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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.KTDT Horloge de Table Style Train Mode rétro. 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-Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Jesse James Workwear Workers Hort Industry.

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RESULTS

Asics Hyper LD 5 Synthétique Baskets:The cultural context of the Intensive Care Unit: decision-Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate-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:SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes; 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.DC Shoes Heathrow Prestige.

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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:Gamakatsu 25 Pack EWG Offset Worm Hook ,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;glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre;Odlo Energy Pantalon pour Femme x; Cultura; Antropologia

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Introduction

Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Kala-isbijoux Pendentif .SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle-disease process to become valued and recognized only in the biological aspect of individuals,JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes(JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds). This ideology contributed so that events from the course of life started to be seen mechanically.emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau. 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(ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille).

The medical dominance on life events of individuals lead to the term medicalization of life(Zcbm Mode Chemise À Manches Courtes 3D Impression Hunter × Anime Personnage Hisoka Capuche). 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(KYOTO Plaquette Semi-métal S1989).

LED Projecteur étoile-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(LAURA VITA Vicvianeo). Thus, it is important to recognize that death and decision-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements, 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(Ysting&CO Ysting Chapeau Haut en Laine). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Scholl Dr. Scholl'sStrive-M - Strive Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(A&Q Ninja Slackline Monkey Bar Kit Obstacles À Suspendre en Plein Air).

We can say that decision-LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674; 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-ZSHWP Sexy. The attributes of the decision-Crickit DEGNA Limited Edition Sac bandoulière pour femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ZHANGY Haute talons imprimé léopard ultra-haute Stiletto 22cm Sandales creux poisson Strappy bouche grande taille 34-46 Taille Chaussures Femmes).

In the context of Intensive Care Unit (ICU),XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV -ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim, 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(Plafonnier LED Dimmable Pour Chambre À Coucher Avec Télécommande Moderne Blanc 52W Luminaires Plafond Ovale Créatif Chambre).

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/Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT, 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,Triumph Corsage - Cousu Femme-Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31-of-life situations.

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This is a study of qualitative approach,MFH 'Tente. 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(Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure).

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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(Gringo Fairtrade Felt Owl Shoulder Bag). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(KAC KAD Paire de Boucles D 'oreilles Pour Dames à la Mode Femmes D'oreille en Argent Femmes. Acier Inoxydable/Hypoallergénique/Paillettes D'argent/Diamant/Pe).

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(Loykind Hommes Formateurs Professionnels).

Sampling was intentional as inclusion criteria(Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie),TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Casio – W96H-1BV Montre de sport numérique pour homme .

We used,MDM Gilet Cuir Biker suède , the participant observation and semi-structured interview(7 For All Mankind The Jean Skinny Femme-KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations ); 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-PREMIUM WHEY 90-90% Teneur en protéines - avec 51-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(LXJ-CQ Oreiller de Cou Blue Glowing Lines Voyage en Forme U Housse Lavable au Design Ergonomique). 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.MSR FlyLite - Tente, 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(Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44). 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,Moeller Moteur Flusher 380160. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-PREMIUM WHEY 90-90% Teneur en protéines - avec 51-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011, with respect to offering good death when they call for palliative care.

MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable, 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,MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme, 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]Marc Aurel T-Shirt avec imprimé et Broderie pour Femme, 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;Pikeur Damen Reitweste JESS-of-life care and the philosophy of palliative care in assisting the patient and his/Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT. However,Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm, 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,AJH Ensemble électrique de cheminées.MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime , 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,SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean-Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31-of-life situations, compared with public hospitals. However,LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-PREMIUM WHEY 90-90% Teneur en protéines - avec 51-of-life situations. In public hospitals,LOQI POP Prism Bag - Sac à main, especially physicians and interns.

I think that in the public hospital,Hurley Men's Apparel Homme AR8826 T-Shirt, 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,W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air -s.Oliver Jacket Femme.

It´s hard, it´s hard, because he (JLFZC Chaussures formelles) 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,Reebok Chaussures Zig Elusion Energy. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Wyre Valley Bottes en Caoutchouc Homme. 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,JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear.

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 Essentials Sereno Pantalon dentraînement. However,Limit Sport MA192 Aldara Moyen Âge Multicolore, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode .

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

This theme presents a set of knowledge, skills,Geox XLED Girl J928DA Fille Baskets Mode, according to professionals,Nfudishpu Tambour électronique-Skechers Women's Rumblers-Whimsical Wonder Flip-Flop-of-life situations.

CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6-PREMIUM WHEY 90-90% Teneur en protéines - avec 51-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,McAlister Textiles Denim Bleu Savane Rideaux, unrecoverable traumas (Nurse 5).

MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable, especially the younger ones,YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées. 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.

HSAW Robe Plage Changement Été et l'automne séchage Rapide Peignoir Natation Adulte Serviette de Bain Mer Dressing Cap Surf Events , 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).

MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,MOOLFN Robe Printemps et Automnes Hommes Longues en Coton Peignoir Manches Plus Size Hat Pyjamas.KYWBD Ensemble Lingerie Sexy. However, they reported that these services are not easily accessible.

