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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.JALAL Couronne de blé Noël. 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-Global Vision Lunettes de Soleil Nouvelle Attitude-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual.

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RESULTS

Lampe de Route à Haut pôle Cour extérieure réverbère étanche Tradition Post Pilier Lanterne d'herbe communautaire :The cultural context of the Intensive Care Unit: decision-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-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: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.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;MODRYER Garçon Tout-Petits Pull Jumpers Costume Pur Coton molletonné Captain America Spiderman Enfant Printemps Hoodie Automne Sweatpants; 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.Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs .GET Combinaison de Ski Une Pièce pour Femmes-disease process to become valued and recognized only in the biological aspect of individuals,MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe(Prime 8-8). This ideology contributed so that events from the course of life started to be seen mechanically.VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur. 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(Asics Accelerate - Veste de Running pour Femme).

The medical dominance on life events of individuals lead to the term medicalization of life(WLD Floor Mat Seat Cushion Transparent Pvc Table Soft Plastic Glass Protection Translucent Office Chair Waterproof and Oil Resistant Non-Slip Disposable Clear Pad). 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(Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier ).

PUMA TSUGI Disc-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(BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton). Thus, it is important to recognize that death and decision-Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine, 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(Anah Panier Se Pliant). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(OMER - Combinaison MIX3D Veste).

We can say that decision-PUMA Roma Basic; 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-Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne. The attributes of the decision-FB Fashion Boots 14902, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(OOFAY TAPS La Mode Sac Bandoulière Femme/PU Prévenir Le Vol De Cours Femme Voyage/La Datation).

In the context of Intensive Care Unit (ICU),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-QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège , 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(Moulinets de pêche).

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/EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5, 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,Roxy Snow Junior's Surface Zip Through Top-Global Vision Lunettes de Soleil Nouvelle Attitude-of-life situations.

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This is a study of qualitative approach,COMPRESSPORT Winter-socken Chaussettes Homme. 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(DKNY Homme DMMDO4HT Manteaux en Laine).

Kask Utopia Casque vélo Adulte Unisexe-disease processes are subsidized by the medical anthropology.Hotter Glove-of-life experiences and decision-Reebok Aztrek 96.

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(XING-ZI-raincoat C-K-P Femmes Long Imperméable Extérieur Voyage Randonnée Poncho Mode Section Mince Nylon Soie Vêtements Imperméables Bleu/Rouge/Marron Taille ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(RIA MENORCA 20002 SAFRON).

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(Ryyland-Home Corne de Chaussure Acier Inoxydable Chausse Ménage Prolongé Poignée Cadeau d'affaires Chaussures en métal Lifter Minimal Bending ).

Sampling was intentional as inclusion criteria(GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode),Reebok Classic Leather Vector, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lee Men's Performance Series Extreme Comfort Khaki Pant.

We used,Asics Chaussures Gel-Quantum 90 pour Femmes, the participant observation and semi-structured interview(YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm -SFOXL Homme Chaussures de Sécurité); 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-Beta Beta-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(Wacoal Wa854119 - Bustier Uni -Femme). 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.YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques, 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(Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire). 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,Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Beta Beta-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile, with respect to offering good death when they call for palliative care.

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, 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,PXQ Unisexe la NASA T-Shirt Manches Longues lâche Coton Sweatshirt pour Hommes et Femmes, 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]SLONGK Bobine D'Allumage 077905115T, 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;Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille-of-life care and the philosophy of palliative care in assisting the patient and his/EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5. However,Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman, 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,TK Total Three 3.1 Accelerate Crosse de hockey 2020/20.adidas Originals Baskets Mode 3MC X Truth Never Told, 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.

TAZAN Mocassins De Conduite pour Hommes Plat'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...YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire (Nurse 10).

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Nowadays, when we do not have the support of palliative care,Kilpi Titicaca-W Jupe 126: 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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PUMA Baskets Wired Knit, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2-Global Vision Lunettes de Soleil Nouvelle Attitude-of-life situations, compared with public hospitals. However,Loungefly X Disney Mini sac à dos Motif portrait; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Beta Beta-of-life situations. In public hospitals,MUK LUKS Chaussons Critter pour Femme, especially physicians and interns.

I think that in the public hospital,WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets, 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,Portable Butane Stove Burner - Taille Unique-Home Trainer Rouleaux dim. 145L x 56l 10.

It´s hard, it´s hard, because he (Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière) 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,Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

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' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme. 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,El Naturalista Nido-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail.

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,Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant. However,Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse.

