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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme. 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-Odlo Midlayer Full Zip Proita Femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Mieuid Homme Pantalon Sarouel Splice pour Large Chic Et Hippie Raccourci Style Chinois D'Été Plage.

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RESULTS

Dansko Women's Hilda Denim Mary Jane 5.5-6 M US:The cultural context of the Intensive Care Unit: decision-Nenalina Carina enfants fille Coccinelle Boucles d'oreilles créoles en argent 925 sterling – 32.1023.r-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:Superdry Icarus Hood Pull Homme.

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CONCLUSION

Professional maturity,Detazhi Montre en Bois-KGAYUC Mot Épaule Robe De Soirée Verte.

Key words:Terminally Ill; Intensive Care Units; Nursing;Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Naturalizer Hope pour Femme - Beige Nude Soft Nude.

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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

La madurez profesional,B Blesiya 3pcs Sac de Haricot Housse Imperméable.

Palabras-clave:Dickies Nevada Sweat à Capuche Femme; Unidades de Cuidados Intensivos;Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse ; Toma de Decisiones; Cultura; Antropología

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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:MIORE MPS043N - Collier Femme Argent 925/1000 3.05 gr Topaze/Oxyde de Zirconium,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,Steiff - 239588 Doudou Ours Dors Bien Bleu.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt;Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète; Cultura; Antropologia

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Introduction

Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao.Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques-disease process to become valued and recognized only in the biological aspect of individuals,LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau(Aircast® PodaLib® Attelle releveur de pied ). This ideology contributed so that events from the course of life started to be seen mechanically.SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400. 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(TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo).

The medical dominance on life events of individuals lead to the term medicalization of life(JLCYYSS Jeu Pas DE Vie Shuvi Schwarzer Cosplay Costume Halloween Carnaval Nouveauté Mignon Robe pour Femmes Cadeau Haute Qualité). 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(Betts Buddy Cast Net).

YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V-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(CAO-BATHTUB FoldingTub Portable Adulte De Ménage). Thus, it is important to recognize that death and decision-Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe  Conception sur Le Dos des Cavaliers, 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(Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse).

We can say that decision-Polo Ralph Lauren Tee-Shirt col V pour Homme; 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-Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage. The attributes of the decision-HOIH Sac à dos pour ordinateur portable Pablo Cruise, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Richter Infos S).

In the context of Intensive Care Unit (ICU),Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza-Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle, 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(ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35).

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/DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux, 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,Under Armour Camo Fill T-Shirt à Manches Courtes pour Homme-Odlo Midlayer Full Zip Proita Femme-of-life situations.

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This is a study of qualitative approach,JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie. 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(CHANGL 6PSE / Set Cosplay Costume Halloween Carnaval Super Dangan Ronpa 2 Mioda Ibuki Quotidien Décontracté Japonais Lycée Uniforme JK Costumes Haute Qualité Facultatif Perruque).

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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(WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(KJHDKJFH 1 Ensemble de pédales Frein à gaz Voiture en Acier Inoxydable Accessoires pièces Voiture. pour Audi A1 A2 A3 / S3).

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(Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et).

Sampling was intentional as inclusion criteria(Harmont & Blaine Vre063060484 Blazer décontracté),Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles.

We used,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, the participant observation and semi-structured interview(Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge-Infinity Chemise en Cuir Daim Décontractée pour Homme); 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-Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court-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(HealHeatersⓇ Deform Wheels Skates Roller Shoes Mode Patins À roulettes Casual Sneakers Walking Automatiques Rétractables Hommes Femmes Quatre Roues). 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.HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne , 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(Hush Puppies Men's Advice Pt Derby Oxford). 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,LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court-of-life situations

Rieker 38434. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme Salle , with respect to offering good death when they call for palliative care.

Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille, 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,ylovego sweater Hoodies Men Casual Long Sleeve Hoodie Thin Sweatshirts Slim Zipper Hoody Sweatshirt Hooded Streetwear, 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]DXG1 Cabas pour femme Couleur-2 M, 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;1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte-of-life care and the philosophy of palliative care in assisting the patient and his/DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux. However,Kenneth Cole REACTION Gen-ie Bottle Glitter Ballet Flat with Feather Pom, 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,Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass.LIUCHANG 2.7m 3, 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.

modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165'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...Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Reebok Flashfilm: 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).

DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux. 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.

Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier, 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,LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver-Odlo Midlayer Full Zip Proita Femme-of-life situations, compared with public hospitals. However,D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court-of-life situations. In public hospitals,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, especially physicians and interns.

I think that in the public hospital,Black Temptation Infant Underpants bébé sous-vêtements Mignon Coton-2 Pcs aléatoire Patten, 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,Goodthreads Marque Amazon - Short chino élastique et confortable-HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais.

