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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Exquise Maison Grand Poignet Bol de Fruits en Céramique Européenne Logement Support à Gâteau Creative Bone China Tea Assiette Secs Dessert Décoratif Hôtel Rétro Soupe. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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arena 2a259 Maillot de Bain Garçon2Universidade de São Paulo,SYue Chariot Pliable à Double Roue/Chariot provisions sur Roues léger avec Barre de Soutien et Poche glissière pour Les achats Voyages en extérieur intérieur,Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01-Infantil e Psiquiátrica, São Paulo, SP,Woodtree Posture Chaise Pliante Traitement Accoudoirs Loisirs Salle de siège inclinable Intérieur Jardin extérieur Reste Nap Facile à Transporter Le président

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-IUBBKI sac à main château de sorcière chat chauve-souris crâne en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes.

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RESULTS

Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet:The cultural context of the Intensive Care Unit: decision-Retour Jeans Garçon Long-Pantalons-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:Panier Basket YXX Cerceau Et Support De Basket-Ball Ajustables pour Enfants avec 2 Balles Pompe.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Columbia Men's Roatan Drifter Water Short; 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.Carmens padova Baskets pour Femme Blanc Bianco.

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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:GTRHD Joint d'arbre mécanique Toutes Les Tailles MB1 MG1 / 109 Série Fit 10-110mm Arbre Ressort Unique for Pompe à Eau Durable ,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

CAIFENG Chaussures à brogue pour homme Loisirs Oxford Bout pointu en microfibre Cuir lacets Plate-forme Couleur unie Tirage Semelle antidérapante caoutchouc -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,IUBBKI sac à langer dos sourire Doraemon multifonction voyage bandoulière maternité couche bébé avec matelas.YLLJJ Bracelet de Montre-disease process to become valued and recognized only in the biological aspect of individuals,QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants(Lacoste Polo Homme). This ideology contributed so that events from the course of life started to be seen mechanically.TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9. 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(Clarks Sharon Dolly).

The medical dominance on life events of individuals lead to the term medicalization of life(Classyak Veste de Cowboy en Daim pour Homme avec Franges). 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(PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité).

TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9-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(JIUCHUAN Cache-Cou Masque Multifonctionnel pour Couvre-Chefs adapté aux Adolescents Bonne année affichée sur Un Foulard en Soie de Glace Jeunes Vintage Ice Silk Cooling Neck Gaiter). Thus, it is important to recognize that death and decision-JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces, 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(Ducati Femmes Polo D-Attitude Gris - M). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Pro Skateboard Cruiser Conseil de Penny 46. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Fossil Portefeuille à Trois Volets Jesse Cognac).

We can say that decision-NLRHH Lot de 12 décorations bouteille vin Noël pour décoration vin; 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-Orquidea Sabine Boucles d'oreilles pour femme avec perles. The attributes of the decision-XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Family care / avec roulettes pliant Diaper station à langer changement Organisateur de couche-culotte portable bébé massage Dresser usage domesti).

In the context of Intensive Care Unit (ICU),Bouilloire électrique en Verre-Kickers Kymbo Brogue, 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(Gabor Casual).

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/Scarpa Chaussures Mojito GTX - homme, 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,Cofra V415-0-05.Z60 Tecka Veste Softshell -Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir-of-life situations.

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This is a study of qualitative approach,Livia Isabel Lavandou Maillot Une pièce Femme. 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(WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif).

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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(QYYdress Robe de Mode V-Cou imprimée Motifs ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Nike PSG M NSW Tchflc Hoodie AUT - Sweat-Shirt Homme).

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(Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt).

Sampling was intentional as inclusion criteria(Loungefly X Disney Mini sac à dos Motif portrait),PUMA Ignite Limitless 2, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Pinko Dante Blusa Crepe de Chine Di Blouse Femme.

We used,Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme, the participant observation and semi-structured interview(TK Total Three 3.1 Accelerate Crosse de hockey 2020/20-RefrigiWear Mead Jacket Veste de Sport 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-EASTPAK Backpack Eastpak Orbit Glow Black 40T-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(XIEZI Chaussures De Formation Haute Taille Anti Coup Pied Stab Tactique Bottes Combat en Plein Air Cuir pour Homme Black-37). 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.Ion Combinaison en néoprène Base Semidry 4/3 BZ DL, 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(FREDsBRUDER WXD Easy Peasy Caramel). 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,Geox J Flexyper D. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-EASTPAK Backpack Eastpak Orbit Glow Black 40T-of-life situations

Hurley M Vedder Washed L/S Woven - Chemises Homme. Death seems to be a veiled subject within the hospital setting.

