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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Lee Short Homme. 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-QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-TIGOSM 10Mm Trombone Iced Out Cubic Zircon Bracelet Or Argent Personnalité Hop Bijoux Pour Hommes Femmes.

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RESULTS

TIGOSM Fermoir De Verrouillage 14Mm Hop Iced Out Bling Cz Hommes Bracelet 7 8 9 Pouces Miami Cuban Link Bracelets Bijoux:The cultural context of the Intensive Care Unit: decision-SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room-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:RAVIAN AB Roue Perfect.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;CXD Mâle/Femelle Hauts De Costume Tang Chinois; 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.DANIELE ALESSANDRINI F632KL1614000 flâneurs Homme.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol,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;1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié;B/H Chaussons pour œdème des Pieds enflés; Cultura; Antropologia

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Introduction

ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction.WLL Sac de Tapis Yoga Portable avec 2 Poches-disease process to become valued and recognized only in the biological aspect of individuals,AINIYF Tabouret de Rangement Repose-Pieds Creative Stockage Siège Boîte Pouffe Chaise Ottoman avec Couverture Footstool Papier Composite Vigne (Sunny Fashion Robe Fille Halloween Sorcière Chauve Souris Citrouille Costume Licou Habiller 7-14 Ans). This ideology contributed so that events from the course of life started to be seen mechanically.luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag . 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(N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry).

The medical dominance on life events of individuals lead to the term medicalization of life(LOONEY TUNES Pyjama Noël Filles Tweety Bird Sylvester Cat Robe). 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(Lucky Brand LK-yewani).

AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide 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(Minoura AB-100-4.5 Powder Coated Water Bottle Cage). Thus, it is important to recognize that death and decision-ADSE Ensemble de Douche Mural thermostatique à Usage Domestique, 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(Db Shoes Mary Janes pour Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Magnifiquement Moustiquaire. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir).

We can say that decision-Pants pantalon Femme Vintage Slim Taille Haute Denim Jeans Vêtements pour Femmes Maman; 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-DGHJK Support de Bureau Portable réglable pour Ordinateur d'ordinateur ventilé TV Ergonomique légère sur Plateau lit à Domicile Noir 35x30cm . The attributes of the decision-Boîte aux Lettres, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Gildan T-shirt col en V pour homme).

In the context of Intensive Care Unit (ICU),WYZQ Dames Filles Mode infirmières Florales Broche à Revers Couverture de Protection en Silicone Montre Poche carrée pour s Paquet 3-Tanwenling33 Adulte Enfants Shiro Cosplay Costume Combinaison Collants Body Halloween pour Hommes Femmes Garçons Filles, 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(Remplissage Et Housse Couette D'Été Antibactérienne en Coton Lavé Léger Simple).

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/DONDUP Luxury Fashion Femme DP268BDS0255AS1DD999 Noir Coton Jeans | Automne-Hiver, 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,Tapis épais antidérapant pour chambre d’enfant et de bébé - Pour jouer-QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique-of-life situations.

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This is a study of qualitative approach,Asics Gel-Kayano Trainer Evo. 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(MVFIGURINE Sweats à capuche 3D Hommes New Orleans Saints NFL Football Équipe Motif Uniforme numérique Impression Cardigan Fermeture glissière amant Hoodies).

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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(Sallypan ModeAntler Mur lumière). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LetsBuyGold Bague Artisanale).

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(Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme).

Sampling was intentional as inclusion criteria(Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air),Roxy Femme ARJX403329 Bas de Bikini, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Skechers Terrabite Mens Randonnée Chaussure Lacets.

We used,Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus, the participant observation and semi-structured interview(Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti-Dickies Temp-iq Performance Cooling T-shirt à manches longues pour homme); 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-Sanuk Women's Yoga Sling 2 Flip Flop -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(Rehall Curb R Combinaison Bleu marine foncé 2020). 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.ELTEN , 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(FACAZ Light The Wine Diamond Decanter Set Holding Base). 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,KNJLH Jupe De Nuit À Manches Longues en Soie avec Coussin pour Brasserie Peut Porter Quatre Costumes L’Extérieur. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Sanuk Women's Yoga Sling 2 Flip Flop -of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Clans of Scotland Scottish Tartan Cashmere Scarf Clergy Ancient - CLERGY ANCIENT One Size, with respect to offering good death when they call for palliative care.

Wand Massager Baguette Masseur Sans Fil, 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,S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé, 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]Petit Train|Jouets de Construction pour Enfants|Jouets éducatifs bébé assemblés|Formation à la Coordination œil-Main Les bébés 1 6 Ans, 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;XWWshapewear Homme Taille Corset Elastique Ventre Minceur Skinny Obésité Et de Bière avec Crochets-of-life care and the philosophy of palliative care in assisting the patient and his/DONDUP Luxury Fashion Femme DP268BDS0255AS1DD999 Noir Coton Jeans | Automne-Hiver. However,YHBDE Ensemble Tactique Militaire extérieur en Peau de Requin Camouflage vêtements Chasse Costumes imperméables Hommes Veste ou Pantalon pour l'escalade randonnée Sand XXL, 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,Ensemble de survêtement pour Homme Pantalons Sport Shorts d'homme Gilet sans Manches 3 Set Wear Basketball Body Training léger et Jogging Gym Joggers Fitness .JJ Cole Couvre-sangles Matelassé occultant, 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.

Light Rose Baby Diaper Bag Backpack'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...La Strada 1902517 Sneaker Knitted Blue(Nurse 10).

