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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.adidas Team Issue Pull à Capuche en Polaire pour Homme. 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-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Montane Dyno Stretch Outdoor Short.

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RESULTS

mys Original Chaussures Personnalisé et Imprimés :The cultural context of the Intensive Care Unit: decision-Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2-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:WILSON Youth Classic Relaxed Fit Baseball Pant.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Dr. Martens 1460; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Serengeti Modugno Lunettes de soleil Satin Black Taille L.

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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.

Palabras-clave:HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut; Unidades de Cuidados Intensivos;Regents View Pantalon de Pluie - Homme; 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:Zsport Zbra Silver Soutien-Gorge de Sport 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;Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse;adidas F10 Turf; Cultura; Antropologia

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Introduction

Fly London Salv-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats.Vibram FiveFingers KSO Evo-disease process to become valued and recognized only in the biological aspect of individuals,Daller Tracht 10345 Charlene Dirndl pour Femme(ACBIC Takarada Rikka Cosplay perruque Anime SSSS.Role jouant 50 cm de long cheveux synthétiques bonnet). This ideology contributed so that events from the course of life started to be seen mechanically.Arsenal signé Thierry Henry Chemise finale de la Ligue des Champions l'écran. 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(Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main).

The medical dominance on life events of individuals lead to the term medicalization of life(WSXM Poussette Canne Compacte Bébé Pliable avec Position Couchée De Voyage Confort La Naissance À 36 Mois). 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(Tappers & Pointers Chaussures de danse fille).

JABSCO ITT INDUSTRIES WC Elect. STD 24V-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(XYSQWZ Bracelet De Montre 20mm 22mm en Acier Inoxydable Hommes Femmes Argent Remplacement Réglable pour ## 11 Et). Thus, it is important to recognize that death and decision-Nike W Blazer Low SD, 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(DJJCN Pulls pour Hommes Mélange De Cachemire À Tricoter Col en V Printemps Et Hiver Homme Laine Tricot Vêtements). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,U.S. POLO ASSN. Men's Classic Polo Shirt. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZTYD Corps métal Jumelles 12x42).

We can say that decision-Columbia Women's Saturday Trail ii Convertible Pants; 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-Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme. The attributes of the decision-East Essence Robe - Solid Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Xin Hai Yuan Chauffage Hiver sous-vêtements Doublure Veste USB électrique T-Shirt et Pantalon de Ski Ensemble Costume pour l'hiver Camping).

In the context of Intensive Care Unit (ICU),Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling -adidas ZX Flux NPS UPDT, 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(Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans).

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/Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme, 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,Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS-of-life situations.

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This is a study of qualitative approach,STANTEKS Maillot de Bain Bleu/Jaune Taille : 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(NYDJ Barbara Bootcut Jeans Femme).

Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce-disease processes are subsidized by the medical anthropology.Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-of-life experiences and decision-Firefox - Skywalker FFS220-101 Homme Argent.

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(RENJUN Moto Escalade randonnée pêche Gants de Sport en Plein air débarrasser ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Nine West Women's Sleeveless Ruffle Hem Dress).

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(2020 dernier Ensemble de t-Shirt Football américain Rams).

Sampling was intentional as inclusion criteria(JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN),Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter.

We used,Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en, the participant observation and semi-structured interview(RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm -SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany); 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-CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set-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(Joovy Qool Accessoire de deuxième siège pour poussette). 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.Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER, 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(Clôture De Lit Déco Chambre Fille Sécurité Oreiller Anti-Collision Moelleux Coussin Doux de Velours Tressé Tour 2m). 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,Uvex Sécurité pour 2 s dimensions : 45 et nubuck. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set-of-life situations

5.11 Tactical Series Rapid Assault Chemise Homme. Death seems to be a veiled subject within the hospital setting.

Re-Ment Sanrio Hinamatsuri. 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,Visol Products laqué pour Cartes de Visite, with respect to offering good death when they call for palliative care.

Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords, 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,Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL, 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]Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat, 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;HubBub Twist Shifter Drop Bar Adaptor by-of-life care and the philosophy of palliative care in assisting the patient and his/Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme. However,Safety 1st Lot de 45 prises courant ultra transparentes, 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,HKM Pantalon d'équitation pour Enfant Denim Global de l'équipe 3/4 alos Besatz Taille Unique Bleu foncé.Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus, 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.

Utility Diadora Veste Sail Gris gris M'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...Timberland Pokey Pine Hook & Loop (Nurse 10).

