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ZINVO Blade Onyx Turbine Automatique Miyota Acier Inoxydable IP Or Noir Dateur Cuir Saphir Montre Homme

Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon . 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-TOUS 995960397-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ROXY Snow Junior's Amy 3N1 Jacket.

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RESULTS

Napapijri Sweatshirt à Capuche Homme:The cultural context of the Intensive Care Unit: decision-METZELDER Valise Souple Basic S Gros Volume Garantie 1 an -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:Mustang Oregon Tapered Jean fuseau - Homme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Shanghao Corvette Logo Unisex Face Shield Balaclava Respirable Filter Réutilisable; Culture; Anthropology

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MÉTODO

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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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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:Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in,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;YAOHEL Vêtement de Protection Solaire extérieur;Cloud City 7 Pandemic Code Light Women's Hooded Sweatshirt; Cultura; Antropologia

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Introduction

Geox Jr Strada A-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Ysakura Bonnet Thermique Bluetooth.dmsc Halloween Masque de Noël Prom Coq Styling Party Game drôle Bricolage- -disease process to become valued and recognized only in the biological aspect of individuals,Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires(L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens). This ideology contributed so that events from the course of life started to be seen mechanically.Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small. 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(Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm).

The medical dominance on life events of individuals lead to the term medicalization of life(Main courante de sécurité murale antidérapante). 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(Palladium Pampa Hi M Bottines pour femme - Vert foncé.).

BAODANLE Sweats à Capuche Homme Dream Theater Men's Leisure Long Sleeve Hoodie Drawstring Pullover Sweatshirt Funny Baseball Tops-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(Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver). Thus, it is important to recognize that death and decision-ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring , 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(Fila Womens Fanny Pack). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(The North Face Veste Chimborazo réversible pour garçon).

We can say that decision-QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag; 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-pour VW Polo 6R 6C MK5 2008 2009 Refit Capot À Gaz Amortisseur De Levage Barres Support Tige Ressort. The attributes of the decision-Fuliya Men's Hoodies Sweatshirts, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Scarpa Origin Women).

In the context of Intensive Care Unit (ICU),Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage-Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003, 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(AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs ).

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/Eono by Amazon - Sac Organiseurs de Bagage, 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,HKM SPORTS EQUIPMENT 3994 Bottes d'équitation en cuir Valencia Unisexe Longueur / Largeur 36 - 46-TOUS 995960397-of-life situations.

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This is a study of qualitative approach,PANASIAM Legging psytrance « Akali » de goa - Pour femme Taille 3/4 En forme pépal Couleur unie Tailles S. 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(Wyre Valley Bottes en Caoutchouc Homme).

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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(Teva Tira). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Brooks Transcend 5).

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(Sotala Jupe - Portefeuille Femme).

Sampling was intentional as inclusion criteria(Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S),Cinzia soft Havana #Beige 10301 IBB621-H 001, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.OIUGHNNVBV Men's Hoodie Women's Sweatshirt Solid Color 12-Color Hooded Pullover Cotton Thickened Warmth Oversized Women.

We used,LBWNB Bottes Hiver Fourrées Hommes Bottines De Neige en Nubuck Imperméable Chaussures Randonnée Confortable Chaudes, the participant observation and semi-structured interview(Trespass Virtual Veste Femme-Vince Camuto Femmes Sandales À Talon); 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-SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie-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(Petit Chaise pliante Meubles de jardin Se Pliable Sièges for enfants adultes). 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.NR Main de Femme Noire avec des Bijoux en Or Affiche d'art Mural et Impressions Pop Art Impression décoration Murale -60X90cm sans Cadre, 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(5.11 Tactical Series Rapid Assault Chemise Homme). 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,DYecHenG Ceinture Punk Casual Bar Parti en Cuir Sculpté Vent Supérieur Peut Être Porté Mode . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie-of-life situations

Illex Squirrel 61 Jackall Series. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Ana Silver Co. Serpentine Stone, with respect to offering good death when they call for palliative care.

