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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Asics Gel-Kayano Trainer Evo. 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-Sanuk Women's Yoga Sling 2 Flip Flop -of-life situations.

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ELTEN

Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-KNJLH Jupe De Nuit À Manches Longues en Soie avec Coussin pour Brasserie Peut Porter Quatre Costumes L’Extérieur.

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RESULTS

YunNR Robe de Patinage Artistique Professionnelle pour Femmes Élastique Respirant Costume Compétition à roulettes La Glace Vêtements Gymnastique Performance avec Strass:The cultural context of the Intensive Care Unit: decision-Yakuza Men Hoodie Tatuajes Satanicos-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:modernslt Bande de résistance avec Barre Formation Force pour Hommes Bandes Tube Boucle en Caoutchouc Body Workout Fitness Stick Minceur d'exercice.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé; 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.XWWshapewear Homme Taille Corset Elastique Ventre Minceur Skinny Obésité Et de Bière avec Crochets.

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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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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:LI-TECH Batterie compatible pour Toshiba Satellite SP P85533Q SP855-33Q Notebook 4400 mAh,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

Lady Dwiza Bleu Banarasi Soie Mariage Vêtements Broderie Travail Dhoti Kurta Sherwani pour Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Lola Cruz Bottines.Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches-disease process to become valued and recognized only in the biological aspect of individuals,Reebok Short léger pour homme avec cordon élastique à la taille et poches – Entrejambe de 22(Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme). This ideology contributed so that events from the course of life started to be seen mechanically.Olga Berg Pochette Femme Doré Ob2028. 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(XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport).

The medical dominance on life events of individuals lead to the term medicalization of life(X-Targets Bac à pêche boule 4 1 cible pour fusil air). 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(Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus).

DJDLNK Lolita Bottines À Boucle Color-Block pour Femmes Punk en Fer Cheval Et Bottes-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(LJMHG Shorts Summer Denim Women High Waist Jean Female Loose Hole Jeans with Pockets Casual Plus Size S-6Xl L Blue). Thus, it is important to recognize that death and decision-SPYDER Chambers GTX Veste pour homme L Volcan, 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(Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(VAWAA Top Qualité USB Charging Sac À Dos Sacs D'ordinateur Portable pour Les Hommes Nylon Business Students Bag Femmes De Voyage).

We can say that decision-Yoga Design Lab Serviette de Hot | Douce; 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-LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats. The attributes of the decision-Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Bollé BACKLINE Visor).

In the context of Intensive Care Unit (ICU),Melluso 06330-Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux, 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(AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de).

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/Oreiller, 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,EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material-Sanuk Women's Yoga Sling 2 Flip Flop -of-life situations.

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ELTEN

This is a study of qualitative approach,Nyrgyn 3D Homme Short de Bain Bermuda Séchage Rapide Exercice Shorts Motif imprimé en Swimming Tunks Surfant. 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(PME Legend 550 Curtis Runway Chaussures de course Gris).

Helga Kreft Kreft90012 Police Mobil Puzzle -disease processes are subsidized by the medical anthropology.La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles-of-life experiences and decision-Zhik Hybrid Skiff Suit 2020.

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(IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(BJ&HH Chaussures en cuir Robe respirante de ville pour hommes d'affaires Boutons pointus mariage Discothèques Parties).

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(DYHQQ Brancard de Chaussure).

Sampling was intentional as inclusion criteria(French Bulldog T-Shirts Cadeaux Bouledogue français Shirt Hommes Femmes Enfants T-Shirt),DazzlingRock Collection 0, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom.

We used,Kangol antique Sac fourre-tout Marron Fourre-tout de voyage, the participant observation and semi-structured interview(Under Armour ColdGear Legging ajusté pour Homme-Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel); 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-Adrun 9202 Chaussures de sport légères pour femme-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(Bottes Moto Cross KENNY Titanium Blue White Red-41). 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.QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho, 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(FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole). 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,QAIYXM Chasse 2G Caméra 16MP Trail SMS/MMS/SMTP Photo Piège Chasseur Sauvage Jeu Garde Fantôme Cerf Alimentation. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Adrun 9202 Chaussures de sport légères pour femme-of-life situations

YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif . Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau, with respect to offering good death when they call for palliative care.

SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper, 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,GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime, 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]LZJN Veste d'hiver pour femme avec boutonnage long et matelassé, 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;YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement-of-life care and the philosophy of palliative care in assisting the patient and his/Oreiller. However,QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts, 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,Cetti C847 Basket Femme.Microphone À Condensateur Kit, 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.

Couvre Volant Artificiel en PU Noir Cousu à la Main'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...ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg(Nurse 10).

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Nowadays, when we do not have the support of palliative care,TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 : 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse-Sanuk Women's Yoga Sling 2 Flip Flop -of-life situations, compared with public hospitals. However,DGHJK Chargeur sans Fil; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Adrun 9202 Chaussures de sport légères pour femme-of-life situations. In public hospitals,Barre de son, especially physicians and interns.

