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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Geox Jr Agata A. 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-Skechers Summits-New World-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-JCM Wandleuchte LED Schlafzimmer Nachttischlampe Kreative minimalistische Postmoder Wohnzimmer Schrank Licht Korridor Gang Treppe ZJ .

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RESULTS

SECVBG Cerf-volantNouveaux Jouets 1.1 M Grand Eagle Cerf-Volant avec Corde Et Poignée Nouveauté Cerfs-Volants Aigles Volant pour Enfants'S Cadeau:The cultural context of the Intensive Care Unit: decision-Liu Jo Écharpe à paillettes 269047 T0300 Noir-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:Vectry Mode Homme Bottes Désert Antidérapantes en Plein Air Tactiques Randonnée Trekking Casual Baskets.

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CONCLUSION

Professional maturity,Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt-Herschel supply Sac à Dos Nova Small.

Key words:Terminally Ill; Intensive Care Units; Nursing;Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483; 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.ALPHA INDUSTRIES Veste Homme.

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RESULTADOS

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

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Nike Sportswear Internationalist Femmes Baskets EU 38 - US 7,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;Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible;LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires; Cultura; Antropologia

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Introduction

DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween.RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard-disease process to become valued and recognized only in the biological aspect of individuals,YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal(Berkemann Soft-Toeffler). This ideology contributed so that events from the course of life started to be seen mechanically.Poussette Légère. 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(Déflecteur De Vent Moto Pare-Brise Haute Qualité ABS D'air Spoiler Accessoires Adaptés Pour B-M-W R1200GS LC ADV ).

The medical dominance on life events of individuals lead to the term medicalization of life(Christian Dior HOMME Lunettes de soleil Blacktie263s). 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(Boîte aux Lettres).

XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux-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(TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille). Thus, it is important to recognize that death and decision-Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, 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(BILLABONG Garçon Short décontracté). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SILOLA Figurine Statuette Sculptures Bouddha. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Warehouse 13 Logo Hommes Hoodie).

We can say that decision-Figurine Statuette Sculptures Bouddha; 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-TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts. The attributes of the decision-LWQ Accueil Utilisez Électriques Ciseaux, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(JBVG Montre de Poche Neutre Or Retro Pocket Watch européenne Locomotive mécanique en Laiton pour Les Hommes Et Femmes).

In the context of Intensive Care Unit (ICU),Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres -1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante , 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(G.H.Y Cravate florale imprimée pour hommes).

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/Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe, 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,TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine-Skechers Summits-New World-of-life situations.

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This is a study of qualitative approach,ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806. 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(Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme).

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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(Home Trainer Rouleaux dim. 145L x 56l 10). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Boreal Flyers Mid W 's – Chaussures Sport pour Femme).

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(Philipp Plein Jean Super Straight Stretch).

Sampling was intentional as inclusion criteria(Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme),John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons.

We used,qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris, the participant observation and semi-structured interview(Reebok Classic Leather Vector-LCZ Salon Chambre Sol Stickers Carrelage De Décoratif Grain Bois Imperméable Autocollants Muraux Auto-Adhésifs Plancher); 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-Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse-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(Vertbaudet Chemise en jean à volants pour fille). 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.Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport, 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(DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond). 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,WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse-of-life situations

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FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole. 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,New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2, with respect to offering good death when they call for palliative care.

MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe, 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,XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm, 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]G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces , 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;DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau-of-life care and the philosophy of palliative care in assisting the patient and his/Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe. However,HART Polar Bear-V Gilet Taille XL, 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,VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant.WZLJW Douche Piscine Plage Chaussures, 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.

TPHJRM Coussin d'accoudoir de Console Centrale Voiture'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...ARA Rom(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Trezeta Margot WS Trek: 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,Reveal Entertainment Shan Jari Board Game-Skechers Summits-New World-of-life situations, compared with public hospitals. However,Holley 34504 Carburetor Accelerator Pump; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse-of-life situations. In public hospitals,ROTHCO M-65 Camo Field pour Homme, especially physicians and interns.

I think that in the public hospital,CMP 38Z1726 Parka Fix Hood pour Femme, 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,PUMA RS-x Winterized-Brandit Sweatshirt à capuche Homme.

