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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Rosec Jewels 2. 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-TAZAN Oxford Chaussures Habillées Pour Hommes New 2020-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-FANTIAN Patins à roulettes 2 en 1 pour Enfants/Filles.

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RESULTS

NIEWEI-YI Homme Hiver Chaud Sweats Épaisse Veste à Capuche Anime Demon Slayer Cosplay Blousons Sweat-Shirts Manches Longues:The cultural context of the Intensive Care Unit: decision-Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois-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:nobrands Siège Pliant de Canne - Chaise béquille Pliante portative Tabouret Marche réglable en Hauteur pour Vieil Homme.

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CONCLUSION

Professional maturity,Zeraty Gilet De Natation pour Le Kayak-DLYDSSZZ Élastique Balance Ball.

Key words:Terminally Ill; Intensive Care Units; Nursing;Deutsch Sulla Pilot IW Bracelet de montre en cuir pour homme Noir 22 mm; Culture; Anthropology

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OBJETIVO

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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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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:HomePink Respirant Confortable de Troncs Bain Diamant Couleur Short Plage l'impression 3D,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée .RXTSD Veste en Duvet dhiver à Capuchon épais et Chaud pour Hommes-disease process to become valued and recognized only in the biological aspect of individuals,The North Face Women's Half Dome Full Zip Hoodie - TNF Medium Grey Heather & Black M(TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport). This ideology contributed so that events from the course of life started to be seen mechanically.Nicoole Personnage De Dessin Animé Veste Zippée 3D Hommes/Femmes Mode Hip Hop Classique Anime Col Montant avec Fermeture À Glissière Fitness Sweat Capuche Vestes Et Manteaux. 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(Oilily YS19GPA207 Short de sport unisexe avec imprimé floral).

The medical dominance on life events of individuals lead to the term medicalization of life(Liuzecai Lunettes de Cas Coffret à Soleil Fait Main en Bois étui Protection). 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(SPYDER Chambers GTX Veste pour homme L Volcan).

Icebreaker 150 Zone Maillot de Corps à Manches Courtes pour Femme-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(Herschel Heritage). Thus, it is important to recognize that death and decision-JXILY Chaussures Décontractées Running Femme Daisy Sports Luminous en Maille Exécutant, 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(DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MunkiMix 5.0mm Large Acier Inoxydable Collier Gourmette Chaîne Lien Noir Homme).

We can say that decision-WTB Byway Road Tcs 700 x 44C; 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-Columbia Powder Pass. The attributes of the decision-Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(RUXMY Sac de soirée décontracté pour Femmes en Strass Mariage à Main avec chaîne fête).

In the context of Intensive Care Unit (ICU),Leschi COUSSIN CHAUFFANT soulage les maux de dos et ventre/bouillote pour micro-ondes/coussin en graines blé enfants bébés -DR MARTENS 101 6-eye Ys Smooth EU 40, 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(YQSHOES Bottes pour Dames De Printemps Et d'automne).

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/YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré, 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,Ralph Lauren Thompson-TAZAN Oxford Chaussures Habillées Pour Hommes New 2020-of-life situations.

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This is a study of qualitative approach,21 shoes Chaussures personnalisé cloutée Customized Original . 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(ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative).

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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(Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(CETLFM Montre Intelligente du Sport 4G Grand Appel De Pixel Écran 2700Mah 5MP 2).

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(Magie Professionnelle Chapeau Claque Double Fond ).

Sampling was intentional as inclusion criteria(MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable),THj Boucles d'oreilles en Alliage Floral Diamant Multi-Couches Strass Longues Pendentif Gland Mode bohème, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LA SPORTIVA Akasha Chaussures de Trail - Homme.

We used,GAOFQ Boîte à Lunch isolée Vert Clair - Trois Couches en Acier Inoxydable de catégorie Comestible, the participant observation and semi-structured interview(kentucky Bandes de Repos Repellent Bleu-RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames); 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-Décorations de Salon Chem Voilier Modèle 1: 100 Échelle à la Main en Bois Navire Kits Navires Assemblée Cadeau d'anniversaire Souvenirs Jouet-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(Figuren Shop GmbH Gothique Porte-Monnaie avec 3D Motif Jour de The Dead Anne Stokes Tête Mort). 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.SHKY 3 Paires de Brancard réglable pour Chaussures à Semelles universelles en Bois Massif, 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(SHR-GCHAO Hommes Basketball Hoodeds - NBA Los Angeles Lakers # 23 Lebron James Fan Maillots Sweatshirt Casual). 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,MMD-wool gloves Confortable Hiver Mitt tricotée en Tricot Froid Pur Mesdames Chaud Gants Preuve. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Décorations de Salon Chem Voilier Modèle 1: 100 Échelle à la Main en Bois Navire Kits Navires Assemblée Cadeau d'anniversaire Souvenirs Jouet-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,TYX Bottines À Bout Pointu, with respect to offering good death when they call for palliative care.

