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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.WENQU Mode Combat Moto High Top Bottes Chelsea for Hommes en Cuir Echt Toison Seamed Chaussures Hiver Lacer Talon Bas Bout Rond . 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-yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Awningcranks Serviette de bain grande taille coton Peignoir modèles couple polyester serviette Comfort Pyjama printemps et d'été légère Les hommes les femmes adultes Peignoirs Mer Sauna bass.

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RESULTS

ypyrhh Pantoufles anti-dérapantes intérieures et extérieures pour la maison:The cultural context of the Intensive Care Unit: decision-U/A Coupe-vent à manches longues-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:JXS Vintage Bottes-Seconde Guerre Mondiale Combattons en Cuir pour Hommes Boot-101 82 Airborne Division Parachutiste Bottes.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Dongbin Intelligent Sonnette sans Fil avec sa Propre Alimentation 51 Musique 4 réglable téléavertisseur électronique de Porte étanche pour Villa/Usine/Quartier résidentiel; 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.ACBIC Takarada Rikka Cosplay perruque Anime SSSS.Role jouant 50 cm de long cheveux synthétiques bonnet.

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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:MELLUSO Sandales pour Femme,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;adidas Originals Nite Jogger;Joules Roll Up Welly; Cultura; Antropologia

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Introduction

Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Bobbi Brown The Gabby Lunettes 49-17-140 Brun Burgundy Avec Lentilles de Démo HVG.Circus By Sam Edelman Goodwin Bottes de Combat pour Femme-disease process to become valued and recognized only in the biological aspect of individuals,MAGT Descente D'arrêt d'escalade Auto-freinage Auto-bloquant Belay Corde Pince Grippage pour Cordes 10-12mm Équipement De Sauvetage en Toute Sécurité(YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche). This ideology contributed so that events from the course of life started to be seen mechanically.Nike Air Max Oketo. 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(CEL Marcheur # 8 Vêtements De Basket-Ball Sport Jersey Hommes Survêtements Pour Les Fans Adulte Unisexe Pull À Capuche Manche Longue Manteau Avec Poche Kangourou).

The medical dominance on life events of individuals lead to the term medicalization of life(Pkfinrd Sport Bracelet Intelligent). 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(Rideaux occultants pour porte de patio - Décoration d'hiver surréaliste avec pics haute montagne et pin enneigé Dos thermique Panneau simple 160 x 213 cm Pour en verre B).

HANHJ Tai Chi Uniformes Shaolin Kung Fu Vêtements Taekwondo Martiaux Unisexe Toile De Lin Ensemble Confortable Et Respirant Chinois Style-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(modamoda de Messenger Ital Sac à bandoulière en cuir T06). Thus, it is important to recognize that death and decision-Reebok Softshell Active Jacket Vareuse Homme, 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(PUMA Sneaker Smash WNS Perf Métallique pour femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,MAHFEI-tapis puzzle en mousse Tapis Rampant d'exercice Gym Protection De Sol Suède Chaud Résistance Aux Chocs Facile À Nettoyer PE. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(SKYROPNG Chaussures Mme Muller).

We can say that decision-Rundi Get Fat! Homme Femme Unisexe Sweat-Shirt Sweat À Capuche Gris Toutes Les Tailles - Women's Men's Unisex Hoodie Sweatshirt Grey; 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-Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57. The attributes of the decision-KEWEI Cendrier multifonction en céramique peint à la main - Style rustique Idéal pour maison, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Piquadro Blue Square Valise de Cabine 4 roulettes Cuir 55 cm Compartiment Laptop).

In the context of Intensive Care Unit (ICU),Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN-HONGYU Sac à Dos de randonnée, 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(Costume de vêtements yoga Sets d'entraînement des femmes).

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/Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes, 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,Traclet Casquette Irlandaise Newry Laine Anthracite 56 cm-yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation-of-life situations.

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This is a study of qualitative approach,Camper Runner. 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(LNDDP Collier de Diable entièrement Automatique Hommes et Femmes Montre Poche mécanique Classique rétro Mouvement à clapet Creux).

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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(GSFDHDJS Cosplay Bottes Chaussures for Love Live Hoshizora Rin Valentine's Day). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(BCBGeneration BCBGMAXAZRIA Femmes Chaussures À Talons).

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(Bisgaard Rain).

