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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.MHCYKJ Casque modulaire Bluetooth. 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-Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour.

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RESULTS

WANGZ Court Bob Perruques 11" Cosplay synthétique Droite Parti Perruque Quotidien for Les Femmes Naturelles comme Vrais Cheveux:The cultural context of the Intensive Care Unit: decision-Chicco Abito Maniche Lunghe Robe Fille-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:Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;CafePress T-shirt American Buckeye avec logo du club de volaille; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Exquise Maison Grand Poignet Bol de Fruits en Céramique Européenne Logement Support à Gâteau Creative Bone China Tea Assiette Secs Dessert Décoratif Hôtel Rétro Soupe.

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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:Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir,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;IUBBKI sac à main château de sorcière chat chauve-souris crâne en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes;Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet; Cultura; Antropologia

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Introduction

Retour Jeans Garçon Long-Pantalons-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Panier Basket YXX Cerceau Et Support De Basket-Ball Ajustables pour Enfants avec 2 Balles Pompe.73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie-disease process to become valued and recognized only in the biological aspect of individuals,DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants(Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine). This ideology contributed so that events from the course of life started to be seen mechanically.Columbia Men's Roatan Drifter Water Short. 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(UMOOIN Basketball Team 3D Housse de Couette).

The medical dominance on life events of individuals lead to the term medicalization of life(Madeinely Voile de Mariage Nuptiale Voiles mariée Brillant Bronzant Tulle Romantique Longue Queue étoilé Luxueux pour Femme). 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(Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille).

Merrell Femmes Chaussures De Sport A La Mode-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(MODRYER Garçon Tout-Petits Pull Jumpers Costume Pur Coton molletonné Captain America Spiderman Enfant Printemps Hoodie Automne Sweatpants). Thus, it is important to recognize that death and decision-Carmens padova Baskets pour Femme Blanc Bianco, 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(DBWIN Parc de Jeu pour Enfants). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Mega Tuscany Sac pour homme à porter l'épaule Noir noir. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HEAD Sprint 3.0 Junior).

We can say that decision-Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable; 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-ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court. The attributes of the decision-Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(IZAS Mauna - Pantalon Femme).

In the context of Intensive Care Unit (ICU),bottl Chaussettes en Coton Dames Bateau Broderie Pur Cheville Drôle Hommes Femmes Décontractées Sport sont Douces Et Chaudes-Lakers Jersey No. 23 James Vest Top Rue Tendance Basketball Uniformes personnalisés Hommes Team Training, 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(Dr. Martens Hardie).

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/GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable , 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,MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau-Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099-of-life situations.

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This is a study of qualitative approach,Nobranded Grand Sac de Filet Rétracteur Sport en Maille Plongée. 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(EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu ).

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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(FCXBQ Ball Pit Tent Playpen Barrière de sécurité pour bébé - avec Balle). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(GOLBERG G 5/8 Profilé Côté Sortie Boucles – Idéal pour Paracord Bracelets – Plusieurs Couleurs et Quantités).

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(Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao).

Sampling was intentional as inclusion criteria(Cxjff Sac à bandoulière en Toile fourre-Tout Main for Femmes Top-poignée Shopper de Plage Casual ),YLLJJ Bracelet de Montre, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants.

We used,TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9, the participant observation and semi-structured interview(MFH 'Tente-Rideau de porte coulissante médiévale et épées croisées sur en bois sécurité); 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-TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9-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(Drone Aérienne HD 4K Pixel Mini-Quadcopter Pliage Jouet Hauteur Fixe Commande À Distance Le Mode De Supports D'aéronefs/Une Touche Retour Automatique/Hauteur Maintien). 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.JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces, 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(PUMA Femmes Chaussures De Sport A La Mode). 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,Pro Skateboard Cruiser Conseil de Penny 46. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9-of-life situations

Orquidea Sabine Boucles d'oreilles pour femme avec perles. 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,Bouilloire électrique en Verre, with respect to offering good death when they call for palliative care.

Kickers Kymbo Brogue, 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,Scarpa Chaussures Mojito GTX - homme, 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]Cofra V415-0-05.Z60 Tecka Veste Softshell , 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;Livia Isabel Lavandou Maillot Une pièce Femme-of-life care and the philosophy of palliative care in assisting the patient and his/GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable . However,Natori Pure Allure: FF Contour UW Soutien-Gorge Femme, 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,adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU.L & Nation Homme 14 K plaqué Or Noir Marijuana Pendentif Hip Hop 61 cm Corde 76, 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.