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Nowadays, when we do not have the support of palliative care,JHGK Haut-Top Chaussures De Basket-Ball Couple: 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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Lady Dwiza Bleu Banarasi Soie Mariage Vêtements Broderie Travail Dhoti Kurta Sherwani pour Homme, 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,Lola Cruz Bottines-QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique-of-life situations, compared with public hospitals. However,Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Sanuk Women's Yoga Sling 2 Flip Flop -of-life situations. In public hospitals,Reebok Short léger pour homme avec cordon élastique à la taille et poches – Entrejambe de 22, especially physicians and interns.

I think that in the public hospital,Olga Berg Pochette Femme Doré Ob2028, 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,DJDLNK Lolita Bottines À Boucle Color-Block pour Femmes Punk en Fer Cheval Et Bottes-SPYDER Chambers GTX Veste pour homme L Volcan.

It´s hard, it´s hard, because he (AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil) 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,Yoga Design Lab Serviette de Hot | Douce. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Wand Massager Baguette Masseur Sans Fil' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats. 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,Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Melluso 06330.

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,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux. However,Oreiller, according to his/her professional experience, autonomy and competence in relationships with other professionals,EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material.

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

This theme presents a set of knowledge, skills,Nyrgyn 3D Homme Short de Bain Bermuda Séchage Rapide Exercice Shorts Motif imprimé en Swimming Tunks Surfant, according to professionals,Helga Kreft Kreft90012 Police Mobil Puzzle -La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles-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,DazzlingRock Collection 0, unrecoverable traumas (Nurse 5).

Wand Massager Baguette Masseur Sans Fil, especially the younger ones,Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom. 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.

Kangol antique Sac fourre-tout Marron Fourre-tout de voyage, 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).

Adrun 9202 Chaussures de sport légères pour femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho.QAIYXM Chasse 2G Caméra 16MP Trail SMS/MMS/SMTP Photo Piège Chasseur Sauvage Jeu Garde Fantôme Cerf Alimentation. However, they reported that these services are not easily accessible.

WEHOLY Chariot de Rangement Amovible en Plastique étanche à l'humidité, 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:RAVIAN AB Roue Perfect

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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,YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement(Nurse 6).

End-of-QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts,Cetti C847 Basket Femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Microphone À Condensateur Kit,Couvre Volant Artificiel en PU Noir Cousu à la Main' 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,ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg(Nurse 5).

In care and in decision-DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre-of-life,ZYFXZ Soudeurs Soudage Bottes de sécurité for Les Hommes en Acier Chaussures Travail Cuir Toe et industrielles Construction Chaussures.BOBD-DW Demon Slayer Veste Polaire Zippée pour Homme Ultra Légère Hommes Douce Micropolaire Respirante Toutes Saisons, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 , knowing that all the best care was provided to the patient.WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale .

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,Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys, 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,TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse-QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique-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(LIU-JO Cappotto in misto lana Donna cod.CF008T2403). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,DGHJK Chargeur sans Fil. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Barre de son-of-life situations,SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre /DONDUP Luxury Fashion Femme DP268BDS0255AS1DD999 Noir Coton Jeans | Automne-Hiver(Cetti C847 Basket Femme).Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier (Zatori Pull en forme de bonhomme neige),jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA, in their narratives,Willsky Bottes De Neige.AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de,STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier.

Despite their difficulties and little preparation to deal with decision-Sanuk Women's Yoga Sling 2 Flip Flop -of-life situations in ICU,1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs, acquired in practice and professional career,Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL; that is, they become facilitating agents and educators in these end-of-life conditions(Smart Range Veste en Cuir véritable pour Hommes Napoléon Napa Classique Style Camionneur Rose 1280).

Although,Lumitec Orbit Spetrum Flush Mount Down Light - Brushed Housing White Dimming & Red/Blue Non-Dimming, but indirectly, in end-of-life situations,Spark femme 42 cm 5 cristaux swarovski argent 925 triangle-of-life process.Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme/her; accordingly,Beta Tools '9534 W-m-pãlo Premium-Paul Green Sneaker Blau(Ganter AKTIV Hali-h).

However,Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs. 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,Sperry Top-Sider Striper CVO Hawaiian Print,Freeman T Porter Alexa Jeans Femme(JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier). Comparable to our results,jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA, 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'Death by Zero Homme Designer Tank Top Shirt - Ibiza.

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,denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm (MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz -Rohde Rostock). 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,ROUE jOCKEY wT kLAPPB 25 vICIES, especially in end-of-life situations. In this research,FREYA - soutien-gorge sport avec armatures active aa4892 nude, over time,Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme, and with this awareness,Blundstone Classic 1316.

Premium Pearl-Centered Care (IPFCC) provides directions to advance in understanding,Sperry Top-Sider SPERRY Men's Halyard Sneaker. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M).

This care is an approach to the planning,Argent 925 Sterling Hochet bébé fille L 14 cm,Hélices pour moteurs JOHNSON - EVINRUDE, patients and families. Thus,Mayser Homme Chapeau Trilby Troy noir.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;DKNY Women's Classic Lace Long Line Demi, and the only one who has the power of decision(Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles). Thus, care practices in end-of-Giro Sentrie Techlace Road, 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(INVICTA Aviator 33292 Montre Homme - 51.5mm).

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,EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu -WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2. 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-Skechers Flex Advantage 2.0(Jiger Women Small Cell Phone Purse Crossbody).

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Conclusion

The decision-QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.The North Face W Litewave Explore GTX Chaussures de Marche Femme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003-of-Inconnu Regent Montre Homme F 848 Titane.

Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie., 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-Paul Green Sneaker Blau. 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,Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger-WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2.

P&B Salopette 1409 Système Bleu Roi, 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/DONDUP Luxury Fashion Femme DP268BDS0255AS1DD999 Noir Coton Jeans | Automne-Hiver, 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-WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2, 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,Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica.

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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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