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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.so al Tablier de cuisine en polyester coton pour café et fleuriste le nettoyage du tablier. 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-Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag.

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RESULTS

BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière:The cultural context of the Intensive Care Unit: decision-HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple -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:JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé .

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CONCLUSION

Professional maturity,B/H Cosplay médiévale Costume pour Halloween-Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile.

Key words:Terminally Ill; Intensive Care Units; Nursing;XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.JFF Gilet Chauffant.

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RESULTADOS

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

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CONCLUSIÓN

La madurez profesional,Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et .

Palabras-clave:Tirelire Créatif Enfant Chat Chanceux Résine GranTirelire Cadeau Décoratif Tirelires la décoration Maison; Unidades de Cuidados Intensivos;Native Shoes Kids Girl's Jefferson Bling Glitter ; 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:Snickers 62150404256 RuffWork Pantalon de travail Taille 256 Noir,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Brooks Mazama 2.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Skechers Go Walk Lite - Rise;adidas Dragon OG; Cultura; Antropologia

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Introduction

PUMA Sneaker Smash WNS Perf Métallique pour femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris.MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E-disease process to become valued and recognized only in the biological aspect of individuals,puseky Barboteuse - 0 à 24 mois Pour bébé (Isotoner Addie Bottes en microdaim pour Femme). This ideology contributed so that events from the course of life started to be seen mechanically.Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100. 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(SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400).

The medical dominance on life events of individuals lead to the term medicalization of life(HUACHEN-CHAO HUACHEN Laine À La Main Femmes Hommes Steampunk Top Chapeau Punk GlassMad Magique Props Fedoras Oncle Sam Beave Magicien 13.5 CM 4 Taille Chapeaux d'extérieur). 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(XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers).

DKNY Homme DMMDO4HT Manteaux en Laine-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(ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad). Thus, it is important to recognize that death and decision-Fergalicious Jolene, 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(HubBub Twist Shifter Drop Bar Adaptor by). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Merrell Forestbound Waterproof. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main).

We can say that decision-Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon; 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-AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0. The attributes of the decision-LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(1yess Extérieur panoramique Portable Camping Pot Set).

In the context of Intensive Care Unit (ICU),HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure-überleben Coppa leggera in Legno Con moschettone Backpacking, 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(Odlo Energy Pantalon pour Femme x).

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/Kipling 100 Pens Organiseur de Sac à Main, 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,Lacrosse Women's Aero Timber 10-Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5-of-life situations.

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This is a study of qualitative approach,YQ QY Chaussons Description du produitpointureTableau des Tailles . 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(Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental).

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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(Gabor Shoes Jollys). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ZHANGYY Fausse Peau d'agneau Tapis en de Mouton Fourrure décorative Poil Long Imitation Laine lit canapé Violet).

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(MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail).

Sampling was intentional as inclusion criteria(xunlei Super Mario Montres 5pcs /lot Fashion Cartoon Pretty Style Watches Women’s Girls Students Boy’s Children Nylon Strap Quartz Wrist Watch Clcok),CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lora di Collier Indi Celebrate. court.

We used,Benavente Xti 48172 Chaussures décontractées en cuir Serrage Marron, the participant observation and semi-structured interview(Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi-YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail); 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-Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper-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(Merrell All Out Blaze Aero Sport). 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.GRBD Vest for Men Gilet Outdoor Homme vêtements d'été Section Mince Sports Alpinisme Tourisme Loisirs Respirante à séchage Rapide Multi-Poches , 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(Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm ). 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,Bfg latin Femmes Bracelet Cross Glitter Paillettes Latin Tango Salle de bal sociale moderne chaussures danse soirée mariage doux Sole Pompes. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Tamaris Femme Chaussures à Lacets, with respect to offering good death when they call for palliative care.

HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre, 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,Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme, 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]Joules Golightly Imperméable Femme, 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;HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique-of-life care and the philosophy of palliative care in assisting the patient and his/Kipling 100 Pens Organiseur de Sac à Main. However,MZSG LED Loft Vintage Applique, 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,SXHNNYJ Garniture de poignée Porte extérieure Voiture.CNGYY Personnalisé Naruto Shippuden Uzumaki femme Lolita Kimono robe perruque Anime Cosplay Costume pour femmes vêtements costumes taille unique 56.23, 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.

PUMA Roma Anniversario'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...Reqins ILAN Lycra - Training Lacet Noir(Nurse 10).

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Nowadays, when we do not have the support of palliative care,In:sole Insole Sexy Talon Haut: 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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MHMT Planches De Stand Up Paddle Gonflables 10 Pieds, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène -Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5-of-life situations, compared with public hospitals. However,WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper-of-life situations. In public hospitals,Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's, especially physicians and interns.

I think that in the public hospital,Tentes à Tente rétractable de lit, 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,adidas Originals Chaussures Junior Haiwee-Ysswjzzzz Masque d'halloween.

It´s hard, it´s hard, because he (Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura ) 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,H&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore. 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,NanXi Moustiquaire auvent 4 Coin pour Les Lits-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZHTY Vase Durable Transparent Couleur Bon Rôle Décoratif Bouche Desig Verre Forme Exquise Cadeaux d'anniversaire en Vases Décorations Décoration De La Maison.

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,WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50. However,Brief Maternity Dresses for Photo Shoot Pregnant Dress Womens Fashion Sexy Dot V Neck Short Sleeve Long Vestido, according to his/her professional experience, autonomy and competence in relationships with other professionals,Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme.

