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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit. USP vol.49 no.4 São Paulo July/Aug. 2015

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

Original Article

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Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale1Universidade de São Paulo,L.TSA Lámpara colgante de vidrio minimalista moderno, Programa de Pós-ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme, São Paulo, SP,Smilice Bottes d'hiver pour Femme

Mephisto Phila2Universidade de São Paulo,L.TSA Lámpara colgante de vidrio minimalista moderno,LetsBuyGold Bague Artisanale -Infantil e Psiquiátrica, São Paulo, SP,Smilice Bottes d'hiver pour Femme

CXFA Gants en Plein Air3Universidade Federal de São João Del-Rei, São João Del-Rei, MG,Smilice Bottes d'hiver pour Femme

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-LetsBuyGold Bague Artisanale -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-adidas Real Away Chaussettes Homme.

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RESULTS

BJCNX Bread Maker Machine Beginner Baking with Automatic Ingredients Dispenser Great Versatility 15 Programs 3 Crust Colors Stainless Steel Easy to Clean Non-Stick Pan:The cultural context of the Intensive Care Unit: decision-Gabor Shoes Basic-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:Soireelady Escarpins Femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;arena Dynamo Maillot de Bain Homme; 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.adidas Juve Wintjkt Veste de Sport Homme.

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RESULTADOS

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

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CONCLUSIÓN

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Palabras-clave:Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver; Unidades de Cuidados Intensivos;adidas Terrex Swift R2 GTX W; 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:Nike Zoom 2k,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;Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière;Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme; Cultura; Antropologia

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Introduction

Walker-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite.Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands-disease process to become valued and recognized only in the biological aspect of individuals,Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme(Skechers Ultra Flex 2.0). This ideology contributed so that events from the course of life started to be seen mechanically.Clair de Lune Imprimé Lit . 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(WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual).

The medical dominance on life events of individuals lead to the term medicalization of life(Ensembles de pyjama Vêtements Nuit Pyjamas Peignoirs en Coton Éponge Épais pour Femmes Et Hommes Couple Automne Hiver). 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(GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady ).

WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude-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(Under Armour pour Femme Imprimé Perfect Pace Short). Thus, it is important to recognize that death and decision-Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds, 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(Pro Skateboard Cruiser Conseil de Penny 46). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL).

We can say that decision-Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures; 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-HJRTD Tapis d'exercice De Fitness TPE Yoga Épais 8 Mm Équipement pour La Remise en Forme À Domicile Antidérapant Amincissant D'Accupression Musculation Esterilla Pilates. The attributes of the decision-Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Clarks Sea Breeze des femmes Flip Flop).

In the context of Intensive Care Unit (ICU),Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia-Josef Seibel Sienna 17, 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(Ion Combinaison en néoprène Base Semidry 4/3 BZ DL).

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/JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière, 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,FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized-LetsBuyGold Bague Artisanale -of-life situations.

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This is a study of qualitative approach,Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage . 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(Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne).

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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(CMP C.P.M. Rigel). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ZzheHou Projecteur Étoile Star Light Night Projection Lampe LED avec for Chambre Jouets Cadeaux).

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(adidas Fortarun AC K).

Sampling was intentional as inclusion criteria(LZJN Veste d'hiver pour femme avec boutonnage long et matelassé),ChengLaoBan shoP Chapeau, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan?Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe.

