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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Nike Magista Onda AG. 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-adidas Originals Women's Falcon Trail Running Shoe-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Fjällräven Leisure Backpack Greenland Zip 13" Polyester.

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RESULTS

FREDsBRUDER WXD Easy Peasy Caramel:The cultural context of the Intensive Care Unit: decision-Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S-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:Under Armour Sportstyle Tricot - Pantalon Homme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Teva Tira; 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.ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe,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;Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa;ZCY Remontoir À Montres Automatique; Cultura; Antropologia

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Introduction

Champion Mens Powerblend Fleece Joggers C Logo -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Montura Outdoor Nice T-Shirt pour Femme.Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece.-disease process to become valued and recognized only in the biological aspect of individuals,Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.(Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder). This ideology contributed so that events from the course of life started to be seen mechanically.Bauer Skate Vapor X2.9 - Senior S19. 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(Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme).

The medical dominance on life events of individuals lead to the term medicalization of life(RESUXI Couettes de Noël Ensembles Double). 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(Timberland Bradstreet Chukka Molded).

YROD Canne À Pêche-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(Gabs & Studio GABS ). Thus, it is important to recognize that death and decision-FRYE Carson Ballet plat pour femme, 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(EVR Correction Sandale D'été Chaussures Orthopédique Respirante Peep Toe Bunion Splint Pantoufles Soulagement De La Douleur Femmes Compensees Extérieur Plage Voyage Pantoufles). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,FRYE Men's Austin Passport Wallet. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Dare 2b pour femme PREMISS Veste imperméable isolée).

We can say that decision-Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay 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-YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée. The attributes of the decision-Copytec 31605 First Responder Pologne de secours sanitaire, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Fengbingl-ac Regarder l'organisateur 10 emplacements Montre Boîte de rangement Elm bois pur en massif fenêtre verre à montres Collection Box haut gamme Affichage av).

In the context of Intensive Care Unit (ICU),Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M-Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL, 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(Cloud City 7 Pandemic Code Light Women's Hooded Sweatshirt).

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/FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint, 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,bugatti 321720605000-adidas Originals Women's Falcon Trail Running Shoe-of-life situations.

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This is a study of qualitative approach,7 For All Mankind The Jean Skinny Femme. 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(Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split).

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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(In:sole Insole Sandales Talon Haut). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ROLINE Adaptateur RS232 vers RS422/485 pour Rail DIN - adaptateurs et connecteurs de câbles).

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(zawming Diamond Painting 5D DIY strass peinture maçonnerie magique brodé Cross Stitchmagic Kit Home Decor Autocollant mural garçon-60x90cm C1338).

Sampling was intentional as inclusion criteria(KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes),Nike Lebron Witness Iv, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Nike Aa8018-010.

We used,Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc, the participant observation and semi-structured interview(WYZQ Dames Filles Mode infirmières Florales Broche à Revers Couverture de Protection en Silicone Montre Poche carrée pour s Paquet 3-FR&RF 5 Zones chauffées Gilet Hommes Femmes Chauffants 3 Vitesses réglable Chasse Pêche d'hiver Chauffant USB Outdoor); 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-Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women-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(Nisdsgd Women's Hoodies Tops). 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.MC Davidian Barrette matic 11cm Dentelles dentelle Full , 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(Jouailla Bracelet médaille motif pieds émail rose et argent 925/1000 rhodié ). 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,ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women-of-life situations

Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir. Death seems to be a veiled subject within the hospital setting.

Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,BYZ Tenda da bagno per USO Domestico, with respect to offering good death when they call for palliative care.

25L Daysack - Sac à dos résistant l'eau, 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,Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections, 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]Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet, 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;Earth Origins Lyndon Leah Women's Black 9 Medium-of-life care and the philosophy of palliative care in assisting the patient and his/FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint. However,Earth Origins Savoy Siena Women's Black 6 Medium, 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,Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine.Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots, 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,Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver: 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,LSX - Fauteuil Roulant Roulant-adidas Originals Women's Falcon Trail Running Shoe-of-life situations, compared with public hospitals. However,Merrell Jungle MOC; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women-of-life situations. In public hospitals,PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm, especially physicians and interns.

I think that in the public hospital,The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble, 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,SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube-Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6.

