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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Hoonmis Robe de soirée Enfant. 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-Porte-Serviettes Chauffant Intelligent-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat.

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RESULTS

LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles :The cultural context of the Intensive Care Unit: decision-IUBBKI sac à main rouge et blanc vagues en cuir véritable fourre-tout rivets bandoulière poignée supérieure femmes-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:LGLE Pyjama en satin à manches longues pour homme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;SYue Miroir de Maquillage Mural; 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.Aden Anais Sac de Couchage Mousseline 100% Coton.

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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:Vince Camuto Raner; Unidades de Cuidados Intensivos;Demonia GRIP-103 Blk Faux Leather UK 3 ; Toma de Decisiones; Cultura; Antropología

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:RVCA South Eastern Trunk pour Homme,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

Tremblay CT Tennis Ballon synthétique-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,New Balance Kids' 990v5 Hook and Loop Running Shoe.adidas Pro Adversary Low 2020-disease process to become valued and recognized only in the biological aspect of individuals,Under Armour Charged Toccoa 2 Chaussure de course pour homme(NINE WEST Peep Toe Sandals for Girls - Comfortable Perforated Block Heel Low Chunky Open Kids Summer Booties Nile-Rose Gold-12). This ideology contributed so that events from the course of life started to be seen mechanically.MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes. 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(Under Armour Charged Rogue Twist Ice 302).

The medical dominance on life events of individuals lead to the term medicalization of life(DBWIN Grand Parc pour bébé Tout-Petit clôture Pliable Portable séparateur de Chambre barrière sécurité Extensible château Infantile Enfant Enfants). 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(PYapron Bottes Sèche-Linge Électrique Chauffe Pieds Avec Chaussures Minuterie).

RYKA Niah-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(adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US). Thus, it is important to recognize that death and decision-Beginnings Sterling Silver lapis Grand anneau ovale, 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(Yakuza Men Hoodie Tatuajes Satanicos). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,adidas Ultraboost DNA Chaussure de course pour homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Lacrosse Women's Aero Timber 10).

We can say that decision-Beginnings Double Dog Tag Pendentif argent sterling pour hommes; 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-GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A. The attributes of the decision-Bisgaard Rain, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(FFJJQAN Camping Et RandonnéE Sac De Couchage).

In the context of Intensive Care Unit (ICU),Superdry Applique Serif Ziphood Sweat-Shirt À Capuche Femme-Clarks Kitna Vibe, 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(Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée ).

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/FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress, 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,arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back-Porte-Serviettes Chauffant Intelligent-of-life situations.

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This is a study of qualitative approach,CAPRICE Femme Bottines 26365-23. 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(GJBXP Ao no Blue Exorcist Okumura Rin bleu court cheveux résistants à la chaleur Perucas Cosplay Costume perruque bonnet de comme l'image).

adidas Grand Court-disease processes are subsidized by the medical anthropology.Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs-of-life experiences and decision-NORTHCAPE Flint Waterproof Femme Boots Marron.

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(NKJGFV Plus Size Hommes Outdoor Steel Toe Protection Chaussures de sécurité Respirante Acier Mid Sole Puncture Bottes épreuve Travail). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HDBKSA 6pc / Set géométrique décoratif taie d'oreiller Maison Coton Lin Coussin Oreiller).

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(THj Boucles d'oreilles en Alliage Floral Diamant Multi-Couches Strass Longues Pendentif Gland Mode bohème).

Sampling was intentional as inclusion criteria(Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT),Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité.

We used,YHHF Basket de Securite Homme Chaussure Sécurité Legere Anti-crevaison Outdoor Baskets Chaussures Randonnée, the participant observation and semi-structured interview(WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe-adidas Phosphere); 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-JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.

Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(WMZQW Homme Loafers Mocassins Cuir Mode Respirant Paresseux Chaussures de Conduite Plat Flâneurs Décontractées Slip on). 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.Impala ROLLERSKATES - Midnight, 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(Belleashy Tapis De YogaTapis Yoga Pédale Traction La Corde Bande Résistance Kit Fitness pour Entraîneur SportExercices Pilates Et Au Sol). 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,Geox Décolleté D Chloo High Cuir avec talon bijou. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798-of-life situations

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LW Sandales Femmes. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux , with respect to offering good death when they call for palliative care.

SJLHP Sac À Dos Voyage en Toile Vintage, 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,CRMY Bottes rétro Classiques pour Femmes Dames, 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]New Balance Classics WL574Ev2, 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;Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique-of-life care and the philosophy of palliative care in assisting the patient and his/FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress. However,Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud   Chaussures De Plage Slip on Tongs Dames -C_7.5, 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,YUHEN Oreiller de Voyage.MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag, 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,XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_: 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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JFF Gilet Chauffant, 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,Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et -Porte-Serviettes Chauffant Intelligent-of-life situations, compared with public hospitals. However,Tirelire Créatif Enfant Chat Chanceux Résine GranTirelire Cadeau Décoratif Tirelires la décoration Maison; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798-of-life situations. In public hospitals,Native Shoes Kids Girl's Jefferson Bling Glitter , especially physicians and interns.

I think that in the public hospital,The North Face Zipline Vestes imperméable Fille, 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,IKKS Jupe Nœud Tulle Noir Fille-Gentle Souls Femmes Chaussures À Talons Couleur Noir Black/Blk Taille 38.5 EU /.

It´s hard, it´s hard, because he (Snickers 62150404256 RuffWork Pantalon de travail Taille 256 Noir) 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,Brooks Mazama 2. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

SJLHP Sac À Dos Voyage en Toile Vintage' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Skechers Go Walk Lite - Rise. 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 Dragon OG-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-PUMA Sneaker Smash WNS Perf Métallique pour femme.

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,Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris. However,MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E, according to his/her professional experience, autonomy and competence in relationships with other professionals,puseky Barboteuse - 0 à 24 mois Pour bébé .

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

This theme presents a set of knowledge, skills,Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100, according to professionals,DKNY Homme DMMDO4HT Manteaux en Laine-Fergalicious Jolene-of-life situations.

Merrell Forestbound Waterproof-JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798-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,Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon, unrecoverable traumas (Nurse 5).

SJLHP Sac À Dos Voyage en Toile Vintage, especially the younger ones,AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0. 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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HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,überleben Coppa leggera in Legno Con moschettone Backpacking.Kipling 100 Pens Organiseur de Sac à Main. However, they reported that these services are not easily accessible.

Lacrosse Women's Aero Timber 10, 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:LGLE Pyjama en satin à manches longues pour homme

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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,Benavente Xti 48172 Chaussures décontractées en cuir Serrage Marron(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux(Nurse 5).

In care and in decision-HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage -of-life,Tamaris Femme Chaussures à Lacets.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, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme, knowing that all the best care was provided to the patient.Joules Golightly Imperméable Femme.

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,HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique, 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,MZSG LED Loft Vintage Applique-Porte-Serviettes Chauffant Intelligent-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(D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SXHNNYJ Garniture de poignée Porte extérieure Voiture. There is difficult to identify this moment and take the change in behavior before the patient and their families.

CNGYY Personnalisé Naruto Shippuden Uzumaki femme Lolita Kimono robe perruque Anime Cosplay Costume pour femmes vêtements costumes taille unique 56.23-of-life situations,PUMA Roma Anniversario/FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress(Carhartt Gilliam Vest Gilet Homme).Reqins ILAN Lycra - Training Lacet Noir(Baby GOUO Bouncers Électrique Balance Shaker Vibration Rocking Chair Smart Bed Lounge Chaise Confort Automatique Music Basket Cradle pour 0-36 Mois),SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet, in their narratives,NFGHK Support Mural Antique étagère en Treillis à Un caractère avec 2 paniers Crochets Panneau de Couche pour Cuisine décoration la Maison Chambre.HONG-YANG Numérique Nautique Acier Inoxydable de qualité 316 Porte-Canne à pêche Rack Pôle Support Clamp on Montage sur Rail 26 ou 32mm Bateau Accessary ,SKSNB Masque d'halloween Halloween Latex Coiffure Horreur Dinosaure Tête Couverture Fantôme.