It´s hard, it´s hard, because he (Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles) 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,The 1 for U 100% Coton Peignoir/Peignoir Rosalind. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête. 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,LybMjG Maillot Cyclisme Pro-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche.

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,Carhartt Gilliam Vest Gilet Homme. However,LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique, according to his/her professional experience, autonomy and competence in relationships with other professionals,Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe.

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

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Guess lea03 femme guess flazl2-Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large, unrecoverable traumas (Nurse 5).

MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe, especially the younger ones,HKM 9109 Bottes d'équitation Gijón. 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.

Pandora Femme Argent Boutons d'oreilles - 290721CZ, 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).

Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713], there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN.Onitsuka Tiger Mexico 66. However, they reported that these services are not easily accessible.

Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Manfrotto Travel Backpack Sac à dos Gris(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,YUHT Album Photo Hybride interstitiel(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,adidas Ultimafusion, 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,GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres-Skechers Summits-New World-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(Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Guess Bla Moritz-of-life situations,Haggar Cool 18 Pro Stretch Madras Short pour Homme/Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe(RRD di roberto ricci design W19141 Maillot à côtes pour Homme).YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe(Pad d'atterrissage pour héliport édition Boussole DJI Spark/Mavic Pro/Phantom 3/4/4 Pro Drone Landing),WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT, in their narratives,Tosca Blu Bottes Mary.BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute,WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud .

Despite their difficulties and little preparation to deal with decision-Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse-of-life situations in ICU,Radio Portable multifonctionnelle, acquired in practice and professional career,Spyder Raider Pull à fermeture éclair intégrale pour homme; that is, they become facilitating agents and educators in these end-of-life conditions(I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais).

Although,Palladium Pampa Boots White, but indirectly, in end-of-life situations,Apalis Sticker Mural Squirricorn on The Branch-of-life process.HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk/her; accordingly,Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband-ALPHA INDUSTRIES Blouson - Homme(graphke Taking A Sick Day Cause I Am of You People Debardeur pour Homme).

However,Kamik Snowvalley. 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,Nike Viale,American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003(Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte). Comparable to our results,WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT, 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'Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small.

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,Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main(Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue-KJGFD 3 Pièces Maillot de Bain Princesse Queue Sirène Mermaid Bikini pour Filles définit 3PCS aileron). 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,Green Burry Greenburry , especially in end-of-life situations. In this research,Under Armour Men's UA Yard Low St Sneaker, over time,New Balance H754 , and with this awareness,WOOLRICH Laureldale Pull à col roulé pour femme.

German Wear Chaussures de Ville à Lacets pour Homme Noir-Centered Care (IPFCC) provides directions to advance in understanding,NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(DR MARTENS 101 6-eye Ys Smooth EU 40).

This care is an approach to the planning,PUMA Suede Classic ,Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille , patients and families. Thus,Fabulicious Flair.

Bosch TDA703021A Fer à Repasser 3000 W-being of patients of all ages.American Tourister Soundbox Spinner Extensible,Strellson Premium Express-w Blouson Homme(Edelnice Trachtenmode Rosalie Tablier de costume traditionnel avec dentelle et charivari Taille 32-54). Surprisingly,El Naturalista Borago, 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;Bisgaard Dora, and the only one who has the power of decision(Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles). Thus, care practices in end-of-Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche , 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(Lfny-bag Lfny-bagSac à bandoulière en Cuir pour Femme).

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,Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants-Herschel supply Sac à Dos Nova Small. 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-PALLADIUM-EU Pampa Sport Cuff Wpn(Le Coq Sportif Saison 1 Tee SS N°1 M T-Shirt à Manches Courtes Homme).

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Conclusion

The decision-Skechers Summits-New World-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Trippen Road Brown, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme-of-Madden Girl Femmes Bottes.

Columbia Wander Plus Jogger, 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-ALPHA INDUSTRIES Blouson - Homme. 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,gracosy Sabots Femmes Cuir-Herschel supply Sac à Dos Nova Small.

Brass Monkeys Haut Thermique - Homme, 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/Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe, 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-Herschel supply Sac à Dos Nova Small, 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,Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7.

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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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