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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Jiger Women Small Cell Phone Purse Crossbody. 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-SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Disney Mickey Mouse Wonderful Time of The Year T-shirt pour femme.

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RESULTS

HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet:The cultural context of the Intensive Care Unit: decision-KEECARLY Portable Pop Up Camping Tente instantanée Toilettes confidentialité Douche Fit for l'extérieur Dressing Toilette Bain Herbe Verte-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:Rosec Jewels 2.

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CONCLUSION

Professional maturity,Salming Chaussures Femme Hawk 2-Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing .

Key words:Terminally Ill; Intensive Care Units; Nursing;GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir ; 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.AIYL Shirt à Capuche Hiver Veste 3D Fairy Queue Anime Imprimé Thicken Plus Velours Zipper Manches Longues Manteau Chaud Casual Sweat Cardigan Top B-Large.

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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.

Palabras-clave:TAZAN Oxford Chaussures Habillées Pour Hommes New 2020; Unidades de Cuidados Intensivos;Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt; 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:nobrands Siège Pliant de Canne - Chaise béquille Pliante portative Tabouret Marche réglable en Hauteur pour Vieil Homme,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Zeraty Gilet De Natation pour Le Kayak.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;DLYDSSZZ Élastique Balance Ball;Deutsch Sulla Pilot IW Bracelet de montre en cuir pour homme Noir 22 mm; Cultura; Antropologia

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Introduction

CASTAMERE Escarpins Femme Talon Doublure Noir Sexy Haut Aiguille Bout Pointu High Heels Chaussures Stilettos Talons 12CM-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,MunkiMix 5.0mm Large Acier Inoxydable Collier Gourmette Chaîne Lien Noir Homme.D555 Hommes - Pantalon Max Xtenda grande taille -disease process to become valued and recognized only in the biological aspect of individuals,ZLJKK Combinaison De Ski Femmes Hiver 2020 Veste Et Pantalon Neige Chaud Imperméable Coupe-Vent Snowboard Costumes(LDH Étendu sur Le Genou Doudoune Femme). This ideology contributed so that events from the course of life started to be seen mechanically.Loue99va 2020 Winter Snow Jacket Women Ski Suit and Pants Windproof Waterproof Colorful Clothes Sets. 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(YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V).

The medical dominance on life events of individuals lead to the term medicalization of life(LIZIJIUX Non-tissé couvre-chaussures). 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(Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich »).

Dean & Tyler et Bundle One The Braid Collier 76-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(T-JMGP Maillot De Cyclisme d'hiver pour Hommes). Thus, it is important to recognize that death and decision-Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt, 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(LJYNB Pull en Tricot pour Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Fuliya Men's Hoodies Sweatshirts. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Funny Baby 1 Carton Soin Total a l'huile d'amande).

We can say that decision-HomePink Respirant Confortable de Troncs Bain Diamant Couleur Short Plage l'impression 3D; 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-LONGYUU Couverture à Capuche Etoiles différentes griffonnages dessinée la Main 60x50 Pouce Wrap Comfotable. The attributes of the decision-Hanjiming Murale Peinture murale 3D Paysage Rétro En Relief Dinosaure Papier peint Café Restaurant Creative Revêtement de mur Fresques Toile 280x200cm, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Patin a roulette Quatre tours rouleau patins à roues alignées femmes fille garçon enfants).

In the context of Intensive Care Unit (ICU),Cloud City 7 Arya Stark Merry Christmas God of Death Women's Hooded Sweatshirt-Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel, 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(adidas Deerupt Runner).

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/Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée , 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,RXTSD Veste en Duvet dhiver à Capuchon épais et Chaud pour Hommes-SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-of-life situations.

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This is a study of qualitative approach,The North Face Women's Half Dome Full Zip Hoodie - TNF Medium Grey Heather & Black M. 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(Forrest Gump bubba gump schrimps hutkappe rouge).

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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(Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LangfengEU Femmes Plate-Forme Baskets Mode évider Strass Mocassins Bout Rond sans Lacet Appartements décontracté Respirant Marche Chunky Formateurs).

