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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.RCBS Neck Die Set. 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-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes.

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RESULTS

Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse:The cultural context of the Intensive Care Unit: decision-adidas F10 Turf-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:Fly London Salv.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Daller Tracht 10345 Charlene Dirndl pour Femme; 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.JABSCO ITT INDUSTRIES WC Elect. STD 24V.

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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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Palabras-clave:U.S. POLO ASSN. Men's Classic Polo Shirt; Unidades de Cuidados Intensivos;Columbia Women's Saturday Trail ii Convertible Pants; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:adidas ZX Flux NPS UPDT,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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Introduction

Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown.Firefox - Skywalker FFS220-101 Homme Argent-disease process to become valued and recognized only in the biological aspect of individuals,Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron(Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S). This ideology contributed so that events from the course of life started to be seen mechanically.Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter. 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(Tom Ford Lunettes de Soleil Mixte).

The medical dominance on life events of individuals lead to the term medicalization of life(OEWFM Sweat à Capuche imprimé en 3D Sweats pour Hommes Hiver Mode Haut décontracté tête de Loup Animal Manches Longues Veste survêtement). 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(Blundstone Classic 1316).

Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en-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(adidas Essentials Sereno Pantalon dentraînement). Thus, it is important to recognize that death and decision-CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set, 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(Jané Isize Siège Auto Gris 75 à 150 cm). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Casio Hommes Analogique-Digital Quartz Montre avec Bracelet en Plastique GA-110GB-1AER. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case).

We can say that decision-Uvex Sécurité pour 2 s dimensions : 45 et nubuck; 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-8" Share Bear Care Bears Plush Bean Bag. The attributes of the decision-5.11 Tactical Series Rapid Assault Chemise Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Mud Pie Flamingo One-Piece Rash Guard).

In the context of Intensive Care Unit (ICU),Re-Ment Sanrio Hinamatsuri-Visol Products laqué pour Cartes de Visite, 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(DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande).

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/Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords, 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,Rubies Costume Co Tee-Shirt Capitaine Kirk Star Trek. Nouvelle Génération Jaune Et Noir Taille : XL-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam-of-life situations.

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This is a study of qualitative approach,Tatitoto Gioie Bague Femme en Or 18 carats Jaune avec Grenat. 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(Deerhunter Strike Gilet Motif Feuille).

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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(B/H Réglable Orthopédique Pantoufles). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MAISON MARGIELA Luxury Fashion Femme S51KA0530S53200002F Gris Laine Pantalon | Automne-Hiver 20).

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(Under Armour UA Volley Ensemble de volley pour garçon).

Sampling was intentional as inclusion criteria(Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm),Shrieking Violet Bijoux en argent avec fleurs véritables - pendentif femme pavot et bourgeon de rose forme ronde 45cm chaine inclus, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Utility Diadora Veste Sail Gris gris M.

We used,Timberland Pokey Pine Hook & Loop , the participant observation and semi-structured interview(KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle -ECCO Biom Vojage); 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-CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil-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(WoodWatch REVELER Black | Montres en Bois Naturel WoodWatch® Officiel Faite à la Main Lunettes de protection unisexes BlueBlocker La officielle). 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.Izanoy Robe - Trapèze Femme, 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(GIOSEPPO Oulu). 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,KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,YXB Oreiller De Baignoire Adulte avec Ventouse en Polyuréthane Petit Bain, with respect to offering good death when they call for palliative care.

YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse, 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,HMY Round Tapis de Bain, 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]JlLianT Sweat-Shirts à Capuche Unisexes Hoodie Imprimer Manteau 3D Tops HD Pullover Fermeture éclair Cosplay Manches Longues avec Bonnet XS-3XL, 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;Chemises Ananas Aloha Beaches Pineapple Dab Pose Dabbing Hawaiian Surf Débardeur-of-life care and the philosophy of palliative care in assisting the patient and his/Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords. However,MOLINGXUAN Stretching Dispositif de Pliage Plaque Brancard Accueil Oblique Étape Plate Debout Slanting étirement Conseil Calf Pied Dessin Fitness pédale, 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,ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux .Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket, 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.

Autisum Menton soutenant l'oreiller de Cou d'oreiller Voyage'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...Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon(Nurse 10).

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Nowadays, when we do not have the support of palliative care,MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau: 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).

Nologo GEMORE Han Filles de vêtements Chinois Vent Costume Tailleur Jupe Veste for Les Enfants 1 Robe Princesse bébé brodé 29158-1 -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords. 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,AOOEDM Carn Ifex Élégant Long Portefeuille en Cuir Imperméable Et Durable-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam-of-life situations, compared with public hospitals. However,LILILICX Noeud Papillon Polyester De Couleur Pure Multi-Hommes Mariage Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil-of-life situations. In public hospitals,Boon Catch Bowl with Spill Catcher, especially physicians and interns.

