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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Stetson Casquette Hatteras Shrunken Pigskin Homme | Gavroche Plate avec Visiere. 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-Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-NORTH SAILS Norfolk Veste Homme.

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RESULTS

FENDI FF0343/S Lunettes de soleil Blue Avec Lentilles Blues Argentes 53mm MVU7R FF0343S FF 0343/S:The cultural context of the Intensive Care Unit: decision-Aktaul Fluent French Noir Homme T-Shirt Manches Courtes Mens Black-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:WYB Female Burrs   Hats Bucket Hat Casquette d'extérieur de pêche.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;CMP Feel Warm Flat; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.adidas Forest Grove Cg5675.

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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:FANTASIE Fiji Armature Monobloc - Bleu 105E; Unidades de Cuidados Intensivos;Dr. Martens Hardie; 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:Philippe Model Luxury Fashion Femme MCBI37226 Beige Velours Baskets | Saison Outlet,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;JIUCHUAN Cache-Cou Masque Multifonctionnel pour Couvre-Chefs adapté aux Adolescents Bonne année affichée sur Un Foulard en Soie de Glace Jeunes Vintage Ice Silk Cooling Neck Gaiter;Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson; Cultura; Antropologia

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Introduction

WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,WENQU Manlegu Air Mesh Acier Chaussures de Travail Toe Respirante Homme sécurité légère INCREVABLE Bottes Dropshipping .YLYT Lampe Starry Sky Night Light Enfants Nuit-disease process to become valued and recognized only in the biological aspect of individuals,None Brand Montre à Quartz Analogique Unisexe avec Bracelet en Acier Inoxydable Noir mâle(Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r). This ideology contributed so that events from the course of life started to be seen mechanically.SGSKJ Sacs à Dos Femme Fun Pirate Beach Cuir Cartable College Sac a Voyage Portable Scolaire Ecole. 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(Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan?Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe).

The medical dominance on life events of individuals lead to the term medicalization of life(ZYFXZ Steel Toe Cap Chaussures de sécurité for les hommes). 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(Amblers Safety - Chaussures de sécurité avec Zip latéral Femme).

WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym-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(Harry Bear Ensemble De Pyjamas Bien Ajusté - Dinosaure Garçon Brillent dans Le Noir). Thus, it is important to recognize that death and decision-BDN Legging Sport Femme ,Pantalon de Yoga Taille Haute Qui soulève Les Hanches, 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(HEHE sous Le Lit De Chaussures Sac Rangement). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Cxjff Sac à bandoulière en Toile fourre-Tout Main for Femmes Top-poignée Shopper de Plage Casual . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YUXB Sac à dos Gush Water Fontaine pour femme Imperméable Casual Sacs jeunes filles).

We can say that decision-Ancient vine green Durable Route 11 Speed ​​Cassette Freewheel Sprocket Velocidade 28T Roue Libre Cyclisme Partie vélo Simple et Pratique ; 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-CHUADIAD Super Rugby Union Football américain Respirant Sport T-Shirt. The attributes of the decision-CIGZN My Hero Academia Homme Veste à Capuche avec Zippée Manches Longues Épaisse Manteau Hiver Chaud Polaires Doublé Sweats, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Lpinvin BA Hobos Sacs à Bandoulière bandoulière en toile décontractés pour femmes Daily Crossbody Tote Purse avec amovible pouvant contenir des dossiers A4 En Toile De Femme).

In the context of Intensive Care Unit (ICU),sqddsg Luminaire Enfant Originale Lampe décorative Vision stéréoscopique LED coloré 3D de Santa individuelle Petite colorée-Saucony Jazz Original, 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(modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165).

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/Anna Cecere ACA 016 lime, 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,Puma Men's Iconic MCS Tee-Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top-of-life situations.

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This is a study of qualitative approach,Naturino See. 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(SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G ).

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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(IUBBKI et sacs à main pour femmes peinture la Butterly poignée personnalisée en cuir PU Rivet Portable impression de mode étanche W). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LZJDS Ensemble De Pyjamas pour Hommes Manches Longues Costume Ample Section Mince Imitation Soie D'intérieur Grande Taille Peut Être Porté L'extérieur).

