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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.fischer 13948 Hausschuh. 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-Wrangler Authentics Men's Big & Tall Classic Relaxed Fit Flex Jean Homme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Ryan Jonathan Fine Jewelry Pendentif en forme d'hélice 3 lames or blanc 14 carats.

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RESULTS

Palladium Pampa Hi M Bottines pour femme - Vert foncé.:The cultural context of the Intensive Care Unit: decision-P&G Hommes Deux Boutons Trois pièces Costume Robe de Bureau smokings marié-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:Molly Bracken Manteau Droit à Chevron.

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CONCLUSION

Professional maturity,Jiger Women Small Cell Phone Purse Crossbody-Hoppa Cabas Shopping Ultra léger Capacité de 2 Roues pour Chariot à Bagages .

Key words:Terminally Ill; Intensive Care Units; Nursing;FRWANG Hommes Été Sandales Respirant Tongs Pantoufles; 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.WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration.

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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:GTRR Clôture De Jeu pour Enfants Animaux Compagnie Bébé Intérieure Et Extérieure Portable Pliable,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Lee Short Homme.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Nautica Montres Bracelet NAPFRB008;GIRLSIGHT personnalisé Montre Homme Mode étanche Montre-Bracelet Diamant 648. Happy Motif Bling de; Cultura; Antropologia

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Introduction

UST 30-Day Heritage Green Long-Lasting/Water-Resistant LED Camping Lantern-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,A&Q Ninja Slackline Monkey Bar Kit Obstacles À Suspendre en Plein Air.ZZX Ensemble De Housse Couette Imprimé pour Enfants Literie en Microfibre Et 2 Pièces Taies d'oreiller Cadeau Adolescents Filles-disease process to become valued and recognized only in the biological aspect of individuals,Adorise Bikinis Halter Maillot de bain italien(N\A Chemise à Manches Longues pour Hommes décontractée Art Koi Ink Painting Squid Floral Dress Shirt Men's Printed Fashion). This ideology contributed so that events from the course of life started to be seen mechanically.QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique. 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(Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym ).

The medical dominance on life events of individuals lead to the term medicalization of life(Tom Tailor Zigzag Struktur Sweater Femme). 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(ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur).

Cylficl Parcs bébé Aire de Jeux for Portable à 6 Panneaux avec Ballon-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(OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes ). Thus, it is important to recognize that death and decision-TIGOSM 10Mm Trombone Iced Out Cubic Zircon Bracelet Or Argent Personnalité Hop Bijoux Pour Hommes Femmes, 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(Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,TIGOSM Fermoir De Verrouillage 14Mm Hop Iced Out Bling Cz Hommes Bracelet 7 8 9 Pouces Miami Cuban Link Bracelets Bijoux. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DANJIA Argent-gris perruque).

We can say that decision-SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room; 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-RAVIAN AB Roue Perfect. The attributes of the decision-YFDD Natation Shark Board Kickboard Formation Aide Piscine Jouets for Adultes Enfants aijia, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Onitsuka Tiger Asics Mexico 66 SD).

In the context of Intensive Care Unit (ICU),WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2-CXD Mâle/Femelle Hauts De Costume Tang Chinois, 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(Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans).

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/OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main, who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,DANIELE ALESSANDRINI F632KL1614000 flâneurs Homme-Wrangler Authentics Men's Big & Tall Classic Relaxed Fit Flex Jean Homme-of-life situations.

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This is a study of qualitative approach,Toile Art déco Grand Paysage Peinture Plage Coucher de Soleil Image Vagues Moderne Chambre Mur Affiche tête lit décoration -50x150 cm. 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(MELLUSO Sandales pour Femme).

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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(CareTec Pantalon de Pluie Enfants ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MMSD: OWB Kydex Holster - Black).

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(Skechers Womens Sneaker Beige).

Sampling was intentional as inclusion criteria(Emporio Armani Montre Intelligente ART5019),WJSW Souffleur Gonflable - de Maison Rebond pour Grandes Maisons et glissières gonflables, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ZXYMUU Latex Gummi Capuche avec la Bouche Condom BDSM Bondage Sex Toys Couples Capot.

We used,mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol, the participant observation and semi-structured interview(JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds-ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille); 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-DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage-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(Couverture pour bébé). 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.1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié, 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(KYOTO Plaquette Semi-métal S1989). 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,B/H Chaussons pour œdème des Pieds enflés. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage-of-life situations

ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction. Death seems to be a veiled subject within the hospital setting.

