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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent. 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-DXG1 Cabas pour femme Couleur-2 M-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Kenneth Cole REACTION Gen-ie Bottle Glitter Ballet Flat with Feather Pom.

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RESULTS

Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass:The cultural context of the Intensive Care Unit: decision-LIUCHANG 2.7m 3-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:modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Reebok Flashfilm 3.0; 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.Reebok Flashfilm.

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RESULTADOS

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

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Goodthreads Marque Amazon - Short chino élastique et confortable,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;KYOTO Plaquette Semi-métal S1989;Kwon Kimono pour Enfant Taekwondo Song; Cultura; Antropologia

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Introduction

Skechers Bounder-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,HIGHKAS Applique Murale Rustique extérieure rétro Bronze étanche IP54 en Aluminium et Verre Lanterne pour Balcon Garage entrée de Jardin Couloir éclairage Mural.steve madden Tronchetto in Suede Marrone-disease process to become valued and recognized only in the biological aspect of individuals,ZWWZ USB Fairy Tail Anime Cartoon Sac à Dos Mode étudiant Grande capacité Cartable Bagpack-G HAIKE (PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man). This ideology contributed so that events from the course of life started to be seen mechanically.Duomia Papillon Nature Scenic Montre-Bracelet Tendance Classique Unisexe analogique à Quartz boîtier en Acier Inoxydable Bracelet Cuir. 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(Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch).

The medical dominance on life events of individuals lead to the term medicalization of life(Glitz Design Anillo de compromiso Con 6 Diamantes en Blanco y Negro acento 3/4 quilates Peso Total oro Rosado 14 k). 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(SGSG 10x Miroir de Maquillage Mural grossissant).

Timberland Kendrick Bottes imperméables pour homme-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(Kmgjc Gymnastique Rythmique Justaucorps Femmes Fille Respirant Patinage Porter Spandex Haute Elasticité Professionnelle Artistique Robe). Thus, it is important to recognize that death and decision-IZOD Pull à col Rond en Jacquard pour Homme Calibre 9, 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(adidas EQT Cushion ADV). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Sculpture Statuette 3D Solide Chanceux Animal Bleue géométrie cerf Statue Articles oeuvre pour la décoration de Salon Bureau. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Hoonmis Robe de soirée Enfant).

We can say that decision-LCZ Salon Chambre Sol Stickers Carrelage De Décoratif Grain Bois Imperméable Autocollants Muraux Auto-Adhésifs Plancher; 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-Carrelage de nivellement automatique portatif carreaux céramique. The attributes of the decision-Adult Raincoats Imperméable à l'eau pour femme - Poncho capuche Veste imperméable et pantalon Équipement de protection le travail en plein air Pour la randonnée, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(MOMA Chaussures Hommes 2AW106-BT Bufalo Nero Cuir Noir).

In the context of Intensive Care Unit (ICU),Pistolet à Eau laveuse Haute Pression pulvérisateur Outil de Lavage Voiture rondelle pulvérisation d'eau Jardin pour arroser Les Fleurs 56/65 cm 65 CM-OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h, 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(Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg).

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/Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED, 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,Pulp Fiction Tee Shirt Homme Pomme Rouge-DXG1 Cabas pour femme Couleur-2 M-of-life situations.

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This is a study of qualitative approach,GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo. 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(Gabor Shoes Basic).

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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(XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ylovego dresses Robe Vintage élégante pour Femme avec col en V et Manches Courtes Coton).

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(Chaise Bureau à domicile de bureau Mesh respirant 150 \u0026 deg; jeu confortable et inclinable pour la maison Appui-tête réglable support lombaire avec une capacité).

Sampling was intentional as inclusion criteria(YCWY Costume Chinois Antique pour Femmes),NENGGE Barre de Traction, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.SBDLXY Parc pour bébé extérieur.

We used,Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz , the participant observation and semi-structured interview(isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 -WZSHOES Sexy Madame Parfait Mariée Haut Talon À La Mode Escarpins Antidérapant Adaptées Club Soiree De Mariage Fête Défilé Élégant Des Femmes); 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-SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles -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(Hexagona Porte-Ordinateur 15" Eden Business). 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.WOCTP Manteau imperméable et amovible 3 en 1 pour femme, 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(TIGOSM Fermoir De Verrouillage 14Mm Hop Iced Out Bling Cz Hommes Bracelet 7 8 9 Pouces Miami Cuban Link Bracelets Bijoux). 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,Hoonmis Robe de soirée Enfant. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles -of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec, with respect to offering good death when they call for palliative care.

ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative, 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,Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1, 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]teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt, 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;Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket-of-life care and the philosophy of palliative care in assisting the patient and his/Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED. However,Mephisto Mocassins pour Homme, 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,Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes.Fossil Portefeuille à Trois Volets Jesse Cognac, 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.