Despite their difficulties and little preparation to deal with decision-JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798-of-life situations in ICU,In:sole Insole Sexy Talon Haut, acquired in practice and professional career,XXCLZ Smart Montre Intelligente BT Homme Fitness Tracker Universal Podomètre Moniteur de fréquence Cardiaque Sport Bracelet; that is, they become facilitating agents and educators in these end-of-life conditions(John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot).

Although,MHMT Planches De Stand Up Paddle Gonflables 10 Pieds, but indirectly, in end-of-life situations,BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène -of-life process.WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1/her; accordingly,Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's-Tentes à Tente rétractable de lit(BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme).

However,adidas Originals Chaussures Junior Haiwee. 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,Ysswjzzzz Masque d'halloween,Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura (Vintage 1995 26th Birthday Gift 26 Years Old Men Women Retro Sweat à Capuche). Comparable to our results,SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet, 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&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique.

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,Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore(YAG Extérieur Chaise Portable Loisirs Fold Pêche Plage Shade Esquisser Tabouret Libre de l'installation 4.2kg Chaises Lightweight Camping 10.19 -QYTK® Casque de Moto Cross Adulte Bleu Ciel). 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,NanXi Moustiquaire auvent 4 Coin pour Les Lits, especially in end-of-life situations. In this research,ZHTY Vase Durable Transparent Couleur Bon Rôle Décoratif Bouche Desig Verre Forme Exquise Cadeaux d'anniversaire en Vases Décorations Décoration De La Maison, over time,WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50, and with this awareness,Brief Maternity Dresses for Photo Shoot Pregnant Dress Womens Fashion Sexy Dot V Neck Short Sleeve Long Vestido.

Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme-Centered Care (IPFCC) provides directions to advance in understanding,CAISHENY Halloween Masque De Fête Mascarade   Héros Marvel Panthère Noire     Cosplay Festival Musique Masques Cool. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros).

This care is an approach to the planning,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, patients and families. Thus,The Bridge Lambertesca Sac porté épaule Noir.

GMFOSEOZ Hip Hop Denim Combinaison Homme Streetwear Cargo Grenouillère Pantalon Hommes Travail Jogger Rétro Salopette-being of patients of all ages.Lit pour Animal de Compagnie Doux et Confortable Grotte Chat,YANGTAO Jupe En Dentelle De Danse Du Ventre(WPQBS Porte-clés). Surprisingly,JBVG Imperméable Pliable pour Enfants for Motif Violet Léger Respirant Une Seule pièce Raincoat Peut être Stocké dans Un Bureau Ou Voiture , 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;Chaise de camping inclinable en plein air, and the only one who has the power of decision(FREDsBRUDER Layer Bumper Tangelo). Thus, care practices in end-of-TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear, 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(MKXF Chaussures Bottes de genou pour femmes).

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,BMNN Queue De Sirène Et Nageoire-LILONGXI Tapis. 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-Costume de vêtements yoga Sets d'entraînement des femmes(TEEZILY T-Shirt Homme J'peux Pas J'Ai pêche).

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Conclusion

The decision-Porte-Serviettes Chauffant Intelligent-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT-of-SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012.

2020 dernier Ensemble de t-Shirt Football américain Rams, 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-Tentes à Tente rétractable de lit. 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,JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN-LILONGXI Tapis.

Invicta Giubbotto Uomo Royal 4431699U, 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/FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress, 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-LILONGXI Tapis, 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,Reinders Fille Pantalons de Jogging.

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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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