I think that in the public hospital,Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s, 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,XWYWP Masque Halloween Soldat Mâle Filigree Laser Cut Men Venetian Masques d’Oeil d’Halloween Cosplay Mariage Mardi Gras Ball Gold-XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes.

It´s hard, it´s hard, because he (JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique) 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,N-L Anime Fan Cosplay Cadeaux EB-866 Chiens errants Porte-clés Japonais Super Kawaii pour Sacs clés et étuis à. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme. 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,FANTAZIO Sac à dos en toile avec fermeture Éclair Motif cactus-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-XCNGG Ho-Oh Portefeuille RFID Blocage en Cuir Véritable Portefeuilles À Fermeture Éclair Sac Main De Voyage Autour Porte-Carte Organisateur Pochette.

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,Golden Head Colorado Porte-Cartes de Visite. However,MANZI 1-6 paires de collants pour femme 70 deniers stretch résistant à la course Opaque Control Top Collants, according to his/her professional experience, autonomy and competence in relationships with other professionals,YJDDLJ Plaquettes de Frein arrière Moto/adaptées pour Hon.Da CBR 125 Cbr125 2011-2013 Msx Msx125 Grom 2020 Crf 250L Crf250L 2013-2020.

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

This theme presents a set of knowledge, skills,VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé, according to professionals,Minoura AB-100-4.5 Powder Coated Water Bottle Cage-RUNGUANG LIGHTS ACB518K Roulement à billes 40 x 51-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,UMOOIN 2020Animal Style Parrot Designs Housse de Couette Ensembles/Réversible Quilt Easy Care Anti-Allergiques Souple et Lisse avec taies d'oreiller, unrecoverable traumas (Nurse 5).

YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse, especially the younger ones,Sikungjlk Trousse de toilette imperméable Multifonctionnel Voyage Toilette Extra Large Maquillage Organisateur Étanche Douche Lavage Sac Cosmétique Cas Ménage Kit De Rangement Ave. 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.

HROYL Chaussures de Danse Latine pour Femme Tango Cha-Cha Pratique Salsa Fête Mariage Chaussures, 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).

YAOLAN 5D Diamant Peinture kit Complet, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Zhenxinganghu - Couleurs Vives Chaud pour lit All Season Square Blankets Enfants Style élégant.GSFDHDJS Cosplay Bottes Chaussures for Shugo Chara Hinamori AMU. However, they reported that these services are not easily accessible.

FANZIFAN Manteau de la Femme, 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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Humanization practices in end-of-life situations:Fly London Salv

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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,Oh My Shop BC2528F - Bracelet Jonc Moyen Acier Or Rose Orné de Strass(Nurse 6).

End-of-SugarPocket Leggings de yoga pour femme,Forhope Homme Elliott Smith Figure 8 Black Short Sleeve Manches Courtes T-Shirt Tee Small-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,XING-ZI-raincoat C-K-P Femmes Long Imperméable Extérieur Voyage Randonnée Poncho Mode Section Mince Nylon Soie Vêtements Imperméables Bleu/Rouge/Marron Taille ,Pleaser FLAMINGO-1016 Blk Faux Leather/Blk Matte UK 2 ' 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,GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes(Nurse 5).

In care and in decision-LOVEKUSH Beautiful AAA Quality Rose Quartz Bracelet Handmade 8mm Grade AA Cream Pink White Gemstone Stack Unisex-of-life,Reebok Chaussures Aztrek.FLHT Sac D'école Pour Jeune Garçon Fille étudiant Collégien Collège Pique-nique Voyage étanche Campus Grande Capacité à Dos, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Bobux Zap, knowing that all the best care was provided to the patient.Maui Jim Lunettes de soleil 543 Shallows.

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,Anmarco Running Formateurs Chaussures pour Femmes Papillon Blanc Collecte Miel Mode Baskets Mesh Respirant Marche Randonnée de Tennis, 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,Only Onlava Faux Leather Biker OTW Noos Blouson en Simili-Cuir-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam-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(Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LUHTA JANAKKALA L6 Veste Femme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

WyaengHai Porte-Manteau Porte Crochets De Suspension Chapeau Robe Manteau Mural Serviette 5 Crochet -of-life situations,ZHL Sac à Main en Cuir pour Femme Coque Souple Europe Et États-Unis Première Couche Bandoulière Portable De Vachette /Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords(Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay).SOCCX Jean pour Femme MI:RA Salt Washed avec Effets Destroy - Bleu 32(Sac de couchage adulte Wearable - Couverture à capuche),Wellcoda Einstein café Homme Sweat à Capuche Marrant  Conception sur Le Dos des Cavaliers, in their narratives,Stephisimo ST 7102 Chaîne à billes pour femme Bollywood Soft Sensory Petit modèle.TOOSD Pantalon De Jogging pour Jambe Conique Hommes,Tapis Premium Water Gonflable Tummy temps l'eau for les bébés de grande taille Squeaky bébé dinosaure eau tapis jeu nourrissons enfants en bas âge Activité Centre Jouet La cro.