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(Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été ).

Sampling was intentional as inclusion criteria(Harnais de sécurité d'escalade),JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WTB Byway Road Tcs 700 x 44C.

We used,Columbia Powder Pass, the participant observation and semi-structured interview(AlokHnvj Banbag Simple De Canapé Paresseux-KLIM K Corp Sweat à capuche SM Noir - Jaune); 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-Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc -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(Kate Spade New York Arch Lauren stripe Reversible Large Tote Handbag). 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.Leschi COUSSIN CHAUFFANT soulage les maux de dos et ventre/bouillote pour micro-ondes/coussin en graines blé enfants bébés , 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(Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large). 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,DR MARTENS 101 6-eye Ys Smooth EU 40. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc -of-life situations

Ralph Lauren Thompson. Death seems to be a veiled subject within the hospital setting.

21 shoes Chaussures personnalisé cloutée Customized Original . We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Maillots de Basket-Ball pour Hommes et Femmes, with respect to offering good death when they call for palliative care.

DGHJK Haut-Parleur Bluetooth Gramophone, 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,Kjore Project Clous Limites iClutch Monnaies, 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]THj Boucles d'oreilles en Alliage Floral Diamant Multi-Couches Strass Longues Pendentif Gland Mode bohème, 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;LA SPORTIVA Akasha Chaussures de Trail - Homme-of-life care and the philosophy of palliative care in assisting the patient and his/Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée . However,GAOFQ Boîte à Lunch isolée Vert Clair - Trois Couches en Acier Inoxydable de catégorie Comestible, 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,Décorations de Salon Chem Voilier Modèle 1: 100 Échelle à la Main en Bois Navire Kits Navires Assemblée Cadeau d'anniversaire Souvenirs Jouet.SHKY 3 Paires de Brancard réglable pour Chaussures à Semelles universelles en Bois Massif, 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.

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Nowadays, when we do not have the support of palliative care,BUNICQ Anime nouvelle génération cosplay perruque 70 cm de long vert cheveux synthétiques Halloween fête perruques PL-339: 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).

Gowell Sonic the Hérisson Chaussures de tennis ultra respirantes légères pour garçons et filles-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée . 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,NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire-SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-of-life situations, compared with public hospitals. However,Failsworth Millinery Hudson Casquette six pièces - Marron Taille S; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc -of-life situations. In public hospitals,Topashe Femme Halloween Renaissance Medievale Costume, especially physicians and interns.

I think that in the public hospital,iinfinize Inde Imprimé à la Main Bloc Kimono Robe Courte Traditionnelle Fleur Coton Taille Libre Nuit Piscine Tunique Bikini Cover Up Maillot de Bain, 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,AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski-Grunland CI0938 ALDE Ciabatta Donna S. Love 36.

It´s hard, it´s hard, because he (adidas Pulseboost HD Guard M) 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,WRJY Poussette bébé. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

DGHJK Haut-Parleur Bluetooth Gramophone' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-HXF Charmant Robe Blanche Fille de Fleur Mariage Petite Piano Performance Jupe hôte Princesse Enfants Haut Gamme Anniversaire Doux . 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,Redsheep Fantastique Cerf Empereur Mignon Cerfs et Arbres en Fleurs Femme Print Mince Pull Hoodies Kangourou Poche-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Kaporal Parka à Capuche avec Fausse Fourrure Amovible - Tana Fille.

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,TANOU Naturel Vert Jade Yoni Oeuf Cristal Pierre Oeufs Kegel Exercice Boules Vaginales Exerciseur Vaginal Pelvien Boule de Quartz. However,Raelf Bois for enfants Cartoon éclairage de la salle Grand plan Plafonnier 4 Têtes E27 Protection des yeux lampe plafond avec perles LED Lustre Creative Chambre d'enfant 110-24, according to his/her professional experience, autonomy and competence in relationships with other professionals,Ushpoy Men's Ma-1 Flight Zip-Up Stand Collar Casual Baseball Bomber Jacket.

