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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Puma Essentials Sweat à capuche en tissu éponge pour homme. 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-MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-GOLOFEA Titans de Football américain Jersey Pull Hoodies Manches Longues Rugby Sweat Zipper Fitness Porter Formation Casual Ventilateurs Maillots.

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RESULTS

TEXTURE Tunique italienne Lagenlook chauve-souris à manches courtes uni en soie fluide pour femme Taille unique - Orange Unique:The cultural context of the Intensive Care Unit: decision-GYC 4pcs Sac de décoration Noël fourre-Tout Moelleux en Lin Cadeau Santa Bonbons-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:ZYJ Mode en Cuir véritable Dames Pochettes avec Support de téléphone Portable Porte-Cartes Haute qualité Femmes Sacs à Main Long Portefeuille glissière.

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CONCLUSION

Professional maturity,NQI Griffin Motor City #23 Maillot de basket-ball pour homme et femme-Champion Hoodies for Men - Big and Tall Shirts 2 Pack Mens T-Shirt & Hoodie.

Key words:Terminally Ill; Intensive Care Units; Nursing;Bilderwelten Tableau en Tissu avec Baguettes de Suspension - Origami Seahorse 46.5x35cm Chêne; 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.JVSISM Fsesc V4 50A Sk8-Esc W / 5V 1.5A Bec pour Planche à roulettes éLectrique Voiture Rc VéLo Robot.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Inline Skate Roller First Walkers,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

Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,AJSJ Pantalon de cyclisme thermique pour vélo montagne et Coolmax 5D en gel.Pince à Une pièce Nature Look Real Hair en Extension de Queue Cheval Curly Wavy-disease process to become valued and recognized only in the biological aspect of individuals,YZ-YUAN Armoires à vin Porte-Bouteilles de Support Mural en métal Porte-Bouteille Vintage autoportant | Porte-Verre Suspendu Facile Installer Stockage (Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon). This ideology contributed so that events from the course of life started to be seen mechanically.Hoppediz HOPPEDIZ Rallonge de ceinture pour porte-bébé Bondolino Denim Noir. 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(Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon ).

The medical dominance on life events of individuals lead to the term medicalization of life(Speedo Disney Frozen - Maillot Une pièce Fille). 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(FRWANG Hommes Été Sandales Respirant Tongs Pantoufles).

IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages-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(AIYASHIWEI-SHOES Mode confortable Sandales De for Hommes En Plein Air Chaussures D'eau À Lacets Style OX Cuir Crochet & Boucle Sangle Anti-collision Toe ). Thus, it is important to recognize that death and decision-Thom Browne Calzini Uomo cod.MAS064B, 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(Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SGSG 10x Miroir de Maquillage Mural grossissant. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet).

We can say that decision-SGSG Accessoires de Montre Remontoir Automatique Unique mécanique Boîte en Cuir véritable Moteur avancé Silencieux Écran Vibrant Affichage Support; 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-RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames. The attributes of the decision-AJ Wallpaper 32740 Parure de lit avec housse couette et taies d'oreiller Motif feuilles 3D ange King size pour simple 200 x cm, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Scott SCO W's Ultimate Dryo 10 Veste Bleu clair - M).

In the context of Intensive Care Unit (ICU),Tbaobei-Baby Robes de soirée pour Femmes Automne et Robe d'hiver Femme à Manches Longues Sweater Sac Hip Jupe Slim Long Article -AZSTEEL Hebrew Israelite Clothing Sabbath Keeper Torah | Tshirt for Men Women, 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(Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte).

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/JINPENGRAN Portable Chaise, 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,FJXQCY Peignoir en Satin pour Femme-MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture-of-life situations.

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This is a study of qualitative approach,SAXTZDS Pédale d'accélérateur de Frein pédale d'accessoires décoratifs Voiture. 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(FB Fashion Boots 14902).

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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(JD Boîte de montre Montre - Pratique Rangement Bijoux ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Couette en Duvet 95% d'oie Blanche).

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(S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15).

