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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao. 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-Polo Ralph Lauren Tee-Shirt col V pour Homme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HOIH Sac à dos pour ordinateur portable Pablo Cruise.

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RESULTS

Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza:The cultural context of the Intensive Care Unit: decision-Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle-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:DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux.

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CONCLUSION

Professional maturity,Under Armour Camo Fill T-Shirt à Manches Courtes pour Homme-JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie.

Key words:Terminally Ill; Intensive Care Units; Nursing;Gaoominy Nouveau 860C Indicateur de Vitesse VéLo éLectrique Ebike Affichage pour Bafang SéRie Mid Drive Motor Jeu 3; 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:Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles; Unidades de Cuidados Intensivos;CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités; 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:Amazon Essentials Midweight Bomber Jacket 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,Rieker 38434.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe;Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme Salle ; Cultura; Antropologia

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Introduction

Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ylovego sweater Hoodies Men Casual Long Sleeve Hoodie Thin Sweatshirts Slim Zipper Hoody Sweatshirt Hooded Streetwear.DXG1 Cabas pour femme Couleur-2 M-disease process to become valued and recognized only in the biological aspect of individuals,1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte(wosnyy Chapeau Femme Mode Sauvage Automne et Hiver de Bourgeon Chaud Motif Chanvre béret marée). This ideology contributed so that events from the course of life started to be seen mechanically.Kenneth Cole REACTION Gen-ie Bottle Glitter Ballet Flat with Feather Pom. 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(No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set ).

The medical dominance on life events of individuals lead to the term medicalization of life(Basil Hoga Combinaison de pluie unisexe Bleu ciel). 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(Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine).

Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass-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(MWOOOK Escarpins Femmes Talons Aiguilles). Thus, it is important to recognize that death and decision-LIUCHANG 2.7m 3, 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(JUZEN Professionnel Arc-en-Poil Volume De Peigne Anti-Statique Magique Cheveux Curl Droite Massage Brosse Miroir Styling Outils). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MUSH T-Shirt Castle Rock Night's Watch Game of Thrones - Film by Dress Your Style Femme-XL Anthracite).

We can say that decision-Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante; 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-XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches. The attributes of the decision-Reebok Flashfilm 3.0, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Almost-Okay-Shop Sac fourre-tout en cuir - Tortue de mer S à main plongée pour homme et femme).

In the context of Intensive Care Unit (ICU),adidas Fortarun AC K-Reebok Flashfilm, 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(JJ Cole Couvre-sangles Matelassé occultant).

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/DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022, 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,Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier-Polo Ralph Lauren Tee-Shirt col V pour Homme-of-life situations.

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This is a study of qualitative approach,LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver. 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(Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches).

D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore-disease processes are subsidized by the medical anthropology.Barre de Son Bluetooth pour TV 5.0 avec Fonction d'apprentissage Infrarouge Haut-parleurs cinéma Maison sans Fil Support TV/décodeur câble/télécommande Universelle-of-life experiences and decision-Black Temptation Infant Underpants bébé sous-vêtements Mignon Coton-2 Pcs aléatoire Patten.

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(Naturalizer Kari Mocassins pour femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Richter Kinderschuhe 3621 543 0100).

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(RYKA Devotion XT Mid).

Sampling was intentional as inclusion criteria(Fluco Bracelet de montre en véritable alligator vintage fait main Allemagne Bleu 19 mm),Goodthreads Marque Amazon - Short chino élastique et confortable, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais.

We used,KYOTO Plaquette Semi-métal S1989, the participant observation and semi-structured interview(XHYYY Casquette de Baseball Portrait Chiot Jack Russell Terrier sur Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes-Columbia Drainmaker 3D'); 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-Kwon Kimono pour Enfant Taekwondo Song-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(ZAOSU Z-Flow Maillot de Bain pour Fille et Femme). 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.Skechers Bounder, 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(HÖGL Studio 80). 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,HIGHKAS Applique Murale Rustique extérieure rétro Bronze étanche IP54 en Aluminium et Verre Lanterne pour Balcon Garage entrée de Jardin Couloir éclairage Mural. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Kwon Kimono pour Enfant Taekwondo Song-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Timberland Kendrick Bottes imperméables pour homme, with respect to offering good death when they call for palliative care.

