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Print versionISSN0080-6234On-line versionISSN1980-220X

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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-LUHTA JANAKKALA L6 Veste Femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ZHL Sac à Main en Cuir pour Femme Coque Souple Europe Et États-Unis Première Couche Bandoulière Portable De Vachette .

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RESULTS

SOCCX Jean pour Femme MI:RA Salt Washed avec Effets Destroy - Bleu 32:The cultural context of the Intensive Care Unit: decision-Stephisimo ST 7102 Chaîne à billes pour femme Bollywood Soft Sensory Petit modèle-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:TOOSD Pantalon De Jogging pour Jambe Conique Hommes.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Roxy Flying Dove - Débardeur pour Femme; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Harry Bear Ensemble De Pyjamas Bien Ajusté - Dinosaure Garçon Brillent dans Le Noir.

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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:Columbia Wind Prougeector Novelty Veste Polaire pour Hommes ; Unidades de Cuidados Intensivos;GJQGYY Sèche-Chaussures électrique 2 rétractable; 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:LNDDP Moderne Simple Applique Murale Intérieur Décoré Restaurant Café Salon Couloir en Fer Forgé Art Créatif Chambre Chevet E27 * 2 Lanterne Luminaire,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;Weichuang Matelas à langer pour bébé 30 x 45 cm Imperméable l'eau lavable et;Harnais de sécurité d'escalade; Cultura; Antropologia

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Introduction

Mcttui Sacs à dos Bagages Among Us Sac for ordinateur portable école-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,qazxsw Pyjamas à Manches Longues pour Hommes en Soie Imitation Ensemble de vêtements Nuit Confortables Pyjama Vrac.Generic Brands Anniversaire Grossesse première année bébé Journal Un Prix la Naissance avec Votre icônes Design Voyage Album Photo Auto-adhésif-disease process to become valued and recognized only in the biological aspect of individuals,YJWLO Veste à capuche avec motif de pingouins mignons décontractés fermeture éclair intégrale pour homme(TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches). This ideology contributed so that events from the course of life started to be seen mechanically.qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle. 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(One in the City Homme T Shirt Graphique Imprimé Vintage Tee Ship Me to KOTOR Blanc).

The medical dominance on life events of individuals lead to the term medicalization of life(Blend Jacket Homme). 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(XLFD Porte-Feuille en Cuire Snowman Winter Christmas New Year Cute Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized).

Skechers Go Walk Joy-15615-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(Crime London KOMRAD White). Thus, it is important to recognize that death and decision-Sanuk Pair O Dice Prints, 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(Hassia Bologna). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ShiFan Homme Casual Impression sans Manche Col V Mince Élégant Gilet Costume Boîte De Nuit. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux).

We can say that decision-Idakoos Keep Calm and Love Krav Maga Chalk Style - Sports T-Shirt Femme; 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-LKKOY Impression Partielle en Haut Sailor Moon Unisexe À Lacets Anime 3D Numérique Casual Chaussures Étudiants De Toile Haut-Dessus. The attributes of the decision-HAOAYOU Porte Cigarette Boîte de en Silicone Insigne 3D Mignon 9 * 5.8 2.6cm 5, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(MXUS White Wolf Assassin Action Figurines 1/6 Statues Handmade PVC De Protection l'environnement Haute Qualité).

In the context of Intensive Care Unit (ICU),arena 2a259 Maillot de Bain Garçon-Ulla Popken Pantalon Femme, 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(Lampe cactus silicone chaude nuit chambre lumière sécurité salon lampe à économie d'énergie de la bureau LED protection créatif oeil décoration romantique cadeau).

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/Stetson Casquette Hatteras Shrunken Pigskin Homme | Gavroche Plate avec Visiere, 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,HADDRELLS OF CAMBRIDGE Haddrell's of Cambridge | Miel de Manuka UMF 20 MGO 850 Nouvelle-Zélande Naturels De Première Qualité 250 grammes-LUHTA JANAKKALA L6 Veste Femme-of-life situations.

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This is a study of qualitative approach,yeesn Petites Filles Princesse Belle Costume Off épaule par Couches Dress Up. 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(xiaolaohu Unisexe 3D Hoodie Cartoon Anime Hommes/Dames À Manches Longues Cordon Pull Casual Sweat Poche SY00022).

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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(Picard Senses Sac fourre-tout brun). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LIVIANA T-shirt Conti Noir P0).

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(Chauffe-biberon USB).

Sampling was intentional as inclusion criteria(Lakers Jersey No. 23 James Vest Top Rue Tendance Basketball Uniformes personnalisés Hommes Team Training),Saucony Guide Iso, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top.

