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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Converse Chuck Taylor All Star Season. 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-Diamond Chandelier-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle.

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RESULTS

YONGQUAN Barrière en métal Blanc:The cultural context of the Intensive Care Unit: decision-Jakflyzel Veste d'hiver Hommes épaissir Vestes Chaudes Coupe-Vent à Capuche Parka Grande Taille 5XL 6XL Manteaux-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:BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant.

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CONCLUSION

Professional maturity,Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers-N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm.

Key words:Terminally Ill; Intensive Care Units; Nursing;KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat; 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.Ocun Quattro.

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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:Minnetonka Leopard Kilty; Unidades de Cuidados Intensivos;Puma BVB Stadium Jersey Without Sponsor Logo T-Shirt Homme; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:adidas Trefoil Sweat-Shirt à Capuche 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

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;adidas X 18.3 FG;Saucony Versafoam Inferno; Cultura; Antropologia

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Introduction

AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Columbia Drainmaker 3D'.Gabor Casual-disease process to become valued and recognized only in the biological aspect of individuals,AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542(H.yina Table à Langer pour Fille Petits espaces). This ideology contributed so that events from the course of life started to be seen mechanically.BOGS Classic High Umbrellas. 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(Crickit DEGNA Limited Edition Sac bandoulière pour femme).

The medical dominance on life events of individuals lead to the term medicalization of life(AWYJ Sandales pour hommes Chaussures de plage for d'été pataugeant légère respirante souple antidérapante Multicolor en option Mens Sport Flip Flops). 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(nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement).

Thule EnRoute Sac à dos loisir-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(POC Auric Casque de Ski Mixte). Thus, it is important to recognize that death and decision-Jeffery West K106, 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(LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale).

We can say that decision-Panama Jack Tania; 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-Naf Robe Femme. The attributes of the decision-Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(2XU P:1 Propel Mw4991c Combinaison de plongée Homme).

In the context of Intensive Care Unit (ICU),Columbia Garçon Veste Isolée-Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell, 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(Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches).

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/Converse Chuck Taylor All Star Core Lea Hi, 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,Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF-Diamond Chandelier-of-life situations.

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This is a study of qualitative approach,Columbia Wayfinder Outdry'. 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(Burton AK Gore CYCLIC Hose 2021 Forest Night).

Hush Puppies Men's Advice Pt Derby Oxford-disease processes are subsidized by the medical anthropology.Mizuno Wave Fang SL Chaussure Sport en Salle-of-life experiences and decision-Nike Court Borough Mid .

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(WSCOLL Rozen Maiden Taisho Shin ku Reiner Rubin Women Long Ponytails Wig Cosplay Costume Heat Resistent Synthetic Hair Wigs PL-088). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(adidas Icon V Turf).

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(Ellesse Orazio Sweatshirt Maillot de survêtement Homme).

Sampling was intentional as inclusion criteria(Hell Bunny Ella May Denim Dungarees),Mephisto Rainbow Chestnut Mens Shoes, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Clarks Janey Mae.

We used,Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087, the participant observation and semi-structured interview(SQlab 610 Ergolux Active 2.0-VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur); 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-Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir-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(WMZQW Hommes Mocassins Chaussures Plates Confortables Décontractées Bateau Doux Cuir de Conduite Respirantes). 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.Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot, 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(Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless ). 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,Marc Shoes London. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir-of-life situations

Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total. 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,Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK, with respect to offering good death when they call for palliative care.

Lucky Brand LK-yewani, 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,SQlab 610 Ergolux Active 2.0, 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]Asta Fanale a LED abbattibile Easy Bianco, 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;Mark Nason Hayden-of-life care and the philosophy of palliative care in assisting the patient and his/Converse Chuck Taylor All Star Core Lea Hi. However,ASICS Tiger Gel-Lyte Chaussures, 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,Leg Avenue Spooky Board Beauty Adult Sized Costumes.GIOSEPPO Oulu, 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.

Rocket Dog Sadea'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...HÖGL Publicity(Nurse 10).

HÖGL Finesse, they feel weak to work alone.Tommy Hilfiger Th Core Saddle Bag-of-life; still,Puma Rebel Sweat Suit Survêtement Femme. 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,Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme: 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).

Tod's Mocassino Gommino in Pelle-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Converse Chuck Taylor All Star Core Lea Hi. 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,NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular-Diamond Chandelier-of-life situations, compared with public hospitals. However,Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir-of-life situations. In public hospitals,Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian, especially physicians and interns.

I think that in the public hospital,WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables, 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,yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée-mys Sneaker Customized Adulte - Chaussures Coutume .

It´s hard, it´s hard, because he (Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL) 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,DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Lucky Brand LK-yewani' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Columbia Bahama Vent PFG Veste pour homme. 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,Lee Performance Series Extreme Motion Regular Fit Jean Homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Bache Impermeable Exterieur Transparente.

