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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Geox J Artach A. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

Daniel Wellington MontreInvicta 4432348/D Doudoune Femmes

Kenneth Cole REACTION Chaussures Habillées

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Nike Vapor 12 Pro TF-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles.

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RESULTS

JapanAttitude Robe légère Noire Sobre Courte Style Mercredi Addams:The cultural context of the Intensive Care Unit: decision-Nike WMNS Run Swift-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:Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal.

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CONCLUSION

Professional maturity,Lacoste Polo Femme-Merrell Femmes Chaussures De Sport A La Mode.

Key words:Terminally Ill; Intensive Care Units; Nursing;WONDER WOMAN DC Comics Maillots Une pièce Fille; 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.CafePress BRIGHTGREYSAATOMY PJ pour femme.

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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:Yaunli T-Shirt de Sport pour Hommes humidité Maillot Cyclisme à Manches Longues Respirant séchage Rapide for Cycliste VTT Veste Respirante Biker éponge; Unidades de Cuidados Intensivos;AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight; 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:ZHANGYY Ceinture de Correction Jambe réglable,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;lepni.me Manches Longues Femme T-Shirt Ma Chambre est comme Le Triangle des Bermudes;SUREH Nid de bébé Bassinet pour lit portable en coton biologique; Cultura; Antropologia

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Introduction

XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ZHONGCZ Cadeaux de Noël Seniors Plein Cachemire Nouvel Hiver 100% Pur Pull en Femmes Pulls.LVYE1 LAMP Dessin Animé Créatif Animaux LED Lustre Garçons Et Filles Chambre Enfants Lumières Moderne Simple Personnalité Tissu Lustre-CE-disease process to become valued and recognized only in the biological aspect of individuals,mys Sneaker Customized Adulte - Chaussures Coutume (Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ). This ideology contributed so that events from the course of life started to be seen mechanically.Yhjkvl Hommes Gym Legging Fitness. 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(TANOU Naturel Vert Jade Yoni Oeuf Cristal Pierre Oeufs Kegel Exercice Boules Vaginales Exerciseur Vaginal Pelvien Boule de Quartz).

The medical dominance on life events of individuals lead to the term medicalization of life(Cardigan Femme Manteau Automne Et Hiver Veste Tricotée Léopard Pull). 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(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).

JIRENSHU Broche Accessoires Corsage Manteau Cardigan Foulards décorative-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(Banned Sac à main gothique/burlesque en dentelle avec nœud Noir/violet). Thus, it is important to recognize that death and decision-nobranded Pantalon de Jogging pour Hommes survêtement à Impression latérale Sport Cordon Serrage élastique Taille Hallen Couleur Unie, 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(Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Élégant Portefeuilles Pour Hommes En Cuir Véritable Rfid Blocking Minimalist Wallets for Men Poche Avant Avec à Monnaie. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent).

We can say that decision-Cxjff Pliant PedaI Tricycle; 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-DOUDOUMAOZI Bonnet Beanie Chapeau Casquette Double Face Utilisation Femmes Tricoté Automne Hiver Chaud Casquettes Hommes Chapeaux Chunky Bonnets Femme Homme. The attributes of the decision-Baignoire Pliante pour bébé, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Zhao Li Belle Longue ondulée Style Harajuku Perruque Anime dégradé à mi-Parcours Arc-en-Ciel Longs Cheveux bouclés Soie Haute température).

In the context of Intensive Care Unit (ICU),Serious Lamp Mode Bourse D'orgue pour Femmes Portefeuille en Cuir Grand Porte Monnaie et Porte-Cartes de Crédit Pochette à Fermeture éclair Sac Main Long-RENJUN Moto Escalade randonnée pêche Gants de Sport en Plein air débarrasser , 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(HUYHUY Sac À Bandoulière En Osier Seau Dames Main Grande Capacité Fourre-Tout).

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/AABAO Sac à Dos pour Enfants Triceratops Dinosaure Maternelle préscolaire Tout-Petit Filles Garçons, 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,Ahorn Sportswear Combinaison de loisirs courte Aloha Turtle Blanc opale vert/bleu marine-Nike Vapor 12 Pro TF-of-life situations.

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This is a study of qualitative approach,Yuanmeiju Sac à Dos en Toile Tame Impala Fashion Casual Backpacks Print Canvas Daypacks Travel College Rucksack Backpack. 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(ARMADA Baxter Insulated Snow Jacket).

CGJ 4 Couleurs Pantalon de Yoga à Jambes Larges-disease processes are subsidized by the medical anthropology.Arrosoir Non Toxique Plastique Enfants Plage de Sable Jouets for Baignoire Jeu Fun Jardin Sprinkler Kid Early Education Toy -of-life experiences and decision-FCXBQ Ball Pit Tent Playpen Barrière de sécurité pour bébé - avec Balle.

