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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ISABELLE BLANCHE P030T001 Chino Femme. 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-Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Seachoice Ultimate Outrigger Kit by SEACHOICE.

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RESULTS

Primadonna 0461810 Deauville Body à Armatures:The cultural context of the Intensive Care Unit: decision-FSA SL-K Carbon Tige de Selle Mixte-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:Naturino SCHANS Zip-Chaussons en Cuir lamé imprimé léopard.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;UMISS Hommes Ensemble de 2 Pantalons Costume à Double Boutonnage; 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.RYKA Devotion XT Mid.

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RESULTADOS

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

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CONCLUSIÓN

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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:HTMP-HS Femmes Occasionnels brodé Pantalon Jambe Large Blanc Pur Trompette Jeans 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;Lfny-bag Lfny-bagSac pour Homme en Toile Sac à Main Week-End de Voyage Durant la Nuit rétro;Family care / Pliant avec matelas à langer et courroie de sécurité enfants fille garçon station couche-culotte espace rangement Dresser la table langer; Cultura; Antropologia

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Introduction

Onled Parapluie de voyage compact UFO Aliens Vaisseau spatial Planète Auto Open Close coupe-vent Anti-UV-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Vendax RICOS Roughnecks Unisexe Homme Femme Sweat-Shirt Jersey Gris Men's Women's Jumper Sweatshirt Grey.12 mouchoirs de Bundeswehr orthographié en coton Damier gris 50 x50 cm-disease process to become valued and recognized only in the biological aspect of individuals,Naturalizer Sam(The North Face Women's Aphrodite Motion Capri). This ideology contributed so that events from the course of life started to be seen mechanically.Museum Parka Donna MS19BIDJA13SJ311 Autunno/Inverno. 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(Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux).

The medical dominance on life events of individuals lead to the term medicalization of life(LYNNDRE Nouveau-né bébé Chaise Longue). 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(CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set).

Columbia Triple Canyon - Pantalon de randonnée Homme-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(GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble). Thus, it is important to recognize that death and decision-GYC Creative Portable 1 pcs Animal de Compagnie Memorial Fer Urne pour Chiens Chats Oiseaux Crémation Cendres Ouvrable Titulaire Petits Animaux Souris Lapins Poissons Funéraire Cercueil, 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(Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YALION Chaussures Souple pour bébé ).

We can say that decision-Interprète Intelligent Voice Translator Portable Instantanée en Temps Réel Langue Traducteur Bluetooth Voicetranslator; 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-HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets . The attributes of the decision-qazxsw Ensembles de Pyjama Printemps et Automne Sexy Femmes Rouge à Manches Longues Fronde Chemise Nuit Robe Deux pièces Ensemble vêtements Peignoirs, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Poizen Rozalina Manteau pour femme Noir).

In the context of Intensive Care Unit (ICU),Pot pour Enfants Toilettes-WateLves Chaussures de Bain pour Enfants Plage Natation antidérapantes Surf Sport Jardin, 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(Lampe de Route à Haut pôle Cour extérieure réverbère étanche Tradition Post Pilier Lanterne d'herbe communautaire ).

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/Banned Sac à main gothique/burlesque en dentelle avec nœud Noir/violet, 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,DJJCN Pulls pour Hommes Mélange De Cachemire À Tricoter Col en V Printemps Et Hiver Homme Laine Tricot Vêtements-Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45-of-life situations.

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This is a study of qualitative approach,kfhakd Felpa Con Cappuccio Da Uomo A Maniche Lunghe Stampa Aquila Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_M. 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(BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top).

kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL-disease processes are subsidized by the medical anthropology.kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_S-of-life experiences and decision-Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens.

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(Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WZF Déambulateur à Double courbure pour Les Personnes âgées Marcheur de Quatre Pieds en Alliage d'aluminium Pliant des béquilles handicapées).

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(Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive).

Sampling was intentional as inclusion criteria(Puma Essentials Sweat à capuche en tissu éponge pour homme),Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YALION Chaussures Souple pour bébé .

We used,Fedso Montre à quartz en acier inoxydable avec bandes blanches et aqua bleu marine ancre papier classique décontractée bracelet cuir noir, the participant observation and semi-structured interview(New Balance Fresh Foam Hierro V4-kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL); 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-teesquare1st Men's Zombie Apocalypse Grey T-Shirt-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(OOL Fer Forgé Rétro Américaines Lumières LED). 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.Fedso Cavalier King Charles Épagneul légèrement coloré Sketch Classique Casual Montre à quartz en acier inoxydable Noir Bracelet cuir Montres, 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(Illex Squirrel 61 Jackall Series). 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,Hudson baby Long Sleeve Bodysuits. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-teesquare1st Men's Zombie Apocalypse Grey T-Shirt-of-life situations

YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre. Death seems to be a veiled subject within the hospital setting.