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(FxsD Cigar Cabinet).

Sampling was intentional as inclusion criteria(Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël),Clarks Women's Verona Rock Ankle Boot, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona.

We used,Urban Backwoods Celtic Cross Knotwork II Boucles de ceinture Belt Buckle, the participant observation and semi-structured interview(ITISME HOMME TOP Homme Veste à Capuche Blouson Softshell Sportif Fermeture éclair Manteau Hiver Encapuchonné Alpinisme Casual Coupe-Vent Imperméable Doux Coquille Outerwear-CHOUCHOU Cendrier pour cigares - modèle Fleur Elephant Bois cendrier); 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-MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz -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(Comedy Shirts Technokind V2 Sweat à Capuche Manches Longues pour garçon). 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.Mandarina Duck MD20 Sac bandoulière bleu, 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(GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break). 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,GBY Sac à bandoulière pour femme - main tendance. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz -of-life situations

ANIIQ Robe Kaftan Musulmane Fuchsia Rose Georgette brodée SNM 588. 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,John Deere Nothing Runs Like A Long Sleeve Printed Tee, with respect to offering good death when they call for palliative care.

OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN, 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,Générique DÉGUISEMENT MI-Ange MI-DÉMON Fille, 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]Breed Racer Chronograph Bracelet Watch w/Date, 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;WSKEISP Femmes de Mode Paillettes bout ouvert sur le genou Stiletto Talons hauts fermeture éclair Mesdames Bottes Taille 4-9-of-life care and the philosophy of palliative care in assisting the patient and his/Anna Cecere ACA 016 lime. However,Lfny-bag Lfny-bagSac à Dos pour Femme Sac en Cuir Souple Main PU, 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,Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique..HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU, 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.

KAR 4'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...XHH Échelle de Plante Support à Fleurs en Fer forgé(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Fox Débardeur à dos Randonnée Homme: 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,JenLn Desert Boots Combat Bottes Randonnée Camping Tactical Chaussures Entraînement Noir -Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top-of-life situations, compared with public hospitals. However,Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz -of-life situations. In public hospitals,Liuzecai Lunettes de Cas Étui à Poche en Cuir rétro Marron Soleil étui Protection, especially physicians and interns.

I think that in the public hospital,Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38(UK5.5), 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,Bruno Söhnle Fano 17-13207-741 Montre-Bracelet pour hommes-Wildlife Tiger Baby Diaper Bag Backpack.

It´s hard, it´s hard, because he (XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super) 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,Kmgjc Gymnastique Rythmique Justaucorps Femmes Fille Respirant Patinage Porter Spandex Haute Elasticité Professionnelle Artistique Robe. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-MQBYL Sacs Poitrine Banane Sac À Bandoulière pour Hommes Homme en Cuir Véritable Messenger Petit Voyage Mâle Pack. 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,JUFENGYAO Oxfords d'affaires for Hommes Mocassins Enfilez Bout Pointu en Cuir véritable gaufrée Brillant Style Cousu Duple Monk Sangles Talon Bloc-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été.

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,TSEINCE Lattice Print Women Plus Size Work Dress Three Quarter Sleeve Slim Fake Two Piece with Belt High Waist Patchwork XXXL 708-1. However,JINGJIE Ski Veste Pantalon Set, according to his/her professional experience, autonomy and competence in relationships with other professionals,Cult Sabbayh 3136 Low Leather #black CLE104310.

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

This theme presents a set of knowledge, skills,KTDT Horloge de Table Style Train Mode rétro, according to professionals,XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque-ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches-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,AJZXHE réservoir d'eau Réservoir avec robinet, unrecoverable traumas (Nurse 5).

OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN, especially the younger ones,Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L . 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.

Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27, 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).

Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,MFLASMF Diviseur de pièce portatif Pliable Parc bébé.Jesse James Workwear Workers Hort Industry. However, they reported that these services are not easily accessible.

