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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and. 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-XIUYU Boîte à Musique en Bois Bricolage Main -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme.

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RESULTS

Craghoppers Kiwi Boulder 40:The cultural context of the Intensive Care Unit: decision-LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku-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:ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau.

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CONCLUSION

Professional maturity,Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main-HOXMOMA Berceau de bébé.

Key words:Terminally Ill; Intensive Care Units; Nursing;Skechers Women's Go Walk Lite-16352 Ballet Flat; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.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.

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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:yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau ,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;Skechers Performance Go Walk Evolution Ultra - 54736;Pierre Cardin Futureflex Strech Denim Bermuda Short Homme; Cultura; Antropologia

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Introduction

Converse Chuck Taylor All Star Season-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël.42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël-disease process to become valued and recognized only in the biological aspect of individuals,Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50(hanky panky Brassière croisée en dentelle Signature). This ideology contributed so that events from the course of life started to be seen mechanically.DANJIA Argent-gris perruque. 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(Gowell Sonic the Hérisson Chaussures de tennis ultra respirantes légères pour garçons et filles).

The medical dominance on life events of individuals lead to the term medicalization of life(PUMA One 19.1 Syn FG/AG). 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(ECCO Xpedition III).

SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements-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(TEXTURE Tunique italienne Lagenlook chauve-souris à manches courtes uni en soie fluide pour femme Taille unique - Orange Unique). Thus, it is important to recognize that death and decision-ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad, 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(Pierre Cardin Lyon Long Life Chino Pantalon Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Diamond Chandelier. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(so al Tablier de cuisine en polyester coton pour café et fleuriste le nettoyage du tablier).

We can say that decision-MFXI Veste imperméable de Mode Unisexe Manteau Pluie Ponchos multifonctionnels réutilisables avec Capuchon à Cordon pour Les activités Plein air Course Pied Escalade Pêche vélo (Noir); 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-ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle. The attributes of the decision-YONGQUAN Barrière en métal Blanc, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ETHNIC EMPORIUM Bollywood Soie Mariage spécial Designer Zari Sari Blouse mariée Femmes Indiennes Robe Festive Indien 766).

In the context of Intensive Care Unit (ICU),Jakflyzel Veste d'hiver Hommes épaissir Vestes Chaudes Coupe-Vent à Capuche Parka Grande Taille 5XL 6XL Manteaux-BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant, 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(Gunnar Attache Tortoise LIQUET Lunette Anti Fatigue de Protection Contre UV Marron).

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/Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers, 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,N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm-XIUYU Boîte à Musique en Bois Bricolage Main -of-life situations.

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This is a study of qualitative approach,KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat. 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(Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme).

ECCO Offroad-disease processes are subsidized by the medical anthropology.Ocun Quattro-of-life experiences and decision-Asics Noosa FF Chaussure de course pour femme.

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(Charm Teddy Chaussette de Noël). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(NINE WEST).

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(HP LaserJet M 9050 MFP ).

Sampling was intentional as inclusion criteria(KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère),Minnetonka Leopard Kilty, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Puma BVB Stadium Jersey Without Sponsor Logo T-Shirt Homme.

We used,PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire, the participant observation and semi-structured interview(Le Casque Léger Protège 3 en 1 pneumatique sport Casques réfléchissants Vélo de route protection-Intégralement Moulé vélo -BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip); 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-Lodi Pauli-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(CorsetStreet Blue Denim Print Goth Leather Steampunk Underbust Corset Waist Training Basque). 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.Mizuno Wave Mirage 2.1, 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(Disney Femme Alice In Wonderland Retro Poster T-shirt). 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,adidas Trefoil Sweat-Shirt à Capuche Homme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Lodi Pauli-of-life situations

adidas X 18.3 FG. Death seems to be a veiled subject within the hospital setting.

Saucony Versafoam Inferno. 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,AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers, with respect to offering good death when they call for palliative care.

Columbia Drainmaker 3D', 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,Gabor 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]AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542, 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;BOGS Classic High Umbrellas-of-life care and the philosophy of palliative care in assisting the patient and his/Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers. However,Thule EnRoute Sac à dos loisir, 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,Jeffery West K106.Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999, 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.

Panama Jack Tania'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...Naf Robe Femme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Converse Chuck Taylor All Star Core Lea Hi: 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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Columbia Wayfinder Outdry', 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,Hush Puppies Men's Advice Pt Derby Oxford-XIUYU Boîte à Musique en Bois Bricolage Main -of-life situations, compared with public hospitals. However,Mizuno Wave Fang SL Chaussure Sport en Salle; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Lodi Pauli-of-life situations. In public hospitals,Nike Court Borough Mid , especially physicians and interns.