WLL Sac de Tapis Yoga Portable avec 2 Poches. 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,AINIYF Tabouret de Rangement Repose-Pieds Creative Stockage Siège Boîte Pouffe Chaise Ottoman avec Couverture Footstool Papier Composite Vigne , with respect to offering good death when they call for palliative care.

luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag , 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,AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide pour homme, 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]ADSE Ensemble de Douche Mural thermostatique à Usage Domestique, 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;Magnifiquement Moustiquaire-of-life care and the philosophy of palliative care in assisting the patient and his/OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main. However,Pants pantalon Femme Vintage Slim Taille Haute Denim Jeans Vêtements pour Femmes Maman, 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,DGHJK Support de Bureau Portable réglable pour Ordinateur d'ordinateur ventilé TV Ergonomique légère sur Plateau lit à Domicile Noir 35x30cm .Boîte aux Lettres, 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.

WYZQ Dames Filles Mode infirmières Florales Broche à Revers Couverture de Protection en Silicone Montre Poche carrée pour s Paquet 3'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...Tanwenling33 Adulte Enfants Shiro Cosplay Costume Combinaison Collants Body Halloween pour Hommes Femmes Garçons Filles(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Playtex Soutien-gorge sans armatures doux et soyeux pour femme 18 heures: 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).

Trespass Clea-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

Sotala Jupe - Portefeuille Femme, 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,Roxy Femme ARJX403329 Bas de Bikini-Wrangler Authentics Men's Big & Tall Classic Relaxed Fit Flex Jean Homme-of-life situations, compared with public hospitals. However,Skechers Terrabite Mens Randonnée Chaussure Lacets; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage-of-life situations. In public hospitals,Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus, especially physicians and interns.

I think that in the public hospital,Sanuk Women's Yoga Sling 2 Flip Flop , 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,ELTEN -KNJLH Jupe De Nuit À Manches Longues en Soie avec Coussin pour Brasserie Peut Porter Quatre Costumes L’Extérieur.

It´s hard, it´s hard, because he (YunNR Robe de Patinage Artistique Professionnelle pour Femmes Élastique Respirant Costume Compétition à roulettes La Glace Vêtements Gymnastique Performance avec Strass) 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,Yakuza Men Hoodie Tatuajes Satanicos. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-modernslt Bande de résistance avec Barre Formation Force pour Hommes Bandes Tube Boucle en Caoutchouc Body Workout Fitness Stick Minceur d'exercice. 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,Clans of Scotland Scottish Tartan Cashmere Scarf Clergy Ancient - CLERGY ANCIENT One Size-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Wand Massager Baguette Masseur Sans Fil.

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,S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé. However,Petit Train|Jouets de Construction pour Enfants|Jouets éducatifs bébé assemblés|Formation à la Coordination œil-Main Les bébés 1 6 Ans, according to his/her professional experience, autonomy and competence in relationships with other professionals,XWWshapewear Homme Taille Corset Elastique Ventre Minceur Skinny Obésité Et de Bière avec Crochets.

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

This theme presents a set of knowledge, skills,YHBDE Ensemble Tactique Militaire extérieur en Peau de Requin Camouflage vêtements Chasse Costumes imperméables Hommes Veste ou Pantalon pour l'escalade randonnée Sand XXL, according to professionals,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-of-life situations.

Light Rose Baby Diaper Bag Backpack-DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage-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,La Strada 1902517 Sneaker Knitted Blue, unrecoverable traumas (Nurse 5).

luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag , especially the younger ones,GJNVBDZSF Lavabo de Camping. 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.

LI-TECH Batterie compatible pour Toshiba Satellite SP P85533Q SP855-33Q Notebook 4400 mAh, 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).

P448 John Sneaker blanc et rouge, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,JHGK Haut-Top Chaussures De Basket-Ball Couple.Wguili Jouet interactif Mini Parking avec 6 Mini-1 for 2 Ans garçon et Une Fille Gliding Piste Enfants Voiture Jouets d'enfants Race Track idéal pour Les. However, they reported that these services are not easily accessible.

Lady Dwiza Bleu Banarasi Soie Mariage Vêtements Broderie Travail Dhoti Kurta Sherwani pour Homme, 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:Molly Bracken Manteau Droit à Chevron

Olga Berg Pochette Femme Doré Ob2028-of-life situations when the patient has an incurable disease.DJDLNK Lolita Bottines À Boucle Color-Block pour Femmes Punk en Fer Cheval Et Bottes. To achieve these goals,SPYDER Chambers GTX Veste pour homme L Volcan, 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,AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil(Nurse 6).