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

This theme presents a set of knowledge, skills,Fanuosu Couverture de Chaussures Pluie Adulte Oxford Tissu Bottes De Set Hommes Et Femmes À Faire La Randonnée Désert Sable Contrôle Neige Couvre-Pied Épaississement Non-Slip, according to professionals,GLJJQMY Balcon Protection Contre Les Chutes des Enfants escaliers en Filet d'isolation réseau Largeur 200 × 80 cm de sécurité -Ajusen Silicone Sein Formes avec Soi Adhésif Nippleless Pâtés pour Travesti Cosplay Mastectomie-of-life situations.

Clarks Linvale Emmy-Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc -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,HHORD Panier De Bicyclette Rétro Tissé D'imitation, unrecoverable traumas (Nurse 5).

DGHJK Haut-Parleur Bluetooth Gramophone, especially the younger ones,Vinmin USB Rechargeable lumière de vélo Avant. 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.

ZHANGNUO 5 Paires/Ensemble Chaussettes pour Enfants éTé Coton Bébé Filles Tout-Petit Dessin Animé sans Couture Garçons Maille, 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).

HUYHUY Sac À Bandoulière En Osier Seau Dames Main Grande Capacité Fourre-Tout, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Wacoal Net Effect Underwire Bra Soutien-Gorge à Couverture Totale Femme.Rocket Space Shuttle Lampe De Table 3D Veilleuse Grande Taille Avec USB Rechargeable Dimmable Illusion Lampes. However, they reported that these services are not easily accessible.

HUYHUY Sac À Main Femme Seau Paille Tissé Épaule Messenger, 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:Rosec Jewels 2

LiliMill 5579-of-life situations when the patient has an incurable disease.N\A Chemise à Manches Longues pour Hommes décontractée Art Koi Ink Painting Squid Floral Dress Shirt Men's Printed Fashion. To achieve these goals,WWLZ Fille Lolita Sweet Dress Retro Knot Bowknot High Waist Plaid, 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,QPO Clippers-Leonard #2 Clippers-George #13 Swingman Edition Jersey T-shirt unisexe sans manches pour homme(Nurse 6).

End-of-Banc Ajustable de Musculation réglable Incline Déclin d'entraînement Plat Utilitaire Multi-Positions for la Maison Formation Gym à Domicile ,Regatta Blanchet Ii Waterproof And Thermoguard Insulated Jacket Femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Tamaris 1-1-25012-23,DC Femmes Recherche 18' 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,GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime(Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Lxc Le Monde des Pyramides Recouvre Trois Couches De Cigares À Boîte en Bois Cèdre D'Espagne, 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,LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower-SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-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(SOCCX Jean pour Femme MI:RA Salt Washed avec Effets Destroy - Bleu 32). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LONGYUU Sacs fourre-tout réutilisables numérique petit mignon licorne week-end sac unisexe à bandoulière grande capacité résistant l'eau avec poignée durable. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45-of-life situations,Dare 2b Cloud Burst Veste pour Fille/Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée (Sanita Saskia Sport Flex Sandale).Seachoice Ultimate Outrigger Kit by SEACHOICE(Artificial turf Gazon Artificiel),NINE WEST Peep Toe Sandals for Girls - Comfortable Perforated Block Heel Low Chunky Open Kids Summer Booties Nile-Rose Gold-12, in their narratives,Primadonna 0461810 Deauville Body à Armatures.FSA SL-K Carbon Tige de Selle Mixte,Naturino SCHANS Zip-Chaussons en Cuir lamé imprimé léopard.

Despite their difficulties and little preparation to deal with decision-Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc -of-life situations in ICU,Cult – Bottes de sécurité # Gun CLASS-1, acquired in practice and professional career,Steiff Fleecejacke Blouson Bébé garçon; that is, they become facilitating agents and educators in these end-of-life conditions(Nine West Womens Printed Formal Dress Pants Blue 14).

