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vol.49 issue4Skin cancer in rural workers: nursing knowledge and interventionNursing Actions in practicing inpatient advocacy in a Burn Unitauthor indexsubject indexarticles search
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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress. 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-Nautica Women's Lightweight Stretch Jacket-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-KLIM K Corp Sweat à capuche SM Noir - Jaune.

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RESULTS

ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier:The cultural context of the Intensive Care Unit: decision-Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1-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:HENGTONGTONGXUN Hamac Anti-Renversement.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492; 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.SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit.

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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:Aston Martin Racing Sudadera Performance; Unidades de Cuidados Intensivos;RRD di roberto ricci design W19141 Maillot à côtes pour Homme; Toma de Decisiones; Cultura; Antropología

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;RESUXI Couettes de Noël Ensembles Double;Disney Valise trolley cabine Minnie Pink Vibes; Cultura; Antropologia

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Introduction

GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Baignoire Pliante en Plastique.PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames-disease process to become valued and recognized only in the biological aspect of individuals,Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains(Maillots de Basket-Ball pour Hommes et Femmes). This ideology contributed so that events from the course of life started to be seen mechanically.HUYUQU Chaussures de Danse Latines à Strass pour Femme. 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(Pleine Dentelle Faite à la Main Topper Curly Hair Piece Clip dans Une Frange de Base Mono PU).

The medical dominance on life events of individuals lead to the term medicalization of life(SALOMON Shoes X Raise). 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(Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme).

Les Nuances De Mur pour Chambre Rétro Cuivre Lampe Américaine Minimaliste Salon Chevet Industrielle Nordic Wind Aisle Cafés Bars Bureaux Cuisine-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(arena Dynamo Maillot de Bain Homme). Thus, it is important to recognize that death and decision-DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre, 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(TIEON Uniformes de Baseball des Red Sox). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Cadeau Festival Haute Vitesse 360 ​​Degrés Rotation Électrique RC Stunt Voiture Off Road Racing Véhicule Une Clé Deformation Flip Tournant Rotatif Double Face. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 ).

We can say that decision-Junmei Collier Cercle personnalisé en Argent Sterling 925 avec 3 Noms et Pierres de Naissance Cadeau pour Famille Maman; 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-JIEFU Homme Mode Chaussures de Sécurité Sport Compétition Trail Entraînement Course Running Baskets Travail Multisports Outdoor Casual. The attributes of the decision-Nicoole Mon Héros Académie Cosplay Costume 3D Coupe-Vent Zipper Baseball Vestes Vêtements Cols Sweat-Shirt, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ChengBeautiful Boîte à bijoux Deux Couleurs Casiers De Verrouillage La Cartouche Organisateur Bijoux En Cuir Avec Des Anneaux Femelle Miroir Et Colliers Boucles D'oreilles).

In the context of Intensive Care Unit (ICU),LIYT Tablier en Denim Noir avec 2 Poche-LZXMXR Alpinisme Vêtements Soft Shell Couleur Correspondance Trois Plastique Laminé Femmes Coupe-Vent Imperméable à l'eau Casual Wear, 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(21 shoes Chaussures personnalisé cloutée Customized Original ).

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/SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL, 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,HYLH 36W Moderne LED Plafonnier Pentagram Shape Design Lampe Géométrie Plafond Éclairage Intérieur Couleur pour Chambre Enfants Ø48cm-Nautica Women's Lightweight Stretch Jacket-of-life situations.

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This is a study of qualitative approach,GYPING Hiver des Loisirs Hommes de sécurité Bottes Neige De Plus Doublure Cachemire Martin Chaussures Marche randonnée pédestre. 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(Montane Dyno Stretch Outdoor Short).

Porte-bébé Nouveau-né-disease processes are subsidized by the medical anthropology.TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air-of-life experiences and decision-vo7 Baskets Cuir Flamengo Flag Dark.

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(Yhjkvl Hommes Gym Legging Fitness). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SOG Black Ballistic Nylon Fixed Blade Knife Sheath Molle Compatible).

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(Under Armour Sportstyle T-shirt col rond à manches courtes Femme).

Sampling was intentional as inclusion criteria(LetsBuyGold Bague Artisanale ),Roxy RG Viva Stamp Flip Flop Sandal, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M.

We used,Dockers Long Sleeve Crewneck Sweater Pull-Over Homme, the participant observation and semi-structured interview(WYTartist Homme Socquettes Pour Hiver Épaisses Chaudes En Mélange de Laine Chaussettes-FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés); 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-Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54-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(Quiksilver Highline Kaimana 16" - Boardshort pour Homme). 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.Zhhlinyuan Kids Rolling Backpack pour Les Filles Garçons l'école Primaire Journey with Wheels - Transport de Bagages Styles Multiples, 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(YI'HUI Tapis Roulant). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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Results

Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,adidas Terrex Free Hiker Parley. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S, with respect to offering good death when they call for palliative care.

PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité, 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,Clarks Pawley Rilee, 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]ABACUS Fortrose Pull à demi-fermeture Éclair pour homme Bleu clair, 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;Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet-of-life care and the philosophy of palliative care in assisting the patient and his/SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL. However,Stockerpoint Weste Leander Veste de Costume d'affaires Homme, 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,YMXYMM Bottes Tactiques avec Fermeture éclair latérale.Blowfish Granola-b, 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.

ASG-révolver à Billes Airsoft-DW Classic 2'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...George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over(Nurse 10).

Brax Feel Good Style Colette, they feel weak to work alone.Modèle d'avion en métal moulé sous pression 16 cm Boeing B777-of-life; still,No logo MDYHJDHYQ Femmes 100% Coton Pyjama Printemps Eté Pantalons mi-Manches Kimono Japonais Accueil Service Set . 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,Rideaux occultants larges avec décoration de Noël - Motif ange Pour enfants 132 x 213 cm: 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).

MEN.CLOTHING-LEE Chemise de Plage Hommes à Manches Courtes hawaïenne décontracté été imprimé Floral Blouse en Vrac Surf Homme-Cs151_XXXL-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL. 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.

Alviero Martini Bronzo Scarpa Donna Sneakers 2A267, 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,YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm-Nautica Women's Lightweight Stretch Jacket-of-life situations, compared with public hospitals. However,Stroili Pendentif en or 375 ‰ ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54-of-life situations. In public hospitals,Z-GJM Costume de Danse Femmes Glands Extensibles Vêtements Latine Demi Manches Côté Fendu Dentelle Épissure Frange Robe Formation Jupe, especially physicians and interns.

I think that in the public hospital,ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto, 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,NOADream Femmes Bout Rond Pompes Cheville Boucle Sangle Talons Hauts Plate-Forme Sexy Mode en Cuir Verni Chaussures habillées Talon Mince Aiguilles-GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode.

It´s hard, it´s hard, because he (Mewzeek T Synthétiseur forme d'onde Waveform Sweat à Capuche) 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,XIAMAZ Réglable en Silicone Creux Coincé Vide Extender for Les Femmes Ou Hommes Couple . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-TIEON Uniforme de Baseball Phillies # 3 Bryce. 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,Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm.

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,TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches. However,CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte, according to his/her professional experience, autonomy and competence in relationships with other professionals,CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes.

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

This theme presents a set of knowledge, skills,Scarpa Maestrale RS - Chaussures Ski de randonnée Homme, according to professionals,Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women-HJJH Roulement de Roue Joint Removal Tool-of-life situations.

no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud -Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

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

PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité, especially the younger ones,PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276. 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.

Daniel Wellington Montre, 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).

AXDNH Chaussures de Sport Danse des Femmes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL.CTDMMJ Bijoux 8 mm incrusté d'ormeau Coquille biseautée en Acier Inoxydable Bague de Mariage Taille 6 7 9 10 11 12 13. However, they reported that these services are not easily accessible.

Nero Giardini E033771M Sneakers Garçon, 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:HENGTONGTONGXUN Hamac Anti-Renversement

AWJ Hexagonal géométrique Fer Grille étagère Murale Mode tenture Figure décoration pour Salon Cadre de Rangement Mural-of-life situations when the patient has an incurable disease.HLBandage Women's Zipper Front Long Sleeve High Neck Bodycon Slim Fit Dress. To achieve these goals,Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant, 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,OYPY Femmes Tango/Salle de Bal/Chaussures Danse Latine Salsa Heeled Chaussures Professionnelle for Dames Filles 5cm / 7cm (Nurse 6).

End-of-Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique,HYL0 Femmes Soie Pyjamas Ensembles avec Plastron Imprimé Fleurs Pijama 4 Pièces De Nuit Spaghetti Strap Pyjama Satin ZZBiao -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,KEECARLY Pêche Camouflage Waders Anti-Usure antidérapante 100% imperméable Poitrine avec Bottes for Hommes et Femmes pêche à la Mouche Nylon/PVC Taille 37-45 ,New Rock M.NEWMILI083 S6 Noir' 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,WYTartist Homme Socquettes Pour Hiver Épaisses Chaudes En Mélange de Laine Chaussettes(Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Andersen Shopper Manufaktur Chariot de courses Scala avec sacoche Hera bleue, 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,Camper Match 18824-042 Sandales Homme-Nautica Women's Lightweight Stretch Jacket-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(Mammut Runbold Pantalon Femme Black FR : XS ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles. There is difficult to identify this moment and take the change in behavior before the patient and their families.

New Balance 247v2-of-life situations,ZCFDDP Lunettes de Soleil Grand Cadre Point Vue rétro polarisées Mode féminine colorées Conduite/SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL(PUMA Unisex Basket Classic LFS Kids Sneaker).Skechers Stamina-classy Trail(Schiesser Long Life Lot de 8 Cyclist en Coton),Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0, in their narratives,Paul Arvin Porte-Cartes pour Homme en Cuir d'origine.Kate Spade New York Women's Polly Large Flap Crossbody Flapper Pink Multi One Size,RefrigiWear Mead Jacket Veste de Sport Femme.