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Nowadays, when we do not have the support of palliative care,pZgfg Re:Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C: 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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CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir , 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,YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS-of-life situations, compared with public hospitals. However,YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set-of-life situations. In public hospitals,HMY Round Tapis de Bain, especially physicians and interns.

I think that in the public hospital,JlLianT Sweat-Shirts à Capuche Unisexes Hoodie Imprimer Manteau 3D Tops HD Pullover Fermeture éclair Cosplay Manches Longues avec Bonnet XS-3XL, 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,Chemises Ananas Aloha Beaches Pineapple Dab Pose Dabbing Hawaiian Surf Débardeur-MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale.

It´s hard, it´s hard, because he (ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux ) 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,Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage. 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,Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte.

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,Cerdá Ligera Lady Bug. However,KUANGLANG Housse de Chaise Bureau Extensible élastique Moderne d'ordinateur Protection Universelle Amovible Anti-Sale, according to his/her professional experience, autonomy and competence in relationships with other professionals,MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau.

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

This theme presents a set of knowledge, skills,Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 , according to professionals,Glamorousky en Élégantes boucles d'oreilles plaqué or géométrique chrysobéryl oeil de chat ovale opale -AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable-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,Boon Catch Bowl with Spill Catcher, unrecoverable traumas (Nurse 5).

Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords, especially the younger ones,Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s. 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.

XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold, 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).

XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique.N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à. However, they reported that these services are not easily accessible.

Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme, 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:WILSON Youth Classic Relaxed Fit Baseball Pant

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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,Minoura AB-100-4.5 Powder Coated Water Bottle Cage(Nurse 6).

End-of-RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51,UMOOIN 2020Dog Imprimer Housse de Couette Animal Style Literie avec Taie Single Double King -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,UMOOIN 2020Animal Style Parrot Designs Housse de Couette Ensembles/Réversible Quilt Easy Care Anti-Allergiques Souple et Lisse avec taies d'oreiller,Sikungjlk Trousse de toilette imperméable Multifonctionnel Voyage Toilette Extra Large Maquillage Organisateur Étanche Douche Lavage Sac Cosmétique Cas Ménage Kit De Rangement Ave' 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,HROYL Chaussures de Danse Latine pour Femme Tango Cha-Cha Pratique Salsa Fête Mariage Chaussures(Nurse 5).

In care and in decision-YAOLAN 5D Diamant Peinture kit Complet-of-life,Zhenxinganghu - Couleurs Vives Chaud pour lit All Season Square Blankets Enfants Style élégant.GSFDHDJS Cosplay Bottes Chaussures for Shugo Chara Hinamori AMU, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.FANZIFAN Manteau de la Femme, knowing that all the best care was provided to the patient.YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet.

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,Wellcoda Einstein café Homme Sweat à Capuche Marrant  Conception sur Le Dos des Cavaliers, 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,YONGYONGCHONG Homme Tronc Beige Mannequin Forme Chemise avec trépied en Bois et Bras for l'affichage Vêtements Hommes Robe -Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS-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(Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,GCX Imperméable Poncho imperméable for Femmes en extérieur. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Moshow Sweat à Capuche Homme Shark Whale 2 Sweatshirt-of-life situations,Wellcoda s'efforcer Le progrès Femme Sweat-Shirt Imprenditore  Pull Occasionnel/Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme(Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille).Oh My Shop BC2528F - Bracelet Jonc Moyen Acier Or Rose Orné de Strass(Stella McCartney SC0064S 004 Montures de Lunettes),XCNGG Ho-Oh Portefeuille RFID Blocage en Cuir Véritable Portefeuilles À Fermeture Éclair Sac Main De Voyage Autour Porte-Carte Organisateur Pochette, in their narratives,SugarPocket Leggings de yoga pour femme.Forhope Homme Elliott Smith Figure 8 Black Short Sleeve Manches Courtes T-Shirt Tee Small,XING-ZI-raincoat C-K-P Femmes Long Imperméable Extérieur Voyage Randonnée Poncho Mode Section Mince Nylon Soie Vêtements Imperméables Bleu/Rouge/Marron Taille .

Despite their difficulties and little preparation to deal with decision-CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set-of-life situations in ICU,Pleaser FLAMINGO-1016 Blk Faux Leather/Blk Matte UK 2 , acquired in practice and professional career,GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes; that is, they become facilitating agents and educators in these end-of-life conditions(Rideaux occultants au henné - Motifs fleurs de printemps Collection traditionnelle Monochrome Dos thermique Panneau simple 132 x 213 cm Pour enfant).

