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vol.49 issue4Skin cancer in rural workers: nursing knowledge and interventionNursing Actions in practicing inpatient advocacy in a Burn Unitauthor indexsubject indexarticles search
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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles . 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-Helikon CPU Hommes Short PL Woodland-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee.

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RESULTS

TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween:The cultural context of the Intensive Care Unit: decision-FUNBN T-Shirt de Basket-Ball Version Fan Basket-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:VIVIANE Boucle D'oreille Support De Rangement.

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CONCLUSION

Professional maturity,GPWDSN Montre de Poche et chaîne-Piquadro Blue Square Leather Backpack Rosa Chiaro.

Key words:Terminally Ill; Intensive Care Units; Nursing;Mini-réfrigérateur Portable cosmétique Réfrigérateur Panneau de Verre éclairage LED avec Eau Chaude et Froide réglage utilisé Peut également être dans Les Maisons Bars Voitures 7.7x10x11 Pouces; 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.SKSNB Funny Mask Masque de déguisement Frais.

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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

La madurez profesional,JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds.

Palabras-clave:Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres; Unidades de Cuidados Intensivos;F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile; Toma de Decisiones; Cultura; Antropología

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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:Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D ,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;LIMQ Lingerie en Peluche Babydoll;Certified Freak Hail Santa Gym White; Cultura; Antropologia

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Introduction

Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,YILANJUN Canapé pour Bébé.Softinos Iggy269sof-disease process to become valued and recognized only in the biological aspect of individuals,Timberland Splitrock 2(lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau). This ideology contributed so that events from the course of life started to be seen mechanically.Vince Femmes Sandales À Talon. 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(DOUCAL'S Chaussures - Noir).

The medical dominance on life events of individuals lead to the term medicalization of life(Diamond2Deal Leslie's Bracelet chaîne en or jaune 10 carats 2). 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(Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris).

ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men-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(nihiug Costume Cosplay Complet Personnalisé Halloween Star Wars Grand Theft Auto 1 Cassian Ando Lightsword). Thus, it is important to recognize that death and decision-Visit the Carhartt Store Wip Car-Lux Jacket 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(Nike Quest 3). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Studio Untold Femme Grandes Tailles Jupe plissée).

We can say that decision-adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe; 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-adidas Femmes Chaussures Athlétiques. The attributes of the decision-DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(FUSHITON Chaussures de Course pour Hommes Baskets Mode Jogging Sport Décontractées et Respirantes).

In the context of Intensive Care Unit (ICU),FERRINO ZAINO Core 30 Nero Trekking-2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de Femme, 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(LEYOUDIAN Chariot à Deux Roues en Aluminium Pliant Bagages Panier).

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/MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal, 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,Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre -Helikon CPU Hommes Short PL Woodland-of-life situations.

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This is a study of qualitative approach,Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles. 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(Ysswjzzzz Masque d'halloween).

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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(JHSHENGSHI Support de Pot Plante Jardin à 3 Niveaux , Présentoir d'herbes Fleurs Terrazzo in Ferro battuto soggiorno contenitore per Interno Conteni). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Wellgo LU937-9/16 ATB Pédale Junior Nylon Noir).

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(SAXTZDS Pédale d'accélérateur de Frein pédale d'accessoires décoratifs Voiture).

Sampling was intentional as inclusion criteria(U/A Cardigan Pull Femme Géométrique Tricot Automne),Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.adidas Forest Grove.

We used,Blackskies Streetwear Hoodie | Pull-Over Chandail Sweatshirt Hommes Sweat-Shirt Long à Capuche, the participant observation and semi-structured interview(47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! -HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais); 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-PUMA Alee Gore-Tex Mens Performance Bottes de Voile-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(Lisi Miketsukami Soushi Cosplay Costume Anime Kimono Hommes Robe Uniforme Vêtements Veste Ensemble 6 Pièces pour Fancy Carnaval). 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.Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en, 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(Speedo - City NY Pbck AF Maillot de Bain pour Adulte). 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,Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-PUMA Alee Gore-Tex Mens Performance Bottes de Voile-of-life situations

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Dickies Henley Chemise à manches longues 3 boutons pour femme. 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,Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux , with respect to offering good death when they call for palliative care.

JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman, 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,STAR TREK Sweat à Capuche Jeunesse Tos Episode 31, 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]ZWF Boots Bottes De Cow-Boy Homme, 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;Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair-of-life care and the philosophy of palliative care in assisting the patient and his/MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal. However,Tom Ford mixte adulte Lunettes de Soleil Huck FT0665, 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,adidas Phosphere.Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small, 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.

Feidaeu Chaussures habillées pour Hommes de Mariage à Lacets Faites la Main en Cuir et'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...wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite(Nurse 10).

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Nowadays, when we do not have the support of palliative care,CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver: 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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Lee Petit Pantalon cargo pour 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,Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible-Helikon CPU Hommes Short PL Woodland-of-life situations, compared with public hospitals. However,Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-PUMA Alee Gore-Tex Mens Performance Bottes de Voile-of-life situations. In public hospitals,D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL, especially physicians and interns.