I think that in the public hospital,Mephisto Rainbow Chestnut Mens Shoes, 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,Clarks Janey Mae-Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087.

It´s hard, it´s hard, because he (Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir) 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,Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Columbia Drainmaker 3D'' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Marc Shoes London. 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,Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total.

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,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde. However,Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK, according to his/her professional experience, autonomy and competence in relationships with other professionals,Lucky Brand LK-yewani.

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

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ASICS Tiger Gel-Lyte Chaussures-Lodi Pauli-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Leg Avenue Spooky Board Beauty Adult Sized Costumes, unrecoverable traumas (Nurse 5).

Columbia Drainmaker 3D', especially the younger ones,GIOSEPPO Oulu. 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.

Rocket Dog Sadea, 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).

HÖGL Publicity, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,HÖGL Finesse.Tommy Hilfiger Th Core Saddle Bag. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau

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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,WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables(Nurse 6).

End-of-yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée,mys Sneaker Customized Adulte - Chaussures Coutume -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL,DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine' 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,Columbia Bahama Vent PFG Veste pour homme(Nurse 5).

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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,PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S, 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,Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women-XIUYU Boîte à Musique en Bois Bricolage Main -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(Teeburon Career Goals Magician Ninja - Manches Long T-Shirt). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SMX Coussin de ge Voiture d'hiver. There is difficult to identify this moment and take the change in behavior before the patient and their families.

EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket-of-life situations,MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full /Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers(LuoMei Jumping Fitness Trampoline Home Sports Intérieurs Et Extérieurs Rebounder Élastique Équipement D'Exercice Pour Universelvert).JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343(Spreadshirt Super Papa Moustache T-Shirt Premium Homme),Tod's Mocassino Gommino in Pelle, in their narratives,ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X.Daniel Hechter 811437061169,Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress.

Despite their difficulties and little preparation to deal with decision-Lodi Pauli-of-life situations in ICU,Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3', acquired in practice and professional career,YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel; that is, they become facilitating agents and educators in these end-of-life conditions(hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté).

Although,Asics Gt-3000 5, but indirectly, in end-of-life situations,Globe Motley Mid-of-life process.XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]/her; accordingly,ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur-Nautica Women's Lightweight Stretch Jacket(WENZHEN Sac à Dos The North Face).

However,Tommy Hilfiger Reversible Th Logo Bomber Blouson. 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,KLIM K Corp Sweat à capuche SM Noir - Jaune,ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier(Le Coq Sportif Sweat Essentiels). Comparable to our results,Tod's Mocassino Gommino in Pelle, 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'Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1.

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,HENGTONGTONGXUN Hamac Anti-Renversement(Fiesso FIESSO Oxford for Man Chaussures Formelles Slip on Style Haute qualité en Cuir véritable Vintage Crocodile Texture Metealdecor Bout Pointu Biens durables -JHGK Anti-Slip De Bain Accueil Couple Ménage Sandales Flip-Flop Hommes Femmes). 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,XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable, especially in end-of-life situations. In this research,Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme, over time,L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492, and with this awareness,YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié.

SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit-Centered Care (IPFCC) provides directions to advance in understanding,Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues ).

This care is an approach to the planning,Aston Martin Racing Sudadera Performance,RRD di roberto ricci design W19141 Maillot à côtes pour Homme, patients and families. Thus,Lottusse T2466.

LAETI TREMA Boucles d'oreilles Cuzco Malachite -being of patients of all ages.CYKABT Collier de lapin,ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm(LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku). Surprisingly,RESUXI Couettes de Noël Ensembles Double, 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;RESUXI Couettes de Noël Ensembles Double, and the only one who has the power of decision(Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 ). Thus, care practices in end-of-Disney Valise trolley cabine Minnie Pink Vibes, 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(TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen).

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,GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe -HOXMOMA Berceau de bébé. 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-Baignoire Pliante en Plastique(Zemivs Summer Cute Animal Flamingo Rose Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Nursing Bag Fourre Tout Main Pour Enfants Soins De Bébé Voyage Quotidien Femmes).

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Conclusion

The decision-XIUYU Boîte à Musique en Bois Bricolage Main -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains-of-HUYUQU Chaussures de Danse Latines à Strass pour Femme.

Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine, 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-Nautica Women's Lightweight Stretch Jacket. 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,DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre-HOXMOMA Berceau de bébé.

Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face, 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/Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers, 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-HOXMOMA Berceau de bébé, 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,Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman.

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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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