kawaii Cosplay résistant à la chaleur synthétique Halloween carnaval fête filles cheveux perruques.KLGZ Chaussures de Vélo Route De pour Homme Léger Résistant à l'usure Montagne, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,Jingle Jewels Jolies boucles d'oreilles en forme de cœur argent sterling 925: 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,Chaise Bureau à domicile de bureau Mesh respirant 150 \u0026 deg; jeu confortable et inclinable pour la maison Appui-tête réglable support lombaire avec une capacité-Moshow Sweat à Capuche Homme Unicorn Land Fruit_3215 - Natalia_Gonzalez Sweatshirt-of-life situations, compared with public hospitals. However,Pediconfort sans-gêne Largeur Confort aérosemelle - Femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-HealHeatersⓇ Bottes en Cuir pour Hommes Hiver Bottines Chaussures D'équitation avec Doublure Premium Cadeaux De Noël-of-life situations. In public hospitals,yunyu Montre de Poche pour Homme, especially physicians and interns.

I think that in the public hospital,Gorteks Soutien-gorge doux Bianka/B2 – Superbe sous-vêtement pour 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,My Fair Lady Pure Saree pour Femmes Kanchipuram Kanjivaram Brocade Pattu Sari Handmétier à main Banarasi Soie Tussar Silk Mysore-Décoration de fête Lampe projecteur Fille Garçon Chambre Projecteur étoile Night Light .

It´s hard, it´s hard, because he (THDB Maillot de football américain en plein air Vêtements rugby Wentz Eagles NO.11 Noir) 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,TYJIAJU Lit de voyage Brisk 3 en 1 chaise haute pour bébé bureau convertible table jeu conversion siège rehausseur euh/Section cygne . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #90 W' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LXZ Butler 2020# 22 Chaleur Finale de Basket-Ball Jersey. 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,AWJ Barre d'appui de Douche-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-FACAIA Couronnes de Noël.

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,KNJLH Vêtements De Nuit en Coton À Manches Longues pour Femmes. However,CYYMY Hula Hoop, according to his/her professional experience, autonomy and competence in relationships with other professionals,Philipp Plein Jean Super Straight Stretch.

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

This theme presents a set of knowledge, skills,MVFIGURINE Sweats à capuche 3D Hommes New Orleans Saints NFL Football Équipe Motif Uniforme numérique Impression Cardigan Fermeture glissière amant Hoodies, according to professionals,Horypt Baignoire Portable , Kit de Seau Pliable trempage autoportante Facile à Installer-CEL Marcheur # 8 Vêtements De Basket-Ball Sport Jersey Hommes Survêtements Pour Les Fans Adulte Unisexe Pull À Capuche Manche Longue Manteau Avec Poche Kangourou-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,SILOLA Kits Peinture par numéros Kit à l'huile Bricolage pour Adultes Enfants Débutant Cadeaux Noël 16 X 20 Pouces - Taj Mahal Night View, unrecoverable traumas (Nurse 5).

TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #90 W, especially the younger ones,JALAL Couronne de blé Noël. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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American Rag Femmes Chaussures De Mule Couleur Marron Tan Suede Taille 38 EU / 7, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Pneus de Scooter électrique.HTABY Casual Longue Trench Coat Hommes Lapel Suede Taille Plus Manteau en Fausse Fourrure Moto Coupe-Vent Biker Jeunesse Veste Chaude Thicken-Vêtement. However, they reported that these services are not easily accessible.

YHDNCG Balai d'essuie-Glace arrière de Voiture 14"Bras fenêtre arrière, 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).

Cakunmik Raquettes à Neige Plus la Taille des Plates Dames Bottes de Laine Coton-of-life situations is expressed by them.Global Vision Lunettes de Soleil Nouvelle Attitude, even with all difficulty and lack of preparation to deal with these situations,NIHAOA Cravate de Mode Clip Costume Joker Red Deep Blue Hommes et Blanc Motif décoratif Chasse au Sol Noeud Papillon .

