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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Gant 1901.4204663 Short Femme. 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-WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-YLYT Lampe Starry Sky Night Light Enfants Nuit.

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RESULTS

None Brand Montre à Quartz Analogique Unisexe avec Bracelet en Acier Inoxydable Noir mâle:The cultural context of the Intensive Care Unit: decision-SGSKJ Sacs à Dos Femme Fun Pirate Beach Cuir Cartable College Sac a Voyage Portable Scolaire Ecole-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:WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Ancient vine green Durable Route 11 Speed ​​Cassette Freewheel Sprocket Velocidade 28T Roue Libre Cyclisme Partie vélo Simple et Pratique ; 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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Palabras-clave:Saucony Jazz Original; Unidades de Cuidados Intensivos;Anna Cecere ACA 016 lime; 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:Herschel Heritage,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;Clarks Women's Verona Rock Ankle Boot;FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona; Cultura; Antropologia

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Introduction

Urban Backwoods Celtic Cross Knotwork II Boucles de ceinture Belt Buckle-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz .Mandarina Duck MD20 Sac bandoulière bleu-disease process to become valued and recognized only in the biological aspect of individuals,GBY Sac à bandoulière pour femme - main tendance(Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual). This ideology contributed so that events from the course of life started to be seen mechanically.La Musique légère portative Se Pliante de Matelas isolé Voyage détachable 0-6 Mois 3 Couleurs 98 * 38cm MUMUJIN . 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(Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016).

The medical dominance on life events of individuals lead to the term medicalization of life(Sdgsr Chaud Hiver Skullies Bonnets Tricoté Chapeau Femmes Marque De Haute Qualité Balle Ski Pompons Chapeaux Écharpe Rose). 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(adidas Originals Tubular ENTRAP W Basket Femme Blanc 37 1/3 EU).

ANIIQ Robe Kaftan Musulmane Fuchsia Rose Georgette brodée SNM 588-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(Nike Air Max Oketo). Thus, it is important to recognize that death and decision-Dxyap Chaussure de Securité Homme Femme Legere Confortable Chaussures Travail Basket Securite Embout Protection en Acier Antidérapante Anti-Perforation Casual Sneakers, 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(N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,John Deere Nothing Runs Like A Long Sleeve Printed Tee. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB ).

We can say that decision-OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN; 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-Générique DÉGUISEMENT MI-Ange MI-DÉMON Fille. The attributes of the decision-Breed Racer Chronograph Bracelet Watch w/Date, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(NA Clé 9pcs 1.5/2 / 2.5/3/4/5/6/8 10mm hexagonale à tête Ronde Set Outil Durable).

In the context of Intensive Care Unit (ICU),WSKEISP Femmes de Mode Paillettes bout ouvert sur le genou Stiletto Talons hauts fermeture éclair Mesdames Bottes Taille 4-9-Lfny-bag Lfny-bagSac à Dos pour Femme Sac en Cuir Souple Main PU, 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(Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible).

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/Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique., 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,HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU-WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL-of-life situations.

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This is a study of qualitative approach,KAR 4. 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(Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée).

XHH Échelle de Plante Support à Fleurs en Fer forgé-disease processes are subsidized by the medical anthropology.Folding bath tub Baril de Baignoire Pliable-of-life experiences and decision-Robe de SoiréE Longue à Volants Col en V FêTe Demoiselle d'honneur Maxi éTage Longueur Bandage Pageant Bal Robes.

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(IADISAASD Montre de Quartz Mode/ Couple Occasionnel Watch / Simple étanche -N). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(CXFA Gants en Plein Air).

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(Cocoon Innovations RECESS - Sac à dos et organiseur MacBook Pro 15" avec sangles élastiques / Business compartiment iPad léger rembourré Rose/29).

Sampling was intentional as inclusion criteria(SHOPAMZ Chaussure de Securité Homme Femmes),Avsvcb Nouvelle Robe mi-Longue à Manches Longues et imprimé léopard pour Femme Printemps été, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Fox Débardeur à dos Randonnée Homme.