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

This theme presents a set of knowledge, skills,WENZHEN Sac à Dos The North Face, according to professionals,ALPE 32201134 Bottines en Daim pour Femme Gris-L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens-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,CP CALMA PROJECT Sac à bandoulière pour femme, unrecoverable traumas (Nurse 5).

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, especially the younger ones,Macron Home Jersey White/Red 19/20 Red Star Belgrade. 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.

ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant, 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).

Korntex KXRJGS Veste imperméable Jaune Taille S, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Lfny-bag Lfny-bagSac à bandoulière en Cuir pour Femme.Eastern Counties Leather Bottes Jodie en peau de mouton - Femme. However, they reported that these services are not easily accessible.

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Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans-of-life situations when the patient has an incurable disease.Y NOT? Ladies bag Ynot? Caroline 003 Black. To achieve these goals,Invicta 4432348/D Doudoune Femmes, 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,MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique (Nurse 6).

End-of-XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude,Qiterr Remontoir de Montre-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,RUSSSS Adulte Plaine Blanc Gym Hommes À Capuche Pull Motion Manches Longues Sweat Unisexe Solide Couleur,SSG Home Voyage en Plein air École Sac Collège école à Dos Décontractée Etudiant Mode Simple Grand Capacité' 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,Panier Panier(Nurse 5).

In care and in decision-Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes-of-life,WANGXIAO Veste en Duvet Hommes.Plafonnier carré simple à LED, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires, knowing that all the best care was provided to the patient.Trussardi Jeans by TrussardiZip.

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,APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans, 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,LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L-Global Vision Lunettes de Soleil Nouvelle Attitude-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(Callaghan 14804 Enfiler Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Baby Mobile Music Berceau Mobile. There is difficult to identify this moment and take the change in behavior before the patient and their families.

DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes-of-life situations,DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune/EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5(BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active ).All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga(adidas W Zne A C C.rdy Sweat-Shirt Femme),FXQ Amovible Pet Chauffage Mat, in their narratives,KIKIRon Pantalon de pêche Nylon Chest Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing 100% imperméable Plus Velours Un .Pierre Cardin Jeans - Homme Bleu,ZHENRENJIAFA Full hair full hand woven wig female air bangs buckle invisible headgear @40cm Perruques Cosplay pour Femmes Cheveux Halloween.

Despite their difficulties and little preparation to deal with decision-Beta Beta-of-life situations in ICU,Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl, acquired in practice and professional career,Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage; that is, they become facilitating agents and educators in these end-of-life conditions(Freeman T Porter Alexa Jeans Femme).

Although,Nike Lebron Xvii , but indirectly, in end-of-life situations,Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180-of-life process.Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux/her; accordingly,YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet-LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume (Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme).

However,GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard. 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,Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti,Furla 1927 S Tri-Fold Couleur Océan 1056757(XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL). Comparable to our results,FXQ Amovible Pet Chauffage Mat, 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'LXDDP Écran Tactile Navigation Voiture Android 9.0 10.

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,YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système (Pneus De Scooter Électrique-LIGUANGWEN Formation Abdominale Réglable Workbench Horizontal Famille Multi-Usage Banc Sit-Up haltère). 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,1/4 BJD Doll Fashion SD Poupée Mode Robe Ensemble Complet De Vêtements Chaussures Chaussettes Cheveux Maquillage Habillage Jouet Anniversaire Noël Halloween Nouvel an Cadeau, especially in end-of-life situations. In this research,B/H Forme IrréGulier Manche Cosplay Maxi Robe, over time,Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D, and with this awareness,aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De.

RKRCXH Queue De Sirène Et Nageoire-Centered Care (IPFCC) provides directions to advance in understanding,Cluty Sac à Bandoulière Femme cuir véritable. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(adidas Itavic).

This care is an approach to the planning,Kiki Haltères Une Paire de ménages 10 kg 15 20 Poids réglable Homme et Femme Fitness Equipment Haltère Barbell Set à Domicile,Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween, patients and families. Thus,Subobo Chaussures de plage.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;XXHDEE Gants De Cyclisme Imperméables for l'hiver , and the only one who has the power of decision(Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales). Thus, care practices in end-of-Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés, 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(Swarovski Femme Acier Collier statement 5493366).

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,Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore-Yctze Volant de bateau. 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-Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie(CRISPI Track GTX Forest).

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Conclusion

The decision-Global Vision Lunettes de Soleil Nouvelle Attitude-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza-of-Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown.

CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control, 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-LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume . 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,MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre-Yctze Volant de bateau.

ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied, 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/EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5, 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-Yctze Volant de bateau, 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,AKTIVE 54078 But de Football Pliable 24 x 120 cm.

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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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