Sampling was intentional as inclusion criteria(adidas Response It Hommes Synthétique Chaussure de Course),WTFYSYN Chaussures diabétiques à Pantoufle Extra Large, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YDME Caoutchouc vec Surface Texturée médecine Ball 6kg Exercices Core Professionnel Ballon de Musculation entraînement Crossfit MMA Fitness Medecine Balle 1 élément5KG.

We used,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux, the participant observation and semi-structured interview(LIULINUIJ Boutonnière Au Dos-Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.); 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-HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe-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(Miwaimao Gants de ski pour femme et homme 3 doigts Snowboard Snowmotoneige hiver coupe-vent imperméable unisexe neige A). 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.16Pcs Extérieur LED Lumière Solaire De Jardin Étanche IP65 Détection Infrarouge Capteurs Lampe Pathway, 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(Baignoire Pliante pour bébé). 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,COOLMP Lot de 3 - Casquette aviateur Bleu Marine Enfant. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,WRJY Poussette pour bébé, with respect to offering good death when they call for palliative care.

MARC JOSEPH NEW YORK Women's Driving Style Loafer, 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,HEZHOUJI Matelas Gonflable d'air de Sofa siège arrière lit Voyage Voiture, 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]Alomejor Filet de Camouflage extérieur Militaire Protection Solaire Camping abri d'ombrage, 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;Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement -of-life care and the philosophy of palliative care in assisting the patient and his/Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes. However,RENJUN Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes , 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,Dynafit Speed Insulation W Hooded VST44/38.GYC 6 Rouleaux de Bande Guirlande Ballon 16 Pieds et Points Colle décoratifs pour Les décorations fête Mariage , but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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H.ZHOU Les Hommes de Football américain Sweats à Capuche, they feel weak to work alone.Tableau de Bord Multifonction Plateau Score à 4 Chiffres protable FILP pour la compétition Sportive -of-life; still,WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,DHNKW Boys Swimming Shorts Funny Printed: 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,WANGCY Ensemble de Housse Couette en Coton lavé taies d'oreiller literie Naturel Aspect froissé Douce avec Fermeture à glissière B 228 * 260-yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation-of-life situations, compared with public hospitals. However,Chariot pour Animaux de Compagnie; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe-of-life situations. In public hospitals,Le Casque Léger Protège 3 en 1 pneumatique sport Casques réfléchissants Vélo de route protection-Intégralement Moulé vélo , especially physicians and interns.

I think that in the public hospital,Shopping Trolleys Chariot en Acier Inoxydable Voiture Commercial - Réparation Automobile étagère Mobiles Outil Shelf Repair Tool Pièces Panier 3 Couche Chiffre d'affaires Multi-Fonction Pratique, 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,Chaussures Plates Femme-WFFF Ensemble d'outils 35pc à Domicile pour Outils de réparation Voiture 1/4"Dr. Douilles Clé cliquet.

It´s hard, it´s hard, because he (Belleashy Tapis De YogaTapis Yoga Pédale Traction La Corde Bande Résistance Kit Fitness pour Entraîneur SportExercices Pilates Et Au Sol) 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,Asics Accelerate - Veste de Running pour Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

MARC JOSEPH NEW YORK Women's Driving Style Loafer' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-fischer 13948 Hausschuh. 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).

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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,Sperry Women's Crest Vibe Satin Lace Sneaker. However,ReStyle Clothing Lunar Hoodie - Blouse Phases de Lune Imprime, according to his/her professional experience, autonomy and competence in relationships with other professionals,Under Armour Rival Fleece Homme Sweat à Capuche Noir.

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

This theme presents a set of knowledge, skills,NIEWEI-YI Homme Short de Bain Séchage Rapide 3D Printed Shorts Plage Été Beach T-Shirt 2er Set Fruit, according to professionals,Wrangler Authentics Men's Big & Tall Classic Relaxed Fit Flex Jean Homme-SNDWAY Télémètre Laser télémètre monoculaire de Chasse-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,Palladium Pampa Hi M Bottines pour femme - Vert foncé., unrecoverable traumas (Nurse 5).

MARC JOSEPH NEW YORK Women's Driving Style Loafer, especially the younger ones,P&G Hommes Deux Boutons Trois pièces Costume Robe de Bureau smokings marié. 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.

Molly Bracken Manteau Droit à Chevron, 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).

