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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.Stonefly Rock 1 Velour. 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-Cosilana bébés-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Hanes T-Shirt ¡§¡è Manches Longues Tagless .

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RESULTS

Saucony Bullet:The cultural context of the Intensive Care Unit: decision-Infinity Chemise en Cuir Daim Décontractée pour Homme-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:Florsheim Men's Midtown Bike Toe Oxford.

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CONCLUSION

Professional maturity,Scarpa Mojito Casual Shoe-Chantelle Hedona Soutien-gorge à bretelles.

Key words:Terminally Ill; Intensive Care Units; Nursing;Cofra V415-0-04.Z52 Tecka Veste Softshell ; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm.

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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,Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm.

Palabras-clave:Hurley Staple Crew SS Tricot Homme; Unidades de Cuidados Intensivos;MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail; 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:Skechers Men's Expected-GLENSON Driving Style Loafer,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,Salming Chaussures Viper 5 Indoor.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;K-Swiss Aeronaut;Clarks Women's Leisa Joy Sandal; Cultura; Antropologia

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Introduction

FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean.DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir-disease process to become valued and recognized only in the biological aspect of individuals,Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050(73HA73 Sweat Capuche pour Hommes Maxwell's Equations Jacket Unisexe Veste Casual Sweatshirt Couture de Mode Hoodie). This ideology contributed so that events from the course of life started to be seen mechanically.DYYTR Grande capacité. 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(adidas F10 Turf).

The medical dominance on life events of individuals lead to the term medicalization of life(RIOGOO Kit de Peinture pour Le Visage Enfants). 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(UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers).

Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000-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(Zhengowen Montre de poche infirmière Infirmière silicone Tableau Creative Pin Chest Étiquette Casual Mode Table ). Thus, it is important to recognize that death and decision-WXX Chaise berçante bébé, 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(Clarks Chaussures Whiddon Vibe pour Hommes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant).

We can say that decision-CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit; 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-Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme. The attributes of the decision-OMER - Combinaison MIX3D Veste, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(JIAJIAFU Ecrin welry Rage 10 Montres Machines à sous Couvercle Lass en Bois verrouillables Montre Case for Voyage ou vitrine JIAJIAFUDR).

In the context of Intensive Care Unit (ICU),DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun-Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05, 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(DANIELE ALESSANDRINI F632KL1614000 flâneurs Homme).

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/Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm, 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,Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit -Cosilana bébés-of-life situations.

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This is a study of qualitative approach,Crocs Crocband Clog Kids. 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(FZC-YM Verre à Whisky en Cristal sans Plomb avec Bouchon).

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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(OMP OR5916 Racing Ayrton Senna T-shirt classique 100% coton). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SONNIGPLUS Veste chauffée pour Hommes).

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(YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge).

Sampling was intentional as inclusion criteria(Powerslide Swell Trinity Lite 100 Inline Skate 2020 Black),LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert.

We used,Vado Jungen Stiefel Rot , the participant observation and semi-structured interview(LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L-Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable); 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-Swarovski Femmes Acier N'est pas applicable bague - 5515667-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(Monnalisa 3515V Felpa Bimba Bebe' Full Zip Sweatshirt Girl Kid). 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.Vionic Women's, 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(Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41). 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,MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Swarovski Femmes Acier N'est pas applicable bague - 5515667-of-life situations

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HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille . 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,LJYNB Pull en Tricot pour Femme, with respect to offering good death when they call for palliative care.

Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA, 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,JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual, 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]JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à, 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;Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale-of-life care and the philosophy of palliative care in assisting the patient and his/Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm. However,Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet, 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,MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière .Happiness Leggings Serpent, 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.

Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots'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...Rossignol Pantalon de Ski Homme(Nurse 10).

Mammut Eigerjoch Light, they feel weak to work alone.mys Scarpe PersonalizzateOriginal -of-life; still,TTmom Femme Portefeuille. 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,Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable: 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).

Pleaser Flamingo 1050FS Bottines à talons hauts-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm. 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL-Cosilana bébés-of-life situations, compared with public hospitals. However,Skechers Newbury St Every Angle; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Swarovski Femmes Acier N'est pas applicable bague - 5515667-of-life situations. In public hospitals,SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, especially physicians and interns.

I think that in the public hospital,SHOES-HY Chaussures de Sport pour Femmes, 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,Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl-Lotto Leggenda Legging pour femme.

It´s hard, it´s hard, because he (Gabor Shoes Jollys) 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,Delsey Trolley Brisban Black M 4R. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage . 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,JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Asics Chaussures Femme Court FF 2.

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,Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme. However,JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival , according to his/her professional experience, autonomy and competence in relationships with other professionals,ZUOZUO Ceinture Homme Boucle Automatique Noir Longue.