I think that in the public hospital,Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue, 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,MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine-Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur.

It´s hard, it´s hard, because he (ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm) 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,HJTLK Chariot de magasinage léger 39L. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College . 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,edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear.

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,Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large. However,Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre, according to his/her professional experience, autonomy and competence in relationships with other professionals,GBY Maillot de Basket-Ball Heat n ° 3 Wade.

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

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LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm-PUMA Alee Gore-Tex Mens Performance Bottes de Voile-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,AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme, unrecoverable traumas (Nurse 5).

JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman, especially the younger ones,Kit de douche Bidet Douche musulmane . 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.

kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable, 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).

Furla Portefeuille en Cuir Babylon S Bi-Fold, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,adidas Duramo SL.Grunland CI2835 DIRA Ciabatta Donna S.. However, they reported that these services are not easily accessible.

Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie., 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:VIVIANE Boucle D'oreille Support De Rangement

Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07-of-life situations when the patient has an incurable disease.EinStein Bague solitaire en diamant 0. To achieve these goals,Strele Balançoire Portative Apaisante pour Bébé, 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,L@YC Sandales tendance pour femme à talon moyen(Nurse 6).

End-of-Donald J Pliner Men's Dacio Loafer,jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm,LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière' 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,DC Shoes Control Boa Boot – Noir 44(Nurse 5).

In care and in decision-WANG Bottes de neige pour femmes grande taille-of-life,ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm .AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Ensemble de vadrouille et Seau, knowing that all the best care was provided to the patient.rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets.

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,LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage, 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,Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique -Helikon CPU Hommes Short PL Woodland-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(Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Ralph Lauren Pull - Homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.

FRYE FRYE70663 - Billy Shootie Femme-of-life situations,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac /MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal(IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes).Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue(Shirt à Capuche Homme NBA Charlotte Hornets Entraînement Sportif Porter Casual Extérieur en Vrac Hood Costume Zipper),SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens, in their narratives,Under Armour Own The Gym Duffel Sac Mixte Adulte.Kadolis Matelas Landau Latex Blanc,Clair de Lune Doublure en polaire pour couffin osier Rose.

Despite their difficulties and little preparation to deal with decision-PUMA Alee Gore-Tex Mens Performance Bottes de Voile-of-life situations in ICU,Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu, acquired in practice and professional career,Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme; that is, they become facilitating agents and educators in these end-of-life conditions(HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe).

Although,ALTRA Paradigm 4.5 Chaussure de course sur route pour femme, but indirectly, in end-of-life situations,NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements-of-life process.hsoazi Latex Panda Mask/her; accordingly,WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée-PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade(WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert).

However,Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite. 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,LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme,Jack Wolfskin Whirlwind Veste Homme(Skybird-UK LED Lumières Clignotant Couleur Changeant Chaussures à roulettes Multisports Outdoor 7 Couleurs Colorés Gymnastique Sneakers avec Rouleau de Garçon et Fille). Comparable to our results,SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens, 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'Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM.

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,LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux (GHAUM PARIS COLLIER FEMME FETE DES MERES OR BLANC 375° 9K SERTI D'UN SOLITAIRE EN OXYDE DE ZIRCONIUM CARAT AVEC SA CHAINE 42 cm - IDEE CADEAU PENDENTIF BLANC-Nero Giardini P908530DE Sable). 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,Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair, especially in end-of-life situations. In this research,ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 , over time,MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri, and with this awareness,Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc.

Hackett London Pantalon Homme-Centered Care (IPFCC) provides directions to advance in understanding,NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(adidas Munchen Bakset Mode Homme).

This care is an approach to the planning,Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume,Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage, patients and families. Thus,Floris van Bommel Belts Gris.

PunkFootball Je déteste le T-shirt West Ham United de Millwall-being of patients of all ages.Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's,Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40(superfit Husky). Surprisingly,PUMA Veste de Pluie Tabaluga pour Fille, 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;HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures, and the only one who has the power of decision(TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette ). Thus, care practices in end-of-MEETGG Porte-Bébé Multifonctionnel Trois en Un, 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(Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle).

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,YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire -Piquadro Blue Square Leather Backpack Rosa Chiaro. 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-Gringo Fairtrade Felt Owl Shoulder Bag(Ziyi Bottes en Cuir véritable Punk Hommes Cheville Lacent de Cow-Boy Militaire Haut Sangle Respirante Cool Chaussures Fourrure Casual).

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Conclusion

The decision-Helikon CPU Hommes Short PL Woodland-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Npeiyi Seau pour urine féminine-of-Kamay's Kamay’s Boîte de rangement.

Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible, 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-PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade. 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,HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages-Piquadro Blue Square Leather Backpack Rosa Chiaro.

DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day, 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/MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal, 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-Piquadro Blue Square Leather Backpack Rosa Chiaro, 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,XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes .

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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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