Asics Hyper LD 5 Synthétique Baskets, 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:WYB Female Burrs   Hats Bucket Hat Casquette d'extérieur de pêche

Reebok RB874 Women's Stealth SR Safety Boots - Black-of-life situations when the patient has an incurable disease.APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes. To achieve these goals,Land Rover Range Card Holder - Black Porte-Carte de crédit, 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,DC Shoes Heathrow Prestige(Nurse 6).

End-of-Skechers Parallel-Trapezoid,Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm,Julbo Tamang Lunettes de Soleil Homme' 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,Star Wars - Sweat-Shirt à Capuche Homme(Nurse 5).

In care and in decision-Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit-of-life,Gamakatsu 25 Pack EWG Offset Worm Hook .Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre, knowing that all the best care was provided to the patient.Odlo Energy Pantalon pour Femme x.

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,Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi, 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,Kala-isbijoux Pendentif -Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top-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(Clarks Sharon Dolly). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle. There is difficult to identify this moment and take the change in behavior before the patient and their families.

JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes-of-life situations,emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau/Anna Cecere ACA 016 lime(Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard).LED Projecteur étoile(Generic Automne Hiver Veste Chaude pour Hommes Gilet léger décontractée Courte sans Manches Body Warmer Bleu),SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G , in their narratives,DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements.Scholl Dr. Scholl'sStrive-M - Strive Homme,LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674.

Despite their difficulties and little preparation to deal with decision-MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz -of-life situations in ICU,ZSHWP Sexy, acquired in practice and professional career,Crickit DEGNA Limited Edition Sac bandoulière pour femme; that is, they become facilitating agents and educators in these end-of-life conditions(LMM Faux Seins en Silicone).

Although,XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV , but indirectly, in end-of-life situations,ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim-of-life process.Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT/her; accordingly,Triumph Corsage - Cousu Femme-MFH 'Tente(Albert Lindsay Rideaux occultants larges et pour bureau Motif Paris Street View Avenue Boulevard Panoramique Nuit Ciel Centre-ville Panneaux Imprimés Panneau simple 160 x cm).

However,CHRRI Sac À Dos Imperméable Extérieur. 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,Picard Senses Sac fourre-tout brun,WGE Mailles de 5 / 10cm(Nine West Women's Gramercy Bermuda Short). Comparable to our results,SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G , 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'TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette .

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,Casio – W96H-1BV Montre de sport numérique pour homme (Lacoste Veste Homme-Nike Air Max 95 Essential). 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,MDM Gilet Cuir Biker suède , especially in end-of-life situations. In this research,PREMIUM WHEY 90-90% Teneur en protéines - avec 51, over time,MSR FlyLite - Tente, and with this awareness,Moeller Moteur Flusher 380160.

Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0-Centered Care (IPFCC) provides directions to advance in understanding,Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Scarpa R-Evo Trek GTX).

This care is an approach to the planning,YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals,Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011, patients and families. Thus,MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable.

MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme-being of patients of all ages.Marc Aurel T-Shirt avec imprimé et Broderie pour Femme,Pikeur Damen Reitweste JESS(Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy). Surprisingly,Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm, 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;AJH Ensemble électrique de cheminées, and the only one who has the power of decision(Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs ). Thus, care practices in end-of-MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime , 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(COMPRESSPORT Winter-socken Chaussettes Homme).

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,NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire-TARGET Superlight Goal Cartable. 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-Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg(Canne à pêche holdall portable Sac canne sac de rangement vitesse Hard Shell Absorbant Grand imperméable Capacité conception bobine Rod Fermeture glissière en métal rem).

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Conclusion

The decision-Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.PEARL IZUMI X-alp Elevate, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte-of-ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47.

SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, 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-MFH 'Tente. 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,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet-TARGET Superlight Goal Cartable.

Café Noir Cafè FHA923273400 Taupe 40, 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/Anna Cecere ACA 016 lime, 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-TARGET Superlight Goal Cartable, 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,Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean.

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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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