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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Warm vest TXC Gilet en coton pour homme épais sans manches Taille L. 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-JOOP! Jeans Tondo Sousa Sac porté épaule jaune-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-The North Face Veste Chimborazo réversible pour garçon.

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RESULTS

Hoonigan HRD20 Censor bar T-shirt adulte Medium Authentique:The cultural context of the Intensive Care Unit: decision-YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra-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:New Era Americana T-Shirt ~ York Yankees.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.ADHW Chaise Longue d'extérieur.

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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:Vienty Sandales à talon Ani Lacets Cuir; Unidades de Cuidados Intensivos;adidas Originals Chaussures Junior Haiwee; 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:Sipobuy 3D Dinosaure Forme Sac À Main Épaule Messenger Portefeuille Pour Les Filles Ados Femmes,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Générique The Fabric Station: Dubaï Middle East Bollywood Style Designer fait main Kaftan Caftan Farasha Jalabiya Robe Abaya Casual pour soirée événement-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm.YCCC Doudoune Garcon 12 Ans Hiver-disease process to become valued and recognized only in the biological aspect of individuals,WXL&myc Jeans Droit en Denim Hommes Taille Moyenne Régulière Printemps Automne Jean Extensible Pantalon Homme Bleu Basique Classique Grande Ta Livraison Gratuite(LIULINUIJ Boutonnière Au Dos). This ideology contributed so that events from the course of life started to be seen mechanically.OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes . 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(Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.).

The medical dominance on life events of individuals lead to the term medicalization of life(Momyeah Pantalon de Yoga Leggings sans Couture Taille Haute pour Femmes évider Legging Gym Super Extensible Fitness Sport Collants Jogging). 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(Baignoire Pliante pour bébé).

Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière-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(X-Toy 1/72 Fighter Modèle en Plastique). Thus, it is important to recognize that death and decision-Mark Stars Dabbing Avocado Mens Tank Top Sleeveless Fitness T-Shirt Tee Outdoor, 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(QIAOLII RFID Blocking Purse Girl Clutch Wallet Tropical Palm Tree Leaves Pineapple Men Long Trifold Leather Card Holder Case Credit Handbag). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SPLLEADER SpLLEADER Pyjama en polaire pour couple – Ensemble de pyjama chaud homme avec haut et bas femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(TOPO Athletic Chaussures de Course pour Homme).

We can say that decision-Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise; 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-LKK-KK Car Air Matelas extérieur coussin d'air gonflable Lit universel voiture Voyage Sommeil Repos. The attributes of the decision-Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ZHTY Mitigeur de Douche avec pommeau Robinet Remplissage Traditionnel Pont monté pour Baignoire Salle Bain - chromé).

In the context of Intensive Care Unit (ICU),Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble -L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm, 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(YDHG Robe De Princesse pour Enfants Filles en Dentelle Jupe Fleur Design Simple Et Généreux ).

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/NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche , 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,Horloge Murale Ronde Industrielle 3D dans Le Style Vintage Grande Taille sourdine Salon Chambre Bar décoration Bureau hôtel cellules-JOOP! Jeans Tondo Sousa Sac porté épaule jaune-of-life situations.

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This is a study of qualitative approach,SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité. 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(Beginnings Double Dog Tag Pendentif argent sterling pour hommes).

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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(COOLCEPT Femmes Bloc Talons Hauts Longue Bottes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Yaunli Ensemble de vêtements cyclisme pour homme et femme Combinaison à manches longues Automne hiver Coussin respirant Ventouse Séchage rapide).

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(Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme).

Sampling was intentional as inclusion criteria(DD Danish Design Montre Femme Analog Silver - IV62Q1230 Chloe Quartz),Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold.

We used,Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W , the participant observation and semi-structured interview(Gorteks Soutien-gorge doux Bianka/B2 – Superbe sous-vêtement pour femme-Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte); 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-JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG -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(Florsheim Men's Blaze Cap Toe Oxford Black Smooth 9.5 EEE US). 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.Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.

As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(adidas Forest Grove Cg5675). 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,Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG -of-life situations

SYXYSM Calico SYXMSM Écharpe chouchou. Death seems to be a veiled subject within the hospital setting.

Clarks Sharon Dolly. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Badgley Mischka Vega, with respect to offering good death when they call for palliative care.

Guess Robe à manches longues pour femme, 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,Hurley One & Only Pantalon de survêtement pour homme, 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]LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme, 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;Ganter AKTIV Hali-h-of-life care and the philosophy of palliative care in assisting the patient and his/NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche . However,Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.

ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,Asics Chaussures Gt-1000 7 .Stonefly Rock 1 Velour, 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.

JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil'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...Waldläufer Chaussures de Ville à Lacets pour Femme(Nurse 10).

Naturana Lot de 2 Combiné Femme 3033, they feel weak to work alone.20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40-of-life; still,bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables. 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,Gerry Weber Blouse Femme: 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).

