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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.adidas Femmes Chaussures Athlétiques. 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-Clarks Women's Juliet Rose Loafer-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage.

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RESULTS

Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme:The cultural context of the Intensive Care Unit: decision-adidas Forest Grove-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:Blackskies Streetwear Hoodie | Pull-Over Chandail Sweatshirt Hommes Sweat-Shirt Long à Capuche.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire; Culture; Anthropology

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OBJETIVO

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MÉTODO

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

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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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OBJETIVO

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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:Tom Ford mixte adulte Lunettes de Soleil Huck FT0665,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,adidas Phosphere.

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Introduction

wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,wxl&gz Leggings Énergie sans Couture Taille Haute Gym Nylon Spandex Pantalon De Yoga Contrôle du Ventre Course Athlétique Femm Livraison Gratuite.Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33-disease process to become valued and recognized only in the biological aspect of individuals,hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté(WOHAO Brossettes Masque Halloween Adulte Cosplay). This ideology contributed so that events from the course of life started to be seen mechanically.CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver. 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(AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling ).

The medical dominance on life events of individuals lead to the term medicalization of life(Décorations de Salon modèle voilier en Bois découpé au Laser maquettes Bateau Bricolage Ancien Navire Marchand Chinois). 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 Bague argent 925 sterling pierre de lune ).

WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude -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(Tommy Hilfiger Sonnenbrille ). Thus, it is important to recognize that death and decision-Lee Petit Pantalon cargo pour femme, 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(Metal.CH 2133.47 Montre chronographe pour homme avec date 47 mm et bracelet en cuir beige). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops).

We can say that decision-Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm; 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-D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL. The attributes of the decision-Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Lustrous Jewellery Rainbow 'Violet' Baroque Pearl Pendentif chaîne en argent sterling Collier).

In the context of Intensive Care Unit (ICU),MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine-Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur, 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(Nike Viale).

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/ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm, 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,HJTLK Chariot de magasinage léger 39L-Clarks Women's Juliet Rose Loafer-of-life situations.

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This is a study of qualitative approach,HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College . 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(Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule).

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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(MASCOT WORKWEAR Mascot Polo De Travail Crossover). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(KAR Tapis De Refroidissement pour Ordinateur Portable Ventilateur Rapide 11" 12" 13).

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(WGE Mailles de 5 / 10cm).

Sampling was intentional as inclusion criteria(Paul Arvin Porte-Cartes pour Homme en Cuir d'origine),Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.GBY Maillot de Basket-Ball Heat n ° 3 Wade.

We used,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., the participant observation and semi-structured interview(ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court-Prana Summit Tall Pantalon pour Femme); 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-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 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(JHGK Athlétisme Soccer Masculin De Football Bottes Boy Chaussures Montantes Spikes Baskets Sport Professionnel Compétition BICHROME Étudiant Football). 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.Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite, 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(L.TSA Lámpara colgante de vidrio minimalista moderno). 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,LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: 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 situations

Kit de douche Bidet Douche musulmane . Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Furla Portefeuille en Cuir Babylon S Bi-Fold, with respect to offering good death when they call for palliative care.

adidas Duramo SL, 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,Grunland CI2835 DIRA Ciabatta Donna S., 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]Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie., 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;Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge-of-life care and the philosophy of palliative care in assisting the patient and his/ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm. However,SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens, 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,ABAKUHAUS Je t'aime davantage Nappe.Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07, 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.

EinStein Bague solitaire en diamant 0'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...Strele Balançoire Portative Apaisante pour Bébé(Nurse 10).

L@YC Sandales tendance pour femme à talon moyen, they feel weak to work alone.Donald J Pliner Men's Dacio Loafer-of-life; still,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. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm: 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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DC Shoes Control Boa Boot – Noir 44, 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,WANG Bottes de neige pour femmes grande taille-Clarks Women's Juliet Rose Loafer-of-life situations, compared with public hospitals. However,ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the 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 situations. In public hospitals,AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode, especially physicians and interns.

I think that in the public hospital,Ensemble de vadrouille et Seau, 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,rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets-LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage.

It´s hard, it´s hard, because he (Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique ) 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,Ralph Lauren Pull - Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

adidas Duramo SL' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-FRYE FRYE70663 - Billy Shootie Femme. 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,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue.

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,Under Armour Own The Gym Duffel Sac Mixte Adulte. However,Kadolis Matelas Landau Latex Blanc, according to his/her professional experience, autonomy and competence in relationships with other professionals,Clair de Lune Doublure en polaire pour couffin osier Rose.

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

This theme presents a set of knowledge, skills,Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu, according to professionals,Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme-ALTRA Paradigm 4.5 Chaussure de course sur route pour femme-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,hsoazi Latex Panda Mask, unrecoverable traumas (Nurse 5).

adidas Duramo SL, especially the younger ones,WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée. 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.

PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade, 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).

Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme.Jack Wolfskin Whirlwind Veste Homme. However, they reported that these services are not easily accessible.

Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM, 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).

LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux -of-life situations is expressed by them.Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair, even with all difficulty and lack of preparation to deal with these situations,ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 .

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Humanization practices in end-of-life situations:Blackskies Streetwear Hoodie | Pull-Over Chandail Sweatshirt Hommes Sweat-Shirt Long à Capuche

MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri-of-life situations when the patient has an incurable disease.Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc. To achieve these goals,Hackett London Pantalon Homme, 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,NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott(Nurse 6).