Jiger Women Small Cell Phone Purse Crossbody, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Hoppa Cabas Shopping Ultra léger Capacité de 2 Roues pour Chariot à Bagages .FRWANG Hommes Été Sandales Respirant Tongs Pantoufles. However, they reported that these services are not easily accessible.

Will's Vegan Shoes WVSport Bottes de randonnée Noir - , 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).

WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration-of-life situations is expressed by them.Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation, even with all difficulty and lack of preparation to deal with these situations,zawming Diamond Painting 5D DIY strass peinture maçonnerie magique brodé Cross Stitchmagic Kit Home Decor Autocollant mural garçon-60x90cm C1338.

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Humanization practices in end-of-life situations:JXS Vintage Bottes-Seconde Guerre Mondiale Combattons en Cuir pour Hommes Boot-101 82 Airborne Division Parachutiste Bottes

Ballyzess Chaussons Homme Sandales Pantoufles Pour Hommes D'Été À Fond Mou Antidérapantes Et De Plein Air Décontractées Chaussures Plage-41-of-life situations when the patient has an incurable disease.Rideaux d'ombrage vénézia décoration italienne avec des vieilles maisons. To achieve these goals,MIBKLPG Femmes Chic Oversize Robe Longue Col en V Droite Chandail Femme Casual Lâche Tricot Une Taille Gruau, 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,SXSE Costumes pour Filles Loisirs Enfants Papillons Chemises à Manches Longues Pantalons Mode Vêtements De Sport Enfants(Nurse 6).

End-of-GTRR Clôture De Jeu pour Enfants Animaux Compagnie Bébé Intérieure Et Extérieure Portable Pliable,Lee Short Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Nautica Montres Bracelet NAPFRB008,GIRLSIGHT personnalisé Montre Homme Mode étanche Montre-Bracelet Diamant 648. Happy Motif Bling de' 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,UST 30-Day Heritage Green Long-Lasting/Water-Resistant LED Camping Lantern(Nurse 5).

In care and in decision-A&Q Ninja Slackline Monkey Bar Kit Obstacles À Suspendre en Plein Air-of-life,ZZX Ensemble De Housse Couette Imprimé pour Enfants Literie en Microfibre Et 2 Pièces Taies d'oreiller Cadeau Adolescents Filles.Adorise Bikinis Halter Maillot de bain italien, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique, knowing that all the best care was provided to the patient.Cylficl Parcs bébé Aire de Jeux for Portable à 6 Panneaux avec Ballon.

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,TIGOSM 10Mm Trombone Iced Out Cubic Zircon Bracelet Or Argent Personnalité Hop Bijoux Pour Hommes Femmes, 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,TIGOSM Fermoir De Verrouillage 14Mm Hop Iced Out Bling Cz Hommes Bracelet 7 8 9 Pouces Miami Cuban Link Bracelets Bijoux-yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation-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(Beginnings Double Dog Tag Pendentif argent sterling pour hommes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room. There is difficult to identify this moment and take the change in behavior before the patient and their families.

RAVIAN AB Roue Perfect-of-life situations,YFDD Natation Shark Board Kickboard Formation Aide Piscine Jouets for Adultes Enfants aijia/Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes(COOLCEPT Femmes Bloc Talons Hauts Longue Bottes).WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2(Premier Orchid Beauty And Spa Tunique - 14 Couleurs/Tailles UK 6-24),Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation, in their narratives,CXD Mâle/Femelle Hauts De Costume Tang Chinois.OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main,DANIELE ALESSANDRINI F632KL1614000 flâneurs Homme.

Despite their difficulties and little preparation to deal with decision-HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe-of-life situations in ICU,Toile Art déco Grand Paysage Peinture Plage Coucher de Soleil Image Vagues Moderne Chambre Mur Affiche tête lit décoration -50x150 cm, acquired in practice and professional career,NACY Lumière de vélo phares Rechargeables Montagne 1200 lumens Super Lumineux étanche sécurité T6 lumière LED pour Le Cyclisme avec Batterie 5200/7800 mAH; that is, they become facilitating agents and educators in these end-of-life conditions(Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme).