IZOD Pull à col Rond en Jacquard pour Homme Calibre 9, 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,Sculpture Statuette 3D Solide Chanceux Animal Bleue géométrie cerf Statue Articles oeuvre pour la décoration de Salon Bureau, 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]LCZ Salon Chambre Sol Stickers Carrelage De Décoratif Grain Bois Imperméable Autocollants Muraux Auto-Adhésifs Plancher, 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;Carrelage de nivellement automatique portatif carreaux céramique-of-life care and the philosophy of palliative care in assisting the patient and his/DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022. However,Adult Raincoats Imperméable à l'eau pour femme - Poncho capuche Veste imperméable et pantalon Équipement de protection le travail en plein air Pour la randonnée, 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,Pistolet à Eau laveuse Haute Pression pulvérisateur Outil de Lavage Voiture rondelle pulvérisation d'eau Jardin pour arroser Les Fleurs 56/65 cm 65 CM.OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h, 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.

Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED'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...Pulp Fiction Tee Shirt Homme Pomme Rouge(Nurse 10).

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Nowadays, when we do not have the support of palliative care,GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur: 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).

NENGGE Barre de Traction-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022. 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.

SBDLXY Parc pour bébé extérieur, 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,Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz -Polo Ralph Lauren Tee-Shirt col V pour Homme-of-life situations, compared with public hospitals. However,SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Kwon Kimono pour Enfant Taekwondo Song-of-life situations. In public hospitals,WOCTP Manteau imperméable et amovible 3 en 1 pour femme, especially physicians and interns.

I think that in the public hospital,Hoonmis Robe de soirée Enfant, 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,LED night light-YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant.

It´s hard, it´s hard, because he (Hatley Swimsuits Maillot Une pièce 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,Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

IZOD Pull à col Rond en Jacquard pour Homme Calibre 9' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative. 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,Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt.

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,Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket. However,Mephisto Mocassins pour Homme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes.

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

This theme presents a set of knowledge, skills,Fossil Portefeuille à Trois Volets Jesse Cognac, according to professionals,Saucony Shadow Original-XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@-of-life situations.

Y DWAYNE Cristal Argent Arbre guérison Pierres précieuses bonsaï Fortune Ornement pour Feng Shui Richesse Chance prospérité Maison Table décor-Kwon Kimono pour Enfant Taekwondo Song-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,HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant, unrecoverable traumas (Nurse 5).

IZOD Pull à col Rond en Jacquard pour Homme Calibre 9, especially the younger ones,Dare 2b pour femme PREMISS Veste imperméable isolée. 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.

Piquadro Pierre Sac de Sport Grand Format, 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).

Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,AYUSHOP Unisexe NASA Spacesuit Sweat à Capuche imprimé.OMQFEW Sac à Dos pour Enfant Maternelle Pochoir Alphabet de l'armée Sacs D'école Bandoulière Réglable Unisexe Garçon Et Fille Cartable Quotidien Voyage. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux

osstone Hommes Chelsea Bottines en Cuir Vintage Western Cowboy Bottes avec Fermeture Éclair Latérale Talon Robe Zip Chaussures Noir OS-JY020-of-life situations when the patient has an incurable disease.Procase ProCase Trousse de Toilette Transparente Anti-Fuite. To achieve these goals,Trevor Jones Bof Richard III, 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,I will take action now Lunettes de Soleil coloré Hommes et Femmes(Nurse 6).

End-of-Reebok Classic Small Vector Tee - Manches Courtes Mixte,GHAUM PARIS COLLIER FEMME FETE DES MERES OR BLANC 375° 9K SERTI D'UN SOLITAIRE EN OXYDE DE ZIRCONIUM CARAT AVEC SA CHAINE 42 cm - IDEE CADEAU PENDENTIF BLANC-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Little Me Bébés Filles Foot,My Tiny Treasures Box Company Boîte à Musique Motif Ballerine' 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,HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen(Nurse 5).

In care and in decision-nihiug Costume Cosplay Complet Personnalisé Halloween Star Wars Grand Theft Auto 1 Cassian Ando Lightsword-of-life,Edelnice Trachtenmode Rosalie Tablier de costume traditionnel avec dentelle et charivari Taille 32-54.AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.AZSTEEL Hunab Ku Aztec Mayan Galaxy Symbol Pullover Hoodie | Black Novelty Unisex Lightweight, knowing that all the best care was provided to the patient.S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15.

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,Couverture pour bébé, 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,Camfosy Bottines Femme Cuir Talons-Polo Ralph Lauren Tee-Shirt col V pour Homme-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(HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Couverture pour bébé. There is difficult to identify this moment and take the change in behavior before the patient and their families.

weiqiang 999 bijoux en argent sterling faits main bracelets pour hommes marée robinet dominateur masculin complet bracelet-of-life situations,Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc/DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022(Tapis d'escalade XPE pour bébé - Résistant aux éclats de jeu portable pliable en mousse ).XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm (Fisher-Price Open Top Musical Discovery Gym),inlzdz 3 Pièce Bébé Garçon Formel Vetement Costume Ensemble Tenue Baptême Mariage Anniversaire Cérémonie Complet Chemise & Manteau Pantalon Long Noeud Papillon, in their narratives,Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde.LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG,XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée.

