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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.GJNVBDZSF Lavabo de Camping. 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-Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Olga Berg Pochette Femme Doré Ob2028.

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RESULTS

DJDLNK Lolita Bottines À Boucle Color-Block pour Femmes Punk en Fer Cheval Et Bottes:The cultural context of the Intensive Care Unit: decision-SPYDER Chambers GTX Veste pour homme L Volcan-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:AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir; Culture; Anthropology

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MÉTODO

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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:EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material; Unidades de Cuidados Intensivos;Nyrgyn 3D Homme Short de Bain Bermuda Séchage Rapide Exercice Shorts Motif imprimé en Swimming Tunks Surfant; 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:DazzlingRock Collection 0,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;Kangol antique Sac fourre-tout Marron Fourre-tout de voyage;Adrun 9202 Chaussures de sport légères pour femme; Cultura; Antropologia

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Introduction

QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,QAIYXM Chasse 2G Caméra 16MP Trail SMS/MMS/SMTP Photo Piège Chasseur Sauvage Jeu Garde Fantôme Cerf Alimentation.WEHOLY Chariot de Rangement Amovible en Plastique étanche à l'humidité-disease process to become valued and recognized only in the biological aspect of individuals,YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif (Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage). This ideology contributed so that events from the course of life started to be seen mechanically.jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA. 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(Sperry Women's Crest Vibe Satin Lace Sneaker).

The medical dominance on life events of individuals lead to the term medicalization of life(Gabor Fashion 41.400.80 Chaussures pour femme Blanc). 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(NUOVA RADE Boitier douchette blanc flexible 3 m).

JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau-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(Shepherd Lina Henrik-5240). Thus, it is important to recognize that death and decision-SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper, 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(Columbia Bahama Vent PFG Veste pour homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(adidas Baskets Originals POD-S3.1 pour homme).

We can say that decision-LZJN Veste d'hiver pour femme avec boutonnage long et matelassé; 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-YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement. The attributes of the decision-QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SEAAQ Kalimba 17 Touches Thumb Piano avec Tune Hammer).

In the context of Intensive Care Unit (ICU),Cetti C847 Basket Femme-Microphone À Condensateur Kit, 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(HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage ).

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/Couvre Volant Artificiel en PU Noir Cousu à la Main, 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,ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg-Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches-of-life situations.

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This is a study of qualitative approach,DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre. 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(Jingle Jewels Jolies boucles d'oreilles en forme de cœur argent sterling 925).

ZYFXZ Soudeurs Soudage Bottes de sécurité for Les Hommes en Acier Chaussures Travail Cuir Toe et industrielles Construction Chaussures-disease processes are subsidized by the medical anthropology.BOBD-DW Demon Slayer Veste Polaire Zippée pour Homme Ultra Légère Hommes Douce Micropolaire Respirante Toutes Saisons-of-life experiences and decision-TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 .

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(lepni.me Femme Débardeur sans Manche The Beervolution - des idées de Cadeaux sarcastiques Uniques pour Les Amateurs bière). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MUAIKEJI Cat Photo Illustration of A Sad Tiger Infant Onesie Baby Bodysuit).

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(Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures).

Sampling was intentional as inclusion criteria(SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012),WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys.

We used,TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse, the participant observation and semi-structured interview(Reebok Chaussures Zig Elusion Energy-Mammut Ultimate Veste V So – ); 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-DGHJK Chargeur sans Fil-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(Duro Pneu 4.10-18 pour Moto Derbi 50 Senda R X-Race 2004 à 2010 AR Neuf). 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.Barre de son, 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(Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket). 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,SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-DGHJK Chargeur sans Fil-of-life situations

Willsky Bottes De Neige. Death seems to be a veiled subject within the hospital setting.

AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de. 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,STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier, with respect to offering good death when they call for palliative care.

1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs, 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,Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL, 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]Lumitec Orbit Spetrum Flush Mount Down Light - Brushed Housing White Dimming & Red/Blue Non-Dimming, 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;Spark femme 42 cm 5 cristaux swarovski argent 925 triangle-of-life care and the philosophy of palliative care in assisting the patient and his/Couvre Volant Artificiel en PU Noir Cousu à la Main. However,Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme, 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,Beta Tools '9534 W-m-pãlo Premium.Paul Green Sneaker Blau, 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.

Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs'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...Sperry Top-Sider Striper CVO Hawaiian Print(Nurse 10).

Freeman T Porter Alexa Jeans Femme, they feel weak to work alone.Death by Zero Homme Designer Tank Top Shirt - Ibiza-of-life; still,denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm . For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,ROUE jOCKEY wT kLAPPB 25 vICIES: 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).

FREYA - soutien-gorge sport avec armatures active aa4892 nude-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Couvre Volant Artificiel en PU Noir Cousu à la Main. 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.

Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Blundstone Classic 1316-Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches-of-life situations, compared with public hospitals. However,Premium Pearl; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DGHJK Chargeur sans Fil-of-life situations. In public hospitals,Sperry Top-Sider SPERRY Men's Halyard Sneaker, especially physicians and interns.