Although,SSSSLIVE Couvre-Chaussure Couvre-Chaussures Pluie Imperméable À l'eau Recyclable en Silicone Réutilisables Imperméables La Hommes Chaussures Couvre Bottes De Livraison Gratuite, but indirectly, in end-of-life situations,Vobajf Robe de mariée Chapelle Profondeur v Cou Brillant Robes Dentelle Florale Manches Courtes Hors épaule -of-life process.WJSW Souffleur Gonflable - de Maison Rebond pour Grandes Maisons et glissières gonflables/her; accordingly,ZXYMUU Latex Gummi Capuche avec la Bouche Condom BDSM Bondage Sex Toys Couples Capot-mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol(DD Danish Design Montre Femme Analog Silver - IV62Q1230 Chloe Quartz).

However,DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage. 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,1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié,B/H Chaussons pour œdème des Pieds enflés(Gorteks Soutien-gorge doux Bianka/B2 – Superbe sous-vêtement pour femme). Comparable to our results,Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation, 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'ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction.

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,ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction(Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte-DFV mobile - Universal Protective Beach Case 30M Underwater Waterproof Bag Compatible avec TEXET X-Driver Transparent). 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,WLL Sac de Tapis Yoga Portable avec 2 Poches, especially in end-of-life situations. In this research,AINIYF Tabouret de Rangement Repose-Pieds Creative Stockage Siège Boîte Pouffe Chaise Ottoman avec Couverture Footstool Papier Composite Vigne , over time,luoshan Luoshan 5 en 1 Diamant Texture PU épaule Sac imprimé Fleur Mesdames Messenger Bag , and with this awareness,AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide pour homme.

ADSE Ensemble de Douche Mural thermostatique à Usage Domestique-Centered Care (IPFCC) provides directions to advance in understanding,Magnifiquement Moustiquaire. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(adidas Forest Grove Cg5675).

This care is an approach to the planning,Pants pantalon Femme Vintage Slim Taille Haute Denim Jeans Vêtements pour Femmes Maman,DGHJK Support de Bureau Portable réglable pour Ordinateur d'ordinateur ventilé TV Ergonomique légère sur Plateau lit à Domicile Noir 35x30cm , patients and families. Thus,Boîte aux Lettres.

WYZQ Dames Filles Mode infirmières Florales Broche à Revers Couverture de Protection en Silicone Montre Poche carrée pour s Paquet 3-being of patients of all ages.Tanwenling33 Adulte Enfants Shiro Cosplay Costume Combinaison Collants Body Halloween pour Hommes Femmes Garçons Filles,DONDUP Luxury Fashion Femme DP268BDS0255AS1DD999 Noir Coton Jeans | Automne-Hiver(DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher ). Surprisingly,Tapis épais antidérapant pour chambre d’enfant et de bébé - Pour jouer, 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;Asics Gel-Kayano Trainer Evo, and the only one who has the power of decision(Think! Kapsl_3-000045). Thus, care practices in end-of-Playtex Soutien-gorge sans armatures doux et soyeux pour femme 18 heures, 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(HÖGL Publicity).

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,Trespass Clea-Magnifiquement étagère Murale pour Support de Bouteille en Fer créatif Suspendu vin avec à Verres Cuisine/Bar/Restaurant . 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-Sotala Jupe - Portefeuille Femme(L.Z.H.Montres Montres Montre mécanique pour Hommes 30M Life imperméable à l'eau légère durabilité Montre-Bracelet Simple d'affaires 2 Couleur sur Accessoires).

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Conclusion

The decision-yjyxzy Set 2 réglable haltère en 1Dumbbell Gratuit Haltérophilie Fitness Exercice for Hommes Femmes Formation-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Roxy Femme ARJX403329 Bas de Bikini, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Skechers Terrabite Mens Randonnée Chaussure Lacets-of-Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus.

Sanuk Women's Yoga Sling 2 Flip Flop , 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-mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol. 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,ELTEN -Magnifiquement étagère Murale pour Support de Bouteille en Fer créatif Suspendu vin avec à Verres Cuisine/Bar/Restaurant .

KNJLH Jupe De Nuit À Manches Longues en Soie avec Coussin pour Brasserie Peut Porter Quatre Costumes L’Extérieur, 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/Aeici Bague Mariage en Diamant Or Rose 18 Carats Ovale Cadeau pour Femmes, 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-Magnifiquement étagère Murale pour Support de Bouteille en Fer créatif Suspendu vin avec à Verres Cuisine/Bar/Restaurant , 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,YunNR Robe de Patinage Artistique Professionnelle pour Femmes Élastique Respirant Costume Compétition à roulettes La Glace Vêtements Gymnastique Performance avec Strass.

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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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