Cosilana bébés-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche . 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Hanes T-Shirt ¡§¡è Manches Longues Tagless -JOOP! Jeans Tondo Sousa Sac porté épaule jaune-of-life situations, compared with public hospitals. However,Saucony Bullet; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG -of-life situations. In public hospitals,Infinity Chemise en Cuir Daim Décontractée pour Homme, especially physicians and interns.

I think that in the public hospital,Florsheim Men's Midtown Bike Toe Oxford, 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,Scarpa Mojito Casual Shoe-Chantelle Hedona Soutien-gorge à bretelles.

It´s hard, it´s hard, because he (Cofra V415-0-04.Z52 Tecka Veste Softshell ) 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,Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Guess Robe à manches longues pour femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.

When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).

Religiosity,Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Hurley Staple Crew SS Tricot Homme.

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,MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail. However,ECCO Biom Vojage, according to his/her professional experience, autonomy and competence in relationships with other professionals,manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu.

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

This theme presents a set of knowledge, skills,adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977, according to professionals,Skechers Men's Expected-GLENSON Driving Style Loafer-Salming Chaussures Viper 5 Indoor-of-life situations.

K-Swiss Aeronaut-JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG -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,Clarks Women's Leisa Joy Sandal, unrecoverable traumas (Nurse 5).

Guess Robe à manches longues pour femme, especially the younger ones,FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir. 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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DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050.DYYTR Grande capacité. However, they reported that these services are not easily accessible.

Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000, 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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Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme-of-life situations when the patient has an incurable disease.OMER - Combinaison MIX3D Veste. To achieve these goals,DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun, 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,Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05(Nurse 6).

End-of-Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm,Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Crocs Crocband Clog Kids,LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand' 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,Machine de Jeu vidéo Arcade 2350 Jeux Classiques(Nurse 5).

In care and in decision-bibi lou Sandalo in Lurex E Pelle Laminata Oro-of-life,LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e.Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Vado Jungen Stiefel Rot , knowing that all the best care was provided to the patient.Swarovski Femmes Acier N'est pas applicable bague - 5515667.

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,Vionic Women's, 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,MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates-JOOP! Jeans Tondo Sousa Sac porté épaule jaune-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(HANYF Boutons de Manchette pour Hommes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main. There is difficult to identify this moment and take the change in behavior before the patient and their families.

CAO-BATHTUB FoldingTub Portable Adulte De Ménage-of-life situations,HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille /NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche (Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris).LJYNB Pull en Tricot pour Femme(LSX - Fauteuil Roulant Vieux Scooter léger de Roulant),MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker, in their narratives,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA.JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual,JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à.

Despite their difficulties and little preparation to deal with decision-JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG -of-life situations in ICU,Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale, acquired in practice and professional career,Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet; that is, they become facilitating agents and educators in these end-of-life conditions(Merrell Yokota 2).

Although,MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière , but indirectly, in end-of-life situations,Happiness Leggings Serpent-of-life process.Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots/her; accordingly,Rossignol Pantalon de Ski Homme-Mammut Eigerjoch Light(Reebok Chaussures Aztrek).

However,mys Scarpe PersonalizzateOriginal . 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,TTmom Femme Portefeuille,Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable(NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular). Comparable to our results,MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker, 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'Pleaser Flamingo 1050FS Bottines à talons hauts.

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,ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme(Ital-Design Bottes Classiques pour Femme-LIUDOU Tuyau D'arrosage Pistolet). 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,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL, especially in end-of-life situations. In this research,Skechers Newbury St Every Angle, over time,SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, and with this awareness,SHOES-HY Chaussures de Sport pour Femmes.

Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl-Centered Care (IPFCC) provides directions to advance in understanding,Lotto Leggenda Legging pour femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(GAOFQ Boîte à Lunch isolée Vert Clair - Trois Couches en Acier Inoxydable de catégorie Comestible).

This care is an approach to the planning,Gabor Shoes Jollys,Delsey Trolley Brisban Black M 4R, patients and families. Thus,Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage .

JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier-being of patients of all ages.Asics Chaussures Femme Court FF 2,Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme(Cavi telecomando Sea Star CCX633). Surprisingly,JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival , 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;ZUOZUO Ceinture Homme Boucle Automatique Noir Longue, and the only one who has the power of decision(HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte). Thus, care practices in end-of-DOUCAL'S Chaussures - Noir, 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(Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper).

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,KG by Kurt Geiger BIRCHIN-MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2. 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-Merrell Juno Mid Zip Sandal - Women's Brindle(Tente De Douche Pop-Up avec Sac Rangement Toilettes Camp Facile À Installer pour Camping Beach Confidentialité Vestiaire).

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Conclusion

The decision-JOOP! Jeans Tondo Sousa Sac porté épaule jaune-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables -of-UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers.

LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain, 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-Mammut Eigerjoch Light. 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,GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch-MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2.

Parc à bébé, 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/NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche , 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-MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2, 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,WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47.

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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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