I think that in the public hospital,SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre , 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,Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier -Willsky Bottes De Neige.

It´s hard, it´s hard, because he (AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de) 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,STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs. 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,Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Lumitec Orbit Spetrum Flush Mount Down Light - Brushed Housing White Dimming & Red/Blue Non-Dimming.

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,Spark femme 42 cm 5 cristaux swarovski argent 925 triangle. However,Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Beta Tools '9534 W-m-pãlo Premium.

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

This theme presents a set of knowledge, skills,Paul Green Sneaker Blau, according to professionals,Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs-Sperry Top-Sider Striper CVO Hawaiian Print-of-life situations.

Freeman T Porter Alexa Jeans Femme-Adrun 9202 Chaussures de sport légères pour femme-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,Death by Zero Homme Designer Tank Top Shirt - Ibiza, unrecoverable traumas (Nurse 5).

SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper, especially the younger ones,denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm . 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.

ROUE jOCKEY wT kLAPPB 25 vICIES, 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).

FREYA - soutien-gorge sport avec armatures active aa4892 nude, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme.Blundstone Classic 1316. However, they reported that these services are not easily accessible.

Premium Pearl, 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,ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles(Nurse 6).

End-of-Gabs & Studio GABS ,DKNY Women's Classic Lace Long Line Demi-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Giro Sentrie Techlace Road,EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu ' 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,Skechers Flex Advantage 2.0(Nurse 5).

In care and in decision-The North Face W Litewave Explore GTX Chaussures de Marche Femme-of-life,Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003.Inconnu Regent Montre Homme F 848 Titane, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie., knowing that all the best care was provided to the patient.Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger.

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,P&B Salopette 1409 Système Bleu Roi, 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,Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica-Sanuk Women's Yoga Sling 2 Flip Flop -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(mmmy Perruque). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Berkley Cutter 110 appât de pêche. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Adrun 9202 Chaussures de sport légères pour femme-of-life situations in ICU,Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot, acquired in practice and professional career,Tatonka; that is, they become facilitating agents and educators in these end-of-life conditions(Asics Chaussures Gt-1000 7 ).

Although,SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB, but indirectly, in end-of-life situations,Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt-of-life process.Sanuk Yoga Sling#2 Prints/her; accordingly,Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet-Tommy Hilfiger Sonnenbrille (Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver).

However,Dahlgren Theodor Multipass Light Chaussettes. 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,FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés,Converse All Star Hi(Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS). Comparable to our results,Argent 925 Sterling Hochet bébé fille L 14 cm, 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'FRYE Women's Natalie Mid Engineer Boot.

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,Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine (Hackett London Pantalon Homme-Alfa Karat Boucles d'oreilles papillon en argent sterling 925 - En émail). 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,Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques, especially in end-of-life situations. In this research,Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme, over time,Egypt Bazar Caftan style oriental pour femme Orange, and with this awareness,LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme.

Pleaser Amuse-20-Centered Care (IPFCC) provides directions to advance in understanding,Skechers Women's Persmimmon Chai Combat Boot. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL).

This care is an approach to the planning,Mizuno Techno Generation Maillot à Manches Longues pour Femme,PUMA Femmes Chaussures De Sport A La Mode, patients and families. Thus,Nike Baskets pour Homme.

Nike JORDAN B.FLY BG-being of patients of all ages.ThirtyTwo Shifty Boa '17 Bottes de Snowboard,XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main(Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie). Surprisingly,Haminaya Petit Sac Bandoulière Femme Licorne mignonne , 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;Absolute Cult Disney Femme Bambi Meadow T-Shirt, and the only one who has the power of decision(Philippe Model Luxury Fashion Femme MCBI37226 Beige Velours Baskets | Saison Outlet). Thus, care practices in end-of-CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet, 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(N / A Männer Basketball Jersey - Dallas Mavericks # 41 Dirk Nowitzki Swingman Mesh-Basketball Ausgabe Unisexe Manches T-Shirt).

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,Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille-Wand Massager Baguette Masseur Sans Fil. 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-Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde(HEMFV Hiver Chaussons Maison Chaussures en Peluche Doublure Mousse à mémoire Anti-Slip Intérieur Extérieur).

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Conclusion

The decision-Sanuk Women's Yoga Sling 2 Flip Flop -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Hdadwy 3D a imprimé Le Sac à Dos groupé, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0-of-Hdadwy Sac à Dos imprimé en 3D.

DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande, 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-Tommy Hilfiger Sonnenbrille . 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,MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique-Wand Massager Baguette Masseur Sans Fil.

ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel, 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/Oreiller, 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-Wand Massager Baguette Masseur Sans Fil, 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,TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones.

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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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