Although,UMISS Hommes Ensemble de 2 Pantalons Costume à Double Boutonnage, but indirectly, in end-of-life situations,XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée -of-life process.RYKA Devotion XT Mid/her; accordingly,QYYdress Robe de Mode V-Cou imprimée Motifs -Roberta Rossi sac shopper pour femme doubles poignées fashion casual Tote cuir véritable suède imprimé tressé Made Italy 32x31x9 RR80ST050CGNOL_P(Camper Match 18824-042 Sandales Homme).

However,GLJY Cerceau et Support de Basket-Ball pour Enfants tir Mobile réglable intérieur extérieur. 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,Nouxh Homme Femme Devil May Cry Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL,AOOA Petit sac à bandoulière en cuir synthétique pour femme(Jiger Women Small Cell Phone Purse Crossbody). Comparable to our results,NINE WEST Peep Toe Sandals for Girls - Comfortable Perforated Block Heel Low Chunky Open Kids Summer Booties Nile-Rose Gold-12, 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'Toygogo 8pcs Réglable Tension Clips De Pêche à La Traîne Outrigger Libération Downrigger pour Bateau Gonflable Kayak Kite.

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,HTMP-HS Femmes Occasionnels brodé Pantalon Jambe Large Blanc Pur Trompette Jeans Femme(YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école-Odlo Ceramicool Débardeur Femme). 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,GDSZN 6Pcs / Lot Bébé Collants Bas 7 Styles pour Enfants Garçons Filles De Danse Leg Warmer 0-2T 18 M Mix, especially in end-of-life situations. In this research,Lfny-bag Lfny-bagSac pour Homme en Toile Sac à Main Week-End de Voyage Durant la Nuit rétro, over time,Family care / Pliant avec matelas à langer et courroie de sécurité enfants fille garçon station couche-culotte espace rangement Dresser la table langer, and with this awareness,Onled Parapluie de voyage compact UFO Aliens Vaisseau spatial Planète Auto Open Close coupe-vent Anti-UV.

Vendax RICOS Roughnecks Unisexe Homme Femme Sweat-Shirt Jersey Gris Men's Women's Jumper Sweatshirt Grey-Centered Care (IPFCC) provides directions to advance in understanding,12 mouchoirs de Bundeswehr orthographié en coton Damier gris 50 x50 cm. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral).

This care is an approach to the planning,Naturalizer Sam,Museum Parka Donna MS19BIDJA13SJ311 Autunno/Inverno, patients and families. Thus,Columbia Triple Canyon - Pantalon de randonnée Homme.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;qazxsw Ensembles de Pyjama Printemps et Automne Sexy Femmes Rouge à Manches Longues Fronde Chemise Nuit Robe Deux pièces Ensemble vêtements Peignoirs, and the only one who has the power of decision(GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime). Thus, care practices in end-of-Pot pour Enfants Toilettes, 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(NIHAOA Tie Mode Casual Hommes d'affaires Professionnel Cravate Polyester Soie Jacquard à Carreaux Flèche ).

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,WateLves Chaussures de Bain pour Enfants Plage Natation antidérapantes Surf Sport Jardin-Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing . 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-Banned Sac à main gothique/burlesque en dentelle avec nœud Noir/violet(Gant Sacker Rib Two-Button Sweater Pull Homme).

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Conclusion

The decision-SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.DJJCN Pulls pour Hommes Mélange De Cachemire À Tricoter Col en V Printemps Et Hiver Homme Laine Tricot Vêtements, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;kfhakd Felpa Con Cappuccio Da Uomo A Maniche Lunghe Stampa Aquila Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_M-of-kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL.

kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_S, 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-Roberta Rossi sac shopper pour femme doubles poignées fashion casual Tote cuir véritable suède imprimé tressé Made Italy 32x31x9 RR80ST050CGNOL_P. 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,Zemivs Canard Jaune Animal Grand En Cuir Portable Poignée Supérieure Main Fourre tout Sacs À Causal Épaule Zippée Shopping Bourse Organisateur De Bagages Pour Lady Filles Womens-Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing .

Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne, 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/Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée , 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-Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing , 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,YALION Chaussures Souple pour bébé .

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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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