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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ESDY Ensemble de sous-Vêtements Thermiques Homme. 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-GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-eeddoo Ti Gloss Titan - BCR Klemmring .

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RESULTS

Sotala Pantalon - Femme:The cultural context of the Intensive Care Unit: decision-Nike M nK sQD coutil Top Shirt à manches longues-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:K-Swiss Ultra Express.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle; 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.GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet.

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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.

Palabras-clave:Nike Court Borough Mid Winter; Unidades de Cuidados Intensivos;Columbia Granite Mountain Veste polaire pour homme; Toma de Decisiones; Cultura; Antropología

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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:Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar ,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

Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Columbia Fall Pine Washed Crew Chemise Femme.Feagar Voiture Oreillers de Cou-disease process to become valued and recognized only in the biological aspect of individuals,TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille(Vince Camuto Robe décontractée à volants floraux pour femme). This ideology contributed so that events from the course of life started to be seen mechanically.Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme. 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(Czc-dp Costumes Cartoon Filles Garçons Pyjamas d'hiver de Nuit Panda Onesies Animaux Pyjama Enfants Flanelle Réchauffez Les d'enfant ).

The medical dominance on life events of individuals lead to the term medicalization of life(EDELRID Greenclimb Manches Longues Homme). 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(LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs ).

KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme-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(Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47). Thus, it is important to recognize that death and decision-Anodi per Motori Mercury - Mercruiser, 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(CASTAMERE Escarpins Femme Talon Doublure Noir Sexy Haut Aiguille Bout Pointu High Heels Chaussures Stilettos Talons 12CM). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger).

We can say that decision-AILIBOTE Squad T-shirt pour homme; 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-Cavi telecomando Sea Star CC330. The attributes of the decision-SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Triumph Boost Balconnet Ampliforme Magic Wire Soutien-Gorge Femme).

In the context of Intensive Care Unit (ICU),Timberland Jayne Bottes de confort pour femme 15 cm-TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear, 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(HÖGL Cosmos).

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/Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite, 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,PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL-GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball -of-life situations.

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This is a study of qualitative approach,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route . 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(YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines ).

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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(LWQ Moulin Portable). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(CafePress - Right Handers are Annoying Sac fourre-tout en toile naturelle).

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(Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6).

Sampling was intentional as inclusion criteria(Magma Products),SPORTUBE Series 1 Platinum Deluxe Étui à snowboard, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45.

We used,Nike M NKCT Jacket Stadium Veste Homme, the participant observation and semi-structured interview(nobrands Siège Pliant de Canne - Chaise béquille Pliante portative Tabouret Marche réglable en Hauteur pour Vieil Homme-Saucony Bullet); 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-Kipling Kassandra S-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(Vogue Lunettes de Soleil Femme). 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.Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie, 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(Jost Bergen X-Change ). 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,Prana Summit Tall Pantalon pour Femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Kipling Kassandra S-of-life situations

Piquadro Porte-Cartes de crédit. Death seems to be a veiled subject within the hospital setting.

LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge. 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,zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit, with respect to offering good death when they call for palliative care.

FRWANG Hommes Chaussures Cuir Brogue Lacets, 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,CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite, 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]Glqwe Sac à Dos étanche pour Ordinateur Portable, 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;Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage-of-life care and the philosophy of palliative care in assisting the patient and his/Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite. However,H.yina Table à Langer pour Fille Petits espaces, 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,Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier.Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant, 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.

Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme'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...huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt(Nurse 10).

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Nowadays, when we do not have the support of palliative care,LetsBuyGold Bague Artisanale : I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme-GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball -of-life situations, compared with public hospitals. However,OLYMP Luxor Chemise à col montant Blanc; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Kipling Kassandra S-of-life situations. In public hospitals,TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu, especially physicians and interns.

I think that in the public hospital,TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo, 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,vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron-HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini .

It´s hard, it´s hard, because he (O'NEILL Femme Blouse) 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,Asics Women's Low Cut Performance Short - Coupe Basse pour Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

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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,Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LMWB Moustiquaire de Lit Pliable.

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,adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US. However,TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux, according to his/her professional experience, autonomy and competence in relationships with other professionals,PUMA S XT nuageux Chaussure gris 359 135 02.

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

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione, unrecoverable traumas (Nurse 5).

FRWANG Hommes Chaussures Cuir Brogue Lacets, especially the younger ones,Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt. 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.

MPOQZI Couvre-Volant de Voiture en Cuir Bricolage, 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).

fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne.DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan. However, they reported that these services are not easily accessible.

ECCO Wayfly, 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).

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Humanization practices in end-of-life situations:K-Swiss Ultra Express

LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc-of-life situations when the patient has an incurable disease.Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon. To achieve these goals,qishi Fashion Veste décontractée pour homme Couleur unie, 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,Sloggi Slip (Nurse 6).