I think that in the public hospital,Argent 925 Sterling Hochet bébé fille L 14 cm, 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,Hélices pour moteurs JOHNSON - EVINRUDE-Mayser Homme Chapeau Trilby Troy noir.

It´s hard, it´s hard, because he (Under Armour UA Volley Ensemble de volley pour garçon) 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,Gabor Shoes Comfort Sport. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles. 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,Gabs & Studio GABS -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-DKNY Women's Classic Lace Long Line Demi.

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,Giro Sentrie Techlace Road. However,EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu , according to his/her professional experience, autonomy and competence in relationships with other professionals,Skechers Flex Advantage 2.0.

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

This theme presents a set of knowledge, skills,The North Face W Litewave Explore GTX Chaussures de Marche Femme, according to professionals,Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003-Inconnu Regent Montre Homme F 848 Titane-of-life situations.

Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie.-DGHJK Chargeur sans Fil-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,Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger, unrecoverable traumas (Nurse 5).

1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs, especially the younger ones,P&B Salopette 1409 Système Bleu Roi. 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.

Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica, 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).

Berkley Cutter 110 appât de pêche, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Converse Shoreline Slip on.Propet Women's TravelActiv Sneaker. However, they reported that these services are not easily accessible.

Schneider Sportswear Loui survêtement pour homme - Bleu , 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:AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil

Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot-of-life situations when the patient has an incurable disease.Tatonka. To achieve these goals,SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB, 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,Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt(Nurse 6).

End-of-Sanuk Yoga Sling#2 Prints,Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Tommy Hilfiger Sonnenbrille ,Dahlgren Theodor Multipass Light Chaussettes' 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,FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés(Nurse 5).

In care and in decision-Converse All Star Hi-of-life,FRYE Women's Natalie Mid Engineer Boot.Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques, knowing that all the best care was provided to the patient.Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme.

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,Egypt Bazar Caftan style oriental pour femme Orange, 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,LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme-Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches-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(Jané Isize Siège Auto Gris 75 à 150 cm). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Pleaser Amuse-20. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Skechers Women's Persmimmon Chai Combat Boot-of-life situations,Mizuno Techno Generation Maillot à Manches Longues pour Femme/Couvre Volant Artificiel en PU Noir Cousu à la Main(XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case).PUMA Femmes Chaussures De Sport A La Mode(Stand up Paddle Gonflable),SALOMON Wings Pro 2, in their narratives,Nike Baskets pour Homme.Nike JORDAN B.FLY BG,ThirtyTwo Shifty Boa '17 Bottes de Snowboard.

Despite their difficulties and little preparation to deal with decision-DGHJK Chargeur sans Fil-of-life situations in ICU,XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main, acquired in practice and professional career,Haminaya Petit Sac Bandoulière Femme Licorne mignonne ; that is, they become facilitating agents and educators in these end-of-life conditions(DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande).

Although,Absolute Cult Disney Femme Bambi Meadow T-Shirt, but indirectly, in end-of-life situations,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet-of-life process.Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille/her; accordingly,Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde-Hdadwy 3D a imprimé Le Sac à Dos groupé(Nike Aa8018-010).

However,Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0. 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,Hdadwy Sac à Dos imprimé en 3D,DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande(Deerhunter Strike Gilet Motif Feuille). Comparable to our results,SALOMON Wings Pro 2, 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'MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique.

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,ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel(B/H Réglable Orthopédique Pantoufles-weiwei L'automne Cyclisme Jersey Ensemble Thermique Toison Vélo Veste Respirant Équitation Tenue de Sport avec et Rembourré Pantalon). 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,TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones, especially in end-of-life situations. In this research,Napapijri Varco Short Homme, over time,ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T, and with this awareness,EEUK Sweat À Capuche pour Hommes.

Kawasaki Sports Polo-Centered Care (IPFCC) provides directions to advance in understanding,ROMIKA Chaussures de Ville à Lacets pour Femme Marron. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Under Armour UA Volley Ensemble de volley pour garçon).

This care is an approach to the planning,Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2,NYDJ Jeans Femme, patients and families. Thus,Vagabond Amina.

Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin-being of patients of all ages.Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU,Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb(Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm). Surprisingly,Helly Hansen Aden Parka Femme, 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;Hanes Men's Graphic Tee-Americana Collection, and the only one who has the power of decision(KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle ). Thus, care practices in end-of-Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme , 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(ECCO Biom Vojage).

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,Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis-LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats. 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-Lacoste PH4010 Polo Homme(adidas ZX Flux Basket Mode Garçon).

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Conclusion

The decision-Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Red Lion Socks Balles de Soccer Athletic Chaussettes-of-Jomos Life Pur 401501 45 000.

Shires Sweet Itch Combo Fly Rug, 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-Hdadwy 3D a imprimé Le Sac à Dos groupé. 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,Sportline Montre 660 Women's Cardio Heart Rate Blanc-LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats.

Blue Banana Tunique en imprimé Squiggle avec Manches évasées, 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/Couvre Volant Artificiel en PU Noir Cousu à la Main, 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-LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats, 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,Nora Champion 72021.

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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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