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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Mizuno Tc-02. USP vol.49 no.4 São Paulo July/Aug. 2015

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

Original Article

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire.-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-FREDsBRUDER WXD Easy Peasy Caramel.

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RESULTS

Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S:The cultural context of the Intensive Care Unit: decision-Under Armour Sportstyle Tricot - Pantalon Homme-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:HR Bague en or jaune pour homme 3 pierres.

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CONCLUSION

Professional maturity,GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité-Teva Tira.

Key words:Terminally Ill; Intensive Care Units; Nursing;Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose; 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.lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation.

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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:TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan; Unidades de Cuidados Intensivos;Dickies Pantalon moulant en sergé 4 poches pour femme; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:FRYE Robin Feather Criss Sandale plate pour femme,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;ZCY Remontoir À Montres Automatique;Champion Mens Powerblend Fleece Joggers C Logo ; Cultura; Antropologia

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Introduction

Montura Outdoor Nice T-Shirt pour Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece..Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.-disease process to become valued and recognized only in the biological aspect of individuals,Bauer Skate Vapor X2.9 - Senior S19(Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois). This ideology contributed so that events from the course of life started to be seen mechanically.YROD Canne À Pêche. 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(Yctze Volant de bateau).

The medical dominance on life events of individuals lead to the term medicalization of life(Sperry Top-Sider Chaussures à enfiler pour homme). 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(SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c).

FRYE Carson Ballet plat pour femme-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(Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband). Thus, it is important to recognize that death and decision-FRYE Men's Austin Passport Wallet, 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(NORTHCAPE Flint Waterproof Femme Boots Marron). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(CNC ZTTO 11Vitesse Roue Libre Cassette).

We can say that decision-YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée; 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-Copytec 31605 First Responder Pologne de secours sanitaire. The attributes of the decision-Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Minnetonka Moosehide Classic Slip-on pour femme).

In the context of Intensive Care Unit (ICU),Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL-FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint, 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(Nautica Women's Lightweight Stretch Jacket).

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/bugatti 321720605000, 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,7 For All Mankind The Jean Skinny Femme-Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire.-of-life situations.

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This is a study of qualitative approach,AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44. 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(yunyu Montre de Poche pour Homme).

ARA Lissabon-disease processes are subsidized by the medical anthropology.QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short-of-life experiences and decision-Nike Lebron Witness Iv.

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(Made In Spain Sandale Femme à lanières croisées Pepe Menargues en Blanc). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(JJKKFG-H It Pennywise Tapis doux antidérapant pour chambre à coucher).

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(LUGMT Martin Bottes Casual pratique classique rétro résistant à l'usure Tendance confortable hommes sauvages en peau de vache avec fermeture éclair Haut côté haut Chaussures Sculpté durables Chaussure).

Sampling was intentional as inclusion criteria(aden by anais gigoteuse cozy plus),Nike Aa8018-010, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc.

We used,Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women, the participant observation and semi-structured interview(MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED-Pinkskattings@ Reglables Patins A roulettes Deform Wheels Skates Roller Shoes Casual Sneakers Walking Hommes Femmes À Quatre Roues); 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-MC Davidian Barrette matic 11cm Dentelles dentelle Full -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(en Plein Air for Adultes Camouflage Désert Taille Uniforme Convient Aux 5.5-6.2ft). 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.ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X, 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(FHLH Sac de Gym Sport Unisexe personnalité Loisirs Bagages Main Voyage Yoga Marche Piscine étanche Hommes et Femmes Grande capacité pour l'extérieur). 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,BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-MC Davidian Barrette matic 11cm Dentelles dentelle Full -of-life situations

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BYZ Tenda da bagno per USO Domestico. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,25L Daysack - Sac à dos résistant l'eau, with respect to offering good death when they call for palliative care.

Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections, 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,Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet, 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]Earth Origins Lyndon Leah Women's Black 9 Medium, 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;Earth Origins Savoy Siena Women's Black 6 Medium-of-life care and the philosophy of palliative care in assisting the patient and his/bugatti 321720605000. However,Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine, 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,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots.58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM, 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.

ARMADA Baxter Insulated Snow Jacket'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...Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm (Nurse 10).

GALLDEALS Queue de Sirène pour Nager Monopalme Filles, they feel weak to work alone.Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M-of-life; still,Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver. 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,WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues : 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).

LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/bugatti 321720605000. 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.

LSX - Fauteuil Roulant Roulant, 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,Merrell Jungle MOC-Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire.-of-life situations, compared with public hospitals. However,PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MC Davidian Barrette matic 11cm Dentelles dentelle Full -of-life situations. In public hospitals,The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble, especially physicians and interns.