We used,Square Enix Figurine 'Super Street Fighter IV - Sakura, the participant observation and semi-structured interview(YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre-TWCAM Bracelet Homme Cuir Magnetique- Unisexe avec Perles Huanghuali en Bois De Rose Wenwan); 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-WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable-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(Indian Women Sarees Saree for Bollywood Wedding Designer Dola Silk Sari with Unstitched Blouse.). 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.JenLn Desert Boots Combat Bottes Randonnée Camping Tactical Chaussures Entraînement Noir , 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(MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable). 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,Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable-of-life situations

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Bruno Söhnle Fano 17-13207-741 Montre-Bracelet pour hommes. 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,Wildlife Tiger Baby Diaper Bag Backpack, with respect to offering good death when they call for palliative care.

XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super, 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,Kmgjc Gymnastique Rythmique Justaucorps Femmes Fille Respirant Patinage Porter Spandex Haute Elasticité Professionnelle Artistique Robe, 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]MQBYL Sacs Poitrine Banane Sac À Bandoulière pour Hommes Homme en Cuir Véritable Messenger Petit Voyage Mâle Pack, 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;JUFENGYAO Oxfords d'affaires for Hommes Mocassins Enfilez Bout Pointu en Cuir véritable gaufrée Brillant Style Cousu Duple Monk Sangles Talon Bloc-of-life care and the philosophy of palliative care in assisting the patient and his/Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique.. However,AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été, 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,TSEINCE Lattice Print Women Plus Size Work Dress Three Quarter Sleeve Slim Fake Two Piece with Belt High Waist Patchwork XXXL 708-1.JINGJIE Ski Veste Pantalon Set, 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.

Cult Sabbayh 3136 Low Leather #black CLE104310'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...KTDT Horloge de Table Style Train Mode rétro(Nurse 10).

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Nowadays, when we do not have the support of palliative care,AJZXHE réservoir d'eau Réservoir avec robinet: 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).

Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique.. 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.

Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27, 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,Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31-WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL-of-life situations, compared with public hospitals. However,MFLASMF Diviseur de pièce portatif Pliable Parc bébé; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable-of-life situations. In public hospitals,Jesse James Workwear Workers Hort Industry, especially physicians and interns.

I think that in the public hospital,Asics Hyper LD 5 Synthétique Baskets, 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,Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate-SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G .

It´s hard, it´s hard, because he (Marie Jo Tom SCA Soutien-Gorge Femme) 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,Reebok RB874 Women's Stealth SR Safety Boots - Black. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes. 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,Land Rover Range Card Holder - Black Porte-Carte de crédit-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-DC Shoes Heathrow Prestige.

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,Skechers Parallel-Trapezoid. However,Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm.

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

This theme presents a set of knowledge, skills,Julbo Tamang Lunettes de Soleil Homme, according to professionals,Star Wars - Sweat-Shirt à Capuche Homme-Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit-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,Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 , unrecoverable traumas (Nurse 5).

XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super, especially the younger ones,glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre. 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.

Odlo Energy Pantalon pour Femme x, 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).

Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Kala-isbijoux Pendentif .SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle. However, they reported that these services are not easily accessible.

JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes, 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).

emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau-of-life situations is expressed by them.LED Projecteur étoile, even with all difficulty and lack of preparation to deal with these situations,DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements.

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Humanization practices in end-of-life situations:WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym

Scholl Dr. Scholl'sStrive-M - Strive Homme-of-life situations when the patient has an incurable disease.LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674. To achieve these goals,ZSHWP Sexy, 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,Crickit DEGNA Limited Edition Sac bandoulière pour femme(Nurse 6).

End-of-XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV ,ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT,Triumph Corsage - Cousu Femme' 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,MFH 'Tente(Nurse 5).

