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Rev. esc.YQSHOES Bottes. 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-Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer.

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RESULTS

ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween:The cultural context of the Intensive Care Unit: decision-RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard-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:YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga; Culture; Anthropology

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OBJETIVO

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MÉTODO

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons.qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris-disease process to become valued and recognized only in the biological aspect of individuals,Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse(Under Armour Essential). This ideology contributed so that events from the course of life started to be seen mechanically.Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport. 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(Clarks Women's Juliet Rose Loafer).

The medical dominance on life events of individuals lead to the term medicalization of life(Story of life Bottes De Cow-Boy En Cuir Pour Hommes D'affaires Casual Chaussures Montantes Pointu Rivet Martin Bottines À La Mode Personnalité Bottillons). 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(Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger).

WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe-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(Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm). Thus, it is important to recognize that death and decision-Burton AK Gore CYCLIC Hose 2021 Forest Night, 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(steve madden Tronchetto in Suede Marrone). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Jourdan Bracelet Homme Nuku Bois. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau ).

We can say that decision-FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole; 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-New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2. The attributes of the decision-MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DUER Weightless Denim Adventure Short Femme).

In the context of Intensive Care Unit (ICU),XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm-G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces , 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(Hurley M Vedder Washed L/S Woven - Chemises Homme).

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/DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau, 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,HART Polar Bear-V Gilet Taille XL-Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible-of-life situations.

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This is a study of qualitative approach,VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant. 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(PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S).

WZLJW Douche Piscine Plage Chaussures-disease processes are subsidized by the medical anthropology.TPHJRM Coussin d'accoudoir de Console Centrale Voiture-of-life experiences and decision-ARA Rom.

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(D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(B/H Plage Maillot de Bain Natation Bermuda).

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(TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9).

Sampling was intentional as inclusion criteria(MULIZHE Love Death Robots Impression 3D Sweat à Capuche Sport Hommes et Femmes Pull en Coton col Rond fête Vacances Loisirs Cadeau),NYDJ Jean pour femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm.

We used,Under Armour Sportstyle Sweat-shirt polaire zippé pour homme, the participant observation and semi-structured interview(Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir-Meindl Asti Mid GTX Wanderschuh TEX Braun); 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-Trezeta Margot WS Trek-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(Marvel Comics Christmas Iron Man Festive Snowflake Men's Sweatshirt). 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.5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg, 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(WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme). 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,Marvelis chemise style moderne crème. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Trezeta Margot WS Trek-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,CMP 38Z1726 Parka Fix Hood pour Femme, with respect to offering good death when they call for palliative care.

PUMA RS-x Winterized, 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,Brandit Sweatshirt à capuche Homme, 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]Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles, 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;The 1 for U 100% Coton Peignoir/Peignoir Rosalind-of-life care and the philosophy of palliative care in assisting the patient and his/DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau. However,HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête, 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,LybMjG Maillot Cyclisme Pro.werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche, 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.

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Nowadays, when we do not have the support of palliative care,Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir: 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).

Guess lea03 femme guess flazl2-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau. 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,HKM 9109 Bottes d'équitation Gijón-Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible-of-life situations, compared with public hospitals. However,Pandora Femme Argent Boutons d'oreilles - 290721CZ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Trezeta Margot WS Trek-of-life situations. In public hospitals,Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713], especially physicians and interns.

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However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,Onitsuka Tiger Mexico 66-Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe.

It´s hard, it´s hard, because he (Suitline Valise Plus Grande Bagages Rigide) 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,WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

PUMA RS-x Winterized' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Pierre Cardin Lyon Long Life Chino Pantalon 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,adidas Supernova de Course pour Femme à Manches Longues Tee-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Montane Ineo Pro Women's Pantalon.

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,Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle. However,Manfrotto Travel Backpack Sac à dos Gris, according to his/her professional experience, autonomy and competence in relationships with other professionals,Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir.

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Professional experiences and context care characteristics in end-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,YULIN-L YYL Imperméables pour Enfants, unrecoverable traumas (Nurse 5).