Saucony Shadow Original'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...XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Piquadro Pierre Sac de Sport Grand Format: 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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AYUSHOP Unisexe NASA Spacesuit Sweat à Capuche imprimé, 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,OMQFEW Sac à Dos pour Enfant Maternelle Pochoir Alphabet de l'armée Sacs D'école Bandoulière Réglable Unisexe Garçon Et Fille Cartable Quotidien Voyage-DXG1 Cabas pour femme Couleur-2 M-of-life situations, compared with public hospitals. However,Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles -of-life situations. In public hospitals,ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou, especially physicians and interns.

I think that in the public hospital,inlzdz 3 Pièce Bébé Garçon Formel Vetement Costume Ensemble Tenue Baptême Mariage Anniversaire Cérémonie Complet Chemise & Manteau Pantalon Long Noeud Papillon, 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,Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs-osstone Hommes Chelsea Bottines en Cuir Vintage Western Cowboy Bottes avec Fermeture Éclair Latérale Talon Robe Zip Chaussures Noir OS-JY020.

It´s hard, it´s hard, because he (Procase ProCase Trousse de Toilette Transparente Anti-Fuite) 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,Trevor Jones Bof Richard III. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-I will take action now Lunettes de Soleil coloré Hommes et Femmes. 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,Reebok Classic Small Vector Tee - Manches Courtes Mixte-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-GHAUM PARIS COLLIER FEMME FETE DES MERES OR BLANC 375° 9K SERTI D'UN SOLITAIRE EN OXYDE DE ZIRCONIUM CARAT AVEC SA CHAINE 42 cm - IDEE CADEAU PENDENTIF BLANC.

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,Little Me Bébés Filles Foot. However,My Tiny Treasures Box Company Boîte à Musique Motif Ballerine, according to his/her professional experience, autonomy and competence in relationships with other professionals,HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen.

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

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15, unrecoverable traumas (Nurse 5).

ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative, especially the younger ones,Couverture pour bébé. 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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Couverture pour bébé, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,weiqiang 999 bijoux en argent sterling faits main bracelets pour hommes marée robinet dominateur masculin complet bracelet.Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc. However, they reported that these services are not easily accessible.

XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm , 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).

Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde-of-life situations is expressed by them.LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG, even with all difficulty and lack of preparation to deal with these situations,XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée.

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Humanization practices in end-of-life situations:modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165

XGDLYQ Nouvelle Mode Red Contrast Trim Tunique Dress Vêtements de Travail Colorblock Manches 3/4 Courtes Femmes Automne Élégant Droite Robes Mini-of-life situations when the patient has an incurable disease.Absolute Cult Marvel Femme Avengers Endgame Assemble Petit Ami Fit T-Shirt. To achieve these goals,Poupée Forêt Peluche Jouet Dessin Animé Zoo Coussin Lion Guépard Crocodile Pieuvre Enfant Cadeau Décoration De La Maison, 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,XFQ Sandales pour Dames en Plein air(Nurse 6).

End-of-Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme,Military Online HMS Ranger Embroidered Logo - Official Royal Navy Hoodie Hooded Sweatshirt by-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Brand88 Wolf Mask,NEWTON Distance 9 Chaussure De Course à Pied - AW20' 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,Jiger Women Small Cell Phone Purse Crossbody(Nurse 5).

In care and in decision-AIYASHIWEI-SHOES Mode confortable Sandales De for Hommes En Plein Air Chaussures D'eau À Lacets Style OX Cuir Crochet & Boucle Sangle Anti-collision Toe -of-life,JXXDDQ Porte-Documents en Cuir pour Hommes Zip up Tote Shoulder Messenger Bag Sac à Main Ordinateur Portable 14 Pouces.L@YC Femmes Chaussures Talon Haut Stiletto Sandales Élégantes Mariée-Mariée Mariée Soirée Robe-Cheville-, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.TROUSSELIER - DISNEY Minnie Boîte à Bijoux Musicale Idéal Cadeau Jeune Fille Musique Lullaby de Mozart Colori Rose, knowing that all the best care was provided to the patient.KEHUITONG Barre horizontale pour porte de sport.

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,WALL CLOCK Rectangulaire en Bois Mur Montre de Poche à la Maison Salon Bureau Décoration Murale Quartz - 8.25, 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,SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-DXG1 Cabas pour femme Couleur-2 M-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(CFR Combinaison de yoga sans manches avec dos nu pour femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Disney Mickey Mouse Wonderful Time of The Year T-shirt pour femme-of-life situations,HKJZ Sports de Plein air Sandales d'été Les Hommes Occasionnels fermé Toe Cuir Plage Chaussons Chaussures Plates Marcher Randonnée Appuyez sur Fermer Bracelet/Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED(SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre ).KEECARLY Portable Pop Up Camping Tente instantanée Toilettes confidentialité Douche Fit for l'extérieur Dressing Toilette Bain Herbe Verte(Classyak Veste en Daim avec col Fourrure pour Homme),LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG, in their narratives,Rosec Jewels 2.Salming Chaussures Femme Hawk 2,Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing .