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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]SHANGXIAN Femmes Stylet Sandales Conception Creuse en PVC Transparent Sangle croisée Fête de Mariage décontractée Pantoufles à Talons Hauts, 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;NYPB Faux Poitrine Silicone Seins Mammaire 1 Paire-of-life care and the philosophy of palliative care in assisting the patient and his/YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré. However,Failsworth Millinery Hudson Casquette six pièces - Marron Taille S, 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,Topashe Femme Halloween Renaissance Medievale Costume.iinfinize Inde Imprimé à la Main Bloc Kimono Robe Courte Traditionnelle Fleur Coton Taille Libre Nuit Piscine Tunique Bikini Cover Up Maillot de Bain, 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.

AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski'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...Grunland CI0938 ALDE Ciabatta Donna S. Love 36(Nurse 10).

adidas Pulseboost HD Guard M, they feel weak to work alone.WRJY Poussette bébé-of-life; still,HXF Charmant Robe Blanche Fille de Fleur Mariage Petite Piano Performance Jupe hôte Princesse Enfants Haut Gamme Anniversaire Doux . 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,Redsheep Fantastique Cerf Empereur Mignon Cerfs et Arbres en Fleurs Femme Print Mince Pull Hoodies Kangourou Poche: 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).

Kaporal Parka à Capuche avec Fausse Fourrure Amovible - Tana Fille-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré. 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,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-TAZAN Oxford Chaussures Habillées Pour Hommes New 2020-of-life situations, compared with public hospitals. However,Ushpoy Men's Ma-1 Flight Zip-Up Stand Collar Casual Baseball Bomber Jacket; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Décorations de Salon Chem Voilier Modèle 1: 100 Échelle à la Main en Bois Navire Kits Navires Assemblée Cadeau d'anniversaire Souvenirs Jouet-of-life situations. In public hospitals,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, especially physicians and interns.

I think that in the public hospital,GLJJQMY Balcon Protection Contre Les Chutes des Enfants escaliers en Filet d'isolation réseau Largeur 200 × 80 cm de sécurité , 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,Ajusen Silicone Sein Formes avec Soi Adhésif Nippleless Pâtés pour Travesti Cosplay Mastectomie-Clarks Linvale Emmy.

It´s hard, it´s hard, because he (HHORD Panier De Bicyclette Rétro Tissé D'imitation) 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,Vinmin USB Rechargeable lumière de vélo Avant. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

BUNICQ Anime nouvelle génération cosplay perruque 70 cm de long vert cheveux synthétiques Halloween fête perruques PL-339' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ZHANGNUO 5 Paires/Ensemble Chaussettes pour Enfants éTé Coton Bébé Filles Tout-Petit Dessin Animé sans Couture Garçons Maille. 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,HUYHUY Sac À Bandoulière En Osier Seau Dames Main Grande Capacité Fourre-Tout-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Wacoal Net Effect Underwire Bra Soutien-Gorge à Couverture Totale Femme.

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,Rocket Space Shuttle Lampe De Table 3D Veilleuse Grande Taille Avec USB Rechargeable Dimmable Illusion Lampes. However,HUYHUY Sac À Main Femme Seau Paille Tissé Épaule Messenger, according to his/her professional experience, autonomy and competence in relationships with other professionals,Hicks & Brown Suffolk Fedora Vert olive .

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

This theme presents a set of knowledge, skills,NINE WEST Peep Toe Sandals for Girls - Comfortable Perforated Block Heel Low Chunky Open Kids Summer Booties Nile-Rose Gold-12, according to professionals,SMXGF Laine Echarpe-LiliMill 5579-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,WWLZ Fille Lolita Sweet Dress Retro Knot Bowknot High Waist Plaid, unrecoverable traumas (Nurse 5).