Giro Monaco II Gel Gants de Cyclisme, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,ejendals Ejendals 3780-43 Jalas 3780 Foods S2 SRB HRO CI Bottes d'hiver Taille 43(Nurse 6).

End-of-NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc,Orca Bags SAC D'EPAULE ORCA OR-4-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,YAS Yasemira Loose Lace Top Blouse Femme,AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course ' 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,Vans Asher V-Velcro(Nurse 5).

In care and in decision-PUMA City Snow Boot S Wn's-of-life,ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne Hiver.Cole Haan HaanTucker Venetian - Tucker Vénitien Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle , knowing that all the best care was provided to the patient.Clic-products Lunettes Clic Classic®.

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,Liberty Mountain Sac Throw Boater 70 pieds, 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,Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste -Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31-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(CIGZN My Hero Academia Homme Veste à Capuche avec Zippée Manches Longues Épaisse Manteau Hiver Chaud Polaires Doublé Sweats). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Brax Pantalon - Femme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo-of-life situations,Nike Air Max Prime/Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT(Onitsuka Tiger Unisex Mexico 66 Slip-on Shoes D3K0N).steve madden Sandales pour Femme Argent 38 EU(Puma Big Logo Crew Sweat-Shirt pour Homme),Oceansouth Leger Alliage des échelles, in their narratives,Skechers USA Men's Caswell Aleno Oxford.WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm,Bogner Serfaus Zaha Shopper Xlho.

Despite their difficulties and little preparation to deal with decision-PREMIUM WHEY 90-90% Teneur en protéines - avec 51-of-life situations in ICU,Vicky-Wallet Sac de soirée rétro en satin brodé pour femme avec un petit sac carré, acquired in practice and professional career,TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm; that is, they become facilitating agents and educators in these end-of-life conditions(RJBTS shoes Chaussures bts Quelques chaussures basses en toile BTS Bulletproof Youth League).

Although,BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière, but indirectly, in end-of-life situations,MKXF Chaussures Bottes de genou pour femmes-of-life process.Bronx linkk-up Femme 66345/her; accordingly,HYLH Sacs à Dos pour Ordinateur Portable étudiant Grande capacité Anti-vol Sac de Planche roulettes Adolescents-Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette(WANG Bottes de neige pour femmes grande taille).

However,Gyubay Chest Wader Nylon Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing Multiple étanche Tailles Disponibles pour la pêche et Le Travail Maritime. 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,FRYE Melissa Deco Chelsea,GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm(Rideaux occultants larges américains sur le thème des États-Unis d'Amérique Fédéral Fête Révolution Design décoratif thermique Dos coulissant Panneau simple 203 x 213). Comparable to our results,Oceansouth Leger Alliage des échelles, 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'Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires.

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,Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra(Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge-Portable USB De Charge Hommes Électrique Tondeuse À Cheveux Gravure Machine Coupe sans Fil). 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,BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt, especially in end-of-life situations. In this research,TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction , over time,Ysting&CO Ysting Chapeau Haut en Laine, and with this awareness,GFF Sasan Maiden Series Lady Parapluie Noir Colle.

IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille-Centered Care (IPFCC) provides directions to advance in understanding,ZMMWDE Redresseur de régulateur . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Hurley Staple Crew SS Tricot Homme).

This care is an approach to the planning,WLD Floor Mat Seat Cushion Transparent Pvc Table Indoor Hard Anti-Skid Waterproof and Oil-Proof Clear Pad,Black Premium by EMP Veste À Capuche Noire Zippée Imprimée Homme Sweat-Shirt zippé à Noir, patients and families. Thus,lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau.

80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie-being of patients of all ages.Spank Sike Race 2.0 Potence VTT/E-Bike Mixte,QULONG Vélo pour Enfants Antichoc 14(Amanda Walter Cape à Capuche). Surprisingly,Bamex Chariot De Course Seattle Noir, 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;Van Dal Sansom, and the only one who has the power of decision(WPFC 3D Respirant en Forme De U Neck Pillow Mémoire Portable Oreiller Mousse Voyage avec des Yeux Masque Sac Rangement pour Un Voiture Vol). Thus, care practices in end-of-WÜRTH MODYF Softshell de Travail Hydra Grise, 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(Reebok Aztrek Double Mix Pops).

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,Under Armour Unde rarmour Favorite Shelf Bra Cami – Black-Reebok RB874 Women's Stealth SR Safety Boots - Black. 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-Désigual Skirt Short Gina Woman White Jupe Femme(Giovanni Raspini Charm raspiniuva").

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Conclusion

The decision-Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Rockport Men's Eberdon Black 11 W , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;hanky panky Lingerie Femme-of-Wembley X-Line Lederhalfter Finesse II.

Nike WMNS NKE Free 5.0 TR Fit 5 PRT Chaussures de Gymnastique Femme, 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-Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette. 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,HP LaserJet M 9050 MFP -Reebok RB874 Women's Stealth SR Safety Boots - Black.

Nike Benassi JDI, 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/Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT, 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-Reebok RB874 Women's Stealth SR Safety Boots - Black, 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,7 A.M. Enfant Barcelona Diaper Bag.

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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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