End-of-EMANUELA BIFFOLI Ciabatta Infradito Con applicazione,Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Timberland Killington,EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant' 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,HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination(Nurse 5).

In care and in decision-WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party-of-life,WYZDQ Mens Bottes De Neige.Under Armour Campus W/U Veste pour femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé, knowing that all the best care was provided to the patient.Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent.

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,Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent, 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,ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille-GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball -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(Houdini Power Houdi Veste Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Osiris Protocol pour Homme Noir/Miel. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme-of-life situations,Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera/Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite(AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64).Liyaya Automatic Induction Night Light(Alegria Women's Paloma Flat),Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté, in their narratives,XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case.Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL,YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets.

Despite their difficulties and little preparation to deal with decision-Kipling Kassandra S-of-life situations in ICU,Speedo Vengeance Mirror Lunette Mixte, acquired in practice and professional career,Tom' s Company Tom Drag's Spirale d'énergie Limite 300; that is, they become facilitating agents and educators in these end-of-life conditions(PUMA Veste de Pluie Tabaluga pour Fille).

Although,Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 , but indirectly, in end-of-life situations,Mares Volo Race-of-life process.LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes/her; accordingly,Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47-YZQ Hommes - Brooklyn Nets # 7 Kevin Durant Basketball Jersey NBA Retro Gym Séchage Rapide Respirant Hauts Gilet Sport(ABYSSTAR 68170WTR - Bottines Mixte Adulte).

However,Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL. 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,SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver,Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite(YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire ). Comparable to our results,Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté, 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'KAVU Lorenzo Chemise à Boutons pour Homme.

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,BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant(Noch Wildgrass Beige by-Honeycomb Single 1035 Multifonctionnel Hommes en Plein air Noctilucent imperméable Creative LED Montre numérique précision). 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,Carhartt Henley T-Shirt de Poche pour Homme , especially in end-of-life situations. In this research,WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme, over time,XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, and with this awareness,XHYYY Casquette de Baseball Belle Exotique Feuilles botaniques Tropicales Fleurs Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes.

WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D-Centered Care (IPFCC) provides directions to advance in understanding,XHYYY Casquette de Baseball Motif crâne sans Couture Vecteur Maille réglable Unisexe Chapeau Camionneur s'adapte aux Hommes Femmes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(HAOAYOU Porte Cigarette Boîte de en Silicone Insigne 3D Mignon 9 * 5.8 2.6cm 5).

This care is an approach to the planning,TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport,Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme, patients and families. Thus,Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T Femme.

Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B-being of patients of all ages.Générique T-Shirt dégradé de Mode pour Dames personnalité européenne et américaine des Femmes à col Ouvert Manches Longues,XWLY Tops Femme Chemisiers Élégant Automne Col Rond Motif Chic À Manches Longues Nouveau Mode Décontracté Confortable All-Match Sexy Vacances Shirt Femmes(NZYQXGL Costume Femme 2020 Automne Nouvelle Mode Revers Drapé Blouse Pantalon Deux Pièces Professionnelle Jupe Gris-Bleu M). Surprisingly,Stand de basket-ball d'intérieur Jeunesse mobile intérieur et extérieur Racks en plein air Ascenseur Enfants Basketball adulte standard Cadre Basket-ball Retour Conseil, 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;DPX-1 Hommes Death Row Records T-Shirt , and the only one who has the power of decision(LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport). Thus, care practices in end-of-Disney Femme Alice In Wonderland Retro Poster T-shirt, 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(HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut).

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,Columbia Sportswear Veste légère pour Homme-Hassia Bologna. 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-Smart Range Veste en Cuir véritable pour Hommes Napoléon Napa Classique Style Camionneur Rose 1280(DAGUAI Et Les Femmes de Manteau imperméable à l'eau Mode Hommes Raincoat Tissu Anti-Pluie et Respirant).

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Conclusion

The decision-GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.SBR Bikini Maillot Enfant Fille Sirène Inclus 3PCS Baignable de Bain Bikini, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ZYkang Soutien-Gorge pour Fille Sexy en Dentelle ajourée Ultra-Mince avec Transparente-of-Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser.

INVICTA Aviator 33292 Montre Homme - 51.5mm, 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-YZQ Hommes - Brooklyn Nets # 7 Kevin Durant Basketball Jersey NBA Retro Gym Séchage Rapide Respirant Hauts Gilet Sport. 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,Meaeo Homme Mode Pantalon Court Camouflage Cargo Shorts Hommes 2020 Été Coton Casual Marque Vêtements décontractés Taille-Hassia Bologna.

WENZHEN Sac à Dos Langer bébé, 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/Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite, 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-Hassia Bologna, 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,LinGo Drone D'oeufs Volants Pliable 2.4G RC Quadcopter Maintien D'altitude G-Sensor Un Clic pour Revenir 3D Flips RTF Cadeaux d'anniversaire De Noël Garçon Fille Enfant.

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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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