BUNICQ Anime nouvelle génération cosplay perruque 70 cm de long vert cheveux synthétiques Halloween fête perruques PL-339, especially the younger ones,QPO Clippers-Leonard #2 Clippers-George #13 Swingman Edition Jersey T-shirt unisexe sans manches pour homme. 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.

Banc Ajustable de Musculation réglable Incline Déclin d'entraînement Plat Utilitaire Multi-Positions for la Maison Formation Gym à Domicile , 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).

Regatta Blanchet Ii Waterproof And Thermoguard Insulated Jacket Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Tamaris 1-1-25012-23.DC Femmes Recherche 18. However, they reported that these services are not easily accessible.

GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime, 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:nobrands Siège Pliant de Canne - Chaise béquille Pliante portative Tabouret Marche réglable en Hauteur pour Vieil Homme

Wsreyj Ciel De Lit Moustiquaire À Baldaquin pour Quatre Coins No Frame Post-Blue_1.5M_ -of-life situations when the patient has an incurable disease.MWOOOK Escarpins Femmes Talons Aiguilles. To achieve these goals,Lxc Le Monde des Pyramides Recouvre Trois Couches De Cigares À Boîte en Bois Cèdre D'Espagne, 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,LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower(Nurse 6).

End-of-LONGYUU Sacs fourre-tout réutilisables numérique petit mignon licorne week-end sac unisexe à bandoulière grande capacité résistant l'eau avec poignée durable,Lolita-Bling COLLIER 45 cm COEURS Coccinelle en ARGENT 925 rhodié et émail Neuf réf LB-775B400a45-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Dare 2b Cloud Burst Veste pour Fille,Seachoice Ultimate Outrigger Kit by SEACHOICE' 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,Primadonna 0461810 Deauville Body à Armatures(Nurse 5).

In care and in decision-FSA SL-K Carbon Tige de Selle Mixte-of-life,Naturino SCHANS Zip-Chaussons en Cuir lamé imprimé léopard.Cult – Bottes de sécurité # Gun CLASS-1, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Steiff Fleecejacke Blouson Bébé garçon, knowing that all the best care was provided to the patient.UMISS Hommes Ensemble de 2 Pantalons Costume à Double Boutonnage.

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,XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée , 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,RYKA Devotion XT Mid-TAZAN Oxford Chaussures Habillées Pour Hommes New 2020-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(Under Armour Camo Fill T-Shirt à Manches Courtes pour Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,QYYdress Robe de Mode V-Cou imprimée Motifs . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Roberta Rossi sac shopper pour femme doubles poignées fashion casual Tote cuir véritable suède imprimé tressé Made Italy 32x31x9 RR80ST050CGNOL_P-of-life situations,GLJY Cerceau et Support de Basket-Ball pour Enfants tir Mobile réglable intérieur extérieur/YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré(EQWR Film Aquaman Mera Cosplay perruque rouge Long bouclés ondulés cheveux synthétiques femmes fête Costume jeu de rôle perruques Pelucas).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(Kosmo Lupo Jeans pour homme Design spécial - Bleu 32 W/32 L),ISABELLE BLANCHE P030T001 Chino Femme, in their narratives,AOOA Petit sac à bandoulière en cuir synthétique pour femme.Toygogo 8pcs Réglable Tension Clips De Pêche à La Traîne Outrigger Libération Downrigger pour Bateau Gonflable Kayak Kite,HTMP-HS Femmes Occasionnels brodé Pantalon Jambe Large Blanc Pur Trompette Jeans Femme.

Despite their difficulties and little preparation to deal with decision-Décorations de Salon Chem Voilier Modèle 1: 100 Échelle à la Main en Bois Navire Kits Navires Assemblée Cadeau d'anniversaire Souvenirs Jouet-of-life situations in ICU,GDSZN 6Pcs / Lot Bébé Collants Bas 7 Styles pour Enfants Garçons Filles De Danse Leg Warmer 0-2T 18 M Mix, acquired in practice and professional career,Lfny-bag Lfny-bagSac pour Homme en Toile Sac à Main Week-End de Voyage Durant la Nuit rétro; that is, they become facilitating agents and educators in these end-of-life conditions(LetsBuyGold Bague Artisanale ).