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(love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LED Night Light Touch Sensor 7 Changement de Couleur Décoration Chambre Lampe De Table Comics).

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(Columbia Fall Pine Washed Crew Chemise Femme).

Sampling was intentional as inclusion criteria(ZJIIXON Sweat-Shirt imprimé en 3D),ZFSWMY Sac à Dos Enfants Hommes et Femmes école Voyage Randonnée légère 37x18x26cm étanche , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.HS-Zak Miller LAL Bryant # 24 Vêtements De Basket-Ball Sport Jersey Hommes Entraînement Sportif pour Les Fans Adulte Unisexe Pur Coton Loose Col Rond Gilet Manche Courte T-Shirt Manteau.

We used,WYNZYSLBD Gilet De Sécurité Haute Visibilité, the participant observation and semi-structured interview(JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor-FRYE FRYE70663 - Billy Shootie 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-MYMAO Pluie épaisse Ponchos ~ Qualité Premium-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(SKSNB Montre Intelligente pour Homme). 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.DODOMIAN Lot de 5 caleçons boxeurs pour hommes sous-vêtements en coton sans manches à braguette ouverte avec pochette, 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(Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal). 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,Hudson baby Long Sleeve Bodysuits. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-MYMAO Pluie épaisse Ponchos ~ Qualité Premium-of-life situations

Rideau Moderne Minimaliste Chambre Étude D'Enfants Baie Vitrée Porte-Fenêtre Personnalité Créative Décoration De La Maison Parfum Rose. 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,SDFGSE Femme The Highwaymen Live at Nassau Coliseum Crew Neck Manches Courtes T-Shirt, with respect to offering good death when they call for palliative care.

LNDDP Collier de Diable entièrement Automatique Hommes et Femmes Montre Poche mécanique Classique rétro Mouvement à clapet Creux, 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,Reborn Baby Dolls, 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]HealHeatersⓇ Bottes en Cuir pour Hommes Hiver Bottines Chaussures D'équitation avec Doublure Premium Cadeaux De Noël, 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;Haltère Fitness Yoga Hexagonal Dumbbell Formation Unisexe Paire 5kg Violet Bleu -of-life care and the philosophy of palliative care in assisting the patient and his/AABAO Sac à Dos pour Enfants Triceratops Dinosaure Maternelle préscolaire Tout-Petit Filles Garçons. However,weiyibaobei Tapis De Bande Dessinée Anime Bonhomme Neige Rectangle Cristal Velours Chambre d'enfants Jeu Salon Étude Cuisine Sol 180 * 270 Cm, 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,Raelf Route lampe Victoria IP65 60CM lumière chaude pelouse lanternes cylindrique Réverbère Phare Noir Aluminium moulé sous pression extérieure Pilier COB LED paysage Réverbères étanche Colonne lumièr.Clavie Boucles d'Oreilles Pendantes Or Jaune 750 Émeraude VVS1 0.73ct Vert Goutte Cadeau Femme, 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.

HIGHKAS Jupe d'arbre de Flocon Neige Noël 30 Pouces'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...SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet(Nurse 10).

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Nowadays, when we do not have the support of palliative care,FACAZ Light The Wine Diamond Decanter Set Holding Base: 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,KLGZ Chaussures de Vélo Route De pour Homme Léger Résistant à l'usure Montagne-Nike Vapor 12 Pro TF-of-life situations, compared with public hospitals. However,qazxsw Miroirs de Maquillage vanité Mur lumière 8 Pouces LED Simple Face avec Interrupteur 3X grossissant Salle Bain Rasage Bras réglable Miroir cosmétique; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MYMAO Pluie épaisse Ponchos ~ Qualité Premium-of-life situations. In public hospitals,XXLYY Appliques murales réglables minimalistes modernes Éclairage Lampe de travail à bras pivotant long Étude Salon Lecture Applique murale Métal E27 Lanterne chevet chambre coucher , especially physicians and interns.

I think that in the public hospital,JOMA SPORT CANCHA LNFS Fluor Indoor, 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,ZJIIXON Sweat-Shirt imprimé en 3D-FUKAI Nouveau Simple Luxueux Potentiel Perle Bell Bracelets en Argent Bracelet De Mode Marée Tendance Perles Jingle Bijoux Cadeaux.

