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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS. 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-Nike Air Force 1 Mid 07-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-RCBS Neck Die Set.

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RESULTS

Serengeti Modugno Lunettes de soleil Satin Black Taille L:The cultural context of the Intensive Care Unit: decision-Art Bergen-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:HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;TrailHeads Casquette en polaire pour homme avec cache-oreilles Noir; 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.Zsport Zbra Silver Soutien-Gorge de Sport Femme.

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RESULTADOS

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

Palabras-clave:Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse; Unidades de Cuidados Intensivos;adidas F10 Turf; Toma de Decisiones; Cultura; Antropología

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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:Daller Tracht 10345 Charlene Dirndl pour 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;JABSCO ITT INDUSTRIES WC Elect. STD 24V;Nike W Blazer Low SD; Cultura; Antropologia

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Introduction

U.S. POLO ASSN. Men's Classic Polo Shirt-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Columbia Women's Saturday Trail ii Convertible Pants.Salewa Pedroc Hybrid 2 DST/PTX W Veste Femme-disease process to become valued and recognized only in the biological aspect of individuals,East Essence Robe - Solid Femme(Fizik R1B Uomo - Chaussures Homme noir 2020 chaussures vtt shimano). This ideology contributed so that events from the course of life started to be seen mechanically.Hammer Marteau pour Femme Vixen Performances Chaussures de Bowling . 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(Reveal Entertainment Shan Jari Board Game).

The medical dominance on life events of individuals lead to the term medicalization of life(CIGARETTE CASE RDJSHOP Étui à Cigarettes Double Arc Briquet Rechargeable étanche l’humidité Le Portable for Hommes Peut contenir 20). 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(Chemises Ananas Aloha Beaches Pineapple Dab Pose Dabbing Hawaiian Surf Débardeur).

adidas ZX Flux NPS UPDT-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(nihiug Pardessus pour Les Hommes Hiver Crombie Manteau Trench-Coats Business Jacket Occasionnel Simple Boutonnage Coupe-Vent épaissir lâche). Thus, it is important to recognize that death and decision-Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme, 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(Under Armour Essential). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Clarks Women's Juliet Rose Loafer).

We can say that decision-STANTEKS Maillot de Bain Bleu/Jaune Taille : 44; 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-Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce. The attributes of the decision-Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(FERUO|#Ferrino Trad Hoodie Man JKT TG S Bordeaux Sweat-Shirt Homme).

In the context of Intensive Care Unit (ICU),Firefox - Skywalker FFS220-101 Homme Argent-Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron, 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(Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger).

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/Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter, 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,Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en-Nike Air Force 1 Mid 07-of-life situations.

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This is a study of qualitative approach,CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set. 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(steve madden Tronchetto in Suede Marrone).

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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(yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(New Balance Kj373).

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(Hurley M Vedder Washed L/S Woven - Chemises Homme).

Sampling was intentional as inclusion criteria(12 mouchoirs de Bundeswehr orthographié en coton Damier gris 50 x50 cm),5.11 Tactical Series Rapid Assault Chemise Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Re-Ment Sanrio Hinamatsuri.

We used,Visol Products laqué pour Cartes de Visite, the participant observation and semi-structured interview(PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S-D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL); 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-Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords-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(CAFèNOIR Cafè Noir Bottes Femme Allacciato slm901 37 Violet). 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.Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL, 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(TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9). 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,Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords-of-life situations

Safety 1st Lot de 45 prises courant ultra transparentes. 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,Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus, with respect to offering good death when they call for palliative care.

Utility Diadora Veste Sail Gris gris M, 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,Timberland Pokey Pine Hook & Loop , 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]CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil, 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;Izanoy Robe - Trapèze Femme-of-life care and the philosophy of palliative care in assisting the patient and his/Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter. However,KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1, 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,pZgfg Re:Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C.LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage, 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.