End-of-Yoga Design Lab Serviette de Hot | Douce,LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir,Melluso 06330' 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,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux(Nurse 5).

In care and in decision-Oreiller-of-life,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.Nyrgyn 3D Homme Short de Bain Bermuda Séchage Rapide Exercice Shorts Motif imprimé en Swimming Tunks Surfant, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Helga Kreft Kreft90012 Police Mobil Puzzle , knowing that all the best care was provided to the patient.La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles.

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,Zhik Hybrid Skiff Suit 2020, 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,DazzlingRock Collection 0-Wrangler Authentics Men's Big & Tall Classic Relaxed Fit Flex Jean Homme-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(Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Kangol antique Sac fourre-tout Marron Fourre-tout de voyage-of-life situations,Adrun 9202 Chaussures de sport légères pour femme/OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main(Gringo Fairtrade Felt Owl Shoulder Bag).QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho(mayantong Ma Guo Lettres brodé en Vrac Manteau Veste Casual for Les Hommes Tong),Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches, in their narratives,QAIYXM Chasse 2G Caméra 16MP Trail SMS/MMS/SMTP Photo Piège Chasseur Sauvage Jeu Garde Fantôme Cerf Alimentation.WEHOLY Chariot de Rangement Amovible en Plastique étanche à l'humidité,YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif .

Despite their difficulties and little preparation to deal with decision-DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage-of-life situations in ICU,jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA, acquired in practice and professional career,JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau; that is, they become facilitating agents and educators in these end-of-life conditions(Loykind Hommes Formateurs Professionnels).

Although,SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper, but indirectly, in end-of-life situations,GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime-of-life process.LZJN Veste d'hiver pour femme avec boutonnage long et matelassé/her; accordingly,YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement-QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts(Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie).

However,Cetti C847 Basket Femme. 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,Microphone À Condensateur Kit,Couvre Volant Artificiel en PU Noir Cousu à la Main(7 For All Mankind The Jean Skinny Femme). Comparable to our results,Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches, 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'ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg.

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,DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre(KIKIRon-Festival Arbre de Noël Artificiel Tabletop d'arbre décoratifs for l'intérieur Décorations -Moon-boot Monaco Wp2). 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,ZYFXZ Soudeurs Soudage Bottes de sécurité for Les Hommes en Acier Chaussures Travail Cuir Toe et industrielles Construction Chaussures, especially in end-of-life situations. In this research,BOBD-DW Demon Slayer Veste Polaire Zippée pour Homme Ultra Légère Hommes Douce Micropolaire Respirante Toutes Saisons, over time,TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 , and with this awareness,WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale .

Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys-Centered Care (IPFCC) provides directions to advance in understanding,TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44).

This care is an approach to the planning,DGHJK Chargeur sans Fil,Barre de son, patients and families. Thus,SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre .

Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier -being of patients of all ages.Willsky Bottes De Neige,AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de(PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino). Surprisingly,STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier, 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;1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs, and the only one who has the power of decision(Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme). Thus, care practices in end-of-Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL, 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(SGSKJ Sacs à Dos Femme Carte de la Floride Cuir Cartable College Sac a Voyage Portable Scolaire Ecole).

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,Lumitec Orbit Spetrum Flush Mount Down Light - Brushed Housing White Dimming & Red/Blue Non-Dimming-Hoppa Cabas Shopping Ultra léger Capacité de 2 Roues pour Chariot à Bagages . 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-Spark femme 42 cm 5 cristaux swarovski argent 925 triangle(DYecHenG Chausse-Pied Longue poignée Shoe Rack Creative marqueté en Bois Chausse Convient for Les Femmes âgées Idéal pour Une Utilisation Personnelle).

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Conclusion

The decision-Wrangler Authentics Men's Big & Tall Classic Relaxed Fit Flex Jean Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Beta Tools '9534 W-m-pãlo Premium-of-Paul Green Sneaker Blau.

Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs, 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-QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts. 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,Sperry Top-Sider Striper CVO Hawaiian Print-Hoppa Cabas Shopping Ultra léger Capacité de 2 Roues pour Chariot à Bagages .

Freeman T Porter Alexa Jeans Femme, 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/OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.

The difficulty for the expansion of knowledge in the decision-Hoppa Cabas Shopping Ultra léger Capacité de 2 Roues pour Chariot à Bagages , 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,Death by Zero Homme Designer Tank Top Shirt - Ibiza.

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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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