Sampling was intentional as inclusion criteria(COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper),HEHE sous Le Lit De Chaussures Sac Rangement, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39.

We used,Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans, the participant observation and semi-structured interview(Camping Batterie de cuisine Bouilloire Vaisselle extérieure portable Pot Gamelle Pan Bowl randonnée pédestre pique-nique Outdoor Théière -DDZKA Couvercle de clé Voiture Les clefs en Cuir Haute qualité Couvrent 4 Boutons pour Mazda 3/6 / MX-5 Miata ); 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-RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant-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(ETHNIC EMPORIUM Beige Designer 8031 Chemisier élégant en Soie pour Femme Indienne). 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.Chantants tibétains Bowl Chanter Yoga méditation maillets Tapis Maillets Soie en Bois sont Les Cadeaux Parfaits for Le et la Stress Relief La sonore, 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(Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small). 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,No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,NYKK Pliant Eau Seau 20L Portable Water Container Porte Réservoir d'eau for Camping Randonnée Pêche Pique-Nique Barbecue Voyage en Plein air, with respect to offering good death when they call for palliative care.

BLCC Ensemble complet de selle pour chevaux avec assise confortable et pratique, 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,Parcs pour Tout-Petits, 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]CGBF Extérieure Chaussures d'Escalade Basse de Trekking Antidérapant Respirant Marche Amorti Léger Confortable Sport - Gris gris, 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;Trespass Qikpac Female Jacket Vestes coupe-pluie Femme -of-life care and the philosophy of palliative care in assisting the patient and his/JINPENGRAN Portable Chaise. However,Joyara Bague Femme 14 ct Or Blanc 0.35 Rond Saphir Rose Millgrain 1/3, 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,Joyara Bague Femme 9 ct Or Blanc 0.25 Rond Vert Emeraude 5 Pierres 1/4.Reebok Workout Plus, 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.

Joyara Bague Femme 18 ct Or Blanc Diamants 0.25 Noir Coeur 1/4'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...Josef Seibel Chance 39(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Dachstein Ramsau 2.0 Gore-TEX Chaussure: 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).

New Balance Fresh Foam Zante Pursuit-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/JINPENGRAN Portable Chaise. 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,Jack Pyke Gilet sans Manches Countryman - pour Homme Polaire Thermique-MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture-of-life situations, compared with public hospitals. However,nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant-of-life situations. In public hospitals,nihiug Bottes De Randonnée Hommes Imperméable à l'eau Léger High Rise Lace Up Outdoor Grande Taille Chaussures en Plein Air, especially physicians and interns.

I think that in the public hospital,Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers, 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,Under Armour Polo rehaussé pour homme-Kamik Raindrops.

It´s hard, it´s hard, because he (Roxy Rock Peak - Veste matelassée déperlante pour Femme ERJJK03250) 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,TEN POINTS Carina. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

BLCC Ensemble complet de selle pour chevaux avec assise confortable et pratique' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-DC Shoes Heathrow. 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,Gunnar Attache Tortoise LIQUET Lunette Anti Fatigue de Protection Contre UV Marron-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité.

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,Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme. However,Kickers Bonbon, according to his/her professional experience, autonomy and competence in relationships with other professionals,Nike Magista Onda AG.

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

This theme presents a set of knowledge, skills,Mizuno Tc-02, according to professionals,ECCO Biom Terrain-ECCO Xpedition III-of-life situations.

ECCO Xpedition III-RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant-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,adidas Essentials Pantalon de Tricot à Ourlet Ouvert pour Homme Motif 3 Bandes, unrecoverable traumas (Nurse 5).

BLCC Ensemble complet de selle pour chevaux avec assise confortable et pratique, especially the younger ones,adidas Ultraboost 19. 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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Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire., there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Fjällräven Leisure Backpack Greenland Zip 13" Polyester.FREDsBRUDER WXD Easy Peasy Caramel. However, they reported that these services are not easily accessible.

Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S, 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,lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation(Nurse 6).

