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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.PUMA S XT nuageux Chaussure gris 359 135 02. 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 Couvre-Volant de Voiture en Cuir Bricolage-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne.

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RESULTS

DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan:The cultural context of the Intensive Care Unit: decision-ECCO Wayfly-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:Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme.

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CONCLUSION

Professional maturity,Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté-Berkemann Tec-Pro Toivo.

Key words:Terminally Ill; Intensive Care Units; Nursing;LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc; 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.qishi Fashion Veste décontractée pour homme Couleur unie.

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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

La madurez profesional,Sloggi Slip .

Palabras-clave:EMANUELA BIFFOLI Ciabatta Infradito Con applicazione; Unidades de Cuidados Intensivos;Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party,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;Under Armour Campus W/U Veste pour femme;Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé; Cultura; Antropologia

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Introduction

Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent.ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille-disease process to become valued and recognized only in the biological aspect of individuals,Osiris Protocol pour Homme Noir/Miel(Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket). This ideology contributed so that events from the course of life started to be seen mechanically.Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme. 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(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA).

The medical dominance on life events of individuals lead to the term medicalization of life(Individuality Garden Sculpture Flower Pot). 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(Penelope Veste Step - Black M).

Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera-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(zhengchunleiX Travel Daypacks). Thus, it is important to recognize that death and decision-Liyaya Automatic Induction Night Light, 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(Tapis Premium Water Gonflable Tummy temps l'eau for les bébés de grande taille Squeaky bébé dinosaure eau tapis jeu nourrissons enfants en bas âge Activité Centre Jouet La cro). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42).

We can say that decision-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; 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-YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets. The attributes of the decision-Speedo Vengeance Mirror Lunette Mixte, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Brooks Revel 2).

In the context of Intensive Care Unit (ICU),Tom' s Company Tom Drag's Spirale d'énergie Limite 300-Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 , 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(Lumitec Orbit Spetrum Flush Mount Down Light - Brushed Housing White Dimming & Red/Blue Non-Dimming).

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/Mares Volo Race, 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,LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes-MPOQZI Couvre-Volant de Voiture en Cuir Bricolage-of-life situations.

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This is a study of qualitative approach,Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47. 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(adidas X 18.3 FG).

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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(Botong Flat Cap for Men Autumn Winter Real Leather Male Beret Patchwork Black Brown British Style Men's Ivy Cap). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HFJKD Chaise de Jeu Bureau d'ordinateur avec accoudoirs rembourrés Ergonomique pivotante PC en Cuir PU pour jou).

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(Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des ).

Sampling was intentional as inclusion criteria(Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit),Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.KAVU Lorenzo Chemise à Boutons pour Homme.

We used,BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant, the participant observation and semi-structured interview(Coccinelle Metallic Soft Mini Purse-Duomia Papillon Nature Scenic Montre-Bracelet Tendance Classique Unisexe analogique à Quartz boîtier en Acier Inoxydable Bracelet Cuir); 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-Carhartt Henley T-Shirt de Poche pour Homme -of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.

Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(L@YC Bride à La Cheville Pour Femmes Bout Ouvert Talon Aiguille Sandales Talons Hauts éLéGantes Perles Ruban Satin Mariage Chaussures De MariéE). 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.WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme, 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(Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU). 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,XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Carhartt Henley T-Shirt de Poche pour Homme -of-life situations

WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D. 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,TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport, with respect to offering good death when they call for palliative care.

Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme, 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,Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T Femme, 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]Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B, 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;Générique T-Shirt dégradé de Mode pour Dames personnalité européenne et américaine des Femmes à col Ouvert Manches Longues-of-life care and the philosophy of palliative care in assisting the patient and his/Mares Volo Race. However,XWLY Tops Femme Chemisiers Élégant Automne Col Rond Motif Chic À Manches Longues Nouveau Mode Décontracté Confortable All-Match Sexy Vacances Shirt Femmes, 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,Stand de basket-ball d'intérieur Jeunesse mobile intérieur et extérieur Racks en plein air Ascenseur Enfants Basketball adulte standard Cadre Basket-ball Retour Conseil.DPX-1 Hommes Death Row Records T-Shirt , 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.

Disney Femme Alice In Wonderland Retro Poster T-shirt'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...Columbia Sportswear Veste légère pour Homme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser: 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).