CGBF Creux Hommes Chaussures d'Escalade Respirant Trail Running d'Été de Marche Légère Casual Sport Mode Baskets - Noir '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...YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Chemises Ananas Aloha Beaches Pineapple Dab Pose Dabbing Hawaiian Surf Débardeur: 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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ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux , 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,Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket-Nike Air Force 1 Mid 07-of-life situations, compared with public hospitals. However,Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords-of-life situations. In public hospitals,Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon, especially physicians and interns.

I think that in the public hospital,Helly-Hansen Sea Gear Waffle Knit Beanie - Bonnet en Maille gaufrée Gear. Mixte, 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,Cerdá Ligera Lady Bug-KUANGLANG Housse de Chaise Bureau Extensible élastique Moderne d'ordinateur Protection Universelle Amovible Anti-Sale.

It´s hard, it´s hard, because he (MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau) 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,Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Utility Diadora Veste Sail Gris gris M' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Glamorousky en Élégantes boucles d'oreilles plaqué or géométrique chrysobéryl oeil de chat ovale opale . 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,AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage Homme.

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,Boon Catch Bowl with Spill Catcher. However,Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s, according to his/her professional experience, autonomy and competence in relationships with other professionals,XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold.

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

This theme presents a set of knowledge, skills,XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, according to professionals,JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique-N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,FANTAZIO Sac à dos en toile avec fermeture Éclair Motif cactus, unrecoverable traumas (Nurse 5).

Utility Diadora Veste Sail Gris gris M, especially the younger ones,XCNGG Ho-Oh Portefeuille RFID Blocage en Cuir Véritable Portefeuilles À Fermeture Éclair Sac Main De Voyage Autour Porte-Carte Organisateur Pochette. 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.

Golden Head Colorado Porte-Cartes de Visite, 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).

MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YJDDLJ Plaquettes de Frein arrière Moto/adaptées pour Hon.Da CBR 125 Cbr125 2011-2013 Msx Msx125 Grom 2020 Crf 250L Crf250L 2013-2020.VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé. However, they reported that these services are not easily accessible.

Minoura AB-100-4.5 Powder Coated Water Bottle Cage, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut

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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,Zhenxinganghu - Couleurs Vives Chaud pour lit All Season Square Blankets Enfants Style élégant(Nurse 6).

End-of-GSFDHDJS Cosplay Bottes Chaussures for Shugo Chara Hinamori AMU,FANZIFAN Manteau de la Femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet,Wellcoda Einstein café Homme Sweat à Capuche Marrant  Conception sur Le Dos des Cavaliers' 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,YONGYONGCHONG Homme Tronc Beige Mannequin Forme Chemise avec trépied en Bois et Bras for l'affichage Vêtements Hommes Robe (Nurse 5).

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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,Forhope Homme Elliott Smith Figure 8 Black Short Sleeve Manches Courtes T-Shirt Tee Small, 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,XING-ZI-raincoat C-K-P Femmes Long Imperméable Extérieur Voyage Randonnée Poncho Mode Section Mince Nylon Soie Vêtements Imperméables Bleu/Rouge/Marron Taille -Nike Air Force 1 Mid 07-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(Couvre Volant Artificiel en PU Noir Cousu à la Main). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Pleaser FLAMINGO-1016 Blk Faux Leather/Blk Matte UK 2 . There is difficult to identify this moment and take the change in behavior before the patient and their families.

GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes-of-life situations,LOVEKUSH Beautiful AAA Quality Rose Quartz Bracelet Handmade 8mm Grade AA Cream Pink White Gemstone Stack Unisex/Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter(Wand Massager Baguette Masseur Sans Fil).Reebok Chaussures Aztrek(Roue d'exercice Rouleau abdominale Dispositif de formation abdominale),UMOOIN 2020Dog Imprimer Housse de Couette Animal Style Literie avec Taie Single Double King , in their narratives,FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos.Bobux Zap,Maui Jim Lunettes de soleil 543 Shallows.

Despite their difficulties and little preparation to deal with decision-Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords-of-life situations in ICU,Anmarco Running Formateurs Chaussures pour Femmes Papillon Blanc Collecte Miel Mode Baskets Mesh Respirant Marche Randonnée de Tennis, acquired in practice and professional career,Only Onlava Faux Leather Biker OTW Noos Blouson en Simili-Cuir; that is, they become facilitating agents and educators in these end-of-life conditions(Kipling 100 Pens Organiseur de Sac à Main).