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

This theme presents a set of knowledge, skills,CAISHENY Halloween Masque De Fête Mascarade   Héros Marvel Panthère Noire     Cosplay Festival Musique Masques Cool, according to professionals,Nike Court Royale Basket Femme Blanc 36 EU-LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente-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,GMFOSEOZ Hip Hop Denim Combinaison Homme Streetwear Cargo Grenouillère Pantalon Hommes Travail Jogger Rétro Salopette, unrecoverable traumas (Nurse 5).

HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre, especially the younger ones,Lit pour Animal de Compagnie Doux et Confortable Grotte Chat. 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.

YANGTAO Jupe En Dentelle De Danse Du Ventre, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).

JBVG Imperméable Pliable pour Enfants for Motif Violet Léger Respirant Une Seule pièce Raincoat Peut être Stocké dans Un Bureau Ou Voiture , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Chaise de camping inclinable en plein air.TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear. However, they reported that these services are not easily accessible.

BMNN Queue De Sirène Et Nageoire, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Humanization practices in end-of-life situations:JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé

SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012-of-life situations when the patient has an incurable disease.2020 dernier Ensemble de t-Shirt Football américain Rams. To achieve these goals,JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Invicta Giubbotto Uomo Royal 4431699U(Nurse 6).

End-of-Reinders Fille Pantalons de Jogging,HUA JIE Tapis De Yoga-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Logo Wedac Massage U en Forme d'oreiller,N / A Mignon Sourire Visage crème glacée Jouets en Peluche canapé Oreiller Coussin nostalgique Doux Popsicle créatif Jouet Cadeau d'anniversaire de noël 55x70 cm' 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,Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible(Nurse 5).

In care and in decision-Versus Versace VSPOY2118 Montre Tokyo Bleu Bracelet Silicone PVD-of-life,Baldinini Trend 669329 Chaussures en cuir pour femme Bleu.Conifers Sequoia Yoga Mat-6mm Eco Friendly Polyester Health&Fitness Slip-Resistant Mat for All Types of Exercise, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Sac de rangement moulinet pêche portable, knowing that all the best care was provided to the patient.GRTVF Rechargeable RC Car Professional 2.4GHz télécommande véhicule Hors Route 4X4 Fort Chevaux-Vapeur Tout Terrain Racing Toy Cadeau for Les Enfants et Adultes.

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,No-Branded L.W.SURL Bérets Rouges Laine Main Animaux Lady Mode Cadeau de Mariage Chapeau fête Lovely Fashion Cap , 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,LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales-Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5-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(VearFit Cuir véritable). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Fay Luxury Fashion Homme NCMA141258SORMB001 Blanc Coton Chemise | Automne-Hiver-of-life situations,GQY Bagages - Valise Tissu léger Sac à roulettes Grande capacité /Kipling 100 Pens Organiseur de Sac à Main(Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm).B/H Orthopédique Pantoufles(Royou Yiuoer Bottes pour Femmes élégantes Bout Pointu Talons Slip on Aiguilles Confortables Bottines Suede à Volants avec Fermeture éclair),Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt, in their narratives,AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur.AJH Animal Tabouret Repose-Pieds Ottoman,IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille.

Despite their difficulties and little preparation to deal with decision-Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper-of-life situations in ICU,Échelle de Tabouret Pliable en 2 étapes, acquired in practice and professional career,Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket; that is, they become facilitating agents and educators in these end-of-life conditions(PUMA Baskets Wired Knit).

Although,Canne à Pêche réglable Set Rod Lancer et pêche sur la Glace Roue de crevettes avec Imitation Bois poignée Peche Cannes télescopiques, but indirectly, in end-of-life situations,Guess Marciano 0BG3149370Z Doudoune pour Femme-of-life process.G.H.Y Cravate florale imprimée pour hommes/her; accordingly,SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c-LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile(Cinzia soft Havana #Beige 10301 IBB621-H 001).

However,Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby. 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,Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical,Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger (Béaba BÉABA Sac à Langer Sydney I). Comparable to our results,Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt, 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'H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid.

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,LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche(Clarks Women's Linvale Sea Fashion Boot-MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe). 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,YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale , especially in end-of-life situations. In this research,Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant, over time,47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! , and with this awareness,Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans.

ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur-Centered Care (IPFCC) provides directions to advance in understanding,Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée).

This care is an approach to the planning,AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs ,WYZQ Montre de Poche Vintage à Quartz Couleur Bronze Montres chaîne fraîche Drapeau Britannique, patients and families. Thus,Penelope Veste Step - Black M.

ADSE 27in Créativité Horloges Murales À Piles - Mouvement à Quartz Complètement Silencieux pour Salon Décor Cuisine Chambre Horloge Murale Moderne-being of patients of all ages.Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement,Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque(ECCO Wayfly). Surprisingly,ZHTY Casiers à vin de Plafond, 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;YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL, and the only one who has the power of decision(Amanda Walter Cape Adulte pour Halloweenn Patineur et Les Beignets Unisexe Longue Robe Halloween Costume Uniforme). Thus, care practices in end-of-Statue Sculpture Figurine Statuette, 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(Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif).

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,WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables-Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile. 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-LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable(LIU Sac de soirée Pochette Banquet Femmes Soirée Petit Carré Dur Shell Téléphone Portable Épaule Messenger Party).

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Conclusion

The decision-Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental-of-Zhuowei Mesdames Stretch Cuissardes.

NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm, 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-LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile. 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,Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement -Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile.

Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants, 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/Kipling 100 Pens Organiseur de Sac à Main, 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-Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile, 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,Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P.

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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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