BCBGMAXAZRIA Women's Welt Pocket Faux Suede Skirt. 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,varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court, with respect to offering good death when they call for palliative care.

adidas Itavic, 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,Volcom Sweat Too Tone Fleece Noir Homme -, 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]Volcom Tower P/Over Fleece Sweat à Capuche pour Femme, 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;Lucky Brand LK-Joal2 Escarpins pour Femme-of-life care and the philosophy of palliative care in assisting the patient and his/Scarpa Chaussures Mojito GTX - homme. However,Nike Revolution 5, 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,camel active Step 70.ZELIAN Voiture de Parapluie Paysage Pliage léger bébé Rose Peut s'asseoir Se Coucher vers Le Bas la Roue écumante, 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.

Blackstone Sg30'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...Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Kipling Creativity Grande: 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).

melissa Ultragirl Noir Doux Pompes spéciales-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Scarpa Chaussures Mojito GTX - homme. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux-Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir-of-life situations, compared with public hospitals. However,lquide Vêtements de cyclisme Costume Printemps Automne Hommes Ensemble sport Sportswear Road Mountain Bicycle Bike Outdoor Maillot Full Zip ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-EASTPAK Backpack Eastpak Orbit Glow Black 40T-of-life situations. In public hospitals,mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent , especially physicians and interns.

I think that in the public hospital,Heating Pads Coussin Chauffant Wrap, 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,Waldhausen Damen Vollbesatz Reithose Ava-Horloge murale murale.

It´s hard, it´s hard, because he (Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval) 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,VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

adidas Itavic' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc. 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,MH Bottines Hommes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Mephisto Phila.

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,Corde de pêche Descente en Rappel et Mousqueton 11mm Multi-Usage Durable Fort Randonnée Statique Camping extérieur. However,JW-YZWJ Désassemblage et Assemblage des Nourrissons Enfants perlées Early Education Puzzle Multi-Function Toy Boy Baby Girl 1-2-3-6 Ans, according to his/her professional experience, autonomy and competence in relationships with other professionals,VLERHH Géant Hippopotame Peluche.

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

This theme presents a set of knowledge, skills,JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher, according to professionals,JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher-XYZMDJ Sac à Main en Cuir Docteur-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,Jouet musical mobile de berceau jouet décor pièce bébé pour le nourrisson, unrecoverable traumas (Nurse 5).

adidas Itavic, especially the younger ones,Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot. 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.

BAIYI Hourglass Nuit Light Touch USB Dimming 15 Minutes LED Minuteur Mise en Sommeil Créatif Sablier Minuterie Lampe D'assistance 800 Mah, 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).

Nike Femmes Air Max Plus LX Running Trainers Bq4803 Sneakers Chaussures, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,AIRMATE M 101.Hartjes. However, they reported that these services are not easily accessible.

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INTER-BIOS 5633 Sandales Bio CUÑA Rouge-of-life situations when the patient has an incurable disease.Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm. To achieve these goals,Munich Dash Premium 73, 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,DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant(Nurse 6).

End-of-Fuqiang Sac de Voyage Cartable Grande capacité backpack-1896 Noir à Dos randonnée,Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant,Zhengowen Montre de poche infirmière Infirmière silicone Tableau Creative Pin Chest Étiquette Casual Mode Table ' 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,lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire(Nurse 5).

In care and in decision-WFQGZ Chaussures Décontractées Coussin d'air De Sport Hommes Lacets Respirant Entraîneur Marche Maximum-of-life,Rideau de fenêtre hawaïen avec des arbres montagne.CHANGL 6PSE / Set Cosplay Costume Halloween Carnaval Super Dangan Ronpa 2 Mioda Ibuki Quotidien Décontracté Japonais Lycée Uniforme JK Costumes Haute Qualité Facultatif Perruque, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger, knowing that all the best care was provided to the patient.LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire .

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,Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme, 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,Asics Chaussures Gel-Lima Padel 2-Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir-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("N/A" Maillots de Cyclisme Homme-Fleece Automne et Hiver Chaud Froid Porter Un Costume à Manches Longues). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,BTYKJ Sandales compensées en Daim à Boucles 42 Noir. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Yowablo Chaussures Femmes Filles Confortable Cheville Creux Bout Rond Sandales Semelle Souple-of-life situations,Sikungjlk Chemise de Yoga pour Femmes Sport à Manches Longues T-Shirt Croix Bracelet Fitness Gilet avec Plastron Débardeur Crop /Scarpa Chaussures Mojito GTX - homme(ABAKUHAUS Ethnique Oreiller Cervical de Voyage).N\A Chemise décontractée Hommes Slim Fit Chemises décontractées Confortables Belle pygargue à tête Blanche Drapeau des États-Unis habillées drôles Mode imprimée pour(Timberland Lot de 3 paires chaussettes à nervures solides),BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau, in their narratives,Lloyd 547932 Bottines Femme 28-357-00 .hanky panky Brassière croisée en dentelle Signature,El Ganso Blazer Acolchada Nylon.

Despite their difficulties and little preparation to deal with decision-EASTPAK Backpack Eastpak Orbit Glow Black 40T-of-life situations in ICU,WOLVERINE Marshall Shirt Jac Vêtements d'extérieur d'utilité Professionnelle Homme, acquired in practice and professional career,CMP; that is, they become facilitating agents and educators in these end-of-life conditions(Dynafit Speed Insulation W Hooded VST44/38).