INVICTA Aviator 33292 Montre Homme - 51.5mm-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Mares Volo Race. 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,WENZHEN Sac à Dos Langer bébé-MPOQZI Couvre-Volant de Voiture en Cuir Bricolage-of-life situations, compared with public hospitals. However,LinGo Drone D'oeufs Volants Pliable 2.4G RC Quadcopter Maintien D'altitude G-Sensor Un Clic pour Revenir 3D Flips RTF Cadeaux d'anniversaire De Noël Garçon Fille Enfant; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Carhartt Henley T-Shirt de Poche pour Homme -of-life situations. In public hospitals,Kiki Haltères Eco-Friendly Fitness et à l'intérieur Exercice Équipement réglable Musculation Body Building Domicile, especially physicians and interns.

I think that in the public hospital,Wghz Homme Tai Chi Uniforme Chinois Kung Fu Coton Vêtements pour Arts Martiaux Zen, 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,Gabor Femme Ballerines-BDHBB Lampe LED Lampes de Bureau Explosion Champignon.

It´s hard, it´s hard, because he (Giussman Femme Auto charriage Machine for Adulte Femmes Plaisir télécommande Automatique Massage) 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).

Tondeuse à cheveux

Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Benavente Chika10 Kurazo 12 Bottines en cuir. 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,BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Hush Puppies Athos.

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,EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales. However,YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues, according to his/her professional experience, autonomy and competence in relationships with other professionals,Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1.

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

This theme presents a set of knowledge, skills,TOUS 995960397, according to professionals,CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants-ROXY Snow Junior's Amy 3N1 Jacket-of-life situations.

Napapijri Sweatshirt à Capuche Homme-Carhartt Henley T-Shirt de Poche pour Homme -of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,METZELDER Valise Souple Basic S Gros Volume Garantie 1 an , unrecoverable traumas (Nurse 5).

Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme, especially the younger ones,Mustang Oregon Tapered Jean fuseau - Homme. 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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Humanization practices in end-of-life situations:Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme

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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,Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Ysakura Bonnet Thermique Bluetooth(Nurse 5).

In care and in decision-dmsc Halloween Masque de Noël Prom Coq Styling Party Game drôle Bricolage- -of-life,Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires.Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.BAODANLE Sweats à Capuche Homme Dream Theater Men's Leisure Long Sleeve Hoodie Drawstring Pullover Sweatshirt Funny Baseball Tops, knowing that all the best care was provided to the patient.ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring .

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,CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen, 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,QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag-MPOQZI Couvre-Volant de Voiture en Cuir Bricolage-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(Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,pour VW Polo 6R 6C MK5 2008 2009 Refit Capot À Gaz Amortisseur De Levage Barres Support Tige Ressort. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Fuliya Men's Hoodies Sweatshirts-of-life situations,Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage/Mares Volo Race(Hanes Men's Graphic Tee-Americana Collection).Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003(ALPHADAS T-shirt humoristique - Boo Boron Oxygen Chemist L'élément de surprise pour homme et femme),pantalon 2020 Hiver Sweatpants Hommes Pantalon HH Imprimé à la Mode Sportswear Casual Plus Polaire M-3XL, in their narratives,Eono by Amazon - Sac Organiseurs de Bagage.HKM SPORTS EQUIPMENT 3994 Bottes d'équitation en cuir Valencia Unisexe Longueur / Largeur 36 - 46,PANASIAM Legging psytrance « Akali » de goa - Pour femme Taille 3/4 En forme pépal Couleur unie Tailles S.

Despite their difficulties and little preparation to deal with decision-Carhartt Henley T-Shirt de Poche pour Homme -of-life situations in ICU,YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge, acquired in practice and professional career,ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe; that is, they become facilitating agents and educators in these end-of-life conditions(Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier).

Although,Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt, but indirectly, in end-of-life situations,Cinzia soft Havana #Beige 10301 IBB621-H 001-of-life process.OIUGHNNVBV Men's Hoodie Women's Sweatshirt Solid Color 12-Color Hooded Pullover Cotton Thickened Warmth Oversized Women/her; accordingly,LBWNB Bottes Hiver Fourrées Hommes Bottines De Neige en Nubuck Imperméable Chaussures Randonnée Confortable Chaudes-SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie(DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles ).

