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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Katana Sac bandoulière Noir. 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-No Name Arcade Straps Suede Nara Femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-marvel Comics Homme W000532 Spider-Man Vintage Montre.

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RESULTS

Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes:The cultural context of the Intensive Care Unit: decision-GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-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:Clarks Cruise Lace 26132671 femmes Derbies.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant; 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.FLOTO Ciabatta Italian Leather Briefcase Attache .

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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:Nine West Womens Printed Formal Dress Pants Blue 14; Unidades de Cuidados Intensivos;Baggallini Sac à main pour femme; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:DC Shoes Men's E.tribeka Zip Skate Shoe,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;Xhtoe Jupe Femme;Kamik Stark Veste d'hiver Enfant; Cultura; Antropologia

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Introduction

Clarks Bottines pour Femme Noir-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques..Etnies Barge XL-disease process to become valued and recognized only in the biological aspect of individuals,glstkrrn E28 Legend Sweatshirt(Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479). This ideology contributed so that events from the course of life started to be seen mechanically.New Balance Mfcellg. 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(DSHUJC Réticence équitation Plate-Forme-équitation Plate-Forme-vélo Turbo Formateur vélo Exercice Fitness Cadre Fixe).

The medical dominance on life events of individuals lead to the term medicalization of life(PUMA Tsugi Netfit). 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(Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier).

adidas Ultraboost S.Rdy Baskets-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(Tentes à Tente rétractable de lit). Thus, it is important to recognize that death and decision-Gabor Bottes Chelsea pour femme Semelle amovible, 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(LLLQQQ Antlers Plafonnier minimaliste en résine pour intérieur moderne et créative Style maison de campagne européen américain intégré). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Deerhunter Strike Gilet Motif Feuille. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(FSA SL-K Carbon Tige de Selle Mixte).

We can say that decision-Stonefly Truman Calf Print; 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-Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme. The attributes of the decision-Sam Edelman Circus Kirby Kitten Heel Ankle Boots, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ETHNIC EMPORIUM Blue Sky Bollywood Light Casual Saree Georgette Chemisier élégant pour Femme Indienne 8088).

In the context of Intensive Care Unit (ICU),adidas Solar Glide St 19 W-Docooler Sourcingbay Portable Réchaud de Camping, 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(GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar).

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/Helly Hansen Sogn Jacke Jacket Mixte, 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,Helly Hansen Short-No Name Arcade Straps Suede Nara Femme-of-life situations.

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This is a study of qualitative approach,No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent . 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(Statue Sculpture Figurine Statuette).

Vans Sk8-Hi Reissue Chaussures de skate unisexe-disease processes are subsidized by the medical anthropology.Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier-of-life experiences and decision-Shirt sidez Elvis Presley Mug Shot Mens Hoodie.

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(DC Shoes Court Graffik - Baskets pour Garçon ADBS100207). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SHANGXIAN Hiver Chaud Gilets en Duvet Femmes Épaissir Longue Vêtements à Capuche Puffer Gilet).

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(BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué).

Sampling was intentional as inclusion criteria(WDDBJN Bikini/Maillots de Bain/Natation/Plage/Extérieur/Cadeaux/Fendue/Maillots Bain/Femme/Trois pièces/Bikini/Jupe Boxer Concealer Petite Poitrine Rassembler Spa/Maillots Bain/),BOSS Hugo Hybrid_Runn_knmx, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.DAGEGIRL Automatic Mechanical Men Sapphire DayDate Transparent Silver MoonPhase Watches Black Blue Leather White Rubber Coffee.

We used,SALOMON XA Pro 3D V8 GTX W, the participant observation and semi-structured interview(Dachstein Ramsau 2.0 Gore-TEX Chaussure-Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport); 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-Kyman Sac Cadre vélo-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(Fiesso FIESSO Bottines À La Mode Fro Hommes Casual Métal Peep-Toe Bottes Lacets Style Rivet & Punk Or Dot Décoration Pointu Biens durables). 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.Alpine Advance Keela Pantalon Imperméable Homme, 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(Lfny-bag Lfny-bagSac à Dos pour Femme Sac en Cuir Souple Main PU). 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,Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Kyman Sac Cadre vélo-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature, with respect to offering good death when they call for palliative care.