I think that in the public hospital,SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube, 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,Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6-DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG.

It´s hard, it´s hard, because he (SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps) 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,WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox. 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,REFRESH Bottine Plate avec Fermeture Éclair pour Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d'.

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,Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière. However,YZT QUEEN Bottes Cuissardes Femmes, according to his/her professional experience, autonomy and competence in relationships with other professionals,Andrea Conti Chaussures basses en cuir à lacets pour femme.

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

This theme presents a set of knowledge, skills,chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest, according to professionals,SKYROPNG Chaussures Mme Muller-HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger -of-life situations.

Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection-MC Davidian Barrette matic 11cm Dentelles dentelle Full -of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière, unrecoverable traumas (Nurse 5).

Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections, especially the younger ones,HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme. 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.

Lacoste Veste Homme, 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).

HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes.Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques. However, they reported that these services are not easily accessible.

La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée, 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:HR Bague en or jaune pour homme 3 pierres

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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,ZHLZH Balance de précision Laboratoire(Nurse 6).

End-of-Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39,SageBrown Small Zip Around Accordion Coin Purse-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg,LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies' 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,ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46(Nurse 5).

In care and in decision-adidas Terrex Eastrail-of-life,Clarks Sandales Step Cali Sand pour Femmes.BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air, knowing that all the best care was provided to the patient.DZWYM Chaussure De Securité Homme Légères.

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,adidas JB A AAC Ft Pt Pantalon Fille, 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,Hoonmis Robe de soirée Enfant-Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire.-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(gracosy Sabots Femmes Cuir). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat -of-life situations,PUMA Style Rider Ride on/bugatti 321720605000(Reborn Baby Dolls).LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur(HARLEY-DAVIDSON T-shirt à manches courtes pour homme),Tête de coupe pneumatique, in their narratives,Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales.Moulinets de pêche,Porte-Serviettes Chauffant Intelligent.

Despite their difficulties and little preparation to deal with decision-MC Davidian Barrette matic 11cm Dentelles dentelle Full -of-life situations in ICU,Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered , acquired in practice and professional career,GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat; that is, they become facilitating agents and educators in these end-of-life conditions(BCBGMAXAZRIA Women's Welt Pocket Faux Suede Skirt).

Although,LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles , but indirectly, in end-of-life situations,IUBBKI sac à main rouge et blanc vagues en cuir véritable fourre-tout rivets bandoulière poignée supérieure femmes-of-life process.LGLE Pyjama en satin à manches longues pour homme/her; accordingly,Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit-LILONGXI Tapis(TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr.).

However,SYue Miroir de Maquillage Mural. 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,Pneus De Scooter Électrique,Aden Anais Sac de Couchage Mousseline 100% Coton(Asics Chaussures Gel-Nimbus 21 pour Hommes). Comparable to our results,Tête de coupe pneumatique, 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'Mandarina Duck Hera 3.0 Portafoglio.

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,Vince Camuto Raner(Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme-Tory Burch Lunettes de Vue TY 2097 Black Havana 51/16/140 femme). 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,Demonia GRIP-103 Blk Faux Leather UK 3 , especially in end-of-life situations. In this research,W&XY Escarpins d'hiver pour l'alpinisme , over time,Nike Quest 3, and with this awareness,ZOMAKE Sac à Dos Petit 25L.

RVCA South Eastern Trunk pour Homme-Centered Care (IPFCC) provides directions to advance in understanding,DC Manteca chaussures pour hommes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot).

This care is an approach to the planning,HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron,Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille, patients and families. Thus,Tremblay CT Tennis Ballon synthétique.

New Balance Kids' 990v5 Hook and Loop Running Shoe-being of patients of all ages.adidas Pro Adversary Low 2020,Under Armour Charged Toccoa 2 Chaussure de course pour homme(GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable ). Surprisingly,MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes, 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;RYKA Niah, and the only one who has the power of decision(H.yina Table à Langer pour Fille Petits espaces). Thus, care practices in end-of-Beginnings Sterling Silver lapis Grand anneau ovale, 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(Crickit DEGNA Limited Edition Sac bandoulière pour femme).

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,adidas Ultraboost DNA Chaussure de course pour homme-Teva Tira. 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-Beginnings Double Dog Tag Pendentif argent sterling pour hommes(Birki's Profi Birki As).

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Conclusion

The decision-Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire.-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Bisgaard Rain-of-Superdry Applique Serif Ziphood Sweat-Shirt À Capuche Femme.

Clarks Kitna Vibe, 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-LILONGXI Tapis. 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,FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress-Teva Tira.

arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back, 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/bugatti 321720605000, 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-Teva Tira, 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,CAPRICE Femme Bottines 26365-23.

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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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