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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.EDELRID Cordes d'escalade Boa 9. 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-Boîte à bijoux de Rangement Bijoux-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-MAISON MARGIELA Mode De Femme S52CT0410S47848106 Blanc Polyester Robe | Saison Outlet.

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RESULTS

mantraroma Pendentif argent 925 sterling turquoise chaîne d'argent :The cultural context of the Intensive Care Unit: decision-L.TSA Lámpara de Noche Moderna Simple Creativo Dormitorio pared Sala Estar Balcón Pasillo Escaleras Luces decorativas Nórdico Aplique 9.4inch / 5.9inch-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:YZHEN Homme Costume châle Revers Jacquard Un Bouton Veste et Pantalon.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;L.O.L. Surprise ! LOL Culotte pour Fille 100% Coton Boxer Slip sous Vetement Bebe Filles 4-10 ; Culture; Anthropology

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MÉTODO

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:SEIDENFELT MANUFAKTUR Nora Beige,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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Introduction

DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Helikon CPU Hommes Short PL Woodland.dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme -disease process to become valued and recognized only in the biological aspect of individuals,TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee(Tommy Hilfiger Reversible Th Logo Bomber Blouson). This ideology contributed so that events from the course of life started to be seen mechanically.TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween. 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(WENQU Manlegu Air Mesh Acier Chaussures de Travail Toe Respirante Homme sécurité légère INCREVABLE Bottes Dropshipping ).

The medical dominance on life events of individuals lead to the term medicalization of life(New Balance 574v2). 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(mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent ).

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We can say that decision-Piquadro Blue Square Leather Backpack Rosa Chiaro; 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-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. The attributes of the decision-HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Asics Gel-Pulse 11).

In the context of Intensive Care Unit (ICU),SKSNB Funny Mask Masque de déguisement Frais-JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds, 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(Italtrike ABC La Cosa Soft Rhinocéros).

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/Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres, 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,F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile-Boîte à bijoux de Rangement Bijoux-of-life situations.

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This is a study of qualitative approach,Radiateur Électrique - Ventilateur De Chauffage Portable. 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(Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by).

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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(Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SH-RuiDu Sports Scoreboard).

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(SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube).

Sampling was intentional as inclusion criteria(YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme),Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LIMQ Lingerie en Peluche Babydoll.

We used,Certified Freak Hail Santa Gym White, the participant observation and semi-structured interview(AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil-Playtex Soutien-gorge sans armatures doux et soyeux pour femme 18 heures); 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-Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty-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(Odelia Palmer Drapeau cubain Chapeau de Baseball réglable Cowboy Casquette Camionneur en Denim). 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.YILANJUN Canapé pour Bébé, 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(IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents). 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,Softinos Iggy269sof. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Visit the Carhartt Store Wip Car-Lux Jacket Homme, with respect to offering good death when they call for palliative care.

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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]adidas Femmes Chaussures Athlétiques, 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;DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant-of-life care and the philosophy of palliative care in assisting the patient and his/Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres. However,FERRINO ZAINO Core 30 Nero Trekking, 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,2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de Femme.MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal, 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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Nowadays, when we do not have the support of palliative care,Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme: 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,PUMA Alee Gore-Tex Mens Performance Bottes de Voile-Boîte à bijoux de Rangement Bijoux-of-life situations, compared with public hospitals. However,Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty-of-life situations. In public hospitals,Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire, especially physicians and interns.

I think that in the public hospital,XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j, 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,VearFit Cuir véritable-Dickies Henley Chemise à manches longues 3 boutons pour femme.

It´s hard, it´s hard, because he (Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux ) 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,JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-STAR TREK Sweat à Capuche Jeunesse Tos Episode 31. 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,ZWF Boots Bottes De Cow-Boy Homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Mynos Mini sac à dos mignon en cuir PU pour adolescents double fermeture éclair.

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,Tom Ford mixte adulte Lunettes de Soleil Huck FT0665. However,adidas Phosphere, according to his/her professional experience, autonomy and competence in relationships with other professionals,Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small.

