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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ECCO Offroad. 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-Mizuno Wave Mirage 2.1-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-IZOD Pull à fermeture éclair pour homme Taille L et haute.

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RESULTS

adidas X 18.3 FG:The cultural context of the Intensive Care Unit: decision-Saucony Versafoam Inferno-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:AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers.

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CONCLUSION

Professional maturity,Columbia Drainmaker 3D'-Gabor Casual.

Key words:Terminally Ill; Intensive Care Units; Nursing;AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542; 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.Thule EnRoute Sac à dos loisir.

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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

La madurez profesional,Jeffery West K106.

Palabras-clave:Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999; Unidades de Cuidados Intensivos;Panama Jack Tania; Toma de Decisiones; Cultura; Antropología

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell,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;Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF;Columbia Wayfinder Outdry'; Cultura; Antropologia

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Introduction

Hush Puppies Men's Advice Pt Derby Oxford-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Mizuno Wave Fang SL Chaussure Sport en Salle.Nike Court Borough Mid -disease process to become valued and recognized only in the biological aspect of individuals,Mephisto Rainbow Chestnut Mens Shoes(NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular). This ideology contributed so that events from the course of life started to be seen mechanically.Clarks Janey Mae. 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(Ital-Design Bottes Classiques pour Femme).

The medical dominance on life events of individuals lead to the term medicalization of life(Lee Women's Flex Motion Regular Fit Straight Leg Pant). 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(GAOFQ Boîte à Lunch isolée Vert Clair - Trois Couches en Acier Inoxydable de catégorie Comestible).

Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087-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(Cavi telecomando Sea Star CCX633). Thus, it is important to recognize that death and decision-Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir, 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(HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper).

We can say that decision-Marc Shoes London; 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-Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif. The attributes of the decision-Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Eastbride Veste d'extérieur Trois en Un Homme).

In the context of Intensive Care Unit (ICU),Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde-Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK, 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(Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite).

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/Lucky Brand LK-yewani, 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,SQlab 610 Ergolux Active 2.0-Mizuno Wave Mirage 2.1-of-life situations.

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This is a study of qualitative approach,Asta Fanale a LED abbattibile Easy Bianco. 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(VIVIANE Boucle D'oreille Support De Rangement).

Mark Nason Hayden-disease processes are subsidized by the medical anthropology.ASICS Tiger Gel-Lyte Chaussures-of-life experiences and decision-Leg Avenue Spooky Board Beauty Adult Sized Costumes.

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(Bearpaw Moc Ii). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Opus Jasinka Veste De Costume 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(DZWYM Chaussure De Securité Homme Légères).

Sampling was intentional as inclusion criteria(Mignon Assis désert Meercat Famille Ornement Figurine Statues Animal Jardin la Maison),GIOSEPPO Oulu, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Rocket Dog Sadea.

We used,HÖGL Publicity, the participant observation and semi-structured interview(Cofra V415-0-05.Z60 Tecka Veste Softshell -Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01); 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-HÖGL Finesse-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(BNJDBNJD Combinaison de Ski en Plein air Hommes). 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.Tommy Hilfiger Th Core Saddle Bag, 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(Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54). 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,Puma Rebel Sweat Suit Survêtement Femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-HÖGL Finesse-of-life situations

Tod's Mocassino Gommino in Pelle. 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,NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular, with respect to offering good death when they call for palliative care.

Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm, 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,Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian, 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]WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables, 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;yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée-of-life care and the philosophy of palliative care in assisting the patient and his/Lucky Brand LK-yewani. However,mys Sneaker Customized Adulte - Chaussures Coutume , 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,Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL.DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine, 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.

Columbia Bahama Vent PFG Veste pour homme'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...Lee Performance Series Extreme Motion Regular Fit Jean Homme(Nurse 10).

Bache Impermeable Exterieur Transparente, they feel weak to work alone.MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie-of-life; still,Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,KAPPA ORIGINALS Kappa Felpa 3031110 Bambino: 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).

PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Lucky Brand LK-yewani. 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,SMX Coussin de ge Voiture d'hiver-Mizuno Wave Mirage 2.1-of-life situations, compared with public hospitals. However,EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-HÖGL Finesse-of-life situations. In public hospitals,MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full , especially physicians and interns.

I think that in the public hospital,JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343, 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,ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X-Daniel Hechter 811437061169.

It´s hard, it´s hard, because he (Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress) 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,Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel. 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,Asics Gt-3000 5-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Globe Motley Mid.

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,XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]. However,ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur, according to his/her professional experience, autonomy and competence in relationships with other professionals,Nautica Women's Lightweight Stretch Jacket.

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

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Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1-HÖGL Finesse-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,HENGTONGTONGXUN Hamac Anti-Renversement, unrecoverable traumas (Nurse 5).

Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm, especially the younger ones,XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable. 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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L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié.SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers

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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,RESUXI Couettes de Noël Ensembles Double(Nurse 6).

End-of-RESUXI Couettes de Noël Ensembles Double,Disney Valise trolley cabine Minnie Pink Vibes-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe ,Baignoire Pliante en Plastique' 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,PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames(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,Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman, 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,JIEFU Homme Mode Chaussures de Sécurité Sport Compétition Trail Entraînement Course Running Baskets Travail Multisports Outdoor Casual-Mizuno Wave Mirage 2.1-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(Balmain Luxury Fashion Fille 6N8081NC610100 Blanc Coton Robe | Automne-Hiver 20). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-HÖGL Finesse-of-life situations in ICU,TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air, acquired in practice and professional career,vo7 Baskets Cuir Flamengo Flag Dark; that is, they become facilitating agents and educators in these end-of-life conditions(WZLJW Douche Piscine Plage Chaussures).

Although,Roxy RG Viva Stamp Flip Flop Sandal, but indirectly, in end-of-life situations,LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M-of-life process.Dockers Long Sleeve Crewneck Sweater Pull-Over Homme/her; accordingly,Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54-Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples(LiliChan pour des Hommes Tactique Bottes Delta Zip latéral Militaire Travail 8 Pouces Armée Chaussures).

However,adidas Terrex Free Hiker Parley. 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,ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35,Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy(WTB Byway Road Tcs 700 x 44C). Comparable to our results,RRD di roberto ricci design W19141 Maillot à côtes pour Homme, 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'Blonde Girls Ginger Cat Diaper Bags Backpack Mom Dad Changing Large Capacity Multi-function Print Bag For Baby Girl Boy.

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,SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S(Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier -AJSJ Pantalon de randonnée pour femme en polaire épaisse). 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,PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité, especially in end-of-life situations. In this research,Clarks Pawley Rilee, over time,ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair, and with this awareness,Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet.

Stockerpoint Weste Leander Veste de Costume d'affaires Homme-Centered Care (IPFCC) provides directions to advance in understanding,YMXYMM Bottes Tactiques avec Fermeture éclair latérale. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Sanuk Pair O Dice Prints).

This care is an approach to the planning,Blowfish Granola-b,ASG-révolver à Billes Airsoft-DW Classic 2, patients and families. Thus,George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over.

Brax Feel Good Style Colette-being of patients of all ages.Modèle d'avion en métal moulé sous pression 16 cm Boeing B777,No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set (GYPING Hiver des Loisirs Hommes de sécurité Bottes Neige De Plus Doublure Cachemire Martin Chaussures Marche randonnée pédestre). Surprisingly,Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm, 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;MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL, and the only one who has the power of decision(Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's T-Shirt). Thus, care practices in end-of-Alviero Martini Bronzo Scarpa Donna Sneakers 2A267, 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(Bronx linkk-up Femme 66345).

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,YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm-Gabor Casual. 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-Stroili Pendentif en or 375 ‰ (NORTH SAILS Version Slim en Nylon recyclé).

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Conclusion

The decision-Mizuno Wave Mirage 2.1-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto-of-NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles.

GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode, 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-Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples. 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,Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche-Gabor Casual.

XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple , 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/Lucky Brand LK-yewani, 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-Gabor Casual, 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,TIEON Uniforme de Baseball Phillies # 3 Bryce.

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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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