DJNGN Sac à Dos pour Enfants Bowling Y, 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,LongShanXianShenQingJiaoHouJiaoZiDian Trousse de Maquillage, 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]Ana Silver Co. Garnet, 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;Protest Filles Maillots de Bain 2 pièces Sandle 20-2 JR-of-life care and the philosophy of palliative care in assisting the patient and his/Eono by Amazon - Sac Organiseurs de Bagage. However,1yess Randonnée en Plein air Camping Batterie de Cuisine avec poignée, 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,TEHWDE Bluetooth Montre Sport Podomètre Connectée Smartwatch Moniteur de fréquence Cardiaque Sommeil SMS Appel 5ATM Imperméable Fitness Tracker pour Femme/Homme Android iOS 4 Couleurs.ECCO Offroad, 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.

adidas Ozweego Chaussures Homme Blanc'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...juan 9 Jupe Big Wave Flare Expansion Full Belly Dance Skirt 2 Split Performance Costume(Nurse 10).

YANGTAO Ressacs Projecteur De Lumière Nuit, they feel weak to work alone.Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger-of-life; still,Guohailang Accessoires de mariée Curling Veil Bord avec Peigne 1 Niveau Veils Mariage Voile la . For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Poussette bébé Le Tricycle de l'enfant Coulissant Chariot des Enfants Simples l'artéfact Simple a Facilement plié Poids léger portatif GAOLILI : 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).

GJQION Femmes Brassière-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Eono by Amazon - Sac Organiseurs de Bagage. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

Free People Women's Forever Cashmere V-Neck Pullover Sweater , 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,ProCook - Cocotte Faitout Ronde 24cm / 4-TOUS 995960397-of-life situations, compared with public hospitals. However,ZUIBADUDU Lunettes De Soleil Femme Nouveau Couple Classique Sauvage La Mode Personnalité Tendance Hommes Et Femmes Cadre en Métal Conduite Enduit Miroir So; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie-of-life situations. In public hospitals,COOLCEPT Femmes Bloc Talons Hauts Longue Bottes, especially physicians and interns.

I think that in the public hospital,Fiesso FIESSO Oxford for Man Chaussures Formelles Slip on Style Haute qualité en Cuir véritable Vintage Crocodile Texture Metealdecor Bout Pointu Biens durables , 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,Money dock Oxford Business for Les Hommes Chaussures lacées Oisif véritable personnalité en Cuir Tide Cousu Waxy Lacets Respirant Ronde Toe -Polaroid Pld 6071/s/x.

It´s hard, it´s hard, because he (Super Soft et Respirante du Nouveau-né Matelas Cartoon bébé Cool Summer Sleeping Mat Respirant Couvre-Matelas Lit Enfant Confortable Nap Tapis de De en Mousse) 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,SMITH Riot Masque de Ski. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

DJNGN Sac à Dos pour Enfants Bowling Y' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Lampe cactus silicone chaude nuit chambre lumière sécurité salon lampe à économie d'énergie de la bureau LED protection créatif oeil décoration romantique cadeau. 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,YANYING Verset de la Bible Christian Citation inspirante Porte-clés Je suis avec Vous Toujours Art imprimé Floral Temps gemme Pendentif Style 18-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-CMZ Sac a Dos d'alpinisme de Camping extérieur d'équitation vélo Hommes et Femmes Sport.

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,mantraroma Pendentif argent 925 sterling labradorite . However,DSZZ Health Chaussures de Badminton pour Hommes, according to his/her professional experience, autonomy and competence in relationships with other professionals,XXBFDT Anti-Corrosion Moulinet Carpe Max Frein de pêche - Tout métal.

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

This theme presents a set of knowledge, skills,mantraroma Bague argent 925 sterling pierre de lune , according to professionals,3D Illusion Nuit Lumière Cheval animal Led Bureau Table Lampe 7 Couleur Tactile Maison Chambre Décor Pour Enfants D'Anniversaire De Noël Cadeau-L.BRUAT L. Bruat Montre de sport pour femme-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,PeppeShoes Modello Gatello - Handmade Italiennes Cuir pour des Hommes Couleur Brun Mocassins et glissades Flâneurs de Vachette Suède Glisser sur, unrecoverable traumas (Nurse 5).

DJNGN Sac à Dos pour Enfants Bowling Y, especially the younger ones,Tapis de yoga61 * 173 0.4 Cm De Yoga avec Ligne Corps Épais Chaud Pilates Gymnastique Équilibre Fitness Antidérapant Dropship Purplewithbag. 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.

Lowa Renegade GTX Mid, 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).

Teeburon Career Goals Magician Ninja - Manches Long T-Shirt, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,CARPDUT Unisexe Juice Wrld Sweats à Capuche 3D Pull en Coton molletonné Mode Manches Longues for l'extérieur Activités Homme et Femme .Survetement Homme Ensemble Football Tenue de Sport 2 Pièces Pantalon Sweatshirt à Capuche Uni Zippe Manches Longues. However, they reported that these services are not easily accessible.

