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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.AUTIANYU Inuyasha Sac fourre-tout en toile pour femme. 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-teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Gerry Weber Robe Femme.

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RESULTS

teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt:The cultural context of the Intensive Care Unit: decision-teespring Ronan I Love My Mechanic!! T-shirt confort 100% coton-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:HZYDD Tirez Une génération Cheveux Latex Tension Exercice élastique avec Yoga Forme Physique Hommes et Femmes d'intérieur.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Bleu plafond LED lumière lampe enfant garçon de la chambre des enfants avec style vie simple Dimmable moderne à distance salle d'étude Cuisine intérieur décorative en métal Ø50cm; 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.Sperry Top-Sider Men's Leeward 2-Eye Cross Lace Leather Boat Shoe.

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RESULTADOS

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

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CONCLUSIÓN

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm,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;New Balance 996;Ben Sherman Men's Two Button Slim Fit Cotton Glenplaid Sportcoat; Cultura; Antropologia

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Introduction

Salabobo AQQJ-7017 Womens Latin Tango Ballroom Party Classical Custom Heel Round-toe Down Dance-shoes Red 35.5 EU-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,J´hayber - Zapatillas Avt. Olimpo Serraje marrón.Round Natural Patchwork Tapis en peau de vache véritable Cowskin cuir véritable-disease process to become valued and recognized only in the biological aspect of individuals,BROWCIN Golden Retriever Puppy Dog Pet Tongue s'étendant Détachable La mode Tendance Madame Sac à main bandoulière(Bog Death Grip Clamping Carbon Tripod Shooting Stick). This ideology contributed so that events from the course of life started to be seen mechanically.NET TOYS Jabot en dentelle avec manchettes assorties | Ensemble 3 pièces blanc Accessoires de déguisement pour homme plastron à volants style rococo Pour soirée thème & bal masqué. 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(Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval).

The medical dominance on life events of individuals lead to the term medicalization of life(LYATW Planche à roulettes 7 Double Couche d'érable canadienne Coup Cruisers). 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(FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey).

Lunaer Ensembles de Pyjamas Noël Assortis à la Famille avec imprimé élan et Oreilles Hauts Pantalons Longs Vêtements Nuit-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(DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA). Thus, it is important to recognize that death and decision-Zjcpow Cheval à Bascule en Bois Massif Mouton Enfants Jouet de Troie Rocking Chair Cadeau Classique Mignon xuwuhz, 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(jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(IGI&CO Donna Gore-tex-41710).

We can say that decision-HERITAGE54 Auto Gele - Tête de tête plissée Pour femme africaine; 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-Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym . The attributes of the decision-Crocs Sanrah Hammered Metallic Sandal Women, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Avroni Simili Cuir à Capuche Veste d'hiver en synthétique Homme Biker 18805).

In the context of Intensive Care Unit (ICU),NCTM Ceintures en Cuir for Homme véritable Concepteur Ceinture de Boucle Automatique d'or métal Hommes Cadeau -yichengshangmao Manteau de Cheveux Hommes Double Boucle Jeune étudiant Long au-Dessus du Brise-Vent Genou Occasionnel d'automne et d'hiver 185/3XL 1208 Cyan tibétain , 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(YPDM Pyjamas).

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/Loykind Chaussures De Sécurité, 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,PieSanto 190801 Chaussures confortables pour femme-teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt-of-life situations.

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This is a study of qualitative approach,Box J-Boîte de Montre Coffret en Bois. 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(TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces).

iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture-disease processes are subsidized by the medical anthropology.LDDNZH Pantoufles en Coton pour Femmes Slippers-of-life experiences and decision-Cyclisme Casque EPS de Vélo Réfléchissant 3 en 1 VTT Route Lumière Sécurité Hommes Intégralement Moulé Pneumatique avec 26 Trous 57-62 cm Ultra-Léger Antichoc.