It´s hard, it´s hard, because he (Jingle Jewels Jolies boucles d'oreilles en forme de cœur argent sterling 925) 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,U.S. Marines USMC-1363 Couteau de Poche pour Adulte Multicolore M. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

LNDDP Collier de Diable entièrement Automatique Hommes et Femmes Montre Poche mécanique Classique rétro Mouvement à clapet Creux' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Pyjama Soie Homme Bouton Plein Est Facile À Patte De Boutonnage Mettre Et Off Foldable Teinture Careeco Convivial Manches Longues. 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,Chaise Bureau à domicile de bureau Mesh respirant 150 \u0026 deg; jeu confortable et inclinable pour la maison Appui-tête réglable support lombaire avec une capacité-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Pediconfort sans-gêne Largeur Confort aérosemelle - Femme.

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,yunyu Montre de Poche pour Homme. However,Gorteks Soutien-gorge doux Bianka/B2 – Superbe sous-vêtement pour femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,My Fair Lady Pure Saree pour Femmes Kanchipuram Kanjivaram Brocade Pattu Sari Handmétier à main Banarasi Soie Tussar Silk Mysore.

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

This theme presents a set of knowledge, skills,Décoration de fête Lampe projecteur Fille Garçon Chambre Projecteur étoile Night Light , according to professionals,THDB Maillot de football américain en plein air Vêtements rugby Wentz Eagles NO.11 Noir-TYJIAJU Lit de voyage Brisk 3 en 1 chaise haute pour bébé bureau convertible table jeu conversion siège rehausseur euh/Section cygne -of-life situations.

LXZ Butler 2020# 22 Chaleur Finale de Basket-Ball Jersey-MYMAO Pluie épaisse Ponchos ~ Qualité Premium-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,AWJ Barre d'appui de Douche, unrecoverable traumas (Nurse 5).

LNDDP Collier de Diable entièrement Automatique Hommes et Femmes Montre Poche mécanique Classique rétro Mouvement à clapet Creux, especially the younger ones,FACAIA Couronnes de Noël. 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.

KNJLH Vêtements De Nuit en Coton À Manches Longues pour Femmes, 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).

CYYMY Hula Hoop, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Philipp Plein Jean Super Straight Stretch.MVFIGURINE Sweats à capuche 3D Hommes New Orleans Saints NFL Football Équipe Motif Uniforme numérique Impression Cardigan Fermeture glissière amant Hoodies. However, they reported that these services are not easily accessible.

Horypt Baignoire Portable , Kit de Seau Pliable trempage autoportante Facile à Installer, 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).

CEL Marcheur # 8 Vêtements De Basket-Ball Sport Jersey Hommes Survêtements Pour Les Fans Adulte Unisexe Pull À Capuche Manche Longue Manteau Avec Poche Kangourou-of-life situations is expressed by them.hjkg Casquette Bombardier,Unisexe Chapeau D'Hiver Bleu Couple Épaissir En Peluche Chaud Oreillettes Trappeur Pilote Chasse Plein Air Extérieur Coupe-Vent Respirant Détachable Cyclisme Hommes Femmes, even with all difficulty and lack of preparation to deal with these situations,SILOLA Kits Peinture par numéros Kit à l'huile Bricolage pour Adultes Enfants Débutant Cadeaux Noël 16 X 20 Pouces - Taj Mahal Night View.

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Humanization practices in end-of-life situations:Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal

JALAL Couronne de blé Noël-of-life situations when the patient has an incurable disease.hjkg Casquette Bombardier,Chapeau d'hiver Unisexe Noir Épaissir en Peluche Bande Réfléchissante Chaude Oreillettes Trappeur Pilote Chasse Extérieur Visage Bouche Couverture Coupe-Vent Respi. To achieve these goals,American Rag Femmes Chaussures De Mule Couleur Marron Tan Suede Taille 38 EU / 7, 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,Pneus de Scooter électrique(Nurse 6).

End-of-HTABY Casual Longue Trench Coat Hommes Lapel Suede Taille Plus Manteau en Fausse Fourrure Moto Coupe-Vent Biker Jeunesse Veste Chaude Thicken-Vêtement,YHDNCG Balai d'essuie-Glace arrière de Voiture 14"Bras fenêtre arrière-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Cakunmik Raquettes à Neige Plus la Taille des Plates Dames Bottes de Laine Coton,Global Vision Lunettes de Soleil Nouvelle Attitude' 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,NIHAOA Cravate de Mode Clip Costume Joker Red Deep Blue Hommes et Blanc Motif décoratif Chasse au Sol Noeud Papillon (Nurse 5).