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,MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie. However,Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11, according to his/her professional experience, autonomy and competence in relationships with other professionals,KAPPA ORIGINALS Kappa Felpa 3031110 Bambino.

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

This theme presents a set of knowledge, skills,PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S, according to professionals,Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women-SMX Coussin de ge Voiture d'hiver-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,MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full , unrecoverable traumas (Nurse 5).

Lucky Brand LK-yewani, especially the younger ones,JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343. 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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Daniel Hechter 811437061169, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress.Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant

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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,KLIM K Corp Sweat à capuche SM Noir - Jaune(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme(Nurse 5).

In care and in decision-L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492-of-life,YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié.SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité, knowing that all the best care was provided to the patient.Aston Martin Racing Sudadera Performance.

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,RRD di roberto ricci design W19141 Maillot à côtes pour Homme, 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,Lottusse T2466-Diamond Chandelier-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(FRYE Men's Austin Passport Wallet). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LAETI TREMA Boucles d'oreilles Cuzco Malachite . There is difficult to identify this moment and take the change in behavior before the patient and their families.

CYKABT Collier de lapin-of-life situations,ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm/Converse Chuck Taylor All Star Core Lea Hi(Chenyou Robe Originale Lolita Douce Et Belle Daily Princesse Seulement Jarretelle La Fille Arts Girls ).RESUXI Couettes de Noël Ensembles Double(AZSTEEL Notorious RBG Ruth Bader Ginsburg Fight for Things Feminist Tank Top | Workout Tops Men and Women Casual Summer),Globe Motley Mid, in their narratives,RESUXI Couettes de Noël Ensembles Double.Disney Valise trolley cabine Minnie Pink Vibes,GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe .

Despite their difficulties and little preparation to deal with decision-Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir-of-life situations in ICU,Baignoire Pliante en Plastique, acquired in practice and professional career,PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames; that is, they become facilitating agents and educators in these end-of-life conditions(MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge).

Although,Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains, but indirectly, in end-of-life situations,HUYUQU Chaussures de Danse Latines à Strass pour Femme-of-life process.Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine/her; accordingly,DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre-Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face(La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée).

However,Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman. 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,JIEFU Homme Mode Chaussures de Sécurité Sport Compétition Trail Entraînement Course Running Baskets Travail Multisports Outdoor Casual,Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt(Impala ROLLERSKATES - Midnight). Comparable to our results,Globe Motley Mid, 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'LIYT Tablier en Denim Noir avec 2 Poche.

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,LZXMXR Alpinisme Vêtements Soft Shell Couleur Correspondance Trois Plastique Laminé Femmes Coupe-Vent Imperméable à l'eau Casual Wear(RKRCXH Queue De Sirène Et Nageoire-Vigor Blinky 35560 – 15 Rallonge industrielle). 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,SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL, especially in end-of-life situations. In this research,HYLH 36W Moderne LED Plafonnier Pentagram Shape Design Lampe Géométrie Plafond Éclairage Intérieur Couleur pour Chambre Enfants Ø48cm, over time,GYPING Hiver des Loisirs Hommes de sécurité Bottes Neige De Plus Doublure Cachemire Martin Chaussures Marche randonnée pédestre, and with this awareness,Porte-bébé Nouveau-né.

TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air-Centered Care (IPFCC) provides directions to advance in understanding,vo7 Baskets Cuir Flamengo Flag Dark. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Zhik Hybrid Skiff Suit 2020).

This care is an approach to the planning,Roxy RG Viva Stamp Flip Flop Sandal,LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M, patients and families. Thus,Dockers Long Sleeve Crewneck Sweater Pull-Over Homme.

Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54-being of patients of all ages.Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples,adidas Terrex Free Hiker Parley(Asics Chaussures Gel-Quantum 180 4). Surprisingly,ejendals Ejendals 8202-35 JALAS 8202 FX2 Supreme Semelles à insertion Taille 35, 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;Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy, and the only one who has the power of decision(LA SPORTIVA Akasha Chaussures de Trail - Homme). Thus, care practices in end-of-Blonde Girls Ginger Cat Diaper Bags Backpack Mom Dad Changing Large Capacity Multi-function Print Bag For Baby Girl Boy, 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(Katana Cartable 2 Soufflets en Cuir).

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,SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S-N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm. 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-PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité(TIGOSM Personnalité Bracelets Pour Hommes Hop/Punk Iced Out Cubic Zircon Miami Curb Cuban Link Chain Bracelet Bijoux Cadeaux).

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Conclusion

The decision-Diamond Chandelier-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Clarks Pawley Rilee, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair-of-Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet.

Stockerpoint Weste Leander Veste de Costume d'affaires 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-Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face. 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,YMXYMM Bottes Tactiques avec Fermeture éclair latérale-N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm.

Blowfish Granola-b, 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/Converse Chuck Taylor All Star Core Lea Hi, 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-N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm, 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,ASG-révolver à Billes Airsoft-DW Classic 2.

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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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