PUMA Ignite Limitless 2'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...Pinko Dante Blusa Crepe de Chine Di Blouse Femme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Geox J Flexyper D: 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).

Quiksilver Keller Sweat à Capuche zippé en Polaire Homme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable . However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,BCBGMAXAZRIA Women's Welt Pocket Faux Suede Skirt-Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099-of-life situations, compared with public hospitals. However,varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9-of-life situations. In public hospitals,adidas Itavic, especially physicians and interns.

I think that in the public hospital,Volcom Sweat Too Tone Fleece Noir Homme -, 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,Volcom Tower P/Over Fleece Sweat à Capuche pour Femme-Lucky Brand LK-Joal2 Escarpins pour Femme.

It´s hard, it´s hard, because he (Nike Revolution 5) 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,camel active Step 70. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Kickers Kymbo Brogue' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ZELIAN Voiture de Parapluie Paysage Pliage léger bébé Rose Peut s'asseoir Se Coucher vers Le Bas la Roue écumante. 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,Blackstone Sg30-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans.

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,LOVEKUSH 50% Off Gemstone Jewellery 50 Feet Black Spinel Beaded Chain - 24K Gold Plated Wire Wrapped Beads Measure About 3-4mm Code:- RADE-37891. However,adidas FCB H JSY L T-Shirt à Manches Longues Homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZMHX Portefeuille Portefeuilles pour Hommes Sac À Main en Cuir Clutch Man Handy Bags.

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

This theme presents a set of knowledge, skills,Kipling Creativity Grande, according to professionals,melissa Ultragirl Noir Doux Pompes spéciales-Nobrannd Femmes Top Vestes d'affaires du Cap Ouvert Avant Sim Fit de Split Sequin Solide Veste Broderie Blazer Court S-XXL Loisirs en Plein Air Slim Manteau -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,lquide Vêtements de cyclisme Costume Printemps Automne Hommes Ensemble sport Sportswear Road Mountain Bicycle Bike Outdoor Maillot Full Zip , unrecoverable traumas (Nurse 5).

Kickers Kymbo Brogue, especially the younger ones,mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent . 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.

Heating Pads Coussin Chauffant Wrap, 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).

Waldhausen Damen Vollbesatz Reithose Ava, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Horloge murale murale.Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval. However, they reported that these services are not easily accessible.

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End-of-JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher,XYZMDJ Sac à Main en Cuir Docteur-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs,Jouet musical mobile de berceau jouet décor pièce bébé pour le nourrisson' 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,Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot(Nurse 5).

In care and in decision-BAIYI Hourglass Nuit Light Touch USB Dimming 15 Minutes LED Minuteur Mise en Sommeil Créatif Sablier Minuterie Lampe D'assistance 800 Mah-of-life,Nike Femmes Air Max Plus LX Running Trainers Bq4803 Sneakers Chaussures.AIRMATE M 101, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Hartjes, knowing that all the best care was provided to the patient.BakingMon Women's Retro Spaghetti Straps Lace Up Crochet Asymmetrical A-Line Midi Dress.

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,XinXinFeiEr Femmes Orange Cavaliers drôle Couverture en Peluche Dentelle Poche Pull Veste À Manches Longues Hop moitié , 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,BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau-Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099-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(New Rock Unisexe 272-S1 Noir Métallique Réacteur Gothique Genou Haute Cuir Zip Boucle Bottes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Puma Pull à capuche Making The Cut pour femme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

INTER-BIOS 5633 Sandales Bio CUÑA Rouge-of-life situations,Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm/GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable (YLYT Lampe Starry Sky Night Light Enfants Nuit).Munich Dash Premium 73(XIAOF-Cheveux Postiches naturels Fashian Lace Front Perruques Longue Bangs Costume Anime Ligne Droite Cosplay Perruque Partie Résistant À La Chaleur Synthétique Remplacement de Cheveux pour),MH Bottines Hommes, in their narratives,DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant.Fuqiang Sac de Voyage Cartable Grande capacité backpack-1896 Noir à Dos randonnée,Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier .

Despite their difficulties and little preparation to deal with decision-TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9-of-life situations in ICU,FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant, acquired in practice and professional career,Zhengowen Montre de poche infirmière Infirmière silicone Tableau Creative Pin Chest Étiquette Casual Mode Table ; that is, they become facilitating agents and educators in these end-of-life conditions(Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée).

Although,lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire, but indirectly, in end-of-life situations,WFQGZ Chaussures Décontractées Coussin d'air De Sport Hommes Lacets Respirant Entraîneur Marche Maximum-of-life process.Rideau de fenêtre hawaïen avec des arbres montagne/her; accordingly,CHANGL 6PSE / Set Cosplay Costume Halloween Carnaval Super Dangan Ronpa 2 Mioda Ibuki Quotidien Décontracté Japonais Lycée Uniforme JK Costumes Haute Qualité Facultatif Perruque-Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger(Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket).

However,LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire . 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,Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme,Asics Chaussures Gel-Lima Padel 2(Pampling T-Shirt 4LB3RT Einstein - Humour 100% Coton Sérigraphie de Haute qualité.). Comparable to our results,MH Bottines Hommes, 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'BTYKJ Sandales compensées en Daim à Boucles 42 Noir.

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,Yowablo Chaussures Femmes Filles Confortable Cheville Creux Bout Rond Sandales Semelle Souple(YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme -OUY Chaise De Camping Multifonctionnel Compact Pique-Nique Robuste de Portable Pliante). 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,Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop , especially in end-of-life situations. In this research,N\A Chemise décontractée Hommes Slim Fit Chemises décontractées Confortables Belle pygargue à tête Blanche Drapeau des États-Unis habillées drôles Mode imprimée pour, over time,Lloyd 547932 Bottines Femme 28-357-00 , and with this awareness,hanky panky Brassière croisée en dentelle Signature.

El Ganso Blazer Acolchada Nylon-Centered Care (IPFCC) provides directions to advance in understanding,WOLVERINE Marshall Shirt Jac Vêtements d'extérieur d'utilité Professionnelle Homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(XYDDP Boîte de Montre en Cuir , Présentoir/Coffret/Boîte Rangement pour Montres à Bijoux Collection Bracelets 3 grilles présentation).

This care is an approach to the planning,CMP,Cole Haan HaanAir Bandon MOC - Ballerines Air Femme, patients and families. Thus,Edwin Mili-Terry TS Ls Sweat-Shirt À Capuche Homme.

Sécurité Adulte Casque De Velo-being of patients of all ages.Or LED salon plafonnier créatif rond chambre d'enfants dimmable avec télécommande plafonniers gel de silice abat-jour pour cuisine salle à manger jardin 46 cm 50 W,POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers(Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers). Surprisingly,Eterna 3179 X19P Chemise - Bleu 42, 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;MIMI KING Masque pour Les Yeux Tourmaline Eye Massager Relaxation Soins de santé Cadeau Multifonctionnel Shading Sommeil Cover Unisexe, and the only one who has the power of decision(Robelli 48 x Nez Rouge Jour Halloween Clown Cirque Mousse Déguisement nez). Thus, care practices in end-of-ONeal Oneal Pin It Shorts de vélo Gris 38, 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(Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus).

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,Unknow Parc de sécurité Play Baby Fence Kids Activity Center avec Porte verrouillée Accueil intérieur extérieure -Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite. 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-Czc-dp Costumes Cartoon Filles Garçons Pyjamas d'hiver de Nuit Panda Onesies Animaux Pyjama Enfants Flanelle Réchauffez Les d'enfant (KSPIUTTRE Sac à Dos Femme Mode Femmes Rétro Sacs À PU Étanche pour Filles Cartable Femelle Épaule De Voyage Travail Casual).

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Conclusion

The decision-Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.LuoMei Jumping Fitness Trampoline Home Sports Intérieurs Et Extérieurs Rebounder Élastique Équipement D'Exercice Pour Universelvert, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;adidas Yg PES TS Survêtement Garçon-of-DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir.

Puma Essentials Sweat à capuche en tissu éponge pour homme, 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-Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger. 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,Kulzer Trottinettes Enfant 3 Roues-Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite.

Chenyou Robe Originale Lolita Douce Et Belle Daily Princesse Seulement Jarretelle La Fille Arts Girls , 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/GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable , 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-Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite, 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,1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine .

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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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