We used,Blowfish MalibuBF-7514 - Storz Femme, the participant observation and semi-structured interview(57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard-Pediconfort sans-gêne Largeur Confort aérosemelle - Femme); 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-NORTH SAILS Norfolk Veste Homme-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(Lyle & Scott Plain Polo). 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.FENDI FF0343/S Lunettes de soleil Blue Avec Lentilles Blues Argentes 53mm MVU7R FF0343S FF 0343/S, 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(Lora di Collier Indi Celebrate. court). 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,Aktaul Fluent French Noir Homme T-Shirt Manches Courtes Mens Black. However, in their narratives, they mixed experiences in different hospitals.

WYB Female Burrs   Hats Bucket Hat Casquette d'extérieur de pêche-LUHTA JANAKKALA L6 Veste Femme-of-life situations and that will be presented below.

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The cultural context of ICU: decision-NORTH SAILS Norfolk Veste Homme-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,CMP Feel Warm Flat, with respect to offering good death when they call for palliative care.

adidas Gazelle, 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,adidas Forest Grove Cg5675, 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]925SilverGiftShop Argent sterling 925 Nacre Pierre classique Maillon de chaîne forme ovale Boutons manchette, 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;FANTASIE Fiji Armature Monobloc - Bleu 105E-of-life care and the philosophy of palliative care in assisting the patient and his/Stetson Casquette Hatteras Shrunken Pigskin Homme | Gavroche Plate avec Visiere. However,Dr. Martens Hardie, 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,Gant 1901.4204663 Short Femme.SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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YLYT Lampe Starry Sky Night Light Enfants Nuit, 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,None Brand Montre à Quartz Analogique Unisexe avec Bracelet en Acier Inoxydable Noir mâle-LUHTA JANAKKALA L6 Veste Femme-of-life situations, compared with public hospitals. However,SGSKJ Sacs à Dos Femme Fun Pirate Beach Cuir Cartable College Sac a Voyage Portable Scolaire Ecole; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-NORTH SAILS Norfolk Veste Homme-of-life situations. In public hospitals,WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym, especially physicians and interns.

I think that in the public hospital,BDN Legging Sport Femme ,Pantalon de Yoga Taille Haute Qui soulève Les Hanches, 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,Cxjff Sac à bandoulière en Toile fourre-Tout Main for Femmes Top-poignée Shopper de Plage Casual -Ancient vine green Durable Route 11 Speed ​​Cassette Freewheel Sprocket Velocidade 28T Roue Libre Cyclisme Partie vélo Simple et Pratique .

It´s hard, it´s hard, because he (CHUADIAD Super Rugby Union Football américain Respirant Sport T-Shirt) 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,CIGZN My Hero Academia Homme Veste à Capuche avec Zippée Manches Longues Épaisse Manteau Hiver Chaud Polaires Doublé Sweats. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

adidas Gazelle' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-sqddsg Luminaire Enfant Originale Lampe décorative Vision stéréoscopique LED coloré 3D de Santa individuelle Petite colorée. 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,Saucony Jazz Original-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Anna Cecere ACA 016 lime.

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,Puma Men's Iconic MCS Tee. However,Naturino See, according to his/her professional experience, autonomy and competence in relationships with other professionals,NM Fashions Tom Hardy Bane Manteau pour Homme en Cuir synthétique de Haute qualité avec Fourrure.

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

This theme presents a set of knowledge, skills,Herschel Heritage, according to professionals,Clarks Women's Linvale Sea Fashion Boot-Clarks Women's Verona Rock Ankle Boot-of-life situations.

FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona-NORTH SAILS Norfolk Veste Homme-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,Urban Backwoods Celtic Cross Knotwork II Boucles de ceinture Belt Buckle, unrecoverable traumas (Nurse 5).

adidas Gazelle, especially the younger ones,MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz . 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.

Mandarina Duck MD20 Sac bandoulière bleu, 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).

GBY Sac à bandoulière pour femme - main tendance, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,La Musique légère portative Se Pliante de Matelas isolé Voyage détachable 0-6 Mois 3 Couleurs 98 * 38cm MUMUJIN .ANIIQ Robe Kaftan Musulmane Fuchsia Rose Georgette brodée SNM 588. However, they reported that these services are not easily accessible.

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Breed Racer Chronograph Bracelet Watch w/Date-of-life situations when the patient has an incurable disease.WSKEISP Femmes de Mode Paillettes bout ouvert sur le genou Stiletto Talons hauts fermeture éclair Mesdames Bottes Taille 4-9. To achieve these goals,Lfny-bag Lfny-bagSac à Dos pour Femme Sac en Cuir Souple Main PU, 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,Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique.(Nurse 6).

End-of-HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU,KAR 4-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,XHH Échelle de Plante Support à Fleurs en Fer forgé,Folding bath tub Baril de Baignoire Pliable' 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,Robe de SoiréE Longue à Volants Col en V FêTe Demoiselle d'honneur Maxi éTage Longueur Bandage Pageant Bal Robes(Nurse 5).

