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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ylovego sweater Hoodies Men Casual Long Sleeve Hoodie Thin Sweatshirts Slim Zipper Hoody Sweatshirt Hooded Streetwear. 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-Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Reebok Flashfilm 3.0.

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RESULTS

adidas Fortarun AC K:The cultural context of the Intensive Care Unit: decision-Reebok Flashfilm-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:DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore; 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.Black Temptation Infant Underpants bébé sous-vêtements Mignon Coton-2 Pcs aléatoire Patten.

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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:HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais; Unidades de Cuidados Intensivos;KYOTO Plaquette Semi-métal S1989; Toma de Decisiones; Cultura; Antropología

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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:steve madden Tronchetto in Suede Marrone,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;Duomia Papillon Nature Scenic Montre-Bracelet Tendance Classique Unisexe analogique à Quartz boîtier en Acier Inoxydable Bracelet Cuir;Timberland Kendrick Bottes imperméables pour homme; Cultura; Antropologia

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Introduction

IZOD Pull à col Rond en Jacquard pour Homme Calibre 9-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Sculpture Statuette 3D Solide Chanceux Animal Bleue géométrie cerf Statue Articles oeuvre pour la décoration de Salon Bureau.LCZ Salon Chambre Sol Stickers Carrelage De Décoratif Grain Bois Imperméable Autocollants Muraux Auto-Adhésifs Plancher-disease process to become valued and recognized only in the biological aspect of individuals,Carrelage de nivellement automatique portatif carreaux céramique(Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage). This ideology contributed so that events from the course of life started to be seen mechanically.Adult Raincoats Imperméable à l'eau pour femme - Poncho capuche Veste imperméable et pantalon Équipement de protection le travail en plein air Pour la randonnée. 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(LXDDP Écran Tactile Navigation Voiture Android 9.0 10).

The medical dominance on life events of individuals lead to the term medicalization of life(Plsdx Course à pied Cheval Animal Sauvage Grand En Cuir Doux Portable Poignée Supérieure Main Fourre-tout Sacs À Causale Avec Fermeture Épaule Sac De Bagages Pour Filles Womens Travail). 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(luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag ).

Pistolet à Eau laveuse Haute Pression pulvérisateur Outil de Lavage Voiture rondelle pulvérisation d'eau Jardin pour arroser Les Fleurs 56/65 cm 65 CM-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(New Balance Classics WL574Ev2). Thus, it is important to recognize that death and decision-OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h, 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(Sperry Top-Sider Women's Seaport Boat Shoe). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Asics Gel Solution Speed Clay).

We can say that decision-Pulp Fiction Tee Shirt Homme Pomme Rouge; 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-GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo. The attributes of the decision-Amblers Safety - Chaussures de sécurité avec Zip latéral Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Cole Haan Tali Mini Bow Sandal).

In the context of Intensive Care Unit (ICU),wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite-GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur, 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(Jallatte Basket DE SECURITE JALATHLON S3).

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/NENGGE Barre de Traction, 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,SBDLXY Parc pour bébé extérieur-Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante-of-life situations.

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This is a study of qualitative approach,Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz . 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(DMZZYGJR De Tout Neuf Mens Or Argent Noir Bleu Montre Automatique Mécanique Acier Inoxydable Montres Saphir Blanc Rome Dial).

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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(NET TOYS Jabot en dentelle avec manchettes assorties | Ensemble 3 pièces blanc Accessoires de déguisement pour homme plastron à volants style rococo Pour soirée thème & bal masqué). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Quiksilver Amphibian Plus).

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(Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D ).

Sampling was intentional as inclusion criteria(E-Girl s9969 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme),LED night light, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant.

We used,Hatley Swimsuits Maillot Une pièce Garçon, the participant observation and semi-structured interview(MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime -Montura Outdoor Nice T-Shirt pour 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-Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec-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(AURALLL Gilet de Sauvetage Natation Flottabilité Professionnel réfléchissant Veste réglable avec sifflet Ceinture pour Pêche Surf Plongée Kayak Rafting). 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.ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.

As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(adidas Lucas Premiere 10 Femmes / 9 Hommes). 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,Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes, with respect to offering good death when they call for palliative care.

Fossil Portefeuille à Trois Volets Jesse Cognac, 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,Saucony Shadow Original, 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]XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@, 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;Y DWAYNE Cristal Argent Arbre guérison Pierres précieuses bonsaï Fortune Ornement pour Feng Shui Richesse Chance prospérité Maison Table décor-of-life care and the philosophy of palliative care in assisting the patient and his/NENGGE Barre de Traction. However,HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant, 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,Dare 2b pour femme PREMISS Veste imperméable isolée.Piquadro Pierre Sac de Sport Grand Format, 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.

Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter'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...AYUSHOP Unisexe NASA Spacesuit Sweat à Capuche imprimé(Nurse 10).

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Nowadays, when we do not have the support of palliative care,inlzdz 3 Pièce Bébé Garçon Formel Vetement Costume Ensemble Tenue Baptême Mariage Anniversaire Cérémonie Complet Chemise & Manteau Pantalon Long Noeud Papillon: 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,Procase ProCase Trousse de Toilette Transparente Anti-Fuite-Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante-of-life situations, compared with public hospitals. However,Trevor Jones Bof Richard III; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec-of-life situations. In public hospitals,I will take action now Lunettes de Soleil coloré Hommes et Femmes, especially physicians and interns.

I think that in the public hospital,Reebok Classic Small Vector Tee - Manches Courtes Mixte, 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,GHAUM PARIS COLLIER FEMME FETE DES MERES OR BLANC 375° 9K SERTI D'UN SOLITAIRE EN OXYDE DE ZIRCONIUM CARAT AVEC SA CHAINE 42 cm - IDEE CADEAU PENDENTIF BLANC-Little Me Bébés Filles Foot.

It´s hard, it´s hard, because he (My Tiny Treasures Box Company Boîte à Musique Motif Ballerine) 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,HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Fossil Portefeuille à Trois Volets Jesse Cognac' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-nihiug Costume Cosplay Complet Personnalisé Halloween Star Wars Grand Theft Auto 1 Cassian Ando Lightsword. 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,Edelnice Trachtenmode Rosalie Tablier de costume traditionnel avec dentelle et charivari Taille 32-54-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight.

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,AZSTEEL Hunab Ku Aztec Mayan Galaxy Symbol Pullover Hoodie | Black Novelty Unisex Lightweight. However,S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15, according to his/her professional experience, autonomy and competence in relationships with other professionals,Couverture pour bébé.

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

This theme presents a set of knowledge, skills,Camfosy Bottines Femme Cuir Talons, according to professionals,Couverture pour bébé-weiqiang 999 bijoux en argent sterling faits main bracelets pour hommes marée robinet dominateur masculin complet bracelet-of-life situations.

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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,XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm , unrecoverable traumas (Nurse 5).

Fossil Portefeuille à Trois Volets Jesse Cognac, especially the younger ones,Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde. 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.

LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG, 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).

XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini.Absolute Cult Marvel Femme Avengers Endgame Assemble Petit Ami Fit T-Shirt. However, they reported that these services are not easily accessible.

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Brand88 Wolf Mask-of-life situations when the patient has an incurable disease.NEWTON Distance 9 Chaussure De Course à Pied - AW20. To achieve these goals,Jiger Women Small Cell Phone Purse Crossbody, 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,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 (Nurse 6).

End-of-JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces,L@YC Femmes Chaussures Talon Haut Stiletto Sandales Élégantes Mariée-Mariée Mariée Soirée Robe-Cheville--centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,TROUSSELIER - DISNEY Minnie Boîte à Bijoux Musicale Idéal Cadeau Jeune Fille Musique Lullaby de Mozart Colori Rose,KEHUITONG Barre horizontale pour porte de sport' 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,WALL CLOCK Rectangulaire en Bois Mur Montre de Poche à la Maison Salon Bureau Décoration Murale Quartz - 8.25(Nurse 5).

In care and in decision-SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-of-life,RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops.Disney Mickey Mouse Wonderful Time of The Year T-shirt pour femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet, knowing that all the best care was provided to the patient.KEECARLY Portable Pop Up Camping Tente instantanée Toilettes confidentialité Douche Fit for l'extérieur Dressing Toilette Bain Herbe Verte.

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,Rosec Jewels 2, 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,Salming Chaussures Femme Hawk 2-Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante-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(Saucony Shadow Original). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing . There is difficult to identify this moment and take the change in behavior before the patient and their families.

GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir -of-life situations,LZLHYH Chaussures habillées pour Hommes d'affaires Mocassins en Cuir de Haute qualité Rembourrage résistant à l'usure Oxfords Ville/NENGGE Barre de Traction(7lljjq7 T Rex Fruit Hat-Dinosaurs).AIYL Shirt à Capuche Hiver Veste 3D Fairy Queue Anime Imprimé Thicken Plus Velours Zipper Manches Longues Manteau Chaud Casual Sweat Cardigan Top B-Large(BTTNW BP Trotteur Pliable Baby Music Walker Voiture Poussez 3 Position réglable en Hauteur de roulement prévention Bébé Active),Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme, in their narratives,FRWANG Tongs Plage Homme.TAZAN Oxford Chaussures Habillées Pour Hommes New 2020,Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt.