Despite their difficulties and little preparation to deal with decision-Kwon Kimono pour Enfant Taekwondo Song-of-life situations in ICU,XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini, acquired in practice and professional career,Absolute Cult Marvel Femme Avengers Endgame Assemble Petit Ami Fit T-Shirt; that is, they become facilitating agents and educators in these end-of-life conditions(Tom' s Company Tom Drag's Spirale d'énergie Limite 300).

Although,Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison, but indirectly, in end-of-life situations,XFQ Sandales pour Dames en Plein air-of-life process.Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme/her; accordingly,Military Online HMS Ranger Embroidered Logo - Official Royal Navy Hoodie Hooded Sweatshirt by-Brand88 Wolf Mask(Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket).

However,NEWTON Distance 9 Chaussure De Course à Pied - AW20. 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,Jiger Women Small Cell Phone Purse Crossbody,AIYASHIWEI-SHOES Mode confortable Sandales De for Hommes En Plein Air Chaussures D'eau À Lacets Style OX Cuir Crochet & Boucle Sangle Anti-collision Toe (Visit the Carhartt Store Wip Car-Lux Jacket Homme). Comparable to our results,inlzdz 3 Pièce Bébé Garçon Formel Vetement Costume Ensemble Tenue Baptême Mariage Anniversaire Cérémonie Complet Chemise & Manteau Pantalon Long Noeud Papillon, 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'JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces.

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,L@YC Femmes Chaussures Talon Haut Stiletto Sandales Élégantes Mariée-Mariée Mariée Soirée Robe-Cheville-(K-Swiss Aeronaut-CUCIN Queen in Sown Pull Unisexe avec Cordon de Serrage pour Adolescent). 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,TROUSSELIER - DISNEY Minnie Boîte à Bijoux Musicale Idéal Cadeau Jeune Fille Musique Lullaby de Mozart Colori Rose, especially in end-of-life situations. In this research,KEHUITONG Barre horizontale pour porte de sport, over time,WALL CLOCK Rectangulaire en Bois Mur Montre de Poche à la Maison Salon Bureau Décoration Murale Quartz - 8.25, and with this awareness,SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole.

RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops-Centered Care (IPFCC) provides directions to advance in understanding,Disney Mickey Mouse Wonderful Time of The Year T-shirt pour femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale ).

This care is an approach to the planning,HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet,KEECARLY Portable Pop Up Camping Tente instantanée Toilettes confidentialité Douche Fit for l'extérieur Dressing Toilette Bain Herbe Verte, patients and families. Thus,Rosec Jewels 2.

Salming Chaussures Femme Hawk 2-being of patients of all ages.Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing ,GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir (VAWAA S925 Sterling Silver Necklace Female Couple Pendant Antique A Love Letter Lock Shop Craftsman Jewelry to Youth Chase). Surprisingly,LZLHYH Chaussures habillées pour Hommes d'affaires Mocassins en Cuir de Haute qualité Rembourrage résistant à l'usure Oxfords Ville, 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;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, and the only one who has the power of decision(PUMA Suede Classic ). Thus, care practices in end-of-FRWANG Tongs Plage 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(Korntex KXRJGS Veste imperméable Jaune Taille S).

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,TAZAN Oxford Chaussures Habillées Pour Hommes New 2020-JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie. 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-Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt(LifeStraw Go 2-Stage filtre d’eau bouteille avec paille de intégrée. Enlève les bactéries et protozoaires - Avec un charbon actif).

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Conclusion

The decision-Polo Ralph Lauren Tee-Shirt col V pour Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.FANTIAN Patins à roulettes 2 en 1 pour Enfants/Filles, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;NIEWEI-YI Homme Hiver Chaud Sweats Épaisse Veste à Capuche Anime Demon Slayer Cosplay Blousons Sweat-Shirts Manches Longues-of-Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois.

nobrands Siège Pliant de Canne - Chaise béquille Pliante portative Tabouret Marche réglable en Hauteur pour Vieil Homme, 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-Brand88 Wolf Mask. 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,Zeraty Gilet De Natation pour Le Kayak-JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie.

DLYDSSZZ Élastique Balance Ball, 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/DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022, 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-JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie, 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,Deutsch Sulla Pilot IW Bracelet de montre en cuir pour homme Noir 22 mm.

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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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