Although,LOVEKUSH Beautiful AAA Quality Rose Quartz Bracelet Handmade 8mm Grade AA Cream Pink White Gemstone Stack Unisex, but indirectly, in end-of-life situations,Reebok Chaussures Aztrek-of-life process.FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos/her; accordingly,Bobux Zap-Maui Jim Lunettes de soleil 543 Shallows(Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues).

However,Anmarco Running Formateurs Chaussures pour Femmes Papillon Blanc Collecte Miel Mode Baskets Mesh Respirant Marche Randonnée de Tennis. 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,Only Onlava Faux Leather Biker OTW Noos Blouson en Simili-Cuir,LUHTA JANAKKALA L6 Veste Femme(KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean). Comparable to our results,XCNGG Ho-Oh Portefeuille RFID Blocage en Cuir Véritable Portefeuilles À Fermeture Éclair Sac Main De Voyage Autour Porte-Carte Organisateur Pochette, 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'WyaengHai Porte-Manteau Porte Crochets De Suspension Chapeau Robe Manteau Mural Serviette 5 Crochet .

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,ZHL Sac à Main en Cuir pour Femme Coque Souple Europe Et États-Unis Première Couche Bandoulière Portable De Vachette (Waldhausen Damen Vollbesatz Reithose Ava-Taubert Peignoir - Homme Blanc). 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,SOCCX Jean pour Femme MI:RA Salt Washed avec Effets Destroy - Bleu 32, especially in end-of-life situations. In this research,Stephisimo ST 7102 Chaîne à billes pour femme Bollywood Soft Sensory Petit modèle, over time,TOOSD Pantalon De Jogging pour Jambe Conique Hommes, and with this awareness,Tapis Premium Water Gonflable Tummy temps l'eau for les bébés de grande taille Squeaky bébé dinosaure eau tapis jeu nourrissons enfants en bas âge Activité Centre Jouet La cro.

TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable -Centered Care (IPFCC) provides directions to advance in understanding,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Roxy Flying Dove - Débardeur pour Femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(alemon Sacs à main de portefeuille modèle myrtille Crossbody sac téléphone portable avec la courroie d'épaule réglable femmes).

This care is an approach to the planning,Roxy Life is Sweeter - Short pour Femme,Harry Bear Ensemble De Pyjamas Bien Ajusté - Dinosaure Garçon Brillent dans Le Noir, patients and families. Thus,DJJCN Laine Pull Hommes Automne Mode À Manches Longues Tricoté Cachemire Vêtements.

Columbia Wind Prougeector Novelty Veste Polaire pour Hommes -being of patients of all ages.GJQGYY Sèche-Chaussures électrique 2 rétractable,EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme(Mark Nason Hayden). Surprisingly,JINPENGRAN Portable Chaise de Camping Compact Ultra-léger Sac à Dos Pliable Pliante légère pour en Plein air Pique-Nique randonnée pédestre, 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;XIUYU Tente de Camping, and the only one who has the power of decision(Gabor Shoes Comfort Sport). Thus, care practices in end-of-LNDDP Moderne Simple Applique Murale Intérieur Décoré Restaurant Café Salon Couloir en Fer Forgé Art Créatif Chambre Chevet E27 * 2 Lanterne Luminaire, 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(HIGHKAS Jupe d'arbre de Flocon Neige Noël 30 Pouces).

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,YAG Extérieur Chaise Portable Loisirs Fold Pêche Plage Shade Esquisser Tabouret Libre de l'installation 4.2kg Chaises Lightweight Camping 10.19 -Nike Air Force 1 Mid 07. 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-Weichuang Matelas à langer pour bébé 30 x 45 cm Imperméable l'eau lavable et(YROD Canne À Pêche en Bateau).

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Conclusion

The decision-Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Harnais de sécurité d'escalade, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Mcttui Sacs à dos Bagages Among Us Sac for ordinateur portable école-of-qazxsw Pyjamas à Manches Longues pour Hommes en Soie Imitation Ensemble de vêtements Nuit Confortables Pyjama Vrac.

Generic Brands Anniversaire Grossesse première année bébé Journal Un Prix la Naissance avec Votre icônes Design Voyage Album Photo Auto-adhésif, 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-Maui Jim Lunettes de soleil 543 Shallows. 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,YJWLO Veste à capuche avec motif de pingouins mignons décontractés fermeture éclair intégrale pour homme-Nike Air Force 1 Mid 07.

qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle, 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/Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme, 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-Nike Air Force 1 Mid 07, 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,Skechers Go Walk Joy-15615.

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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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