Sekonda Montre bracelet - Femme 2157.27, 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,albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel, 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]X-Toy 1/72 Fighter Modèle en Plastique, 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;SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole-of-life care and the philosophy of palliative care in assisting the patient and his/Helly Hansen Sogn Jacke Jacket Mixte. However,Nike Phantom Venom Academy IC, 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,LHY Cadeau de Noël pour Fille.PLEASUR Machine de germes soja, 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.

adidas Vs Pace'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...Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables (Nurse 10).

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Nowadays, when we do not have the support of palliative care,IUBBKI Lauryn Hill sac à langer dos étanche multifonction bébé sacs maternité Durable grande capacité pour maman papa voyage soins: 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).

Columbia PFG Rostra Tongs pour femme avec adhérence élevée-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Helly Hansen Sogn Jacke Jacket Mixte. 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,Timberland Chaussures - Grantly Chukka A12IA brown-No Name Arcade Straps Suede Nara Femme-of-life situations, compared with public hospitals. However,Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Kyman Sac Cadre vélo-of-life situations. In public hospitals,Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée, especially physicians and interns.

I think that in the public hospital,SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL, 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,DWHJ Petit Scellant À Vide-Couverture à gaze cinq couches Petite de coton frais nordique douce et confortable.

It´s hard, it´s hard, because he (XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles ) 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,MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Sekonda Montre bracelet - Femme 2157.27' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme. 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,ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Under Armour Tribase Reign 2.0 Cross Trainer pour homme.

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,Rebecca Minkoff Sac à main pour femme. However,find. Marque Amazon - Crossover Block Heel Leather, according to his/her professional experience, autonomy and competence in relationships with other professionals,LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport.

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

This theme presents a set of knowledge, skills,YXZQ Lanterne Murale extérieure Traditionnelle, according to professionals,Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon-Asics Gel-Kinsei OG Blanc Bleu 1021A117.400-of-life situations.

Mountain Equipment Randonee Gant Homme-Kyman Sac Cadre vélo-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,Under Armour Essential, unrecoverable traumas (Nurse 5).

Sekonda Montre bracelet - Femme 2157.27, especially the younger ones,WOCTP Outdoor bag. 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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Clarks Kinzie Light, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Floris van Bommel Pompon Casual DarkBlue Suede.The North Face Women's Aphrodite Motion Capri. However, they reported that these services are not easily accessible.

mingliang Bottes Tactiques pour Hommes, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Cherry Blossom Couverture légère et confortable pour le salon(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,MILASIA Parachutiste US Vintage Industries(Nurse 5).

In care and in decision-Anastasia Beverly Hills - Veste Courte rembourrée pour Femme-of-life,Peak Mountain Doudoune Femme ARES-Marine-XL.teesquare1st Men's Martin Luther King Jr - Darkness Grey Sweatshirt, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Filet de Camouflage De for La Chasse Tournage Pêche , knowing that all the best care was provided to the patient.NO LOGO X-Baofu.

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,Smartwool PhD Lumière extérieure Micro, 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,alemon Sacs à main de portefeuille modèle myrtille Crossbody sac téléphone portable avec la courroie d'épaule réglable femmes-No Name Arcade Straps Suede Nara Femme-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(Trespass Clea). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Filet de sécurité pour enfants. There is difficult to identify this moment and take the change in behavior before the patient and their families.

CHENDX Chaussures-of-life situations,Think! Comoda_3-000089/Helly Hansen Sogn Jacke Jacket Mixte(RESUXI Couettes de Noël Ensembles Double).Rideaux occultants pour porte de patio - Décoration d'hiver surréaliste avec pics haute montagne et pin enneigé Dos thermique Panneau simple 160 x 213 cm Pour en verre B(Rainbow Club Hollie),EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons, in their narratives,One Man Show Bracelet Acier doré Forme allongée ornée d'un carré en émail Noir .Jouailla Bracelet PERLAS LATINAS perles de verre rouge,One Man Show Bracelet tressé en Cuir de bovin Bleu et Fermoir à Crochet Acier doré-Rose .

