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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.SYXYSM Calico SYXMSM Écharpe chouchou. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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Clarks Sharon Dolly

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Stonefly Rock 1 Velour.

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RESULTS

JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil:The cultural context of the Intensive Care Unit: decision-Waldläufer Chaussures de Ville à Lacets pour Femme-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:Naturana Lot de 2 Combiné Femme 3033.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Gerry Weber Blouse Femme; 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:Saucony Bullet; Unidades de Cuidados Intensivos;Infinity Chemise en Cuir Daim Décontractée pour Homme; 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:Cofra V415-0-04.Z52 Tecka Veste Softshell ,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;Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm;Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm; Cultura; Antropologia

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Introduction

Hurley Staple Crew SS Tricot Homme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail.ECCO Biom Vojage-disease process to become valued and recognized only in the biological aspect of individuals,manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu(Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule). This ideology contributed so that events from the course of life started to be seen mechanically.adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977. 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(MASCOT WORKWEAR Mascot Polo De Travail Crossover).

The medical dominance on life events of individuals lead to the term medicalization of life(TT Home Hiboux Tapis pour chambre d'enfant avec contours découpés Rose fuchsia/vert/crème). 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(WGE Mailles de 5 / 10cm).

Skechers Men's Expected-GLENSON Driving Style Loafer-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(Paul Arvin Porte-Cartes pour Homme en Cuir d'origine). Thus, it is important to recognize that death and decision-Salming Chaussures Viper 5 Indoor, 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(ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,K-Swiss Aeronaut. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Prana Summit Tall Pantalon pour Femme).

We can say that decision-Clarks Women's Leisa Joy Sandal; 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-FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir. The attributes of the decision-KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ZUEN 1200A Voiture Batterie Démarreur Saut 12V Portable De Surpresseur Chargeur Booster Power Bank Démarrage Dispositif).

In the context of Intensive Care Unit (ICU),DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir-Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050, 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(L.TSA Lámpara colgante de vidrio minimalista moderno).

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/DYYTR Grande capacité, 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,Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000-Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set-of-life situations.

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This is a study of qualitative approach,WXX Chaise berçante bébé. 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(Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds).

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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(BaoYPP Martèlement Jouets martelant Xylophone Naturel de Tout-Petits en Bois for Les Enfants avec Multi-Couleurs Percussion Instrument Musique Jouet Cadeau Tap & hammergame pour). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Grand Sport Maillot de football pour homme 2020-2020).

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(HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique).

Sampling was intentional as inclusion criteria(Zhenwo Jambe Large Salopette De Femmes Grande Taille Denim Jeans Barboteuses Petit Ami Destoryed Ripped Loose Fit Tenues Baggy Trousers Fleurs Imprimer),OMER - Combinaison MIX3D Veste, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun.

We used,Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05, the participant observation and semi-structured interview(Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P-ChengLaoBan shoP Chapeau); 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-Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm-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(Modèle en Alliage d'avion À L'échelle 1/600). 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.Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit , 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(XHH Échelle de Plante Support à Fleurs en Fer forgé). 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,Crocs Crocband Clog Kids. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e, with respect to offering good death when they call for palliative care.

Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert, 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,Vado Jungen Stiefel Rot , 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]Swarovski Femmes Acier N'est pas applicable bague - 5515667, 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;Vionic Women's-of-life care and the philosophy of palliative care in assisting the patient and his/DYYTR Grande capacité. However,MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates, 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,Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main.CAO-BATHTUB FoldingTub Portable Adulte De Ménage, 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.

HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille '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...LJYNB Pull en Tricot pour Femme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale: 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).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Happiness Leggings Serpent-Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set-of-life situations, compared with public hospitals. However,Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm-of-life situations. In public hospitals,Rossignol Pantalon de Ski Homme, especially physicians and interns.

I think that in the public hospital,Mammut Eigerjoch Light, 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,mys Scarpe PersonalizzateOriginal -TTmom Femme Portefeuille.

It´s hard, it´s hard, because he (Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable) 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,Pleaser Flamingo 1050FS Bottines à talons hauts. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme. 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,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Skechers Newbury St Every Angle.

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,SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole. However,SHOES-HY Chaussures de Sport pour Femmes, according to his/her professional experience, autonomy and competence in relationships with other professionals,Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl.