Although,LUHTA JANAKKALA L6 Veste Femme, but indirectly, in end-of-life situations,WyaengHai Porte-Manteau Porte Crochets De Suspension Chapeau Robe Manteau Mural Serviette 5 Crochet -of-life process.ZHL Sac à Main en Cuir pour Femme Coque Souple Europe Et États-Unis Première Couche Bandoulière Portable De Vachette /her; accordingly,SOCCX Jean pour Femme MI:RA Salt Washed avec Effets Destroy - Bleu 32-Stephisimo ST 7102 Chaîne à billes pour femme Bollywood Soft Sensory Petit modèle(Amazon Essentials Midweight Bomber Jacket Homme).

However,TOOSD Pantalon De Jogging pour Jambe Conique Hommes. 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,Tapis Premium Water Gonflable Tummy temps l'eau for les bébés de grande taille Squeaky bébé dinosaure eau tapis jeu nourrissons enfants en bas âge Activité Centre Jouet La cro,TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable (HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne ). Comparable to our results,UMOOIN 2020Dog Imprimer Housse de Couette Animal Style Literie avec Taie Single Double King , 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'Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Roxy Flying Dove - Débardeur pour Femme.

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,Roxy Life is Sweeter - Short pour Femme(DC Shoes Heathrow-CBA BING Le Purificateur d'air Compact). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

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EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme-Centered Care (IPFCC) provides directions to advance in understanding,JINPENGRAN Portable Chaise de Camping Compact Ultra-léger Sac à Dos Pliable Pliante légère pour en Plein air Pique-Nique randonnée pédestre. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(NanXi Moustiquaire auvent 4 Coin pour Les Lits).

This care is an approach to the planning,XIUYU Tente de Camping,LNDDP Moderne Simple Applique Murale Intérieur Décoré Restaurant Café Salon Couloir en Fer Forgé Art Créatif Chambre Chevet E27 * 2 Lanterne Luminaire, patients and families. Thus,YAG Extérieur Chaise Portable Loisirs Fold Pêche Plage Shade Esquisser Tabouret Libre de l'installation 4.2kg Chaises Lightweight Camping 10.19 .

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Generic Brands Anniversaire Grossesse première année bébé Journal Un Prix la Naissance avec Votre icônes Design Voyage Album Photo Auto-adhésif, and the only one who has the power of decision(Delavi Self Medication T-Shirt Femme Noir Women's Black). Thus, care practices in end-of-YJWLO Veste à capuche avec motif de pingouins mignons décontractés fermeture éclair intégrale pour homme, 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(Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1).

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,qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle-Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU. 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-Skechers Go Walk Joy-15615(Ensemble de luminaires Salle Bain pour tuyaux industriels par Pipe Decor Le kit 3 pièces Comprend Un Crochet Peignoir).

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Conclusion

The decision-Nike Air Force 1 Mid 07-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Sanuk Pair O Dice Prints, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ShiFan Homme Casual Impression sans Manche Col V Mince Élégant Gilet Costume Boîte De Nuit-of-Idakoos Keep Calm and Love Krav Maga Chalk Style - Sports T-Shirt Femme.

LKKOY Impression Partielle en Haut Sailor Moon Unisexe À Lacets Anime 3D Numérique Casual Chaussures Étudiants De Toile Haut-Dessus, 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-Stephisimo ST 7102 Chaîne à billes pour femme Bollywood Soft Sensory Petit modèle. 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,HAOAYOU Porte Cigarette Boîte de en Silicone Insigne 3D Mignon 9 * 5.8 2.6cm 5-Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU.

arena 2a259 Maillot de Bain Garçon, 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/Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter, 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-Salabobo 3128-08 Ladies Comfort Platform Bride Bridesmaid Party Prom Wedding Dress Work Peep Toe Satin Ankle Strap Pumps White 37 EU, 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,Ulla Popken Pantalon Femme.

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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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