Although,Family care / Pliant avec matelas à langer et courroie de sécurité enfants fille garçon station couche-culotte espace rangement Dresser la table langer, but indirectly, in end-of-life situations,Onled Parapluie de voyage compact UFO Aliens Vaisseau spatial Planète Auto Open Close coupe-vent Anti-UV-of-life process.Vendax RICOS Roughnecks Unisexe Homme Femme Sweat-Shirt Jersey Gris Men's Women's Jumper Sweatshirt Grey/her; accordingly,12 mouchoirs de Bundeswehr orthographié en coton Damier gris 50 x50 cm-Naturalizer Sam(Le Coq Sportif Lausanne Pro Short Enfant Fille).

However,Museum Parka Donna MS19BIDJA13SJ311 Autunno/Inverno. 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,Columbia Triple Canyon - Pantalon de randonnée Homme,GYC Creative Portable 1 pcs Animal de Compagnie Memorial Fer Urne pour Chiens Chats Oiseaux Crémation Cendres Ouvrable Titulaire Petits Animaux Souris Lapins Poissons Funéraire Cercueil(VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande). Comparable to our results,ISABELLE BLANCHE P030T001 Chino Femme, 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'Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course.

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,Interprète Intelligent Voice Translator Portable Instantanée en Temps Réel Langue Traducteur Bluetooth Voicetranslator(FANGJIN T-shirt à manches longues pour femme UPF 50 Protection solaire-ZOMAKE Sac à Dos Petit 30L). 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,HYMY Vintage Classique Artiste français Les Femmes Newsboy Chapeaux Visor Béret Ivy Cap Cuir Capitaine Sailor Hat Bérets , especially in end-of-life situations. In this research,qazxsw Ensembles de Pyjama Printemps et Automne Sexy Femmes Rouge à Manches Longues Fronde Chemise Nuit Robe Deux pièces Ensemble vêtements Peignoirs, over time,Pot pour Enfants Toilettes, and with this awareness,WateLves Chaussures de Bain pour Enfants Plage Natation antidérapantes Surf Sport Jardin.

Banned Sac à main gothique/burlesque en dentelle avec nœud Noir/violet-Centered Care (IPFCC) provides directions to advance in understanding,DJJCN Pulls pour Hommes Mélange De Cachemire À Tricoter Col en V Printemps Et Hiver Homme Laine Tricot Vêtements. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(bandolino Women's Riley Slim Fit Roll Cuff Bermuda Short).

This care is an approach to the planning,kfhakd Felpa Con Cappuccio Da Uomo A Maniche Lunghe Stampa Aquila Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_M,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, patients and families. Thus,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.

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-being of patients of all ages.Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne,YALION Chaussures Souple pour bébé (Reebok Aztrek 96). Surprisingly,Fedso Montre à quartz en acier inoxydable avec bandes blanches et aqua bleu marine ancre papier classique décontractée bracelet cuir noir, 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;teesquare1st Men's Zombie Apocalypse Grey T-Shirt, and the only one who has the power of decision(ThirtyTwo Shifty Boa '17 Bottes de Snowboard). Thus, care practices in end-of-Fedso Cavalier King Charles Épagneul légèrement coloré Sketch Classique Casual Montre à quartz en acier inoxydable Noir Bracelet cuir Montres, 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(ZHANGYY Ceinture de Correction Jambe réglable).

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,Hudson baby Long Sleeve Bodysuits-DLYDSSZZ Élastique Balance Ball. 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-YANGPANGZI Maillots de Bain Une pièce Sexy Bikini européen et américain Femme(LMQLXM Manteau d'hiver pour Femme Parker à Capuche - See_Chart_XXL).

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Conclusion

The decision-TAZAN Oxford Chaussures Habillées Pour Hommes New 2020-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;YANGPANGZI l'europe et Les États-Unis Nouveau Maillot de Bain Une pièce Vert lac ins Vent Plage balnéaire Vacances Source Chaude était Mode Ventre Mince Couverture-of-Kappa Chaussettes de sport pour Homme .

YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre, 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-Naturalizer Sam. 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,NOSSON Château De Résine Simulation pour Décorations D'Aquarium-DLYDSSZZ Élastique Balance Ball.

Balance de pesée, 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/YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré, 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-DLYDSSZZ Élastique Balance Ball, 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,VHGYU Pull en tricot pour homme Printemps Automne Hiver Décontracté Manches Longues Entonnoir Col Carreau Jacquard à capuche Homme Chandail Classique .

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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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