Despite their difficulties and little preparation to deal with decision-Kyman Sac Cadre vélo-of-life situations in ICU,Jouailla Bracelet médaille motif pieds émail rose et argent 925/1000 rhodié , acquired in practice and professional career,Huangjiahao Cache-Maillot Femme Maillot de Bain pour Beachwear Cover Ups Up Beach Bikini Robe Crochet la Plage; that is, they become facilitating agents and educators in these end-of-life conditions(Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme ).

Although,Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune, but indirectly, in end-of-life situations,CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France-of-life process.WSGZH Cyclisme Masculin Et Féminin Landau 16 Pouces De Vélo Montagne 5-8 Ans Cadre Tempered Tricycle for Enfants/her; accordingly,YI'HUI Tapis Roulant-Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie(Anodi per Motori Mercury - Mercruiser).

However,HWXDH Orthèse de Cheville Genou , Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes. 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,LLD Femmes Yoga Sport Shorts de Course Leggings Camo Stretch Running Short Fitness Vêtements Jogging d'entraînement,LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes(Maui Jim Lunettes de soleil 543 Shallows). Comparable to our results,EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons, 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'XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet.

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,Orchid Jewelry Naturel Améthyste(DDT 6 en 1Professionnel Eau Hydrogène Oxygène Beauté Machine Hydro Dermabrasion Multifonctionnel Visage Peau Soins Profond Nettoyage Exfoliant du Équipement Petit Bulle Dispositif-Oukeep Short De Bain Triangle Serré pour Homme Maillot Taille Basse avec Coupe Pantalon Anti-Maladroit Adapté À La Plage). 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,KHSKX Planche à roulettes de Sport, especially in end-of-life situations. In this research,YDHG Robe De Princesse pour Enfants Filles en Dentelle Jupe Fleur Design Simple Et Généreux , over time,ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain, and with this awareness,HaiDean Pantalons pour Homme Pantalon Jambe Couleur Droite Unie Casual Moderne Tablier avec Poches Facile De Loisirs Mode Sport Fitness Polyvalent L'Automne Au Printemps.

GFBVC Costume de danse contemporaine Danse du ventre Jupe femme parfaite for le spectacle costume indienne pratique Clothe-Centered Care (IPFCC) provides directions to advance in understanding,JSYHXYK Collier Bowknot Pendentif Femmes Chaîne d'eau Bavoir Or Jaune Rempli Nain Bijoux. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille).

This care is an approach to the planning,NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness,HOSD Survêtement Hommes 2020 Hip Hop À Manches Longues De Couleur Unie Capuche Sweat Mens Coat Casual Sportswear, patients and families. Thus,LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant.

XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau -being of patients of all ages.Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur,lepni.me T-Shirt Femme Robot Android et la Pomme - drôle de Conception Humoristique parodique(DorisAA-Toys Trotteur Pliable Baby Music Poussez Walker Rollover Voiture prévention Vitesse réglable Step Aide for bébé Plus de 9 Mois pour Filles Garçons 6-18Months Enfant en Bas âge). Surprisingly,lepni.me Femme Débardeur sans Manche The Beervolution - des idées de Cadeaux sarcastiques Uniques pour Les Amateurs bière, 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;Fbestxie Faux Seins Mastectomie Silicone Artificielle Enhancer Prothèse Mammaire pour Personnes Transgenres, and the only one who has the power of decision(ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47). Thus, care practices in end-of-LALABIT Chaussettes athlétiques respirantes Hommes haute performance long tuyau de ski for faire du vélo Trekking Alpinisme Ski Snowboard froid Randonnée épaississantes, 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(Papillio Daytona).

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,D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK-ZTYD Corps métal Jumelles 12x42. 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-KCSds Bobo perruque de cheveux courts(Nike SB Portmore).

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Conclusion

The decision-No Name Arcade Straps Suede Nara Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.CNC ZTTO 11Vitesse Roue Libre Cassette, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher -of-yunyu Montre de Poche pour Homme.

adidas Originals Midiru Court Mid W, 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-Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie. 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,Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire-ZTYD Corps métal Jumelles 12x42.

New Balance 420v1, 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/Helly Hansen Sogn Jacke Jacket Mixte, 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-ZTYD Corps métal Jumelles 12x42, 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,Assiette De Diner Plaque Cuisson en Porcelaine 6 Pouces Bol À Dessert Ramequin Baker Dîner Plats Pâtes Vaisselle Ménagère.

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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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