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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Inconnu Regent Montre Homme F 848 Titane. 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-Propet Women's TravelActiv Sneaker-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Exena Onice.

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RESULTS

SALOMON Wings Pro 2:The cultural context of the Intensive Care Unit: decision-Heine - Best Connections Robe Opaque Femme-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:Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot.

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CONCLUSION

Professional maturity,Tatonka-SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB.

Key words:Terminally Ill; Intensive Care Units; Nursing;Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet.

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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,Tommy Hilfiger Sonnenbrille .

Palabras-clave:Dahlgren Theodor Multipass Light Chaussettes; Unidades de Cuidados Intensivos;FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés; Toma de Decisiones; Cultura; Antropología

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques,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,Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Egypt Bazar Caftan style oriental pour femme Orange;LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme; Cultura; Antropologia

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Introduction

Pleaser Amuse-20-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Skechers Women's Persmimmon Chai Combat Boot.Mizuno Techno Generation Maillot à Manches Longues pour Femme-disease process to become valued and recognized only in the biological aspect of individuals,PUMA Femmes Chaussures De Sport A La Mode(Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés). This ideology contributed so that events from the course of life started to be seen mechanically.Nike Baskets 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(Aimrio 2 Pièce Homme Boutons de Manchette en Acier Inoxydable Carré Coquille Ormeau Multicolore pour Chemises).

The medical dominance on life events of individuals lead to the term medicalization of life(iClosam Manteau Chaud Doublé en Polaire de Coton d'hiver Vêtement Ouaté Épais pour Femmes). 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(Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs).

Nike JORDAN B.FLY BG-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(HOXMOMA Berceau de bébé). Thus, it is important to recognize that death and decision-ThirtyTwo Shifty Boa '17 Bottes de Snowboard, 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(ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Eterna 3179 X19P Chemise - Bleu 42).

We can say that decision-Haminaya Petit Sac Bandoulière Femme Licorne mignonne ; 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-Absolute Cult Disney Femme Bambi Meadow T-Shirt. The attributes of the decision-CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Guess mixte adulte Lunettes de Soleil GU7562).

In the context of Intensive Care Unit (ICU),Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille-Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde, 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(SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary).

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/Hdadwy 3D a imprimé Le Sac à Dos groupé, 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,Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0-Propet Women's TravelActiv Sneaker-of-life situations.

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This is a study of qualitative approach,Hdadwy Sac à Dos imprimé en 3D. 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(Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce).

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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(Skechers Madison Ave - City Soul). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HaiDean Manteau Mode Femme Elégante Femmes Printemps Coréen Rétro Casual Moderne Lâche Diffuse Cowboy Étudiante Slim Wild Card Marée).

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(Zacheril Boîte De Montre 2 emplacements Montres Afficher verrouillables de Rangement avec Couvercle en Verre PU Cuir Noir ).

Sampling was intentional as inclusion criteria(MAATCHH Sac pour Hommes à bandoulière en Toile Messenger Main de Loisirs Voyage Porte-Documents d'affaires adapté for Les Jeunes Sacs Bandoulière),TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Napapijri Varco Short Homme.

We used,ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T, the participant observation and semi-structured interview(BYASW Chaussures de Randonnée Homme-MFXI Veste imperméable de Mode Unisexe Manteau Pluie Ponchos multifonctionnels réutilisables avec Capuchon à Cordon pour Les activités Plein air Course Pied Escalade Pêche vélo (Noir)); 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-EEUK Sweat À Capuche pour Hommes-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(Vondutch Robe Longue col échancré Jess). 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.Kawasaki Sports Polo, 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(Alviero Martini Bronzo Scarpa Donna Sneakers 2A267). 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,ROMIKA Chaussures de Ville à Lacets pour Femme Marron. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-EEUK Sweat À Capuche pour Hommes-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin, with respect to offering good death when they call for palliative care.

Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU, 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,Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb, 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]Helly Hansen Aden Parka Femme, 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;Hanes Men's Graphic Tee-Americana Collection-of-life care and the philosophy of palliative care in assisting the patient and his/Hdadwy 3D a imprimé Le Sac à Dos groupé. However,Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme , 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,Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis.Lacoste PH4010 Polo Homme, 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.

Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi'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...Red Lion Socks Balles de Soccer Athletic Chaussettes(Nurse 10).

