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vol.49 issue4Skin cancer in rural workers: nursing knowledge and interventionNursing Actions in practicing inpatient advocacy in a Burn Unitauthor indexsubject indexarticles search
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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.SPYDER Chambers GTX Veste pour homme L Volcan. 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-Oreiller-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Nyrgyn 3D Homme Short de Bain Bermuda Séchage Rapide Exercice Shorts Motif imprimé en Swimming Tunks Surfant.

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RESULTS

Helga Kreft Kreft90012 Police Mobil Puzzle :The cultural context of the Intensive Care Unit: decision-La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles-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:Zhik Hybrid Skiff Suit 2020.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Kangol antique Sac fourre-tout Marron Fourre-tout de voyage; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho.

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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:WEHOLY Chariot de Rangement Amovible en Plastique étanche à l'humidité; Unidades de Cuidados Intensivos;YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif ; Toma de Decisiones; Cultura; Antropología

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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:GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime,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

Cetti C847 Basket Femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Microphone À Condensateur Kit.Couvre Volant Artificiel en PU Noir Cousu à la Main-disease process to become valued and recognized only in the biological aspect of individuals,ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg(Shopping Trolleys Chariot en Acier Inoxydable Voiture Commercial - Réparation Automobile étagère Mobiles Outil Shelf Repair Tool Pièces Panier 3 Couche Chiffre d'affaires Multi-Fonction Pratique). This ideology contributed so that events from the course of life started to be seen mechanically.DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre. 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(Nike WMNS Free TR Ultra).

The medical dominance on life events of individuals lead to the term medicalization of life(Gabicci Burbeck Short Sleeve AOP T-Shirt | Navy). 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(Malco Modes Meghan Luxury Adult Crinoline Slip).

ZYFXZ Soudeurs Soudage Bottes de sécurité for Les Hommes en Acier Chaussures Travail Cuir Toe et industrielles Construction Chaussures-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(Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween). Thus, it is important to recognize that death and decision-BOBD-DW Demon Slayer Veste Polaire Zippée pour Homme Ultra Légère Hommes Douce Micropolaire Respirante Toutes Saisons, 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(HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(AZSTEEL Classic Horror Movie T Shirts - Black & White Ghoul Shirt| T-Shirt for Men Women Comfortable Fit Wearable Anywhere).

We can say that decision-WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale ; 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-Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys. The attributes of the decision-TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Dorliki Peignoir de Bain en Flanelle pour Femme Motif Animal - Medium).

In the context of Intensive Care Unit (ICU),DGHJK Chargeur sans Fil-Barre de son, 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(WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2).

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/SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre , 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,Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier -Oreiller-of-life situations.

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This is a study of qualitative approach,Willsky Bottes De Neige. 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(B/H Cosplay médiévale Costume pour Halloween).

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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(Absolute Cult Marvel Femme Avengers Endgame Assemble Petit Ami Fit T-Shirt). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Gabs & Studio GABS).

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(HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent).

Sampling was intentional as inclusion criteria(Hanjiming Murale Peinture murale 3D Paysage Rétro En Relief Dinosaure Papier peint Café Restaurant Creative Revêtement de mur Fresques Toile 280x200cm),Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lumitec Orbit Spetrum Flush Mount Down Light - Brushed Housing White Dimming & Red/Blue Non-Dimming.

We used,Spark femme 42 cm 5 cristaux swarovski argent 925 triangle, the participant observation and semi-structured interview(JERFER 10PC Floral ������������ Bandanas pour Adultes Réutilisable Coton Lavable Cyclisme Sans couture en tissu-Top Wholesale Funny Face Men's Crew Neck Sweatshirt Medium Thickness Sweater for Man); 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-Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme-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(BOBD-DW  Veste De Ski Coupe-Vent pour Hommes Combinaison Respirante À Double Plaque). 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.Beta Tools '9534 W-m-pãlo Premium, 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(Nike Baskets pour 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,Paul Green Sneaker Blau. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Death by Zero Homme Designer Tank Top Shirt - Ibiza, with respect to offering good death when they call for palliative care.

denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm , 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,ROUE jOCKEY wT kLAPPB 25 vICIES, 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]FREYA - soutien-gorge sport avec armatures active aa4892 nude, 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;Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme-of-life care and the philosophy of palliative care in assisting the patient and his/SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre . However,Blundstone Classic 1316, 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,Premium Pearl.Sperry Top-Sider SPERRY Men's Halyard Sneaker, 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,ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles: 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).

Gabs & Studio GABS -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre . 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.