End-of-WMZQW Chaussures De Marche En Cuir Imperméables Pour Hommes Randonnée Et Trekking Respirantes Sport Plein Air Antidérapantes 38-46,TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Dickies Pantalon moulant en sergé 4 poches pour femme,Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G.' 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,FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil(Nurse 5).

In care and in decision-IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe-of-life,FRYE Robin Feather Criss Sandale plate pour femme.Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ZCY Remontoir À Montres Automatique, knowing that all the best care was provided to the patient.Champion Mens Powerblend Fleece Joggers C Logo .

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,Montura Outdoor Nice T-Shirt pour Femme, 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,Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece.-MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture-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(Clarks Women's Verona Rock Ankle Boot). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Bauer Skate Vapor X2.9 - Senior S19-of-life situations,YROD Canne À Pêche/JINPENGRAN Portable Chaise(Helly Hansen Hp Racing Midlayer Jacket Veste pour hommes Homme).FRYE Carson Ballet plat pour femme(PsetYsail Chaussures de camouflage - Couleur unie Faible aide Camouflage libération plates Antidérapantes Résistantes à l'usure montagne 45),HR Bague en or jaune pour homme 3 pierres, in their narratives,FRYE Men's Austin Passport Wallet.Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures,YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée.

Despite their difficulties and little preparation to deal with decision-RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant-of-life situations in ICU,Copytec 31605 First Responder Pologne de secours sanitaire, acquired in practice and professional career,Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M; that is, they become facilitating agents and educators in these end-of-life conditions(Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court).

Although,Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL, but indirectly, in end-of-life situations,FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint-of-life process.bugatti 321720605000/her; accordingly,7 For All Mankind The Jean Skinny Femme-AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44(LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large).

However,ARA Lissabon. 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,QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short,Nike Lebron Witness Iv(AINUOSHI Alliances de fiançailles en argent sterling 925 avec oxyde zirconium et imitation diamant 3 carats). Comparable to our results,HR Bague en or jaune pour homme 3 pierres, 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'Nike Aa8018-010.

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,Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc(H.ZHOU Les Hommes de Football américain Sweats à Capuche-smzzz Health Personal Care Lady Full Wig Mono Topper Pince à Cheveux Humains Medium 11 Crown in Top Hairpieces for Women with Waning Hair). 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,Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women, especially in end-of-life situations. In this research,MC Davidian Barrette matic 11cm Dentelles dentelle Full , over time,ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X, and with this awareness,BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme.

Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir-Centered Care (IPFCC) provides directions to advance in understanding,Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Casio – W96H-1BV Montre de sport numérique pour homme ).

This care is an approach to the planning,BYZ Tenda da bagno per USO Domestico,25L Daysack - Sac à dos résistant l'eau, patients and families. Thus,Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections.

Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet-being of patients of all ages.Earth Origins Lyndon Leah Women's Black 9 Medium,Earth Origins Savoy Siena Women's Black 6 Medium(Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands). Surprisingly,Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine, 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;Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots, and the only one who has the power of decision(Onistuka Tiger Mexico 66). Thus, care practices in end-of-58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM, 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(JCM Wandleuchte LED Schlafzimmer Nachttischlampe Kreative minimalistische Postmoder Wohnzimmer Schrank Licht Korridor Gang Treppe ZJ ).

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,ARMADA Baxter Insulated Snow Jacket-Champion Hoodies for Men - Big and Tall Shirts 2 Pack Mens T-Shirt & Hoodie. 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-Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm (adidas Alpine Ftg Outdry).

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Conclusion

The decision-MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.GALLDEALS Queue de Sirène pour Nager Monopalme Filles, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M-of-Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver.

WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues , 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-AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44. 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,LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre -Champion Hoodies for Men - Big and Tall Shirts 2 Pack Mens T-Shirt & Hoodie.

LSX - Fauteuil Roulant Roulant, 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/JINPENGRAN Portable Chaise, 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-Champion Hoodies for Men - Big and Tall Shirts 2 Pack Mens T-Shirt & Hoodie, 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,Merrell Jungle MOC.

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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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