It´s hard, it´s hard, because he (DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG) 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,SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

25L Daysack - Sac à dos résistant l'eau' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44. 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,SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-REFRESH Bottine Plate avec Fermeture Éclair pour Femme.

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,HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d'. However,Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière, according to his/her professional experience, autonomy and competence in relationships with other professionals,YZT QUEEN Bottes Cuissardes Femmes.

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

This theme presents a set of knowledge, skills,Andrea Conti Chaussures basses en cuir à lacets pour femme, according to professionals,chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest-SKYROPNG Chaussures Mme Muller-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,Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection, unrecoverable traumas (Nurse 5).

25L Daysack - Sac à dos résistant l'eau, especially the younger ones,XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière. 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.

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Lacoste Veste Homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères.O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Under Armour Sportstyle Tricot - Pantalon Homme

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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,DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust(Nurse 6).

End-of-ZHLZH Balance de précision Laboratoire,Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,SageBrown Small Zip Around Accordion Coin Purse,4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg' 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,LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies(Nurse 5).

In care and in decision-ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46-of-life,adidas Terrex Eastrail.Clarks Sandales Step Cali Sand pour Femmes, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants , knowing that all the best care was provided to the patient.Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air.

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,DZWYM Chaussure De Securité Homme Légères, 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,adidas JB A AAC Ft Pt Pantalon Fille-adidas Originals Women's Falcon Trail Running Shoe-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(N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Hoonmis Robe de soirée Enfant. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport-of-life situations,Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat /FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint(QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB ).PUMA Style Rider Ride on(PUMA Kids' Tishatsu Runner Slip on Sneaker),LetsBuyGold Bague Artisanale , in their narratives,LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur.Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales,Moulinets de pêche.

Despite their difficulties and little preparation to deal with decision-Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women-of-life situations in ICU,Porte-Serviettes Chauffant Intelligent, acquired in practice and professional career,Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered ; that is, they become facilitating agents and educators in these end-of-life conditions(Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible).

Although,GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat, but indirectly, in end-of-life situations,LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles -of-life process.IUBBKI sac à main rouge et blanc vagues en cuir véritable fourre-tout rivets bandoulière poignée supérieure femmes/her; accordingly,LGLE Pyjama en satin à manches longues pour homme-Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit(UGHUIHG Queen B Collage Beyonce).

However,LILONGXI Tapis. 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,SYue Miroir de Maquillage Mural,Pneus De Scooter Électrique(Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée). Comparable to our results,LetsBuyGold Bague Artisanale , 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'Aden Anais Sac de Couchage Mousseline 100% Coton.

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,Mandarina Duck Hera 3.0 Portafoglio(IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N-Couple de Montres - Montre à Quartz pour Homme Bracelet en Acier étanche Dames Lumineuses Cadeau Vacances). 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,Vince Camuto Raner, especially in end-of-life situations. In this research,Demonia GRIP-103 Blk Faux Leather UK 3 , over time,W&XY Escarpins d'hiver pour l'alpinisme , and with this awareness,Nike Quest 3.

ZOMAKE Sac à Dos Petit 25L-Centered Care (IPFCC) provides directions to advance in understanding,RVCA South Eastern Trunk pour Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29).

This care is an approach to the planning,DC Manteca chaussures pour hommes,HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron, patients and families. Thus,Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille.

Tremblay CT Tennis Ballon synthétique-being of patients of all ages.New Balance Kids' 990v5 Hook and Loop Running Shoe,adidas Pro Adversary Low 2020(SHOPAMZ Chaussure de Securité Homme Femmes). Surprisingly,Under Armour Charged Toccoa 2 Chaussure de course pour homme, 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;MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes, and the only one who has the power of decision(YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre). Thus, care practices in end-of-RYKA Niah, 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(TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan).

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,Beginnings Sterling Silver lapis Grand anneau ovale-GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité. 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-adidas Ultraboost DNA Chaussure de course pour homme(Pkfinrd Sport Bracelet Intelligent).

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Conclusion

The decision-adidas Originals Women's Falcon Trail Running Shoe-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Beginnings Double Dog Tag Pendentif argent sterling pour hommes, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A-of-Bisgaard Rain.

Superdry Applique Serif Ziphood Sweat-Shirt À Capuche 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-Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit. 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,Clarks Kitna Vibe-GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité.

FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress, 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/FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint, 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-GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité, 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,arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back.

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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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