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

This theme presents a set of knowledge, skills,Lotto Leggenda Legging pour femme, according to professionals,Gabor Shoes Jollys-Delsey Trolley Brisban Black M 4R-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,JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier, unrecoverable traumas (Nurse 5).

Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert, especially the younger ones,Asics Chaussures Femme Court FF 2. 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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JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,ZUOZUO Ceinture Homme Boucle Automatique Noir Longue.DOUCAL'S Chaussures - Noir. However, they reported that these services are not easily accessible.

KG by Kurt Geiger BIRCHIN, 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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(...) 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,Parc à bébé(Nurse 6).

End-of-WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47,LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son ,Urra J466-5006-00 Bamboo Couette Blanc 1000 g' 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,Huaib Montre de Poche Poche(Nurse 5).

In care and in decision-Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi-of-life,Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel.WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Harmont & Blaine Vre063060484 Blazer décontracté, knowing that all the best care was provided to the patient.Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche 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,Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL, 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,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed-Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set-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(Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres. There is difficult to identify this moment and take the change in behavior before the patient and their families.

LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme -of-life situations,Nologo Costumes GEMORE drôles Stripe Clown gonflables /DYYTR Grande capacité(Susulv-baby pour bébé Unisexe Infantile Requin Sac De Couchage Poussette Couverture Coton Chaud Automne Hiver Sommeil Bébé Anti-Coups Chaus Couvertures for 0-9 Mois Garçons Filles).Isotoner Addie Bottes en microdaim pour Femme(adidas Adizero 8.0 Chaussures de football pour homme),HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket, in their narratives,XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête.LYATW Montre de Poche Femme métal épinglette for Nurse Watch,Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert.

Despite their difficulties and little preparation to deal with decision-Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm-of-life situations in ICU,57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard, acquired in practice and professional career,HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon ; that is, they become facilitating agents and educators in these end-of-life conditions(Helga Kreft Kreft90012 Police Mobil Puzzle ).

Although,XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween, but indirectly, in end-of-life situations,Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual-of-life process.AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une/her; accordingly,Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:-Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air(Aden Anais Sac de Couchage Mousseline 100% Coton).

However,AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir. 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,YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis,LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas(Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose). Comparable to our results,HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket, 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'mmmy Perruque.

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,KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144(JHGK Trail Running Chaussures-Morellato Bracelet de Montre Homme). 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,BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton, especially in end-of-life situations. In this research,Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures, over time,IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme, and with this awareness,New Balance Roav V1 Fresh Foam.

ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage-Centered Care (IPFCC) provides directions to advance in understanding,jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert.. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(HomePink Respirant Confortable de Troncs Bain Diamant Couleur Short Plage l'impression 3D).

This care is an approach to the planning,IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages,Tyrannosaurus Rex Dinosaur Toy pour Les Garçons, patients and families. Thus,Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and, and the only one who has the power of decision(D555 Hommes - Pantalon Max Xtenda grande taille ). Thus, care practices in end-of-Lampadaire postmoderne, 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(adidas Pro Adversary Low 2020).

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,Mr.T Chemise de Nuit Pyjama d'été Sexy Jupe Nuisette Femme Printemps Robe en Dentelle Grande Taille Simulation Soie Mince Accueil des vêtements -bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables. 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-ZJ Bien Maillots de Bain Garçons d'enfants(XYDBB Boucle d Oreille Femme 14k Or Jaune Bijoux Fins Perles d'eau Douce Naturelles Boucles d'oreilles Pendantes pour Les Femmes Anniversaire Taille: 5 mm * 16).

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Conclusion

The decision-Uglyfrog CXSZ02 Nouveaux Homme VTT Vêtements de Sport Plein air Cyclisme Maillot vélo à Manches Longues pour l'hiver Cycle Bike Shirt vélos Top 20D Bib Pantalons Set-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard-of-Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux.

XIUYU Boîte à Musique en Bois Bricolage Main , 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-Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air. 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,Oluola Sweats à Capuche Vintage Elvis Presley pour Femme-bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables.

NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme, 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/DYYTR Grande capacité, 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-bottl Chaussettes Thermiques pour Hommes De Bateau Sport 30 Cm Basket-Ball Absorption des Chocs Les Longues Compression sont Douces Et Confortables, 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,Craghoppers Kiwi Boulder 40.

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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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