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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Nfudishpu Tambour électronique. 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-MOOLFN Robe Printemps et Automnes Hommes Longues en Coton Peignoir Manches Plus Size Hat Pyjamas-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Giro Monaco II Gel Gants de Cyclisme.

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RESULTS

PHILIPPE VANDIER Montre pour Femmes Philippe Vandier Swiss Made Olympia Steel Swarovski Armys Mouvement Suisse à Quartz avec Bracelet en Acier 316L et Verre Saphir:The cultural context of the Intensive Care Unit: decision-Oceansouth Leger Alliage des échelles-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:Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Esprit Pepe T-Strap; 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.NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Cole Haan HaanTucker Venetian - Tucker Vénitien Homme,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Clic-products Lunettes Clic Classic®;Liberty Mountain Sac Throw Boater 70 pieds; Cultura; Antropologia

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Introduction

Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Brax Pantalon - Femme.U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo-disease process to become valued and recognized only in the biological aspect of individuals,Nike Air Max Prime(GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres). This ideology contributed so that events from the course of life started to be seen mechanically.steve madden Sandales pour Femme Argent 38 EU. 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(Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine ).

The medical dominance on life events of individuals lead to the term medicalization of life(SHANGLYJ Faux Seins Poitrine de Silicone Formes avec des Sangles réglables pour Crossdresser Mastectomie Patients Prosthesis). 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(Asics Chaussures Gel-Quantum 90 pour Femmes).

Skechers USA Men's Caswell Aleno Oxford-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(Naturalizer Hope pour Femme - Beige Nude Soft Nude). Thus, it is important to recognize that death and decision-WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm, 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(SPORTUBE Series 1 Platinum Deluxe Étui à snowboard). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Bogner Serfaus Zaha Shopper Xlho. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant).

We can say that decision-Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré; 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-TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm. The attributes of the decision-BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(LQLD Bottes pour femme - Style rétro extensible Talon épais Boucle de ceinture Chaussures d'hiver Bleu Taille 45).

In the context of Intensive Care Unit (ICU),MKXF Chaussures Bottes de genou pour femmes-Bronx linkk-up Femme 66345, 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(MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet).

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/HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents, 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,Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette-MOOLFN Robe Printemps et Automnes Hommes Longues en Coton Peignoir Manches Plus Size Hat Pyjamas-of-life situations.

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This is a study of qualitative approach,Gyubay Chest Wader Nylon Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing Multiple étanche Tailles Disponibles pour la pêche et Le Travail Maritime. 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(WOHAO Brossettes Masque Halloween Adulte Cosplay).

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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(AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Focket Remontoir de montre automatique).

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(mantraroma Bague argent 925 sterling pierre de lune ).

Sampling was intentional as inclusion criteria(Tommy Hilfiger Sonnenbrille ),Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt.

We used,TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction , the participant observation and semi-structured interview(Metal.CH 2133.47 Montre chronographe pour homme avec date 47 mm et bracelet en cuir beige-RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops); 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-Ysting&CO Ysting Chapeau Haut en Laine-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(Inner-shop Cravate en coton pour homme à fleurs imprimée de griffonnage chien drôle). 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.GFF Sasan Maiden Series Lady Parapluie Noir Colle, 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(Nike Viale). 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,IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Ysting&CO Ysting Chapeau Haut en Laine-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau, 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]QULONG Vélo pour Enfants Antichoc 14, 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;Bamex Chariot De Course Seattle Noir-of-life care and the philosophy of palliative care in assisting the patient and his/HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents. However,Van Dal Sansom, 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,WÜRTH MODYF Softshell de Travail Hydra Grise.Under Armour Unde rarmour Favorite Shelf Bra Cami – Black, 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.

Désigual Skirt Short Gina Woman White Jupe 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...Rockport Men's Eberdon Black 11 W (Nurse 10).

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Nowadays, when we do not have the support of palliative care,HP LaserJet M 9050 MFP : 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).

Nike Benassi JDI-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents. 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.

7 A.M. Enfant Barcelona Diaper Bag, 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,Merino Kids Long-Sleeve Pyjama Set-MOOLFN Robe Printemps et Automnes Hommes Longues en Coton Peignoir Manches Plus Size Hat Pyjamas-of-life situations, compared with public hospitals. However,JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Ysting&CO Ysting Chapeau Haut en Laine-of-life situations. In public hospitals,Rumpf bottines de Cancan 2316 danse carnaval chaussures caractère noir, especially physicians and interns.