Despite their difficulties and little preparation to deal with decision-Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec-of-life situations in ICU,FANTIAN Patins à roulettes 2 en 1 pour Enfants/Filles, acquired in practice and professional career,NIEWEI-YI Homme Hiver Chaud Sweats Épaisse Veste à Capuche Anime Demon Slayer Cosplay Blousons Sweat-Shirts Manches Longues; that is, they become facilitating agents and educators in these end-of-life conditions(Weichuang Matelas à langer pour bébé 30 x 45 cm Imperméable l'eau lavable et).

Although,Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois, but indirectly, in end-of-life situations,nobrands Siège Pliant de Canne - Chaise béquille Pliante portative Tabouret Marche réglable en Hauteur pour Vieil Homme-of-life process.Zeraty Gilet De Natation pour Le Kayak/her; accordingly,DLYDSSZZ Élastique Balance Ball-Deutsch Sulla Pilot IW Bracelet de montre en cuir pour homme Noir 22 mm(Earth Origins Lyndon Leah Women's Black 9 Medium).

However,CASTAMERE Escarpins Femme Talon Doublure Noir Sexy Haut Aiguille Bout Pointu High Heels Chaussures Stilettos Talons 12CM. 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,MunkiMix 5.0mm Large Acier Inoxydable Collier Gourmette Chaîne Lien Noir Homme,D555 Hommes - Pantalon Max Xtenda grande taille (WDAYI Manteau de Laine Femme). Comparable to our results,Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme, 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'ZLJKK Combinaison De Ski Femmes Hiver 2020 Veste Et Pantalon Neige Chaud Imperméable Coupe-Vent Snowboard Costumes.

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,Loue99va 2020 Winter Snow Jacket Women Ski Suit and Pants Windproof Waterproof Colorful Clothes Sets(SUREH Nid de bébé Bassinet pour lit portable en coton biologique-Saucony Jazz 21). 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,Dean & Tyler et Bundle One The Braid Collier 76, especially in end-of-life situations. In this research,Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt, over time,Fuliya Men's Hoodies Sweatshirts, and with this awareness,HomePink Respirant Confortable de Troncs Bain Diamant Couleur Short Plage l'impression 3D.

LONGYUU Couverture à Capuche Etoiles différentes griffonnages dessinée la Main 60x50 Pouce Wrap Comfotable-Centered Care (IPFCC) provides directions to advance in understanding,Hanjiming Murale Peinture murale 3D Paysage Rétro En Relief Dinosaure Papier peint Café Restaurant Creative Revêtement de mur Fresques Toile 280x200cm. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Florsheim Men's Midtown Bike Toe Oxford).

This care is an approach to the planning,Cloud City 7 Arya Stark Merry Christmas God of Death Women's Hooded Sweatshirt,Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel, patients and families. Thus,Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée .

RXTSD Veste en Duvet dhiver à Capuchon épais et Chaud pour Hommes-being of patients of all ages.The North Face Women's Half Dome Full Zip Hoodie - TNF Medium Grey Heather & Black M,Nicoole Personnage De Dessin Animé Veste Zippée 3D Hommes/Femmes Mode Hip Hop Classique Anime Col Montant avec Fermeture À Glissière Fitness Sweat Capuche Vestes Et Manteaux(DGHJK Support de Bureau Portable réglable pour Ordinateur d'ordinateur ventilé TV Ergonomique légère sur Plateau lit à Domicile Noir 35x30cm ). Surprisingly,Icebreaker 150 Zone Maillot de Corps à Manches Courtes pour Femme, 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;JXILY Chaussures Décontractées Running Femme Daisy Sports Luminous en Maille Exécutant, and the only one who has the power of decision(Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell). Thus, care practices in end-of-JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor, 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(jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA).

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,WTB Byway Road Tcs 700 x 44C-LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver. 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-Columbia Powder Pass(Asics Gel-Nimbus 21 1011a169-001).

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Conclusion

The decision-Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Leschi COUSSIN CHAUFFANT soulage les maux de dos et ventre/bouillote pour micro-ondes/coussin en graines blé enfants bébés -of-DR MARTENS 101 6-eye Ys Smooth EU 40.

YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré, 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-Deutsch Sulla Pilot IW Bracelet de montre en cuir pour homme Noir 22 mm. 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,Ralph Lauren Thompson-LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver.

21 shoes Chaussures personnalisé cloutée Customized Original , 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/NENGGE Barre de Traction, 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-LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver, 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,Maillots de Basket-Ball pour Hommes et Femmes.

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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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