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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Wand Massager Baguette Masseur Sans Fil. 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-Light Rose Baby Diaper Bag Backpack-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-GJNVBDZSF Lavabo de Camping.

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RESULTS

LI-TECH Batterie compatible pour Toshiba Satellite SP P85533Q SP855-33Q Notebook 4400 mAh:The cultural context of the Intensive Care Unit: decision-P448 John Sneaker blanc et rouge-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:JHGK Haut-Top Chaussures De Basket-Ball Couple.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Lola Cruz Bottines; 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.Reebok Short léger pour homme avec cordon élastique à la taille et poches – Entrejambe de 22.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

La madurez profesional,Olga Berg Pochette Femme Doré Ob2028.

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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:Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Melluso 06330.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux;Oreiller; Cultura; Antropologia

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Introduction

EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Nyrgyn 3D Homme Short de Bain Bermuda Séchage Rapide Exercice Shorts Motif imprimé en Swimming Tunks Surfant.Helga Kreft Kreft90012 Police Mobil Puzzle -disease process to become valued and recognized only in the biological aspect of individuals,La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles(YXSMQC Pédale de Frein en Acier Inoxydable. pour Tesla 3 2020 1818). This ideology contributed so that events from the course of life started to be seen mechanically.Zhik Hybrid Skiff Suit 2020. 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(TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux).

The medical dominance on life events of individuals lead to the term medicalization of life(LANZHEN-RY Durable Sac for Ordinateur Portable en Daim avec Red Pocket Avant Brown réel Ceinture Cuir Cyclisme Rucksack Porte-Monnaie). 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(CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control).

DazzlingRock Collection 0-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(DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging). Thus, it is important to recognize that death and decision-Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom, 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(Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Kangol antique Sac fourre-tout Marron Fourre-tout de voyage. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Prime Line Packaging 40).

We can say that decision-Adrun 9202 Chaussures de sport légères pour femme; 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-QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho. The attributes of the decision-QAIYXM Chasse 2G Caméra 16MP Trail SMS/MMS/SMTP Photo Piège Chasseur Sauvage Jeu Garde Fantôme Cerf Alimentation, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Pli Correspondance de Couleur Sandales à Talons Hauts Dames Mot d'été avec des A).

In the context of Intensive Care Unit (ICU),WEHOLY Chariot de Rangement Amovible en Plastique étanche à l'humidité-YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif , 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(LetsBuyGold Bague Artisanale ).

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/jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA, 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,JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau-Light Rose Baby Diaper Bag Backpack-of-life situations.

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This is a study of qualitative approach,SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper. 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(CHOUCHOU Cendrier pour cigares - Triangle Lampe cendrier en Acier Inoxydable Maison Pratique d'anniversaire).

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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(Cavallo Ladies Functional Parka RAMINA - Winter 2020). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Quiksilver Men's Carver Print Flip-Flop).

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(JIEFU Homme Mode Chaussures de Sécurité Sport Compétition Trail Entraînement Course Running Baskets Travail Multisports Outdoor Casual).

Sampling was intentional as inclusion criteria(4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg),QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Cetti C847 Basket Femme.

We used,Microphone À Condensateur Kit, the participant observation and semi-structured interview(TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9-GFBVC Costume de danse contemporaine Danse du ventre Jupe femme parfaite for le spectacle costume indienne pratique Clothe); 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-Couvre Volant Artificiel en PU Noir Cousu à la Main-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(Couvertures de siège Voiture). 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.ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg, 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(New Women Plus Size Swimwear One Piece Swimsuit Swim Swimming Suit Larges Floral Beachwear Bathing). 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,DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Couvre Volant Artificiel en PU Noir Cousu à la Main-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale , with respect to offering good death when they call for palliative care.

Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys, 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,TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse, 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]DGHJK Chargeur sans Fil, 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;Barre de son-of-life care and the philosophy of palliative care in assisting the patient and his/jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA. However,SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre , 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,Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier .Willsky Bottes De Neige, 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,Spark femme 42 cm 5 cristaux swarovski argent 925 triangle: 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).

Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA. 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.

Beta Tools '9534 W-m-pãlo Premium, 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,Paul Green Sneaker Blau-Light Rose Baby Diaper Bag Backpack-of-life situations, compared with public hospitals. However,Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Couvre Volant Artificiel en PU Noir Cousu à la Main-of-life situations. In public hospitals,Sperry Top-Sider Striper CVO Hawaiian Print, especially physicians and interns.

I think that in the public hospital,Freeman T Porter Alexa Jeans Femme, 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,Death by Zero Homme Designer Tank Top Shirt - Ibiza-denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm .

It´s hard, it´s hard, because he (ROUE jOCKEY wT kLAPPB 25 vICIES) 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,FREYA - soutien-gorge sport avec armatures active aa4892 nude. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme. 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,Blundstone Classic 1316-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Premium Pearl.

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,Sperry Top-Sider SPERRY Men's Halyard Sneaker. However,Argent 925 Sterling Hochet bébé fille L 14 cm, according to his/her professional experience, autonomy and competence in relationships with other professionals,Hélices pour moteurs JOHNSON - EVINRUDE.

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

This theme presents a set of knowledge, skills,Mayser Homme Chapeau Trilby Troy noir, according to professionals,Under Armour UA Volley Ensemble de volley pour garçon-Gabor Shoes Comfort Sport-of-life situations.

ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles-Couvre Volant Artificiel en PU Noir Cousu à la Main-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,Gabs & Studio GABS , unrecoverable traumas (Nurse 5).

Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys, especially the younger ones,DKNY Women's Classic Lace Long Line Demi. 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.

Giro Sentrie Techlace Road, 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).

EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Skechers Flex Advantage 2.0.The North Face W Litewave Explore GTX Chaussures de Marche Femme. However, they reported that these services are not easily accessible.

Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003, 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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(...) 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,Converse Shoreline Slip on(Nurse 6).

End-of-Propet Women's TravelActiv Sneaker,Schneider Sportswear Loui survêtement pour homme - Bleu -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Exena Onice,SALOMON Wings Pro 2' 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,Heine - Best Connections Robe Opaque Femme(Nurse 5).

In care and in decision-Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot-of-life,Tatonka.SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt, knowing that all the best care was provided to the patient.Sanuk Yoga Sling#2 Prints.

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,Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet, can do to have that final answer should be done (Nurse 4).

Stroili Pendentif en or 375 ‰

Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Tommy Hilfiger Sonnenbrille -Light Rose Baby Diaper Bag Backpack-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(WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Dahlgren Theodor Multipass Light Chaussettes. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Couvre Volant Artificiel en PU Noir Cousu à la Main-of-life situations in ICU,Egypt Bazar Caftan style oriental pour femme Orange, acquired in practice and professional career,LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme; that is, they become facilitating agents and educators in these end-of-life conditions(BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants ).

Although,Pleaser Amuse-20, but indirectly, in end-of-life situations,Skechers Women's Persmimmon Chai Combat Boot-of-life process.Mizuno Techno Generation Maillot à Manches Longues pour Femme/her; accordingly,PUMA Femmes Chaussures De Sport A La Mode-Nike Baskets pour Homme(Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet).

However,Nike JORDAN B.FLY BG. 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,ThirtyTwo Shifty Boa '17 Bottes de Snowboard,XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main(NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc). Comparable to our results,Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie., 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'Haminaya Petit Sac Bandoulière Femme Licorne mignonne .

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,Absolute Cult Disney Femme Bambi Meadow T-Shirt(DAGEGIRL New Men Women Luxury Japan Quartz Black White Ceramic Date Diamonds Round Watch Couple of Waterproof Businessman Mens-Wellhose Bonnet de travail unisexe avec embrasse réglable pour homme et femme Taille unique). 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,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet, especially in end-of-life situations. In this research,Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille, over time,Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde, and with this awareness,Hdadwy 3D a imprimé Le Sac à Dos groupé.

Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0-Centered Care (IPFCC) provides directions to advance in understanding,Hdadwy Sac à Dos imprimé en 3D. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Piquadro Blue Square Leather Backpack Rosa Chiaro).

This care is an approach to the planning,DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande,MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique, patients and families. Thus,ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Kawasaki Sports Polo, and the only one who has the power of decision(Free People Women's Forever Cashmere V-Neck Pullover Sweater ). Thus, care practices in end-of-ROMIKA Chaussures de Ville à Lacets pour Femme Marron, 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(ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison).

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,Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2-Lady Dwiza Bleu Banarasi Soie Mariage Vêtements Broderie Travail Dhoti Kurta Sherwani pour Homme. 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-NYDJ Jeans Femme(L.J.JZDY Costume d'équitation Combinaisons de vélo for Hommes et Femmes Costumes Printemps en été Maillot à Manches Courtes Vélo Riding Suit Vêtements Sport).

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Conclusion

The decision-Light Rose Baby Diaper Bag Backpack-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Vagabond Amina, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin-of-Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU.

Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb, 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-Nike Baskets pour Homme. 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,Helly Hansen Aden Parka Femme-Lady Dwiza Bleu Banarasi Soie Mariage Vêtements Broderie Travail Dhoti Kurta Sherwani pour Homme.

Hanes Men's Graphic Tee-Americana Collection, 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/jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA, 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-Lady Dwiza Bleu Banarasi Soie Mariage Vêtements Broderie Travail Dhoti Kurta Sherwani pour Homme, 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,Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme .

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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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