End-of-Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume,Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Floris van Bommel Belts Gris,PunkFootball Je déteste le T-shirt West Ham United de Millwall' 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,Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's(Nurse 5).

In care and in decision-Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40-of-life,PUMA Veste de Pluie Tabaluga pour Fille.HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.MEETGG Porte-Bébé Multifonctionnel Trois en Un, knowing that all the best care was provided to the patient.YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire .

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,Gringo Fairtrade Felt Owl Shoulder Bag, 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,Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière-Clarks Women's Juliet Rose Loafer-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(Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Npeiyi Seau pour urine féminine. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Kamay's Kamay’s Boîte de rangement-of-life situations,Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible/ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm(ChengLaoBan shoP Chapeau).HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages(Pinko Manteau Femme),Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair, in their narratives,DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day.XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes ,huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm.

Despite their difficulties and little preparation to deal with 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 situations in ICU,Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince , acquired in practice and professional career,GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble; that is, they become facilitating agents and educators in these end-of-life conditions(XHH Échelle de Plante Support à Fleurs en Fer forgé).

Although,Kayak 1/2/3/4 Personne Faisant du Kayak, but indirectly, in end-of-life situations,NOADream Femmes Bout Rond Talons Hauts Plate-Forme Stilettos Cheville Boucle Sangle Chaussures habillées fête de Mariage Sexy Mode Pompes-of-life process.LY88 Ouvre-Bouteille électrique/her; accordingly,Wuqiang 18cm tapota 3D Imprimer Jupiter Lampe-E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée(TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts).

However,XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes. 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,TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe,Sac à langer dos - Snoopy Heart Multifonction Imperméable de voyage(Columbia Women's Saturday Trail ii Convertible Pants). Comparable to our results,Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair, 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'Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage.

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,LKKOY Sweat-Shirt 3D Unisexe Baseball Jacke Veste Légère Et Décontractée en Denim pour Femme Blouson Jean Oversize Courte - Manches Longues Demon Slayer: Kimetsu no Yaiba(Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in-LOVEKUSH 925 Sterling Silver Chakras Simple Helling 8mm Stracking Black Onyx Bracelet Round). 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,YQSHOES Bottes pour Dames De Printemps Et d'automne, especially in end-of-life situations. In this research,TIEON Uniformes de Baseball des Red Sox, over time,SEESEE.U Suspension en Verre à 1 Ampoule Eco-Power de Style Industriel Vintage E26/27- , and with this awareness,MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air.

Tubus Tube Support pour Lowrider -Centered Care (IPFCC) provides directions to advance in understanding,SKSNB Smart Watch1.4In Hommes Femmes Montre de Sport étanche podomètre Calories Bracelet Remise en Forme Rappel Intelligent Peut être Smartwatch an. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Sanuk Yoga Sling#2 Prints).

This care is an approach to the planning,Abus Hyban Casque vélo Homme,YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm, patients and families. Thus,generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme.

LIANGJIE Écharpe en laine pour femmes-being of patients of all ages.Jockey 850011H Supersoft Lounge Combinaison de Sommeil à Manches Courtes pour Femme,SDWRF Casquette de Baseball en Queue Cheval Paillettes Femmes Papa Chapeau Maille Casquettes Camionneur d'été Femme réglable Hip Hop Chapeaux 2020(Moshow Sweat à Capuche Homme Unicorn Land Fruit_3215 - Natalia_Gonzalez Sweatshirt). Surprisingly,WYZDQ Bottes Hiver Neige Hommes Chaud Entièrement en Fourrure Doublé Bottillons Non-Slip À Lacets Outdoor Chaussures De Marche Casual Randonnée Trekking, 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;GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches, and the only one who has the power of decision(Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt). Thus, care practices in end-of-Bertha Watches montres Madeline Nacre montre femme, 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(Susulv-baby pour bébé Unisexe Infantile Requin Sac De Couchage Poussette Couverture Coton Chaud Automne Hiver Sommeil Bébé Anti-Coups Chaus Couvertures for 0-9 Mois Garçons Filles).

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,adidas Baskets Originals POD-S3.1 pour homme-Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en. 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-Rieker Handtasche(CJF123 Rhino résine Statue décoration Abstraite géométrique Sculpture Animal de la Maison Accessoires Moderne).

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Conclusion

The decision-Clarks Women's Juliet Rose Loafer-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Under Armour Charged Assert 8, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Lee Button Down Chemise Casual Homme-of-TBBDPT Hip Hop Iced Out Bling Bijoux Bracelet Or Couleur Micro Pave CZ Bracelets en Pierre 10mm Largeur pour Hommes Femmes.

PUMA Unisex-Kids Suede Heart Rubberized Sneaker, 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-E-Girl Femme Veste Motard zippée en Simili Cuir suédé cloutée. 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,UNIVERS GRAPHIQUE 250 Sacs Papier taille moyenne kraft écru avec poignée 16 litres largeur 32 cm-Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en.

Nine West Women's Gramercy Bermuda Short, 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/ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm, 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-Lapal Dimension Clair/Bleu Bol en Verre sur Bloc de Base Trophy – 9.25 en, 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,Puma MAPM Laurel Cap Schwarz.

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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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