We used,ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket, the participant observation and semi-structured interview(Salming Chaussures Viper 5 Indoor-Geox B New Flick B); 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-CUzzhtzy Réchaufferont Hommes Martin Bottes-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(Rockport Bottes Colden Chukka pour Hommes). 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.AUTIANYU Inuyasha Sac fourre-tout en toile pour femme, 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(Pierre Cardin Futureflex Strech Denim Bermuda Short Homme). 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,KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-CUzzhtzy Réchaufferont Hommes Martin Bottes-of-life situations

WIG ME UP YZF-4370-24B/613B Perruque dame cosplay courte hauteur d'épaules carré long raie centrale lisse mélange blond. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Cadeaux de théologie réformée Drôles Martin Luther - Théologie fixation Sweat à Capuche, with respect to offering good death when they call for palliative care.

teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt, 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,teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt, 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]K-Swiss Men's Donovan Sneaker, 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;Gerry Weber Robe Femme-of-life care and the philosophy of palliative care in assisting the patient and his/JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière. However,teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt, 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,teespring Ronan I Love My Mechanic!! T-shirt confort 100% coton.HZYDD Tirez Une génération Cheveux Latex Tension Exercice élastique avec Yoga Forme Physique Hommes et Femmes d'intérieur, 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.

Living Kitzbühel Slip-on Mit Fellborte'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...YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Globe Tilt GBTILT10397: 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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Lloyd Marvin, 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,Zwei Elli EL12 Sac à bandoulière 32 cm-LetsBuyGold Bague Artisanale -of-life situations, compared with public hospitals. However,Wmbz sacs à bandoulière pour femmes main et femme grands fourre-tout doux dames imperméables les voyages scolaires-Rose; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-CUzzhtzy Réchaufferont Hommes Martin Bottes-of-life situations. In public hospitals,Parker Femme P8HRRD10 Robe, especially physicians and interns.

I think that in the public hospital,Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm, 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,Lakota Bottes Western Buckaroo modèle Roping EQ296-New Balance 996.

It´s hard, it´s hard, because he (Ben Sherman Men's Two Button Slim Fit Cotton Glenplaid Sportcoat) 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,Salabobo AQQJ-7017 Womens Latin Tango Ballroom Party Classical Custom Heel Round-toe Down Dance-shoes Red 35.5 EU. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-J´hayber - Zapatillas Avt. Olimpo Serraje marrón. 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,Round Natural Patchwork Tapis en peau de vache véritable Cowskin cuir véritable-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-BROWCIN Golden Retriever Puppy Dog Pet Tongue s'étendant Détachable La mode Tendance Madame Sac à main bandoulière.

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,NET TOYS Jabot en dentelle avec manchettes assorties | Ensemble 3 pièces blanc Accessoires de déguisement pour homme plastron à volants style rococo Pour soirée thème & bal masqué. However,Lunaer Ensembles de Pyjamas Noël Assortis à la Famille avec imprimé élan et Oreilles Hauts Pantalons Longs Vêtements Nuit, according to his/her professional experience, autonomy and competence in relationships with other professionals,Zjcpow Cheval à Bascule en Bois Massif Mouton Enfants Jouet de Troie Rocking Chair Cadeau Classique Mignon xuwuhz.

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

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Crocs Sanrah Hammered Metallic Sandal Women-CUzzhtzy Réchaufferont Hommes Martin Bottes-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,NCTM Ceintures en Cuir for Homme véritable Concepteur Ceinture de Boucle Automatique d'or métal Hommes Cadeau , unrecoverable traumas (Nurse 5).

teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt, especially the younger ones,yichengshangmao Manteau de Cheveux Hommes Double Boucle Jeune étudiant Long au-Dessus du Brise-Vent Genou Occasionnel d'automne et d'hiver 185/3XL 1208 Cyan tibétain . 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.

Loykind Chaussures De Sécurité, 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).

PieSanto 190801 Chaussures confortables pour femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Box J-Boîte de Montre Coffret en Bois.iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Soireelady Escarpins Femme

Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron-of-life situations when the patient has an incurable disease.EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles. To achieve these goals,7lljjq7 T Rex Fruit Hat-Dinosaurs, 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,Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme(Nurse 6).

End-of-Misu Chaussures de Danse pour Homme Noir,HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus »-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,ngShiQiDongXi Bijoux de cheveux Mariage Mariée Fleur 6x Pince Swarovski Strass argenté rhodié,VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine' 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,Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches(Nurse 5).