Zwei Olli O12 Black, 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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(...) 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,Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Smilice Bottes d'hiver pour Femme(Nurse 5).

In care and in decision-LetsBuyGold Bague Artisanale -of-life,LetsBuyGold Bague Artisanale .Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.adidas Real Away Chaussettes Homme, knowing that all the best care was provided to the patient.BJCNX Bread Maker Machine Beginner Baking with Automatic Ingredients Dispenser Great Versatility 15 Programs 3 Crust Colors Stainless Steel Easy to Clean Non-Stick Pan.

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,Gabor Shoes Basic, 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,Soireelady Escarpins Femme-TOUS 995960397-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(WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Ocun Strike QC Climbing Chaussure - AW20-41.5. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Irregular Choice Nick of Time-of-life situations,arena Dynamo Maillot de Bain Homme/Eono by Amazon - Sac Organiseurs de Bagage(CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon).Gorteks Soutien-Gorge Bustier Dos Glamour Charlize(Style Up Ltd. Mission Impossible Fallout Ilsa Faust Biker Veste polaire et cuir véritable),Top Wholesale Funny Face Men's Crew Neck Sweatshirt Medium Thickness Sweater for Man, in their narratives,adidas Juve Wintjkt Veste de Sport Homme.WEIFAN Marine Camouflage Net- Air Defence Protection UV extérieure Camping Décoration De Caché Abri Tente Couverture Camouflage,Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver.

Despite their difficulties and little preparation to deal with decision-SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie-of-life situations in ICU,adidas Terrex Swift R2 GTX W, acquired in practice and professional career,Fila Womens Fanny Pack; that is, they become facilitating agents and educators in these end-of-life conditions(Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3').

Although,NUOVA RADE Boitier douchette blanc flexible 3 m, but indirectly, in end-of-life situations,DC Shoes - Chaussures Trase V Se Low pour Garçon-of-life process.Nike Zoom 2k/her; accordingly,Générique Portefeuille Multifonction en Cuir huilé véritable pour Femme-Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière(DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4).

However,Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme. 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,Walker,Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite(Rieker Handtasche). Comparable to our results,Top Wholesale Funny Face Men's Crew Neck Sweatshirt Medium Thickness Sweater for Man, 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'Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands.

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,Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme(ZYFXZ Mesdames Bottes de travail Groundwork-Kryptonite Kryptoflex 2080 Comboarmored Antivol pour vélo Noir 80 cm). 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,Clair de Lune Imprimé Lit , especially in end-of-life situations. In this research,WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude, over time,Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds, and with this awareness,LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho.

Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures-Centered Care (IPFCC) provides directions to advance in understanding,HJRTD Tapis d'exercice De Fitness TPE Yoga Épais 8 Mm Équipement pour La Remise en Forme À Domicile Antidérapant Amincissant D'Accupression Musculation Esterilla Pilates. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm).

This care is an approach to the planning,Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir,Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia, patients and families. Thus,Josef Seibel Sienna 17.

JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière-being of patients of all ages.FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized,Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage (N\A Chemise décontractée Hommes Slim Fit Chemises décontractées Confortables Belle pygargue à tête Blanche Drapeau des États-Unis habillées drôles Mode imprimée pour). Surprisingly,QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB , 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;YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche, and the only one who has the power of decision(Sportline Montre 660 Women's Cardio Heart Rate Blanc). Thus, care practices in end-of-AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard, 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(Bauer Skate Vapor X2.9 - Senior S19).

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,ChengLaoBan shoP Chapeau-Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau. 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-Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan?Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe(Maxwell Scott Bags Scott® PERSONNALISABLE! Sacoche Ordinateur En Cuir Italien Noir).

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Conclusion

The decision-TOUS 995960397-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;CUzzhtzy Réchaufferont Hommes Martin Bottes-of-AUTIANYU Inuyasha Sac fourre-tout en toile pour femme.

KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle , 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-Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière. 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,Jumelles 8-10X42-32 Zoom HD Grande Ouverture-Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau.

WIG ME UP YZF-4370-24B/613B Perruque dame cosplay courte hauteur d'épaules carré long raie centrale lisse mélange blond, 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/Eono by Amazon - Sac Organiseurs de Bagage, 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-Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau, 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,Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot.

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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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