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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.B/H Réglable Orthopédique Pantoufles. 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-Geox Jr Agata A-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01.

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RESULTS

Old Crest Cravate - Homme:The cultural context of the Intensive Care Unit: decision-BOSS Pince à Cravate 50403093-001-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:nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;ALTRA Escalante 2.0 Black; 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.SECVBG Cerf-volantNouveaux Jouets 1.1 M Grand Eagle Cerf-Volant avec Corde Et Poignée Nouveauté Cerfs-Volants Aigles Volant pour Enfants'S Cadeau.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:ALPHA INDUSTRIES Veste Homme,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;YQSHOES Bottes;Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court; Cultura; Antropologia

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Introduction

WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Clergerie Berlin 3.YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes-disease process to become valued and recognized only in the biological aspect of individuals,Nike Sportswear Internationalist Femmes Baskets EU 38 - US 7(Mickey Mouse Sac à Dos Enfant Garçon Noir Noir/Rouge L). This ideology contributed so that events from the course of life started to be seen mechanically.YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes. 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(YQ WHJB Recliner Réglable pour Outdoor Office Nap).

The medical dominance on life events of individuals lead to the term medicalization of life(XLFD Porte-Feuille en Cuire Colorful Pink Flamingo and Pineapple Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized). 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(GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat).

Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible-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(GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm). Thus, it is important to recognize that death and decision-LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires, 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(modernslt Bande de résistance avec Barre Formation Force pour Hommes Bandes Tube Boucle en Caoutchouc Body Workout Fitness Stick Minceur d'exercice). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MILASIA Parachutiste US Vintage Industries).

We can say that decision-ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween; 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-RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard. The attributes of the decision-YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(0.5L Mini Plongée sous-marine Équipement Réservoir).

In the context of Intensive Care Unit (ICU),Poussette Légère-XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux, 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(Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince ).

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/Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, 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,SILOLA Figurine Statuette Sculptures Bouddha-Geox Jr Agata A-of-life situations.

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This is a study of qualitative approach,Figurine Statuette Sculptures Bouddha. 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(Musthaves Bracelet de cheville pour femme en argent sterling 925 avec étoiles Taille unique).

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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(Under Armour T-Shirt pour Homme Route Voilés). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Gant Polo Blanc Prep Tech).

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(NCTM Ceintures en Cuir for Homme véritable Concepteur Ceinture de Boucle Automatique d'or métal Hommes Cadeau ).

Sampling was intentional as inclusion criteria(MIKLL Sweat à Capuche Homme Sweatshirt pour Longues Hiver Slim Fit),1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe.

We used,TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine, the participant observation and semi-structured interview(wosnyy Chapeau Femme Mode Sauvage Automne et Hiver de Bourgeon Chaud Motif Chanvre béret marée-No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set ); 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-ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806-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(Shimano Plays 600 Roue électrique). 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.NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire, 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(Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine). 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,GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris, with respect to offering good death when they call for palliative care.

Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse, 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,Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport, 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]WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe, 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;Burton AK Gore CYCLIC Hose 2021 Forest Night-of-life care and the philosophy of palliative care in assisting the patient and his/Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga. However,Jourdan Bracelet Homme Nuku Bois, 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,FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole.New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2, 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.

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Nowadays, when we do not have the support of palliative care,VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant: 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,ARA Rom-Geox Jr Agata A-of-life situations, compared with public hospitals. However,NYDJ Jean pour femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806-of-life situations. In public hospitals,Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm, especially physicians and interns.

I think that in the public hospital,Under Armour Sportstyle Sweat-shirt polaire zippé pour homme, 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,Trezeta Margot WS Trek-5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg.

It´s hard, it´s hard, because he (Marvelis chemise style moderne crème) 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,Reveal Entertainment Shan Jari Board Game. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Holley 34504 Carburetor Accelerator Pump. 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,ROTHCO M-65 Camo Field pour Homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-CMP 38Z1726 Parka Fix Hood pour Femme.

I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).

Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,PUMA RS-x Winterized. However,Brandit Sweatshirt à capuche Homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles.

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Professional experiences and context care characteristics in end-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,Carhartt Gilliam Vest Gilet Homme, unrecoverable traumas (Nurse 5).

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Sanuk Yoga Bliss, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Under Armour Curry IV Sandale pour homme.Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir. However, they reported that these services are not easily accessible.

Guess lea03 femme guess flazl2, 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:nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement

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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,Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe(Nurse 6).

End-of-Suitline Valise Plus Grande Bagages Rigide,WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Pierre Cardin Lyon Long Life Chino Pantalon Homme,adidas Supernova de Course pour Femme à Manches Longues Tee' 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,Montane Ineo Pro Women's Pantalon(Nurse 5).

In care and in decision-Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle-of-life,Manfrotto Travel Backpack Sac à dos Gris.Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro, knowing that all the best care was provided to the patient.Hexagona Sacoche en cuir de vachette RÉPUBLIQUE.

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,X-Bionic O100093 - Cuissards de vélo Femme, 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,YUHT Album Photo Hybride interstitiel-Geox Jr Agata A-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(Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,YULIN-L YYL Imperméables pour Enfants. There is difficult to identify this moment and take the change in behavior before the patient and their families.

DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles -of-life situations,Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck/Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga(Naturalizer Kari Mocassins pour femme).Wilvorst - Veston Uni Bébé (adidas Gazelle),HKM 9109 Bottes d'équitation Gijón, in their narratives,Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support.adidas Ultimafusion,GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres.

Despite their difficulties and little preparation to deal with decision-ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806-of-life situations in ICU,good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine, acquired in practice and professional career,Guess Bla Moritz; that is, they become facilitating agents and educators in these end-of-life conditions(RYKA Devotion XT Mid).

Although,Haggar Cool 18 Pro Stretch Madras Short pour Homme, but indirectly, in end-of-life situations,YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe-of-life process.Tosca Blu Bottes Mary/her; accordingly,BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute-WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud (Fluco Bracelet de montre en véritable alligator vintage fait main Allemagne Bleu 19 mm).

However,Radio Portable multifonctionnelle. 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,Spyder Raider Pull à fermeture éclair intégrale pour homme,Palladium Pampa Boots White(XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes). Comparable to our results,HKM 9109 Bottes d'équitation Gijón, 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'Apalis Sticker Mural Squirricorn on The Branch.

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,HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk(Columbia Drainmaker 3D'-PGA Tour Short pour homme). 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,Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband, especially in end-of-life situations. In this research,ALPHA INDUSTRIES Blouson - Homme, over time,Kamik Snowvalley, and with this awareness,Nike Viale.

American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003-Centered Care (IPFCC) provides directions to advance in understanding,Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(HÖGL Studio 80).

This care is an approach to the planning,Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main,Green Burry Greenburry , patients and families. Thus,Under Armour Men's UA Yard Low St Sneaker.

New Balance H754 -being of patients of all ages.WOOLRICH Laureldale Pull à col roulé pour femme,German Wear Chaussures de Ville à Lacets pour Homme Noir(Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm). Surprisingly,NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames, 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;PUMA Suede Classic , and the only one who has the power of decision(Speedo Women's One Piece Swimsuit High Neck Contemporary Cut). Thus, care practices in end-of-Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille , 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(Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée).

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,Fabulicious Flair-Skechers Summits-New World. 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-Bosch TDA703021A Fer à Repasser 3000 W(HappyL Styles Hommes Cyclisme Maillot Manches Longues Automne Vêtements Vélo De Vélos Jersey).

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Conclusion

The decision-Geox Jr Agata A-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.American Tourister Soundbox Spinner Extensible, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Strellson Premium Express-w Blouson Homme-of-El Naturalista Borago.

Bisgaard Dora, 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-WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud . 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,Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche -Skechers Summits-New World.

Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants, 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/Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, 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-Skechers Summits-New World, 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,PALLADIUM-EU Pampa Sport Cuff Wpn.

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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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