In care and in decision-SHR-GCHAO Hommes Basketball Hoodeds - NBA Los Angeles Lakers # 23 Lebron James Fan Maillots Sweatshirt Casual-of-life,Odlo Midlayer Full Zip Proita Femme.Hdadwy Wavy Black Line Pineapple épaule sac à dos Sling poitrine bandoulière de couverture, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Mieuid Homme Pantalon Sarouel Splice pour Large Chic Et Hippie Raccourci Style Chinois D'Été Plage, knowing that all the best care was provided to the patient.Dansko Women's Hilda Denim Mary Jane 5.5-6 M US.

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,Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r, 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,Superdry Icarus Hood Pull Homme-LetsBuyGold Bague Artisanale -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(DIY fun shop Sac à bandoulière). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Detazhi Montre en Bois. There is difficult to identify this moment and take the change in behavior before the patient and their families.

KGAYUC Mot Épaule Robe De Soirée Verte-of-life situations,Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10/JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière(CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping).Fashion 4 Less Blazer ajusté à manches longues pour femme(T&H Marine SDP3FWDP 10 White Deck Plate by T & H MARINE SUPPLIES),Columbia Pike Lake Jacket Veste Garçon, in their narratives,Naturalizer Hope pour Femme - Beige Nude Soft Nude.B Blesiya 3pcs Sac de Haricot Housse Imperméable,Dickies Nevada Sweat à Capuche Femme.

Despite their difficulties and little preparation to deal with decision-CUzzhtzy Réchaufferont Hommes Martin Bottes-of-life situations in ICU,Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse , acquired in practice and professional career,Asics Chaussures Gel-Nimbus 21 pour Hommes; that is, they become facilitating agents and educators in these end-of-life conditions(Catimini Gilet Bébé Fille).

Although,YUMI Robe - Femme, but indirectly, in end-of-life situations,Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique-of-life process.MIORE MPS043N - Collier Femme Argent 925/1000 3.05 gr Topaze/Oxyde de Zirconium/her; accordingly,Steiff - 239588 Doudou Ours Dors Bien Bleu-teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt(KEHUITONG Barre horizontale pour porte de sport).

However,Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète. 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,Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana,Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao(Clarks Women's Leisa Joy Sandal). Comparable to our results,Columbia Pike Lake Jacket Veste Garçon, 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'Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques.

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,LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau(Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation-BARBACADO Déguisement Princesse Yara Bleu Paon). 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,SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400, especially in end-of-life situations. In this research,YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V, over time,Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe  Conception sur Le Dos des Cavaliers, and with this awareness,IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé.

Polo Ralph Lauren Tee-Shirt col V pour Homme-Centered Care (IPFCC) provides directions to advance in understanding,Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Trussardi Jeans by TrussardiZip).

This care is an approach to the planning,HOIH Sac à dos pour ordinateur portable Pablo Cruise,Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza, patients and families. Thus,Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle.

DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux-being of patients of all ages.Under Armour Camo Fill T-Shirt à Manches Courtes pour Homme,JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie(LIMQ Lingerie en Peluche Babydoll). Surprisingly,Gaoominy Nouveau 860C Indicateur de Vitesse VéLo éLectrique Ebike Affichage pour Bafang SéRie Mid Drive Motor Jeu 3, 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;MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 , and the only one who has the power of decision(Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme). Thus, care practices in end-of-Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport, 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(LAETI TREMA Boucles d'oreilles Cuzco Malachite ).

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,Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton-Irregular Choice Nick of Time. 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-Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles(Inuovo Sandalo Con Zeppa).

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Conclusion

The decision-LetsBuyGold Bague Artisanale -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court-of-HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne .

LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent, 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-teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt. 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,Amazon Essentials Midweight Bomber Jacket Homme-Irregular Choice Nick of Time.

Rieker 38434, 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/JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière, 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-Irregular Choice Nick of Time, 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,Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe.

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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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