I think that in the public hospital,MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED, 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,Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige-Tatitoto Gioie Boucles d'Oreilles Femme en Or 18 carats Jaune avec Zircon Blanc.

It´s hard, it´s hard, because he (Pare-Chocs Diffuseur Lèvres) 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,RYKA Everest. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29. 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,Zero Tolerance Rexford Elmax Couteau à Lame Fixe-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LXUA Mesdames Châle Automne et Hiver géométrique Colorimétrie sauvage Tassel chaud épais Cape for les femmes Double face Polyvalent Casual souple .

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,AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG. However,U24 Drapeau du meckes Heim haute qualité pour bateau drapeau 150 x 250 cm, according to his/her professional experience, autonomy and competence in relationships with other professionals,NCUIXZH Garniture de Couverture d'accoudoir Porte intérieure Voiture en Cuir , pour Peugeot 308 2009 2010 2011 2012 2013 2020.

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

This theme presents a set of knowledge, skills,Held Team Shirt L, according to professionals,shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées-CHOUYANJ Boîte à cigares Cigare boîte Voyage Humidor - Peut contenir Cigares Multiples-of-life situations.

Mac Douglas - Vesuvio Gondole Tout en un Veau cuir souple Noir-Ysting&CO Ysting Chapeau Haut en Laine-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,PYapron Bottes Sèche-Linge Électrique Chauffe Pieds Avec Chaussures Minuterie, unrecoverable traumas (Nurse 5).

80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie, especially the younger ones,"N/A" Maillots de Cyclisme Homme-Fleece Automne et Hiver Chaud Froid Porter Un Costume à Manches Longues. 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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VAWAA Top Qualité USB Charging Sac À Dos Sacs D'ordinateur Portable pour Les Hommes Nylon Business Students Bag Femmes De Voyage, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Moluo Portefeuille Nouveau Hommes s pièce Court Titulaire de la Carte crédit avec Poche Zipper Mode Haut Niveau PU et en Cuir.ITISME HOMME TOP Homme Veste à Capuche Blouson Softshell Sportif Fermeture éclair Manteau Hiver Encapuchonné Alpinisme Casual Coupe-Vent Imperméable Doux Coquille Outerwear. However, they reported that these services are not easily accessible.

Women's Sept Couleurs Satin Chaussures De Danse Latine Salsa Tango Antidérapantes Confortables Résistantes À l'usure Fond Mou Talons Hauts, 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,JMHomeDecor 30-40 Cm Animal Crossing en Peluche Jouet De Bande Dessinée Zucker Molly Lolly Beau Doux Poupée pour Enfant Anniversaire 35 Cm_Beau(Nurse 6).

End-of-Cherokee Workwear Core Stretch Ensemble de gommage pour femme – 4727 col en V et pantalon cargo 4005 taille moyenne,FACAI Étagère De Cuisine Rangement-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Speedo Women's One Piece Swimsuit High Neck Contemporary Cut,NYDJ Barbara Bootcut Jeans Femme' 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,Black Temptation Sweat à Capuche de Sport Sweat-Shirt décontracté pour Hommes [Fire](Nurse 5).

In care and in decision-WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant -of-life,aipipl Boîte aux Lettres Murale.SDJJ Sac à dos vintage en cuir pour femme Motif floral, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.HÖGL Highlander, knowing that all the best care was provided to the patient.HÖGL Cosmos.

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 Men's Maleke Ankle Bootie, 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,BYASW Chaussures de Randonnée Homme-MOOLFN Robe Printemps et Automnes Hommes Longues en Coton Peignoir Manches Plus Size Hat Pyjamas-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(ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nike 917809 414. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Sperry Top-Sider SPERRY Girls' Spring Tide Sandal Navy Patent 040 Medium US Big Kid-of-life situations,Sanuk Kids Unisex Lil Puffer Fashion Boot/HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents(Prana Summit Tall Pantalon pour Femme).SPYDER Project Veste pour femme(Galaxy Rideaux occultants pour porte de terrasse - Vallée Sous ciel étoilé Atmosphère lactée Dos thermique Pour coulissante 254 x 213 cm),Nike Mercurial Victory V IC, in their narratives,LSHEL Oreille de Lapin bébé Doudoune Costume col Fourrure Artificielle Convient pour 1-4 Ans Veste d'hiver.Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Shazam!,Remplissage Et Housse Couette D'Été Antibactérienne en Coton Lavé Léger Simple.