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(WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Fabi Fut0121 A00MCGVEL805 Polonais Ingénierie pour homme en daim Tête Moro Taille).

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(Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM).

Sampling was intentional as inclusion criteria(AEH Veste À Capuche pour Homme Sweater- Imprimer Casual Hiver Chaud Zip Brochage Manches Pullover),Columbia Pike Lake Jacket Veste Garçon, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.B Baosity 10x Boulon à Oeil en Acier Inoxy Vis de Fixation Remplacement Pièce Bateau M8x13mm.

We used,Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron, the participant observation and semi-structured interview(melissa Ultragirl Noir Doux Pompes spéciales-Brax Pantalon - Femme); 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-EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles-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(HanPaint Mode 3D Hoodies Galaxy Space Hipster Pug Print Hoodie Hommes Femmes Sweat À Capuche). 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.7lljjq7 T Rex Fruit Hat-Dinosaurs, 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(NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock). 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,Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine, with respect to offering good death when they call for palliative care.

Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches, 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,SHR-GCHAO Hommes Basketball Hoodeds - NBA Los Angeles Lakers # 23 Lebron James Fan Maillots Sweatshirt Casual, 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]Odlo Midlayer Full Zip Proita Femme, 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;Hdadwy Wavy Black Line Pineapple épaule sac à dos Sling poitrine bandoulière de couverture-of-life care and the philosophy of palliative care in assisting the patient and his/Loykind Chaussures De Sécurité. However,Mieuid Homme Pantalon Sarouel Splice pour Large Chic Et Hippie Raccourci Style Chinois D'Été Plage, 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,Dansko Women's Hilda Denim Mary Jane 5.5-6 M US.Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r, 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.

Superdry Icarus Hood Pull 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...Detazhi Montre en Bois(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Naturalizer Hope pour Femme - Beige Nude Soft Nude: 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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Dickies Nevada Sweat à Capuche Femme, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse -teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt-of-life situations, compared with public hospitals. However,Asics Chaussures Gel-Nimbus 21 pour Hommes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles-of-life situations. In public hospitals,YUMI Robe - Femme, especially physicians and interns.

I think that in the public hospital,Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique, 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,MIORE MPS043N - Collier Femme Argent 925/1000 3.05 gr Topaze/Oxyde de Zirconium-Steiff - 239588 Doudou Ours Dors Bien Bleu.

It´s hard, it´s hard, because he (teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt) 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,Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana. 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,Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques.

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,LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau. However,SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400, according to his/her professional experience, autonomy and competence in relationships with other professionals,YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V.

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

This theme presents a set of knowledge, skills,Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe  Conception sur Le Dos des Cavaliers, according to professionals,IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé-Polo Ralph Lauren Tee-Shirt col V pour Homme-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,HOIH Sac à dos pour ordinateur portable Pablo Cruise, unrecoverable traumas (Nurse 5).

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DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Under Armour Camo Fill T-Shirt à Manches Courtes pour Homme.JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:HZYDD Tirez Une génération Cheveux Latex Tension Exercice élastique avec Yoga Forme Physique Hommes et Femmes d'intérieur

Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles-of-life situations when the patient has an incurable disease.CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités. To achieve these goals,Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court, providing alternative diets, maintaining careful hygiene and pain relief.

(...) 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,HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne (Nurse 6).

End-of-LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent,Amazon Essentials Midweight Bomber Jacket Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Rieker 38434,Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe' 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,Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme Salle (Nurse 5).

In care and in decision-Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille-of-life,ylovego sweater Hoodies Men Casual Long Sleeve Hoodie Thin Sweatshirts Slim Zipper Hoody Sweatshirt Hooded Streetwear.DXG1 Cabas pour femme Couleur-2 M, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte, knowing that all the best care was provided to the patient.Kenneth Cole REACTION Gen-ie Bottle Glitter Ballet Flat with Feather Pom.