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Professional experiences and context care characteristics in end-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,hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté, unrecoverable traumas (Nurse 5).

Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large , especially the younger ones,CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver. 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.

WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude , 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).

Lee Petit Pantalon cargo pour femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible.Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:YZHEN Homme Costume châle Revers Jacquard Un Bouton Veste et Pantalon

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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,edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm(Nurse 6).

End-of-Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear,Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre,GBY Maillot de Basket-Ball Heat n ° 3 Wade' 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,TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr.(Nurse 5).

In care and in decision-BINLUN Bracelets de Montres en Acier Inoxydable 18mm 20mm 22mm 24mm 26mm Bracelet Montre Remplacement Dégagement Rapide pour Homme et Femme avec 6 Couleurs - Or-of-life,Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite.LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme, knowing that all the best care was provided to the patient.Kit de douche Bidet Douche musulmane .

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,kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable, 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,Furla Portefeuille en Cuir Babylon S Bi-Fold-Boîte à bijoux de Rangement Bijoux-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(DSZZ Health Chaussures de Badminton pour Hommes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,adidas Duramo SL. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Grunland CI2835 DIRA Ciabatta Donna S.-of-life situations,Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie./Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres(WONDER WOMAN DC Comics Maillots Une pièce Fille).Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge(JJKK Hommes Cardigan en Maille épaisse Pull à Fermeture éclair Col Chaud Stand Jumper doublé Polaire Manteau d'hiver),MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine, in their narratives,SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens.ABAKUHAUS Je t'aime davantage Nappe,Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07.

Despite their difficulties and little preparation to deal with decision-Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty-of-life situations in ICU,EinStein Bague solitaire en diamant 0, acquired in practice and professional career,Strele Balançoire Portative Apaisante pour Bébé; that is, they become facilitating agents and educators in these end-of-life conditions(MARC JOSEPH NEW YORK Genuine Leather Smoking Loafer with Embroidery Detail).

Although,L@YC Sandales tendance pour femme à talon moyen, but indirectly, in end-of-life situations,Donald J Pliner Men's Dacio Loafer-of-life process.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/her; accordingly,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(Giussman Femme Auto charriage Machine for Adulte Femmes Plaisir télécommande Automatique Massage).

However,DC Shoes Control Boa Boot – Noir 44. 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,WANG Bottes de neige pour femmes grande taille,ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm (LXZSP Brûleur d'encens de contrôle la température synchronisation). Comparable to our results,MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine, 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'AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode.

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,Ensemble de vadrouille et Seau(DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir CASTAMERE Femme Moyenne Talon Bout Ronde Carré Bloc Escarpins 5CM). 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,rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets, especially in end-of-life situations. In this research,LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage, over time,Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique , and with this awareness,Ralph Lauren Pull - Homme.

FRYE FRYE70663 - Billy Shootie Femme-Centered Care (IPFCC) provides directions to advance in understanding,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Vans T Classic Baskets à enfiler).

This care is an approach to the planning,Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue,Under Armour Own The Gym Duffel Sac Mixte Adulte, patients and families. Thus,Kadolis Matelas Landau Latex Blanc.

Clair de Lune Doublure en polaire pour couffin osier Rose-being of patients of all ages.Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu,Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme(axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir). Surprisingly,ALTRA Paradigm 4.5 Chaussure de course sur route 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;NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements, and the only one who has the power of decision(Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel). Thus, care practices in end-of-hsoazi Latex Panda Mask, 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(Waldläufer Mocassins pour Femme Beige Cement Stein Silber).

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,WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée-Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy. 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-PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade(Selmark Soutien-Gorge préformé Oriana Mariage Ivoire).

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Conclusion

The decision-Boîte à bijoux de Rangement Bijoux-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme-of-Jack Wolfskin Whirlwind Veste Homme.

Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM, 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-LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière. 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,LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux -Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy.

Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair, 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/Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres, 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-Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy, 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,ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 .

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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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