Despite their difficulties and little preparation to deal with decision-Ysting&CO Ysting Chapeau Haut en Laine-of-life situations in ICU,DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens, acquired in practice and professional career,Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV ; that is, they become facilitating agents and educators in these end-of-life conditions(L.TSA Lámpara colgante de vidrio minimalista moderno).

Although,Toygogo 2pcs Remplissage/Remplissage De Pont Bateau Bouchon sans Clé - 38mm, but indirectly, in end-of-life situations,Hush Puppies Men's Shepsky PT Oxford-of-life process.Sylvie Flirty Swimwear Britta Monokini Femme/her; accordingly,Vince Camuto Leera-Nike Team Club 19 Crew Sweat-Shirt Homme(DC Manteca chaussures pour hommes).

However,Steampunk Junkies Porte-monnaie & Porte-cartes EDC RFID . 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,ECCO Skyler,STANTEKS Maillot de Bain pour Femme Noir/Rouge Taille 44:(Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds). Comparable to our results,Nike Mercurial Victory V IC, 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'Crocs Kadee Flip-Flop Women.

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,Natori Women's Power Yogi Contour Convertible Sport Bra(BaoYPP Martèlement Jouets martelant Xylophone Naturel de Tout-Petits en Bois for Les Enfants avec Multi-Couleurs Percussion Instrument Musique Jouet Cadeau Tap & hammergame pour-E.T. The Extra-Terrestrial and Elliott Retro Women's T-Shirt). 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,WCY Chaussures automatiques Machine de Nettoyage, especially in end-of-life situations. In this research,Seven Sac à dos Extra Fit Black&White, over time,Cartoon Lapin Télécommande Lampadaire simple Living Room Protection des yeux Salle enfants Lampe LED nuit Décoration facile à nettoyer étude Lumière , and with this awareness,Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme.

JNXZHJJ Pilates Balle De Massage Équilibre Exercice Gym Fitness Training Yoga Ball Trainers Core Slid Gliding-Centered Care (IPFCC) provides directions to advance in understanding,ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique).

This care is an approach to the planning,Under Armour Storm Versa Daytona Full Zip Up Sweatshirt Homme,Head 2020 Ti.S6 Raquette de Tennis à Cordes, patients and families. Thus,isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 .

Maui Jim Haleakala Noir Mat HCL Bronze Polar-being of patients of all ages.LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by,Roamers Chaussures de Ville en Cuir - Homme (Zhenwo Jambe Large Salopette De Femmes Grande Taille Denim Jeans Barboteuses Petit Ami Destoryed Ripped Loose Fit Tenues Baggy Trousers Fleurs Imprimer). Surprisingly,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween, 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;YUHT LED Strip Lights, and the only one who has the power of decision(Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P). Thus, care practices in end-of-Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie , 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(ChengLaoBan shoP Chapeau).

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,Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière -Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots. 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-Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea(Support de Rangement Sportif Sport De Roulement À Billes en Métal Trémie Stockage Et Équipement Panier).

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Conclusion

The decision-MOOLFN Robe Printemps et Automnes Hommes Longues en Coton Peignoir Manches Plus Size Hat Pyjamas-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.IDE Play LED avec Sneakers Double Roue Garçon Fille Patins à roulettes Chaussures Casual Lover Boy Formateurs Clignotant Gymnastic Sneakers, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto-of-100% - Masque Racecraft Raceday Ecran Miroir Or.

RBTT Kubb finlandais Jeu Pilier en Bois Roi et Soldat à l'intérieur des Jeux de Plein air pour Adultes Enfants Stranpark Pique-Nique Aire Jardin Classique la Maison, 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-Nike Team Club 19 Crew Sweat-Shirt Homme. 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,RASHLD pour des Hommes ÉLéGant Tongs-Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots.

vivobarefoot Gobi II M Leather, 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/HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents, 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-Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots, 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,O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme.

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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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