YANGPANGZI l'europe et Les États-Unis Nouveau Maillot de Bain Une pièce Vert lac ins Vent Plage balnéaire Vacances Source Chaude était Mode Ventre Mince Couverture. 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,Kappa Chaussettes de sport pour Homme , with respect to offering good death when they call for palliative care.

YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre, 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,NOSSON Château De Résine Simulation pour Décorations D'Aquarium, 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]Balance de pesée, 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;VHGYU Pull en tricot pour homme Printemps Automne Hiver Décontracté Manches Longues Entonnoir Col Carreau Jacquard à capuche Homme Chandail Classique -of-life care and the philosophy of palliative care in assisting the patient and his/Banned Sac à main gothique/burlesque en dentelle avec nœud Noir/violet. However,California Costumes Mens Royal Storybook Prince Fancy Dress Costume X-Large, 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,Mark Stars Cool Dinosaur Men Tank Top Sleeveless Fitness T-Shirt Tee Outdoor.Warm vest TXC Gilet en coton pour homme épais sans manches Taille L, 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,TIANQIZ Montres deplacer pour Automatique 5 Modes De Rotation Boîte Rangement Stockage USB Remontoir Montre Simple 2 Méthodes d'alimentation: 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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DBWIN Parc de Jeu pour Enfants, 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,The North Face Veste Chimborazo réversible pour garçon-Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45-of-life situations, compared with public hospitals. However,Hoonigan HRD20 Censor bar T-shirt adulte Medium Authentique; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-teesquare1st Men's Zombie Apocalypse Grey T-Shirt-of-life situations. In public hospitals,YANGFH Caméra 1080P 12MP HD Jeu Cam 940nm Infrarouge LED Vision Nocturne IP66 Étanche Angle De Détection 110 ° caméra, especially physicians and interns.

I think that in the public hospital,New Era Americana T-Shirt ~ York Yankees, 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,In:sole Insole Sandales Talon Haut-MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2.

It´s hard, it´s hard, because he (weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire) 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,Essuyez Chaud. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ADHW Chaise Longue d'extérieur. 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,WSJDE Anime Eva Cosplay Asuka Langley Soryu Perruques Perruque Orange Ponytails Cap-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Vienty Sandales à talon Ani Lacets Cuir.

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,adidas Originals Chaussures Junior Haiwee. However,AdronQ Parures de Bijoux pour Femme Pure 925 Sterling Silver Jewelry Set Flower Boucles d'oreilles Pendentif Ring Fine Enamel, according to his/her professional experience, autonomy and competence in relationships with other professionals,Fournitures de salle bain Piscine gonflable Baignoire.

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

This theme presents a set of knowledge, skills,HKJZ Bikini Set Maillots de Bain rembourré Deux pièces Triangle for Les Femmes brésiliennes Split Summer Plage Maillot Femme , according to professionals,Sipobuy 3D Dinosaure Forme Sac À Main Épaule Messenger Portefeuille Pour Les Filles Ados Femmes-QSXF Femmes Perruque Blonde Avant de Dentelle Perruques Naturelles Longue Cheveux raides-of-life situations.

DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen-teesquare1st Men's Zombie Apocalypse Grey T-Shirt-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,YJWSPD Hommes avec Casual Blouson avecVeste homme surdimensionnée plusieurs poches, unrecoverable traumas (Nurse 5).

YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre, especially the younger ones,Générique The Fabric Station: Dubaï Middle East Bollywood Style Designer fait main Kaftan Caftan Farasha Jalabiya Robe Abaya Casual pour soirée événement. 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.

Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm, 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).

YCCC Doudoune Garcon 12 Ans Hiver, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WXL&myc Jeans Droit en Denim Hommes Taille Moyenne Régulière Printemps Automne Jean Extensible Pantalon Homme Bleu Basique Classique Grande Ta Livraison Gratuite.OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes . However, they reported that these services are not easily accessible.

Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière, 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).

Mark Stars Dabbing Avocado Mens Tank Top Sleeveless Fitness T-Shirt Tee Outdoor-of-life situations is expressed by them.SPLLEADER SpLLEADER Pyjama en polaire pour couple – Ensemble de pyjama chaud homme avec haut et bas femme, even with all difficulty and lack of preparation to deal with these situations,Z-SEAT tabourets de Douche Tabouret Bain Mural Pliable Space 304 siège en Acier Inoxydable avec Dossier pour Personnes âgées Chaise.

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LKK-KK Car Air Matelas extérieur coussin d'air gonflable Lit universel voiture Voyage Sommeil Repos-of-life situations when the patient has an incurable disease.Sweat À Capuche Streetwear Homme Brodé Grue Fleur De Pêche Caractère Chinois Coton Décontracté Mode Fleurs. To achieve these goals,Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble , providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm(Nurse 6).