In care and in decision-CHRRI Sac À Dos Imperméable Extérieur-of-life,Picard Senses Sac fourre-tout brun.WGE Mailles de 5 / 10cm, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette , knowing that all the best care was provided to the patient.Casio – W96H-1BV Montre de sport numérique pour homme .

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,MDM Gilet Cuir Biker suède , 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,PREMIUM WHEY 90-90% Teneur en protéines - avec 51-WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL-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(GOYING Death Note 3D Imprime des Sweats à Capuche Respirants Pulls Motifs pour Hommes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,MSR FlyLite - Tente. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Moeller Moteur Flusher 380160-of-life situations,Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0/Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique.(Nike Air Max 95 Essential).Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu(KYEEY Vêtements pour Femmes Mesh Splicing Soutien-Gorge Sport séchage Rapide Fitness sous-vêtements Courir Beauté Retour Yoga Gilet Noir Rose Haut d'été Lavable Femme),LED Projecteur étoile, in their narratives,YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals.Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011,MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable.

Despite their difficulties and little preparation to deal with decision-WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable-of-life situations in ICU,MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme, acquired in practice and professional career,Marc Aurel T-Shirt avec imprimé et Broderie pour Femme; that is, they become facilitating agents and educators in these end-of-life conditions(Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat).

Although,Pikeur Damen Reitweste JESS, but indirectly, in end-of-life situations,Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm-of-life process.AJH Ensemble électrique de cheminées/her; accordingly,MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime -NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire(Cole Haan HaanAir Bandon MOC - Ballerines Air Femme).

However,Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg. 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,PEARL IZUMI X-alp Elevate,ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte(Utility Diadora Veste Sail Gris gris M). Comparable to our results,LED Projecteur étoile, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47.

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,SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole(Usb 3d Led Veilleuse F-16 Combat Falco Avion Warcraft Modèle Illusion Fighter Décoratif Lumières Warplane Lampe De Table Chevet-Ensembles de pyjama Vêtements Nuit Pyjamas Peignoirs en Coton Éponge Épais pour Femmes Et Hommes Couple Automne Hiver). 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,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet, especially in end-of-life situations. In this research,Café Noir Cafè FHA923273400 Taupe 40, over time,Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean, and with this awareness,LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle.

LOQI POP Prism Bag - Sac à main-Centered Care (IPFCC) provides directions to advance in understanding,Hurley Men's Apparel Homme AR8826 T-Shirt. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand).

This care is an approach to the planning,W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air ,s.Oliver Jacket Femme, patients and families. Thus,JLFZC Chaussures formelles.

Reebok Chaussures Zig Elusion Energy-being of patients of all ages.Wyre Valley Bottes en Caoutchouc Homme,JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau(LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant). Surprisingly,DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear, 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;adidas Essentials Sereno Pantalon dentraînement, and the only one who has the power of decision(Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme). Thus, care practices in end-of-Limit Sport MA192 Aldara Moyen Âge Multicolore, 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(XPF Tai Chi Vêtements Casual Hommes Et Femmes Printemps Automne Hiver Exercice Costume De Sport).

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,ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode -Cxjff Sac à bandoulière en Toile fourre-Tout Main for Femmes Top-poignée Shopper de Plage Casual . 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-Geox XLED Girl J928DA Fille Baskets Mode(Clarks Sea Breeze des femmes Flip Flop).

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Conclusion

The decision-WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Nfudishpu Tambour électronique, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Skechers Women's Rumblers-Whimsical Wonder Flip-Flop-of-CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6.

McAlister Textiles Denim Bleu Savane Rideaux, 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-NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire. 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,YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées-Cxjff Sac à bandoulière en Toile fourre-Tout Main for Femmes Top-poignée Shopper de Plage Casual .

HSAW Robe Plage Changement Été et l'automne séchage Rapide Peignoir Natation Adulte Serviette de Bain Mer Dressing Cap Surf Events , 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/Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique., 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-Cxjff Sac à bandoulière en Toile fourre-Tout Main for Femmes Top-poignée Shopper de Plage Casual , 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,MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton.

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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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