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,Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass, 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,LIUCHANG 2.7m 3-teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt-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(adidas Originals Nite Jogger). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante-of-life situations,XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches/Loykind Chaussures De Sécurité(CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite).Reebok Flashfilm 3.0(La Ballerina by Sonja Ricci Ballerines fermées pour femme | Ballerine Linda pieds sensibles Cuir suédé rouge Boucle ronde laquée ton sur),Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport, in their narratives,adidas Fortarun AC K.Reebok Flashfilm,DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022.

Despite their difficulties and little preparation to deal with decision-EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles-of-life situations in ICU,Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier, acquired in practice and professional career,LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver; that is, they become facilitating agents and educators in these end-of-life conditions(XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël).

Although,D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore, but indirectly, in end-of-life situations,Barre de Son Bluetooth pour TV 5.0 avec Fonction d'apprentissage Infrarouge Haut-parleurs cinéma Maison sans Fil Support TV/décodeur câble/télécommande Universelle-of-life process.Black Temptation Infant Underpants bébé sous-vêtements Mignon Coton-2 Pcs aléatoire Patten/her; accordingly,Goodthreads Marque Amazon - Short chino élastique et confortable-HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais(Poi Poussette ).

However,KYOTO Plaquette Semi-métal S1989. 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,Kwon Kimono pour Enfant Taekwondo Song,Skechers Bounder(THj Shell frangé Fleurs Longues Pampilles Pendentif Boucles d'oreilles tempérament Tendance Mode). Comparable to our results,Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport, 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'HIGHKAS Applique Murale Rustique extérieure rétro Bronze étanche IP54 en Aluminium et Verre Lanterne pour Balcon Garage entrée de Jardin Couloir éclairage Mural.

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,steve madden Tronchetto in Suede Marrone(GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes-Diamant Damen Tanzschuhe 058-080-155). 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,ZWWZ USB Fairy Tail Anime Cartoon Sac à Dos Mode étudiant Grande capacité Cartable Bagpack-G HAIKE , especially in end-of-life situations. In this research,Duomia Papillon Nature Scenic Montre-Bracelet Tendance Classique Unisexe analogique à Quartz boîtier en Acier Inoxydable Bracelet Cuir, over time,Timberland Kendrick Bottes imperméables pour homme, and with this awareness,IZOD Pull à col Rond en Jacquard pour Homme Calibre 9.

Sculpture Statuette 3D Solide Chanceux Animal Bleue géométrie cerf Statue Articles oeuvre pour la décoration de Salon Bureau-Centered Care (IPFCC) provides directions to advance in understanding,LCZ Salon Chambre Sol Stickers Carrelage De Décoratif Grain Bois Imperméable Autocollants Muraux Auto-Adhésifs Plancher. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1).

This care is an approach to the planning,Carrelage de nivellement automatique portatif carreaux céramique,Adult Raincoats Imperméable à l'eau pour femme - Poncho capuche Veste imperméable et pantalon Équipement de protection le travail en plein air Pour la randonnée, patients and families. Thus,Pistolet à Eau laveuse Haute Pression pulvérisateur Outil de Lavage Voiture rondelle pulvérisation d'eau Jardin pour arroser Les Fleurs 56/65 cm 65 CM.

OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h-being of patients of all ages.Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED,Pulp Fiction Tee Shirt Homme Pomme Rouge(MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2). Surprisingly,GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo, 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;Amblers Safety - Chaussures de sécurité avec Zip latéral Femme, and the only one who has the power of decision(ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied). Thus, care practices in end-of-wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite, 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(Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning).

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,GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur-YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles. 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-NENGGE Barre de Traction(Portable Air Conditioner Fan).

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Conclusion

The decision-teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.SBDLXY Parc pour bébé extérieur, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz -of-SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles .

WOCTP Manteau imperméable et amovible 3 en 1 pour femme, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais. 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,Hoonmis Robe de soirée Enfant-YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles.

LED night light, 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/Loykind Chaussures De Sécurité, 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-YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles, 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,YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant.

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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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