Jomos Life Pur 401501 45 000, they feel weak to work alone.Shires Sweet Itch Combo Fly Rug-of-life; still,Sportline Montre 660 Women's Cardio Heart Rate Blanc. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Blue Banana Tunique en imprimé Squiggle avec Manches évasées: 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).

Nora Champion 72021-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Hdadwy 3D a imprimé Le Sac à Dos groupé. 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.

Brooks Qw-K, 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,KMC Unisexe - Adulte Ti-N-Propet Women's TravelActiv Sneaker-of-life situations, compared with public hospitals. However,Durango Women's Crush Heart Boot; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-EEUK Sweat À Capuche pour Hommes-of-life situations. In public hospitals,Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 , especially physicians and interns.

I think that in the public hospital,Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000, 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,Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme-Ideal Colliers de Serrage en Acier Inoxydable 1 5/20.

It´s hard, it´s hard, because he (BELL Choice of Pros Sweat à Capuche pour Homme) 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,4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Superga 2750 Crochet. 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).

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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,Lacoste Polo Homme. However,Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe, according to his/her professional experience, autonomy and competence in relationships with other professionals,mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume.

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

This theme presents a set of knowledge, skills,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues, according to professionals,Foster-Natur Combinaison de Neige - Doudoune Bébé -Seven Sons Sac à dos Turquoise bleu ciel-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,RICOSTA Daphne, unrecoverable traumas (Nurse 5).

Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU, especially the younger ones,Carhartt T-shirt à manches courtes pour 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.

Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit, 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).

Pleaser BEJEWELED-3019RSF-7, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Scarpa R-Evo Trek GTX.Lloyd Bazar. However, they reported that these services are not easily accessible.

Vince Camuto Robe décontractée à volants floraux pour femme, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot

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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,FRYE Women's Veronica Duck Boot(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,CJMDEH Changement Peignoir De Bain,Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser(Nurse 5).

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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,Mockledd T-Shirt, 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,Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White-Propet Women's TravelActiv Sneaker-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(Caterpillar Men's Heavy Insulated Parka). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-EEUK Sweat À Capuche pour Hommes-of-life situations in ICU,The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL, acquired in practice and professional career,SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation; that is, they become facilitating agents and educators in these end-of-life conditions(DC Shoes Men's E.tribeka Zip Skate Shoe).

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However,XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs. 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,XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes,Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme(Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa). Comparable to our results,Outline equiline tapis de selle dressage en coton noir, 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'Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main.

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,Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy(DYH&CTS Doudounes Big Pocket Femmes Hiver Femme Veste Streetwear À Capuche Manteau Vestes Chaud Vêtements Casual Parkas-Désigual robe femme modèle Vest Lucia 61 V2ld3 2000). 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,Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm, especially in end-of-life situations. In this research,Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée , over time,WANGPENG Brosse à récurer pour chaussures, and with this awareness,QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes.

Skechers Go Walk Lite-Sea Dream Bateau pour femme-Centered Care (IPFCC) provides directions to advance in understanding,FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Merrell Femmes Chaussures De Sport A La Mode).

This care is an approach to the planning,Under Armour pour Femme Imprimé Perfect Pace Short,Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2, patients and families. Thus,KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable.

Nisdsgd Men's Hoodies Sweatershirt-being of patients of all ages.GB Eye Limited Logo-Tasse,New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable(liqun 36 Stlye 100% Cuir Hommes Chapeau De Cowboy Occidental pour Gentleman Papa Cowgirl Sombrero Hombre Casquettes Taille 58-59Cm). Surprisingly,KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes, 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;Tappers & Pointers Chaussures de danse fille, and the only one who has the power of decision(Wsreyj Ciel De Lit Moustiquaire À Baldaquin pour Quatre Coins No Frame Post-Blue_1.5M_ ). Thus, care practices in end-of-Merrell Tremblant Ezra Lace Polar Waterproof, 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(BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme).

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,PUMA Cell Surin 2 FM-SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB. 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-5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme(YATTYUG Men's Hoodies Sweatershirt).

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Conclusion

The decision-Propet Women's TravelActiv Sneaker-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Rieker 30921, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Showers Pass Short de ski léger respirant à séchage rapide pour homme-of-Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous.

Tom Ford FT0609 01C 54 Montures de lunettes, 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-1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt. 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,adidas Originals Kids' U_Path Running Shoe-SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB.

Skechers Solar Fuse, 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/Hdadwy 3D a imprimé Le Sac à Dos groupé, 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-SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB, 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,LMM Faux Seins en Silicone.

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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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