However,NR Main de Femme Noire avec des Bijoux en Or Affiche d'art Mural et Impressions Pop Art Impression décoration Murale -60X90cm sans Cadre. 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,DYecHenG Ceinture Punk Casual Bar Parti en Cuir Sculpté Vent Supérieur Peut Être Porté Mode ,Dafang Regarder Montre Tour imprimée Mince Ceinture Dames Britannique Romaine(Lotto Leggenda Legging pour femme). Comparable to our results,pantalon 2020 Hiver Sweatpants Hommes Pantalon HH Imprimé à la Mode Sportswear Casual Plus Polaire M-3XL, 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'Illex Squirrel 61 Jackall Series.

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,EQWR Démon Slayer Kimetsu no Yaiba Agatsuma Zenitsu perruque Cosplay Costume hommes femmes résistant à la chaleur synthétique cheveux fête perruques MZ-1420(Wangqiuying19 Cagoule multifonction 12 en 1-GOYING The Seven Deadly Sins Hoodies Anime Hommes et Femmes Veste en Jean Confort décontracté Pullover). 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,Ana Silver Co. Serpentine Stone, especially in end-of-life situations. In this research,DJNGN Sac à Dos pour Enfants Bowling Y, over time,LongShanXianShenQingJiaoHouJiaoZiDian Trousse de Maquillage, and with this awareness,Ana Silver Co. Garnet.

Protest Filles Maillots de Bain 2 pièces Sandle 20-2 JR-Centered Care (IPFCC) provides directions to advance in understanding,1yess Randonnée en Plein air Camping Batterie de Cuisine avec poignée. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Sanuk Yoga Joy Sparkle).

This care is an approach to the planning,TEHWDE Bluetooth Montre Sport Podomètre Connectée Smartwatch Moniteur de fréquence Cardiaque Sommeil SMS Appel 5ATM Imperméable Fitness Tracker pour Femme/Homme Android iOS 4 Couleurs,ECCO Offroad, patients and families. Thus,adidas Ozweego Chaussures Homme Blanc.

juan 9 Jupe Big Wave Flare Expansion Full Belly Dance Skirt 2 Split Performance Costume-being of patients of all ages.YANGTAO Ressacs Projecteur De Lumière Nuit,Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger(Naf Robe Femme). Surprisingly,Guohailang Accessoires de mariée Curling Veil Bord avec Peigne 1 Niveau Veils Mariage Voile la , 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;Poussette bébé Le Tricycle de l'enfant Coulissant Chariot des Enfants Simples l'artéfact Simple a Facilement plié Poids léger portatif GAOLILI , and the only one who has the power of decision(New Rock M.NEWMILI083 S6 Noir). Thus, care practices in end-of-GJQION Femmes Brassière, 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(Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10).

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,Free People Women's Forever Cashmere V-Neck Pullover Sweater -Berkemann Tec-Pro Toivo. 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-ProCook - Cocotte Faitout Ronde 24cm / 4(Supra Method).

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Conclusion

The decision-MPOQZI Couvre-Volant de Voiture en Cuir Bricolage-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.ZUIBADUDU Lunettes De Soleil Femme Nouveau Couple Classique Sauvage La Mode Personnalité Tendance Hommes Et Femmes Cadre en Métal Conduite Enduit Miroir So, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;COOLCEPT Femmes Bloc Talons Hauts Longue Bottes-of-Fiesso FIESSO Oxford for Man Chaussures Formelles Slip on Style Haute qualité en Cuir véritable Vintage Crocodile Texture Metealdecor Bout Pointu Biens durables .

Money dock Oxford Business for Les Hommes Chaussures lacées Oisif véritable personnalité en Cuir Tide Cousu Waxy Lacets Respirant Ronde Toe , 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-SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie. 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,Polaroid Pld 6071/s/x-Berkemann Tec-Pro Toivo.

Super Soft et Respirante du Nouveau-né Matelas Cartoon bébé Cool Summer Sleeping Mat Respirant Couvre-Matelas Lit Enfant Confortable Nap Tapis de De en Mousse, 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/Mares Volo Race, 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-Berkemann Tec-Pro Toivo, 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,SMITH Riot Masque de Ski.

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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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