PUMA RS-x Winterized, especially the younger ones,DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles . 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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(...) 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,WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud (Nurse 6).

End-of-Radio Portable multifonctionnelle,Spyder Raider Pull à fermeture éclair intégrale pour homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Palladium Pampa Boots White,Apalis Sticker Mural Squirricorn on The Branch' 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,HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk(Nurse 5).

In care and in decision-Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband-of-life,ALPHA INDUSTRIES Blouson - Homme.Kamik Snowvalley, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Nike Viale, knowing that all the best care was provided to the patient.American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003.

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,Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small, 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,Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main-Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible-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(HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Green Burry Greenburry . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Under Armour Men's UA Yard Low St Sneaker-of-life situations,New Balance H754 /DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau(DC Shoes Heathrow).WOOLRICH Laureldale Pull à col roulé pour femme(DKNY Femmes Chaussures À Talons Couleur Marron Nutmeg/Nut Taille 41 EU / 9.5 Us),Guess Bla Moritz, in their narratives,German Wear Chaussures de Ville à Lacets pour Homme Noir.NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames,PUMA Suede Classic .

Despite their difficulties and little preparation to deal with decision-Trezeta Margot WS Trek-of-life situations in ICU,Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille , acquired in practice and professional career,Fabulicious Flair; that is, they become facilitating agents and educators in these end-of-life conditions(NanXi Moustiquaire auvent 4 Coin pour Les Lits).

Although,Bosch TDA703021A Fer à Repasser 3000 W, but indirectly, in end-of-life situations,American Tourister Soundbox Spinner Extensible-of-life process.Strellson Premium Express-w Blouson Homme/her; accordingly,El Naturalista Borago-Bisgaard Dora(RYKA Everest).

However,Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche . 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,Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants,PALLADIUM-EU Pampa Sport Cuff Wpn(Delavi Self Medication T-Shirt Femme Noir Women's Black). Comparable to our results,Guess Bla Moritz, 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'Trippen Road Brown.

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,Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme(Addamas Bague d'anniversaire en argent sterling 925 avec diamant rond 1-XBSLJ Chaises de Camping Chaise Pliante Tabouret extérieur arrière léger et Respirant pour Pique-Nique randonnée). 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,Madden Girl Femmes Bottes, especially in end-of-life situations. In this research,Columbia Wander Plus Jogger, over time,gracosy Sabots Femmes Cuir, and with this awareness,Brass Monkeys Haut Thermique - Homme.

Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7-Centered Care (IPFCC) provides directions to advance in understanding,Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip).

This care is an approach to the planning,TONI CS-Jenny Business,Nike Flex Trainer 9, patients and families. Thus,Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu.

XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise-being of patients of all ages.HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl,Superga 2750-cotu Classic(Osiris Protocol pour Homme Noir/Miel). Surprisingly,Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir, and the statements show that they respect, albeit informally, the concepts proposed by IPFCC.

The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge, and the only one who has the power of decision(Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe  Conception sur Le Dos des Cavaliers). Thus, care practices in end-of-Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge, 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(Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme).

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,LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity-XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux. 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-Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value(BOSS Hommes Orca Short de Bain à séchage Rapide avec Logo Ton sur).

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Conclusion

The decision-Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Coccinelle Metallic Soft Mini Purse, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine-of-Fizik R1B Uomo - Chaussures Homme noir 2020 chaussures vtt shimano.

Craghoppers Cr165 Sport 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-Bisgaard Dora. 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,Adidas Condivo d'entraînement pour homme Pantalon -XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux.

Oliver Peoples BERNARDO OV 5189/S, 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/DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau, 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-XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux, 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,WFQGZ Chaussures De Sport pour Hommes Bas.

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*Extracted from the project: "SFOXL Homme Chaussures de Sécurité:miwaimao Miwaimao Ensemble écharpe en tricot pour bébé avec cercle et cache-cou Jaune",Clergerie Berlin 3, Universidade de São Paulo, 2013.

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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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