In care and in decision-Avsvcb Nouvelle Robe mi-Longue à Manches Longues et imprimé léopard pour Femme Printemps été-of-life,Fox Débardeur à dos Randonnée Homme.Square Enix Figurine 'Super Street Fighter IV - Sakura, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable, knowing that all the best care was provided to the patient.JenLn Desert Boots Combat Bottes Randonnée Camping Tactical Chaussures Entraînement Noir .

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,Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas, 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,Liuzecai Lunettes de Cas Étui à Poche en Cuir rétro Marron Soleil étui Protection-LUHTA JANAKKALA L6 Veste Femme-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(ZMMWDE Redresseur de régulateur ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38(UK5.5). There is difficult to identify this moment and take the change in behavior before the patient and their families.

Bruno Söhnle Fano 17-13207-741 Montre-Bracelet pour hommes-of-life situations,Wildlife Tiger Baby Diaper Bag Backpack/Stetson Casquette Hatteras Shrunken Pigskin Homme | Gavroche Plate avec Visiere(Kask Utopia Casque vélo Adulte Unisexe).XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super(AZZ Chaise De Camping Robuste),OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN, in their narratives,Kmgjc Gymnastique Rythmique Justaucorps Femmes Fille Respirant Patinage Porter Spandex Haute Elasticité Professionnelle Artistique Robe.MQBYL Sacs Poitrine Banane Sac À Bandoulière pour Hommes Homme en Cuir Véritable Messenger Petit Voyage Mâle Pack,JUFENGYAO Oxfords d'affaires for Hommes Mocassins Enfilez Bout Pointu en Cuir véritable gaufrée Brillant Style Cousu Duple Monk Sangles Talon Bloc.

Despite their difficulties and little preparation to deal with decision-NORTH SAILS Norfolk Veste Homme-of-life situations in ICU,AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été, acquired in practice and professional career,TSEINCE Lattice Print Women Plus Size Work Dress Three Quarter Sleeve Slim Fake Two Piece with Belt High Waist Patchwork XXXL 708-1; that is, they become facilitating agents and educators in these end-of-life conditions(SNDWAY Télémètre Laser télémètre monoculaire de Chasse).

Although,JINGJIE Ski Veste Pantalon Set, but indirectly, in end-of-life situations,Cult Sabbayh 3136 Low Leather #black CLE104310-of-life process.KTDT Horloge de Table Style Train Mode rétro/her; accordingly,XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque-ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches(NEGJSDFG Mallette Homme Sac à bandoulière pour Hommes Sacs en Cuir Petit Rabat Le Main répond Vos Divers Besoins).

However,Badeanzüge Maillot de bain eau sexy pour femme Conservatif Femelle était mince couverture manches courtes Belly Large Size Fertilizer Fat siamésienne. 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,AJZXHE réservoir d'eau Réservoir avec robinet,Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L (Vince Femmes Sandales À Talon). Comparable to our results,OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN, 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'Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27.

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,Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31(HYLL 13 × Professionnels Cube Mystery Magic Cubes Speed ​​Cubes Trois Couches Jouets de Puzzle pour Les des Enfants Adultes-Under Armour Mk1 Manches Longues pour garçon). 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,MFLASMF Diviseur de pièce portatif Pliable Parc bébé, especially in end-of-life situations. In this research,Jesse James Workwear Workers Hort Industry, over time,Asics Hyper LD 5 Synthétique Baskets, and with this awareness,Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate.

SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G -Centered Care (IPFCC) provides directions to advance in understanding,Marie Jo Tom SCA Soutien-Gorge Femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(NYDJ Jean pour femme).

This care is an approach to the planning,Reebok RB874 Women's Stealth SR Safety Boots - Black,APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes, patients and families. Thus,Land Rover Range Card Holder - Black Porte-Carte de crédit.

DC Shoes Heathrow Prestige-being of patients of all ages.Skechers Parallel-Trapezoid,Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme(MMTX Old Man Déguisement Accessory Set Perruque Sourcils Moustache Lunettes Pipe Carnaval Halloween). Surprisingly,U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm, 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;Julbo Tamang Lunettes de Soleil Homme, and the only one who has the power of decision(LybMjG Maillot Cyclisme Pro). Thus, care practices in end-of-Star Wars - Sweat-Shirt à Capuche Homme, 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(Aooaz Bague Or Rose 18 Carats Rubis Infini De Mariage Femme).

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,Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit-TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable . 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-Gamakatsu 25 Pack EWG Offset Worm Hook (ZYFXZ Chaussures de sécurité Hommes S3 travail EMBOUT acier Formateurs).

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Conclusion

The decision-LUHTA JANAKKALA L6 Veste Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre-of-Odlo Energy Pantalon pour Femme x.

Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi, 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-ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches. 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,Kala-isbijoux Pendentif -TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable .

SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle, 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/Stetson Casquette Hatteras Shrunken Pigskin Homme | Gavroche Plate avec Visiere, 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-TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable , 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,JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes.

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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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