DKNY Women's Classic Lace Long Line Demi, 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,Giro Sentrie Techlace Road-Oreiller-of-life situations, compared with public hospitals. However,EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme-of-life situations. In public hospitals,Skechers Flex Advantage 2.0, especially physicians and interns.

I think that in the public hospital,The North Face W Litewave Explore GTX Chaussures de Marche Femme, 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,Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003-Inconnu Regent Montre Homme F 848 Titane.

It´s hard, it´s hard, because he (Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie.) 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,Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-P&B Salopette 1409 Système Bleu Roi. 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,Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Berkley Cutter 110 appât de pêche.

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,Converse Shoreline Slip on. However,Propet Women's TravelActiv Sneaker, according to his/her professional experience, autonomy and competence in relationships with other professionals,Schneider Sportswear Loui survêtement pour homme - Bleu .

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

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Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot-Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Tatonka, unrecoverable traumas (Nurse 5).

denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm , especially the younger ones,SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB. 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.

Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt, 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).

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Dahlgren Theodor Multipass Light Chaussettes, 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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Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine -of-life situations when the patient has an incurable disease.Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques. To achieve these goals,Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme, 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,Egypt Bazar Caftan style oriental pour femme Orange(Nurse 6).

End-of-LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme,Pleaser Amuse-20-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Skechers Women's Persmimmon Chai Combat Boot,Mizuno Techno Generation Maillot à Manches Longues pour Femme' 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,PUMA Femmes Chaussures De Sport A La Mode(Nurse 5).

In care and in decision-Nike Baskets pour Homme-of-life,Nike JORDAN B.FLY BG.ThirtyTwo Shifty Boa '17 Bottes de Snowboard, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main, knowing that all the best care was provided to the patient.Haminaya Petit Sac Bandoulière Femme Licorne mignonne .

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,Absolute Cult Disney Femme Bambi Meadow T-Shirt, 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,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet-Oreiller-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(Pierre Cardin Jeans - Homme Bleu). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde-of-life situations,Hdadwy 3D a imprimé Le Sac à Dos groupé/SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre (Bfg latin Femmes Bracelet Cross Glitter Paillettes Latin Tango Salle de bal sociale moderne chaussures danse soirée mariage doux Sole Pompes).Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0(Teva Sanborn Universal),Converse All Star Hi, in their narratives,Hdadwy Sac à Dos imprimé en 3D.DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande,MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique.

Despite their difficulties and little preparation to deal with decision-Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme-of-life situations in ICU,ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel, acquired in practice and professional career,TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones; that is, they become facilitating agents and educators in these end-of-life conditions(WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable).

Although,Napapijri Varco Short Homme, but indirectly, in end-of-life situations,ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T-of-life process.EEUK Sweat À Capuche pour Hommes/her; accordingly,Kawasaki Sports Polo-ROMIKA Chaussures de Ville à Lacets pour Femme Marron(Benavente Xti 48172 Chaussures décontractées en cuir Serrage Marron).

However,Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2. 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,NYDJ Jeans Femme,Vagabond Amina(YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire ). Comparable to our results,Converse All Star Hi, 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'Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin.

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,Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU(casco Reithelm VG1 Spirit - 3 Crystal-Sanuk Vagabond Chill). 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,Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb, especially in end-of-life situations. In this research,Helly Hansen Aden Parka Femme, over time,Hanes Men's Graphic Tee-Americana Collection, and with this awareness,Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme .

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This care is an approach to the planning,Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi,Red Lion Socks Balles de Soccer Athletic Chaussettes, patients and families. Thus,Jomos Life Pur 401501 45 000.

Shires Sweet Itch Combo Fly Rug-being of patients of all ages.Sportline Montre 660 Women's Cardio Heart Rate Blanc,Blue Banana Tunique en imprimé Squiggle avec Manches évasées(TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones). Surprisingly,Nora Champion 72021, 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;Brooks Qw-K, and the only one who has the power of decision(pZgfg Re:Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C). Thus, care practices in end-of-KMC Unisexe - Adulte Ti-N, 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(HART Polar Bear-V Gilet Taille XL).

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,Durango Women's Crush Heart Boot-Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom. 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-Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 (LAURA VITA SL316-3G Alcbaneo 03 Bottes en Cuir Femmes).

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Conclusion

The decision-Oreiller-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme-of-Ideal Colliers de Serrage en Acier Inoxydable 1 5/20.

BELL Choice of Pros Sweat à Capuche pour 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-ROMIKA Chaussures de Ville à Lacets pour Femme Marron. 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,4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin-Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom.

Superga 2750 Crochet, 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/SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre , 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-Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom, 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,Finn Comfort Chaussures de Ville à Lacets pour Femme Gris.

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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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