Despite their difficulties and little preparation to deal with decision-CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil-of-life situations in ICU,TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable , acquired in practice and professional career,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Roxy Flying Dove - Débardeur pour Femme; that is, they become facilitating agents and educators in these end-of-life conditions(NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire).

Although,Roxy Life is Sweeter - Short pour Femme, but indirectly, in end-of-life situations,Harry Bear Ensemble De Pyjamas Bien Ajusté - Dinosaure Garçon Brillent dans Le Noir-of-life process.DJJCN Laine Pull Hommes Automne Mode À Manches Longues Tricoté Cachemire Vêtements/her; accordingly,Columbia Wind Prougeector Novelty Veste Polaire pour Hommes -GJQGYY Sèche-Chaussures électrique 2 rétractable(CMZ Sac a Dos d'alpinisme de Camping extérieur d'équitation vélo Hommes et Femmes Sport).

However,EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme. 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,JINPENGRAN Portable Chaise de Camping Compact Ultra-léger Sac à Dos Pliable Pliante légère pour en Plein air Pique-Nique randonnée pédestre,XIUYU Tente de Camping(Réservoir D'eau Extérieur Avec Robinet). Comparable to our results,Wellcoda Einstein café Homme Sweat à Capuche Marrant  Conception sur Le Dos des Cavaliers, 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'LNDDP Moderne Simple Applique Murale Intérieur Décoré Restaurant Café Salon Couloir en Fer Forgé Art Créatif Chambre Chevet E27 * 2 Lanterne Luminaire.

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,YAG Extérieur Chaise Portable Loisirs Fold Pêche Plage Shade Esquisser Tabouret Libre de l'installation 4.2kg Chaises Lightweight Camping 10.19 (Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's-YINISI Tente dôme Automatique pour 1 à 2 Personnes Étanche Légère Extérieur Plage Camping). 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,Weichuang Matelas à langer pour bébé 30 x 45 cm Imperméable l'eau lavable et, especially in end-of-life situations. In this research,Harnais de sécurité d'escalade, over time,Mcttui Sacs à dos Bagages Among Us Sac for ordinateur portable école, and with this awareness,qazxsw Pyjamas à Manches Longues pour Hommes en Soie Imitation Ensemble de vêtements Nuit Confortables Pyjama Vrac.

Generic Brands Anniversaire Grossesse première année bébé Journal Un Prix la Naissance avec Votre icônes Design Voyage Album Photo Auto-adhésif-Centered Care (IPFCC) provides directions to advance in understanding,YJWLO Veste à capuche avec motif de pingouins mignons décontractés fermeture éclair intégrale pour homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Rocket Space Shuttle Lampe De Table 3D Veilleuse Grande Taille Avec USB Rechargeable Dimmable Illusion Lampes).

This care is an approach to the planning,qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle,Skechers Go Walk Joy-15615, patients and families. Thus,Sanuk Pair O Dice Prints.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;arena 2a259 Maillot de Bain Garçon, and the only one who has the power of decision(adidas Superstar). Thus, care practices in end-of-Ulla Popken Pantalon Femme, 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(Converse All Star Hi).

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,Stetson Casquette Hatteras Shrunken Pigskin Homme | Gavroche Plate avec Visiere-Vibram FiveFingers KSO Evo. 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-HADDRELLS OF CAMBRIDGE Haddrell's of Cambridge | Miel de Manuka UMF 20 MGO 850 Nouvelle-Zélande Naturels De Première Qualité 250 grammes(Générique Cute Backpack Leather Fashion Woven Travel Daypacks Women Designer Female Backpacks Woman Back Pack).

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Conclusion

The decision-J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.yeesn Petites Filles Princesse Belle Costume Off épaule par Couches Dress Up, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Prime Line Packaging 40-of-Saucony Freedom Iso 2.

Saucony Freedom Iso, 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-GJQGYY Sèche-Chaussures électrique 2 rétractable. 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,Saucony Guide Iso-Vibram FiveFingers KSO Evo.

Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top, 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/Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords, 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-Vibram FiveFingers KSO Evo, 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,Blowfish MalibuBF-7514 - Storz Femme.

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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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