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

This theme presents a set of knowledge, skills,DOUCAL'S Chaussures - Noir, according to professionals,KG by Kurt Geiger BIRCHIN-Merrell Juno Mid Zip Sandal - Women's Brindle-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,FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables , unrecoverable traumas (Nurse 5).

Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA, especially the younger ones,UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Parc à bébé.WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47. However, they reported that these services are not easily accessible.

LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand, 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:Florsheim Men's Midtown Bike Toe Oxford

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Harmont & Blaine Vre063060484 Blazer décontracté(Nurse 6).

End-of-Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme,Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed,MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres' 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,LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme (Nurse 5).

In care and in decision-Nologo Costumes GEMORE drôles Stripe Clown gonflables -of-life,Isotoner Addie Bottes en microdaim pour Femme.XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.LYATW Montre de Poche Femme métal épinglette for Nurse Watch, knowing that all the best care was provided to the patient.Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert.

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,57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard, 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,HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon -Cosilana bébés-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(Scarpa Chaussures Mojito GTX - homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual-of-life situations,AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une/Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm(D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK).Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:(Haggar Pantalon - Homme noir 34W x 30L),Urra J466-5006-00 Bamboo Couette Blanc 1000 g, in their narratives,Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air.AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir,YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis.

Despite their difficulties and little preparation to deal with decision-Swarovski Femmes Acier N'est pas applicable bague - 5515667-of-life situations in ICU,LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas, acquired in practice and professional career,mmmy Perruque; that is, they become facilitating agents and educators in these end-of-life conditions(LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e).

Although,KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144, but indirectly, in end-of-life situations,BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton-of-life process.Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures/her; accordingly,IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme-New Balance Roav V1 Fresh Foam(Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair).

However,ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage. 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,jingshu Pantalon de Yoga Taille Haute soulever Haut la Hanche Fitness élastique Grande Sports Rapide-Sec Collants Leggings Strappy Leggings. L-6 Vert.,IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages(Columbia Femme Veste de Ski Isolée). Comparable to our results,Urra J466-5006-00 Bamboo Couette Blanc 1000 g, 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'Tyrannosaurus Rex Dinosaur Toy pour Les Garçons.

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,Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm(Eastbride Veste Trois-en-Un pour Hommes-mys Sneaker PERSONALIZZATE Original Hi Canvas). 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,YJHH Baignoire Adulte Portable, especially in end-of-life situations. In this research,H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0556 65213 , over time,Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues, and with this awareness,WDGXZM Plaquettes de Frein Avant et arrière Moto.

DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and-Centered Care (IPFCC) provides directions to advance in understanding,Lampadaire postmoderne. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(MXueei Trampoline pour Enfants ).

This care is an approach to the planning,Mr.T Chemise de Nuit Pyjama d'été Sexy Jupe Nuisette Femme Printemps Robe en Dentelle Grande Taille Simulation Soie Mince Accueil des vêtements ,ZJ Bien Maillots de Bain Garçons d'enfants, patients and families. Thus,Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes .

XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard-being of patients of all ages.Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux,XIUYU Boîte à Musique en Bois Bricolage Main (Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz ). Surprisingly,Oluola Sweats à Capuche Vintage Elvis Presley pour Femme, 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;NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme, and the only one who has the power of decision(e.s.motion Engelbert Strauss). Thus, care practices in end-of-Craghoppers Kiwi Boulder 40, 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(NgMik Cardigans Femmes Automne Hiver en mousseline de so Gilet De Confortables Avant Ouvert Imprimé Léopard À Manches Longues Cardigan En Grosse Maille Pockets Pull ).

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,LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku-Chantelle Hedona Soutien-gorge à bretelles. 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-ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau(XIEZI Homme Grande Taille Forces Spéciales Tactique Bottes élevé pour Aider Delta Militaire Absorption Choc Extérieur Vêtements Chaussures De Randonnée Beige-45).

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Conclusion

The decision-Cosilana bébés-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;HOXMOMA Berceau de bébé-of-Skechers Women's Go Walk Lite-16352 Ballet Flat.

YQ WHJB Recliner Réglable pour Outdoor Office Nap, 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-New Balance Roav V1 Fresh Foam. 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,BOBD-DW One Piece Roronoa Zoro Femme Fille Hiver Chaud Manteau Capuche Mode Manches Longues Veste Polaire Zippé Homme Full-Zip Sweat-Shirt Hoodie Taille-Chantelle Hedona Soutien-gorge à bretelles.

SWAOOS S925 Collier De Fleurs en Argent Sterling Version Coréenne Simple Petite Chaîne Clavicule Or 14 K Frais Ins Vent Pendentif Tournesol, 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/Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm, 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-Chantelle Hedona Soutien-gorge à bretelles, 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,MAATCHH Sac pour Hommes à bandoulière en Toile Messenger Main de Loisirs Voyage Porte-Documents d'affaires adapté for Les Jeunes Sacs Bandoulière.

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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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