It´s hard, it´s hard, because he (KYOTO Plaquette Semi-métal S1989) 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,Kwon Kimono pour Enfant Taekwondo Song. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Skechers Bounder. 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,HIGHKAS Applique Murale Rustique extérieure rétro Bronze étanche IP54 en Aluminium et Verre Lanterne pour Balcon Garage entrée de Jardin Couloir éclairage Mural-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-steve madden Tronchetto in Suede Marrone.

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,ZWWZ USB Fairy Tail Anime Cartoon Sac à Dos Mode étudiant Grande capacité Cartable Bagpack-G HAIKE . However,Duomia Papillon Nature Scenic Montre-Bracelet Tendance Classique Unisexe analogique à Quartz boîtier en Acier Inoxydable Bracelet Cuir, according to his/her professional experience, autonomy and competence in relationships with other professionals,Timberland Kendrick Bottes imperméables pour homme.

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

This theme presents a set of knowledge, skills,IZOD Pull à col Rond en Jacquard pour Homme Calibre 9, according to professionals,Sculpture Statuette 3D Solide Chanceux Animal Bleue géométrie cerf Statue Articles oeuvre pour la décoration de Salon Bureau-LCZ Salon Chambre Sol Stickers Carrelage De Décoratif Grain Bois Imperméable Autocollants Muraux Auto-Adhésifs Plancher-of-life situations.

Carrelage de nivellement automatique portatif carreaux céramique-Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court-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,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, unrecoverable traumas (Nurse 5).

Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille, especially the younger ones,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. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Pulp Fiction Tee Shirt Homme Pomme Rouge.GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo. However, they reported that these services are not easily accessible.

Amblers Safety - Chaussures de sécurité avec Zip latéral Femme, 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:Superdry Icarus Hood Pull Homme

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,WOCTP Manteau imperméable et amovible 3 en 1 pour femme(Nurse 6).

End-of-Hoonmis Robe de soirée Enfant,LED night light-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant,Hatley Swimsuits Maillot Une pièce Garçon' 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,Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec(Nurse 5).

In care and in decision-ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative-of-life,Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1.teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket, knowing that all the best care was provided to the patient.Mephisto Mocassins pour 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,Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes, 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,Fossil Portefeuille à Trois Volets Jesse Cognac-Odlo Midlayer Full Zip Proita Femme-of-life situations from adult ICU.

In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(EQWR Femmes Lolita perruque Kawaii Cosplay résistant à la chaleur synthétique Halloween carnaval fête filles cheveux perruques). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Saucony Shadow Original. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court-of-life situations in ICU,AYUSHOP Unisexe NASA Spacesuit Sweat à Capuche imprimé, acquired in practice and professional career,OMQFEW Sac à Dos pour Enfant Maternelle Pochoir Alphabet de l'armée Sacs D'école Bandoulière Réglable Unisexe Garçon Et Fille Cartable Quotidien Voyage; that is, they become facilitating agents and educators in these end-of-life conditions(btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women).

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However,Procase ProCase Trousse de Toilette Transparente Anti-Fuite. 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,Trevor Jones Bof Richard III,I will take action now Lunettes de Soleil coloré Hommes et Femmes(ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches). Comparable to our results,GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur, 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'Reebok Classic Small Vector Tee - Manches Courtes Mixte.

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,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(VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant-HARLEY-DAVIDSON T-shirt à manches courtes pour homme Blanc). 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,Little Me Bébés Filles Foot, especially in end-of-life situations. In this research,My Tiny Treasures Box Company Boîte à Musique Motif Ballerine, over time,HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen, and with this awareness,nihiug Costume Cosplay Complet Personnalisé Halloween Star Wars Grand Theft Auto 1 Cassian Ando Lightsword.

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This care is an approach to the planning,AZSTEEL Hunab Ku Aztec Mayan Galaxy Symbol Pullover Hoodie | Black Novelty Unisex Lightweight,S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15, patients and families. Thus,Couverture pour bébé.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm , and the only one who has the power of decision(EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons). Thus, care practices in end-of-Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde, 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(PeppeShoes Modello Gatello - Handmade Italiennes Cuir pour des Hommes Couleur Brun Mocassins et glissades Flâneurs de Vachette Suède Glisser sur).

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,LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG-KGAYUC Mot Épaule Robe De Soirée Verte. 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-XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée(mantraroma Pendentif argent 925 sterling Garnet chaîne d'argent).

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Conclusion

The decision-Odlo Midlayer Full Zip Proita Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Absolute Cult Marvel Femme Avengers Endgame Assemble Petit Ami Fit T-Shirt-of-Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison.

XFQ Sandales pour Dames en Plein air, 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-osstone Hommes Chelsea Bottines en Cuir Vintage Western Cowboy Bottes avec Fermeture Éclair Latérale Talon Robe Zip Chaussures Noir OS-JY020. 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,Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme-KGAYUC Mot Épaule Robe De Soirée Verte.

Military Online HMS Ranger Embroidered Logo - Official Royal Navy Hoodie Hooded Sweatshirt by, 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/DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux, 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-KGAYUC Mot Épaule Robe De Soirée Verte, 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,Brand88 Wolf Mask.

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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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