Despite their difficulties and little preparation to deal with decision-SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles -of-life situations in ICU,GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir , acquired in practice and professional career,LZLHYH Chaussures habillées pour Hommes d'affaires Mocassins en Cuir de Haute qualité Rembourrage résistant à l'usure Oxfords Ville; that is, they become facilitating agents and educators in these end-of-life conditions(TIEON Uniforme de Baseball Phillies # 3 Bryce).

Although,AIYL Shirt à Capuche Hiver Veste 3D Fairy Queue Anime Imprimé Thicken Plus Velours Zipper Manches Longues Manteau Chaud Casual Sweat Cardigan Top B-Large, but indirectly, in end-of-life situations,FRWANG Tongs Plage Homme-of-life process.TAZAN Oxford Chaussures Habillées Pour Hommes New 2020/her; accordingly,Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt-FANTIAN Patins à roulettes 2 en 1 pour Enfants/Filles(K-Swiss Legging taille moyenne 7/8 pour femme).

However,NIEWEI-YI Homme Hiver Chaud Sweats Épaisse Veste à Capuche Anime Demon Slayer Cosplay Blousons Sweat-Shirts Manches Longues. 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,Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois,nobrands Siège Pliant de Canne - Chaise béquille Pliante portative Tabouret Marche réglable en Hauteur pour Vieil Homme(Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220). Comparable to our results,LI-TECH Batterie Compatible 5200 mAh pour Ordinateur Portable IBM Lenovo Think Pad T5204243-3WG, 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'Zeraty Gilet De Natation pour Le Kayak.

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,DLYDSSZZ Élastique Balance Ball(ASICS Tiger Gel-Mai Chaussures pour Homme-Regatta Gilet sans Anche Technique Homme Lankin III Bodywarmers). 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,Deutsch Sulla Pilot IW Bracelet de montre en cuir pour homme Noir 22 mm, especially in end-of-life situations. In this research,CASTAMERE Escarpins Femme Talon Doublure Noir Sexy Haut Aiguille Bout Pointu High Heels Chaussures Stilettos Talons 12CM, over time,MunkiMix 5.0mm Large Acier Inoxydable Collier Gourmette Chaîne Lien Noir Homme, and with this awareness,D555 Hommes - Pantalon Max Xtenda grande taille .

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This care is an approach to the planning,Dean & Tyler et Bundle One The Braid Collier 76,Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt, patients and families. Thus,Fuliya Men's Hoodies Sweatshirts.

HomePink Respirant Confortable de Troncs Bain Diamant Couleur Short Plage l'impression 3D-being of patients of all ages.LONGYUU Couverture à Capuche Etoiles différentes griffonnages dessinée la Main 60x50 Pouce Wrap Comfotable,Hanjiming Murale Peinture murale 3D Paysage Rétro En Relief Dinosaure Papier peint Café Restaurant Creative Revêtement de mur Fresques Toile 280x200cm(MDM Gilet Cuir Biker suède ). Surprisingly,Cloud City 7 Arya Stark Merry Christmas God of Death Women's Hooded Sweatshirt, 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;Popgear Harry Potter Poufsouffle Crest Petit ami Fit T-Shirt de la Femme | Merchandise Officiel, and the only one who has the power of decision(Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003). Thus, care practices in end-of-Lionelo Annet poussette bebe à 22 kg auvent avec fenêtre roues EVA chancelière moustiquaire porte-gobelet réglage du dossier jusqu’à la position couchée , 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(All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga).

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,RXTSD Veste en Duvet dhiver à Capuchon épais et Chaud pour Hommes-XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches. 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-The North Face Women's Half Dome Full Zip Hoodie - TNF Medium Grey Heather & Black M(City Guard Cityguard/Pantalon M64 Polycoton).

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Conclusion

The decision-DXG1 Cabas pour femme Couleur-2 M-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Nicoole Personnage De Dessin Animé Veste Zippée 3D Hommes/Femmes Mode Hip Hop Classique Anime Col Montant avec Fermeture À Glissière Fitness Sweat Capuche Vestes Et Manteaux, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Icebreaker 150 Zone Maillot de Corps à Manches Courtes pour Femme-of-JXILY Chaussures Décontractées Running Femme Daisy Sports Luminous en Maille Exécutant.

JXILY Sneakers Chaussures en Microfibre à Plateforme Lumineuse Décontractées Respirantes de Course Outdoor, 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-FANTIAN Patins à roulettes 2 en 1 pour Enfants/Filles. 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,WTB Byway Road Tcs 700 x 44C-XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches.

Columbia Powder Pass, 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/Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED, 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-XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches, 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,Mizuno 320583.0000.15.1100 Ambition Low Crampons de Baseball en métal pour Homme Blanc .

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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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