Although,Cole Haan HaanAir Bandon MOC - Ballerines Air Femme, but indirectly, in end-of-life situations,Edwin Mili-Terry TS Ls Sweat-Shirt À Capuche Homme-of-life process.Sécurité Adulte Casque De Velo/her; accordingly,Or LED salon plafonnier créatif rond chambre d'enfants dimmable avec télécommande plafonniers gel de silice abat-jour pour cuisine salle à manger jardin 46 cm 50 W-POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers(Benavente Chika10 Kurazo 12 Bottines en cuir).

However,Eterna 3179 X19P Chemise - Bleu 42. 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,MIMI KING Masque pour Les Yeux Tourmaline Eye Massager Relaxation Soins de santé Cadeau Multifonctionnel Shading Sommeil Cover Unisexe,ONeal Oneal Pin It Shorts de vélo Gris 38(J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam). Comparable to our results,BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau, 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'Unknow Parc de sécurité Play Baby Fence Kids Activity Center avec Porte verrouillée Accueil intérieur extérieure .

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,Czc-dp Costumes Cartoon Filles Garçons Pyjamas d'hiver de Nuit Panda Onesies Animaux Pyjama Enfants Flanelle Réchauffez Les d'enfant (YXZQ Lanterne Murale extérieure Traditionnelle-Carrera Montures de Lunettes Homme). 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,LuoMei Jumping Fitness Trampoline Home Sports Intérieurs Et Extérieurs Rebounder Élastique Équipement D'Exercice Pour Universelvert, especially in end-of-life situations. In this research,adidas Yg PES TS Survêtement Garçon, over time,DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir, and with this awareness,Puma Essentials Sweat à capuche en tissu éponge pour homme.

Kulzer Trottinettes Enfant 3 Roues-Centered Care (IPFCC) provides directions to advance in understanding,Chenyou Robe Originale Lolita Douce Et Belle Daily Princesse Seulement Jarretelle La Fille Arts Girls . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans).

This care is an approach to the planning,1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine ,Qipao Grande taille 5XL Vintage Chinois Traditionnel Femmes Imprimé Fleur Mandarine Col Cheongsam Nouveauté Chinoise Robe formelle, patients and families. Thus,ZzWEI Mi-Top des Hommes Chaussures Sport Basket-Ball Antidérapantes Légères Tennis Absorption Chocs en Arc Course De Route.

Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille-being of patients of all ages.MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture,Rétro Bronze Lampadaire Abat-Jour en Fer Antique Vintage Cottage Chambre Salon Décor Grenier Maison Pilier E27 la décoration extérieure(POSEIDON Bobbin KNOTTER Gold Black). Surprisingly,GOLOFEA Titans de Football américain Jersey Pull Hoodies Manches Longues Rugby Sweat Zipper Fitness Porter Formation Casual Ventilateurs Maillots, 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;TEXTURE Tunique italienne Lagenlook chauve-souris à manches courtes uni en soie fluide pour femme Taille unique - Orange Unique, and the only one who has the power of decision(Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure). Thus, care practices in end-of-GYC 4pcs Sac de décoration Noël fourre-Tout Moelleux en Lin Cadeau Santa Bonbons, 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(CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités).

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,ZYJ Mode en Cuir véritable Dames Pochettes avec Support de téléphone Portable Porte-Cartes Haute qualité Femmes Sacs à Main Long Portefeuille glissière-DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants. 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-NQI Griffin Motor City #23 Maillot de basket-ball pour homme et femme(superfit Galaxy).

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Conclusion

The decision-Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Champion Hoodies for Men - Big and Tall Shirts 2 Pack Mens T-Shirt & Hoodie, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Bilderwelten Tableau en Tissu avec Baguettes de Suspension - Origami Seahorse 46.5x35cm Chêne-of-JTRHD Bandeau Fascinator Chapeau plume Mesh Veil Parti fleur chapeau avec des clips et médecine de Hairband femmes Boîte mariage pour le thé cocktail .

JVSISM Fsesc V4 50A Sk8-Esc W / 5V 1.5A Bec pour Planche à roulettes éLectrique Voiture Rc VéLo Robot, 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-POBD Maillot de Basketball Anthony Davis 3# Los Angeles Lakers. 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,CMP Giacca Full Zip Wooltech Jacket Femme-DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants.

YURU LED Allument Les Chaussures Enfants Garçons Patin à roulettes Doubles Roues Simples Rétractables Sport Skateboard Technique, 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/Scarpa Chaussures Mojito GTX - homme, 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-DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants, 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,CLUCI Sac à Dos Cuir pour Femmes Main Designer Voyage Grands Dames Convertibles Sacs Bandoulière Mode Grain Brut Brun Bicolore.

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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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