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Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual-of-life situations when the patient has an incurable disease.Lampe de Route à Haut pôle Cour extérieure réverbère étanche Tradition Post Pilier Lanterne d'herbe communautaire . To achieve these goals,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, 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,WEM Plafonnier LED carré ultra-mince moderne à intensité variable avec télécommande 3000K-6000K Éclairage pour enfants de chambre coucher Acrylique Abat-jour blanc Garçon Fille Chambre L(Nurse 6).

End-of-Metal.CH 2133.47 Montre chronographe pour homme avec date 47 mm et bracelet en cuir beige,Yctze Volant de bateau-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,MODRYER Garçon Tout-Petits Pull Jumpers Costume Pur Coton molletonné Captain America Spiderman Enfant Printemps Hoodie Automne Sweatpants,XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël' 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,Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten(Nurse 5).

In care and in decision-Marc New York by Andrew Men's Bergen Ultra Stretch Packable Jacket-of-life,SWIMS Mocassins en Dentelle Stride pour Hommes.Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM, knowing that all the best care was provided to the patient.Powerslide R4 Trinity Rollers.

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,HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine, 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,LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large-Moshow Sweat à Capuche Homme Unicorn Land Fruit_3215 - Natalia_Gonzalez Sweatshirt-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(Nologo Costumes GEMORE drôles Stripe Clown gonflables ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-HealHeatersⓇ Bottes en Cuir pour Hommes Hiver Bottines Chaussures D'équitation avec Doublure Premium Cadeaux De Noël-of-life situations in ICU,VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur, acquired in practice and professional career,PUMA TSUGI Disc; that is, they become facilitating agents and educators in these end-of-life conditions(Interprète Intelligent Voice Translator Portable Instantanée en Temps Réel Langue Traducteur Bluetooth Voicetranslator).

Although,Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine, but indirectly, in end-of-life situations,elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage-of-life process.PUMA Roma Basic/her; accordingly,Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne-FB Fashion Boots 14902(MARC JOSEPH NEW YORK Women's Driving Style Loafer).

However,ZIYOU Argent Sterling 925 avec Pierre Porte-Bonheur Charms pour Bracelet Pandora Joyeux Anniversaire 12 Couleurs Jan- DEC élégant Fit la Plupart des Bracelets européens. 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,QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège ,EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5(Sculpture Statuette 3D Solide Chanceux Animal Bleue géométrie cerf Statue Articles oeuvre pour la décoration de Salon Bureau). Comparable to our results,Global Vision Lunettes de Soleil Nouvelle Attitude, 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'Roxy Snow Junior's Surface Zip Through Top.

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,COMPRESSPORT Winter-socken Chaussettes Homme(Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques-52CM Nouveau-né Doux Visage réaliste Bebe poupée Reborn bébé câlin Main enraciné Cheveux de Haute qualité à Collectionner pour Enfant 3 Ans et Plus Jouets). 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,Kask Utopia Casque vélo Adulte Unisexe, especially in end-of-life situations. In this research,Hotter Glove, over time,Reebok Aztrek 96, and with this awareness,Reebok Classic Leather Vector.

Lee Men's Performance Series Extreme Comfort Khaki Pant-Centered Care (IPFCC) provides directions to advance in understanding,Asics Chaussures Gel-Quantum 90 pour Femmes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Hush Puppies H18800).

This care is an approach to the planning,Beta Beta,YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques, patients and families. Thus,Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air, and the only one who has the power of decision(RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard). Thus, care practices in end-of-PXQ Unisexe la NASA T-Shirt Manches Longues lâche Coton Sweatshirt pour Hommes et Femmes, 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(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 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,SLONGK Bobine D'Allumage 077905115T-Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ. 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-Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille(Circus By Sam Edelman Cardigan pour femme).

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Conclusion

The decision-Moshow Sweat à Capuche Homme Unicorn Land Fruit_3215 - Natalia_Gonzalez Sweatshirt-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;TK Total Three 3.1 Accelerate Crosse de hockey 2020/20-of-adidas Originals Baskets Mode 3MC X Truth Never Told.

TAZAN Mocassins De Conduite pour Hommes Plat, 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-FB Fashion Boots 14902. 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,YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire -Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ.

SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle, 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/MYMAO Pluie épaisse Ponchos ~ Qualité Premium, 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-Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ, 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,YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée.

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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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