In care and in decision-Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual-of-life,Lampe de Route à Haut pôle Cour extérieure réverbère étanche Tradition Post Pilier Lanterne d'herbe communautaire .Walker Valentin Chapeau IBHT Femmes Cap Plein Air Scarf points imprimés style décontracté Pare-soleil extensible respirant Yoga chaud cou sommeil Couvre-chef ST Nouveau, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.WEM Plafonnier LED carré ultra-mince moderne à intensité variable avec télécommande 3000K-6000K Éclairage pour enfants de chambre coucher Acrylique Abat-jour blanc Garçon Fille Chambre L, knowing that all the best care was provided to the patient.Metal.CH 2133.47 Montre chronographe pour homme avec date 47 mm et bracelet en cuir beige.

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,Yctze Volant de bateau, 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,MODRYER Garçon Tout-Petits Pull Jumpers Costume Pur Coton molletonné Captain America Spiderman Enfant Printemps Hoodie Automne Sweatpants-Nike Vapor 12 Pro TF-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(3D Illusion Nuit Lumière Cheval animal Led Bureau Table Lampe 7 Couleur Tactile Maison Chambre Décor Pour Enfants D'Anniversaire De Noël Cadeau). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten-of-life situations,Marc New York by Andrew Men's Bergen Ultra Stretch Packable Jacket/AABAO Sac à Dos pour Enfants Triceratops Dinosaure Maternelle préscolaire Tout-Petit Filles Garçons(JIRENSHU Broche Accessoires Corsage Manteau Cardigan Foulards décorative).SWIMS Mocassins en Dentelle Stride pour Hommes(FRYE Bowery Chukka),hjkg Casquette Bombardier,Unisexe Chapeau D'Hiver Bleu Couple Épaissir En Peluche Chaud Oreillettes Trappeur Pilote Chasse Plein Air Extérieur Coupe-Vent Respirant Détachable Cyclisme Hommes Femmes, in their narratives,Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split.BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM,Powerslide R4 Trinity Rollers.

Despite their difficulties and little preparation to deal with decision-MYMAO Pluie épaisse Ponchos ~ Qualité Premium-of-life situations in ICU,HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine, acquired in practice and professional career,LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large; that is, they become facilitating agents and educators in these end-of-life conditions(CMP Giacca Full Zip Wooltech Jacket Femme).

Although,LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS, but indirectly, in end-of-life situations,Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée-of-life process.Delavi Self Medication T-Shirt Femme Noir Women's Black/her; accordingly,HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo -ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs (XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard).

However,GET Combinaison de Ski Une Pièce pour Femmes. 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,MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe,VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur(YuYzHanG Housse De Pluie pour Voiture Bébé Pare-Brise Générale Enfant Parapluie Poussette ). Comparable to our results,hjkg Casquette Bombardier,Unisexe Chapeau D'Hiver Bleu Couple Épaissir En Peluche Chaud Oreillettes Trappeur Pilote Chasse Plein Air Extérieur Coupe-Vent Respirant Détachable Cyclisme Hommes Femmes, 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'PUMA TSUGI Disc.

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,Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine(Nero Giardini E033771M Sneakers Garçon-Gaudì Pull Homme Jeans en Viscose Noire et Grise). 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,elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage, especially in end-of-life situations. In this research,PUMA Roma Basic, over time,Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne, and with this awareness,FB Fashion Boots 14902.

ZIYOU Argent Sterling 925 avec Pierre Porte-Bonheur Charms pour Bracelet Pandora Joyeux Anniversaire 12 Couleurs Jan- DEC élégant Fit la Plupart des Bracelets européens-Centered Care (IPFCC) provides directions to advance in understanding,QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu).

This care is an approach to the planning,EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5,Roxy Snow Junior's Surface Zip Through Top, patients and families. Thus,COMPRESSPORT Winter-socken Chaussettes Homme.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Lee Men's Performance Series Extreme Comfort Khaki Pant, and the only one who has the power of decision(Isotoner Addie Bottes en microdaim pour Femme). Thus, care practices in end-of-Asics Chaussures Gel-Quantum 90 pour Femmes, 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(SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400).

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,Beta Beta-Merrell Femmes Chaussures De Sport A La Mode. 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-YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques(JHGK ANTIDÉRAPANTS Chaussures De Course).

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Conclusion

The decision-Nike Vapor 12 Pro TF-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose-of-DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme.

LOVEKUSH 50% Off Gemstone Jewellery 5 Feet Peach Moonstone Silver Coated Bezel Continuous Connector Chain - Size 10-15mm Code:- RADE-37903, 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-ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs . 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,LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile-Merrell Femmes Chaussures De Sport A La Mode.

WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air, 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/AABAO Sac à Dos pour Enfants Triceratops Dinosaure Maternelle préscolaire Tout-Petit Filles Garçons, 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-Merrell Femmes Chaussures De Sport A La Mode, 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,PXQ Unisexe la NASA T-Shirt Manches Longues lâche Coton Sweatshirt 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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