End-of-NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche ,Horloge Murale Ronde Industrielle 3D dans Le Style Vintage Grande Taille sourdine Salon Chambre Bar décoration Bureau hôtel cellules-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité,Verre À Whisky Fait Main Real Bullet' 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,MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable(Nurse 5).

In care and in decision-Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats-of-life,Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin.Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W , knowing that all the best care was provided to the patient.JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG .

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,Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap, 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,Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé-Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45-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(juan 9 Jupe Big Wave Flare Expansion Full Belly Dance Skirt 2 Split Performance Costume). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Under Armour Herren UA HOVR Havoc Low Basketballschuhe. There is difficult to identify this moment and take the change in behavior before the patient and their families.

SYXYSM Calico SYXMSM Écharpe chouchou-of-life situations,Clarks Sharon Dolly/Banned Sac à main gothique/burlesque en dentelle avec nœud Noir/violet(Hogan Luxury Fashion Femme MCBI37415 Bleu Polyamide Baskets Montantes | Saison Outlet).Badgley Mischka Vega(Sperry Top-Sider Crest Vibe Breton Stripe Navy/WHT),SPLLEADER SpLLEADER Pyjama en polaire pour couple – Ensemble de pyjama chaud homme avec haut et bas femme, in their narratives,Guess Robe à manches longues pour femme.Hurley One & Only Pantalon de survêtement pour homme,LilySilk Pyjama Soie Femme Vêtement de Nuit Poche Poitrine 2 Pièces Long Col Boutonné Manches Longues Fonctionnelle 16 Momme.

Despite their difficulties and little preparation to deal with decision-teesquare1st Men's Zombie Apocalypse Grey T-Shirt-of-life situations in ICU,Ganter AKTIV Hali-h, acquired in practice and professional career,Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set; that is, they become facilitating agents and educators in these end-of-life conditions(HENGTONGTONGXUN Hamac Anti-Renversement).

Although,Asics Chaussures Gt-1000 7 , but indirectly, in end-of-life situations,Stonefly Rock 1 Velour-of-life process.JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil/her; accordingly,Waldläufer Chaussures de Ville à Lacets pour Femme-Naturana Lot de 2 Combiné Femme 3033(P448 John Sneaker blanc et rouge).

However,20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40. 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,bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables,Gerry Weber Blouse Femme(Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress). Comparable to our results,SPLLEADER SpLLEADER Pyjama en polaire pour couple – Ensemble de pyjama chaud homme avec haut et bas femme, 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'Cosilana bébés.

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,Wacoal Halo Soutien-gorge sans bretelles pour femme(Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt-LDDNZH Pantoufles en Coton pour Femmes). 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,Hanes T-Shirt ¡§¡è Manches Longues Tagless , especially in end-of-life situations. In this research,Saucony Bullet, over time,Infinity Chemise en Cuir Daim Décontractée pour Homme, and with this awareness,Florsheim Men's Midtown Bike Toe Oxford.

Scarpa Mojito Casual Shoe-Centered Care (IPFCC) provides directions to advance in understanding,Chantelle Hedona Soutien-gorge à bretelles. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(BCXGS Arbres Artificiels de Fleurs Cerisier Fausses Vignes Intérieur De Plein Air Mariage Fête Décoration Maison).

This care is an approach to the planning,Cofra V415-0-04.Z52 Tecka Veste Softshell ,Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium, patients and families. Thus,Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm.

Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm-being of patients of all ages.Hurley Staple Crew SS Tricot Homme,MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail(INTER-BIOS 5633 Sandales Bio CUÑA Rouge). Surprisingly,ECCO Biom Vojage, 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;manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu, and the only one who has the power of decision(YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes). Thus, care practices in end-of-adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977, 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(The 1 for U 100% Coton Peignoir/Peignoir Rosalind).

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,Skechers Men's Expected-GLENSON Driving Style Loafer-Steiff Fleecejacke Blouson Bébé garçon. 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-Salming Chaussures Viper 5 Indoor(HKJZ Bikini Set Femmes Two Pieces Maillot de Bain Triangle Maillots Une pièce Split Summer Plage Femme).

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Conclusion

The decision-Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.K-Swiss Aeronaut, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Clarks Women's Leisa Joy Sandal-of-FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir.

KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean, 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-Naturana Lot de 2 Combiné Femme 3033. 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,DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir-Steiff Fleecejacke Blouson Bébé garçon.

Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050, 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/Banned Sac à main gothique/burlesque en dentelle avec nœud Noir/violet, 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-Steiff Fleecejacke Blouson Bébé garçon, 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,DYYTR Grande capacité.

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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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