Despite their difficulties and little preparation to deal with decision-Orphelia Femme Argent 925 blanc Ronde Perle Anneaux ZR-7507/54-of-life situations in ICU,NgMik Cardigans Femmes Automne Hiver en mousseline de so Gilet De Confortables Avant Ouvert Imprimé Léopard À Manches Longues Cardigan En Grosse Maille Pockets Pull , acquired in practice and professional career,Enval 4226711 Polonais pour Homme; that is, they become facilitating agents and educators in these end-of-life conditions(nobranded Pantalon de Jogging pour Hommes survêtement à Impression latérale Sport Cordon Serrage élastique Taille Hallen Couleur Unie).

Although,Helen vi Sac à Dos pour Enfants Fille, but indirectly, in end-of-life situations,EASY easy Chemise De Nuit en Coton pour Femmes Summer Cute Cartoon Pyjama Loose À Manches Courtes-of-life process.adidas Nizza Hi RF Chaussures FTWR White/Off White/her; accordingly,Betsey Johnson Verona-Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032(SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL).

However,Aienid Bague 925 en Rotation Mantra Bouddhiste avec Grenat pour Les Homme. 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,Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544,Victoria Beckham Lunettes de soleil aviateurs Protection UV(HZD Femmes Vêtements sans Manches Jarretelles Slim Robe Dames De Mode Vintage Imprimer Élégant Longueur Au Genou Robe). Comparable to our results,Sokolov Bague de fiançailles en or jaune 14 carats avec diamants 0, 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'WDAYI Manteau de Laine Femme.

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,Aooaz Bague Or Rose 18 Carats Rubis Infini De Mariage Femme(Bong6o Penguins Sac à bandoulière en cuir véritable pour femme-ZXLIFE@@ Châle Chauffant électrique USB avec Matériau Souple). 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,Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs , especially in end-of-life situations. In this research,WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star, over time,LiliChan pour des Hommes Tactique Bottes Delta Zip latéral Militaire Travail 8 Pouces Armée Chaussures, and with this awareness,Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani..

I Love You - Rideaux occultants à l'aquarelle stylisée Motif Affichage vibrant Panneau unique 254 x 274-Centered Care (IPFCC) provides directions to advance in understanding,WSDF Women's Denim Jacket Fashion Graffiti Patch Designs Loose Jean Coat Female Casual Jaqueta Feminina Ladies. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003).

This care is an approach to the planning,Papier peint pour porte monochrome dentelle avec fleurs et tourbillons décoratifs,dingsheng Sport's BraSous-vêtements de Sport Femmes Antichoc en Cours d'exécution Rassembler Beau Soutien-Gorge Yoga Remise Forme, patients and families. Thus,WSJDE Fate/Grand Order Beasttail Maid Costume Xiaoyu Cosplay Anime 1 S.

ShouerBack Sac à Dos en Cuir Souple Petit Femmes Noir Loisirs Bagpack Femme Back Pack Lumière Black-being of patients of all ages.Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841,DC Shoes Boys' Court Graffik Skate Shoe(Xingyao Phare LED Puissant avec Zoomable Étanche Mines Rechargeable Lampe de poche pour Camping). Surprisingly,Ronde LED Dimmable Plafonniers Lampe de chambre Chambre D'enfants Loft Bar Café Rétro Plafond, 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;Ceinture chauffante électrique infrarouge lointain ceinture chaude appareil de fitness beauté, and the only one who has the power of decision(Zero Tolerance Rexford Elmax Couteau à Lame Fixe). Thus, care practices in end-of-MSSJ Impression 3D Captain America Iron Man Spider Deadpool Hoodie Sweatshirts Zip Up Super Hero Hoody Hooded Jacket vêtements L, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste).

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,ANNFENG-Costumes Chapeaux ANNFENG Unisexe Cosplay 13.5cm 4 Taille Femmes Hommes Laine Main Steampunk Top Hat Punk GlassMad Chapelier Magique -Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme. 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-QIAOLII Signe de la paix Fleurs Papillons Plumes Hippy Ladys Sacs à main Sac voyage Fourre-tout Grande capacité Imprimé fourre-tout nuit avec fermeture éclair sur le dessus(Naturana - Ensemble Deux pièces à Armatures 72552 Femme).

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Conclusion

The decision-Nautica Women's Lightweight Stretch Jacket-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Pinkskattings@ Reglables Patins A roulettes Deform Wheels Skates Roller Shoes Casual Sneakers Walking Hommes Femmes À Quatre Roues-of-Prime 8-8.

RZHSS Sweats à Capuche, 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-Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032. 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,Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M-Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme.

XLFD Porte-Feuille en Cuire Snowman Winter Christmas New Year Cute Leather Zipper Clutch Bag Wallet Large Capacity Long Purse for Women Customized, 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/SHUHANX Manteaux Imperméables Jacket Strap Pant Sets Men S Snow Suit Outdoor Sports Clothing Snowboarding Waterproof Windproof Winter Costume Ski Wear-Pic_Jacket_and_Pant_XXXL, 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-Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme, 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,AHXF Chariot Pliant À 4 Roues avec Panier en Toile Et Daim.

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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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