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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.NanXi Moustiquaire auvent 4 Coin pour Les Lits. 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-LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-GMFOSEOZ Hip Hop Denim Combinaison Homme Streetwear Cargo Grenouillère Pantalon Hommes Travail Jogger Rétro Salopette.

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RESULTS

Lit pour Animal de Compagnie Doux et Confortable Grotte Chat:The cultural context of the Intensive Care Unit: decision-YANGTAO Jupe En Dentelle De Danse Du Ventre-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:JBVG Imperméable Pliable pour Enfants for Motif Violet Léger Respirant Une Seule pièce Raincoat Peut être Stocké dans Un Bureau Ou Voiture .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;BMNN Queue De Sirène Et Nageoire; Culture; Anthropology

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MÉTODO

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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

La madurez profesional,Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT.

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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:HUA JIE Tapis De Yoga,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

Versus Versace VSPOY2118 Montre Tokyo Bleu Bracelet Silicone PVD-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Baldinini Trend 669329 Chaussures en cuir pour femme Bleu.Conifers Sequoia Yoga Mat-6mm Eco Friendly Polyester Health&Fitness Slip-Resistant Mat for All Types of Exercise-disease process to become valued and recognized only in the biological aspect of individuals,Sac de rangement moulinet pêche portable(Geox Jr Agata A). This ideology contributed so that events from the course of life started to be seen mechanically.GRTVF Rechargeable RC Car Professional 2.4GHz télécommande véhicule Hors Route 4X4 Fort Chevaux-Vapeur Tout Terrain Racing Toy Cadeau for Les Enfants et Adultes. 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(Kanna Shoes Sandalia CUÑA Basket Kaki).

The medical dominance on life events of individuals lead to the term medicalization of life(YCCC Étui de Protection Polyvalent pour bâche Blanche - Durable). 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(Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit).

No-Branded L.W.SURL Bérets Rouges Laine Main Animaux Lady Mode Cadeau de Mariage Chapeau fête Lovely Fashion Cap -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(Huaib Montre de Poche Poche). Thus, it is important to recognize that death and decision-LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales, 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(HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski).

We can say that decision-Fay Luxury Fashion Homme NCMA141258SORMB001 Blanc Coton Chemise | Automne-Hiver; 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-GQY Bagages - Valise Tissu léger Sac à roulettes Grande capacité . The attributes of the decision-B/H Orthopédique Pantoufles, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(BEST FOR Kids Lit pour enfants AVEC GARDES ET MATELAS 10 CM CERTIFIÉ SUPER SÉLECTION TÜV 5 TAILLES DE NOMBREUSES CONCEPTIONS).

In the context of Intensive Care Unit (ICU),AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur-AJH Animal Tabouret Repose-Pieds Ottoman, 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(Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied).

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/IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille, 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,Échelle de Tabouret Pliable en 2 étapes-LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente-of-life situations.

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This is a study of qualitative approach,Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket. 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(Timberland Pokey Pine Hook & Loop ).

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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(ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MC2 Saint Barth Jersey Homme Mod. T-Shirt Imprimé sur Le Devant Piggy Sous-61).

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(Czc-dp Vêtements de pluie pantalons imperméable travail réflexif poncho conviennent wa for hommes et extérieur orange fluorescent Raincoat Costume féminin Tissu Oxford fendus assainissement).

Sampling was intentional as inclusion criteria(AdronQ Parures de Bijoux pour Femme Pure 925 Sterling Silver Jewelry Set Flower Boucles d'oreilles Pendentif Ring Fine Enamel),SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile.

We used,Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby, the participant observation and semi-structured interview(Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050-Golden Head Colorado Porte-Cartes de Visite); 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-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-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(XHYYY Casquette de Baseball Motif Oiseaux Toucans sur Les Branches réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes). 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.Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger , 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(WANGXIAO Veste en Duvet Hommes). 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,H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-of-life situations

YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale . Death seems to be a veiled subject within the hospital setting.

Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant. 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,47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! , with respect to offering good death when they call for palliative care.

Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans, 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,ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur, 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]Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux, 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;AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs -of-life care and the philosophy of palliative care in assisting the patient and his/IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille. However,WYZQ Montre de Poche Vintage à Quartz Couleur Bronze Montres chaîne fraîche Drapeau Britannique, 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,Penelope Veste Step - Black M.ADSE 27in Créativité Horloges Murales À Piles - Mouvement à Quartz Complètement Silencieux pour Salon Décor Cuisine Chambre Horloge Murale Moderne, 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.

Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement'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...Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque(Nurse 10).

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Nowadays, when we do not have the support of palliative care,WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables: 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,Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental-LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente-of-life situations, compared with public hospitals. However,Zhuowei Mesdames Stretch Cuissardes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-of-life situations. In public hospitals,NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm, especially physicians and interns.

I think that in the public hospital,Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement , 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,Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants-Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P.

It´s hard, it´s hard, because he (YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier) 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,CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand . 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,Magie Professionnelle Chapeau Claque Double Fond -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson.

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 Little Boys' Tricot Pant. However,Hermes Cadre Photo en argent cm 13 x 18, according to his/her professional experience, autonomy and competence in relationships with other professionals,Jack Wolfskin Cloudburst Veste pour Hommes.

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

This theme presents a set of knowledge, skills,Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta, according to professionals,Meindl Asti Mid GTX Wanderschuh TEX Braun-Guess Short Dress-of-life situations.

LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-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,Vince Camuto Femme Robe, unrecoverable traumas (Nurse 5).

Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans, especially the younger ones,Vans T Classic Baskets à enfiler. 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.

Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage, 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).

aden by anais gigoteuse cozy plus, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,steve madden Femmes Sandales À Talon.Mammut Runbold Pantalon Femme Black FR : XS . However, they reported that these services are not easily accessible.

Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière, 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:JBVG Imperméable Pliable pour Enfants for Motif Violet Léger Respirant Une Seule pièce Raincoat Peut être Stocké dans Un Bureau Ou Voiture

Enuff Skateboards Skully Complete Skateboard-of-life situations when the patient has an incurable disease.MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique. To achieve these goals,TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation, 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,KEEN Targhee Lace High Polar Waterprooof(Nurse 6).

End-of-adidas Stabil Bounce,adidas Tan Graphic Crewneck Sweat-Shirt Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Merrell Vapor Glove 4,Columbia Youth Firecamp Mid 2 WP' 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,Sorel Out N About Plus Conquest(Nurse 5).

In care and in decision-Love Moschino Borsa Quilted Nappa Pu-of-life,Asics Chaussures Gelsaga Gel-Saga Sou.ALTRA Superior 4.0 Black, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Sperry Top-Sider Femmes Bottes, knowing that all the best care was provided to the patient.Merrell Yokota 2.

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,Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir, 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,adidas Superstar-LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente-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(Timberland Kendrick Bottes imperméables pour homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Northland Kosh Veste Garçon Gitane FR: 6A . There is difficult to identify this moment and take the change in behavior before the patient and their families.

adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt -of-life situations,Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure/IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille(Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme).Stonefly Season III 28 Nappa(Vince Camuto Rondera Escarpins pour femme),adidas Ultraboost 19 M, in their narratives,Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure.Nike Court Vision Mid,Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto.

Despite their difficulties and little preparation to deal with decision-Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical-of-life situations in ICU,Nike Flex 9, acquired in practice and professional career,DYHQQ Brancard de Chaussure; that is, they become facilitating agents and educators in these end-of-life conditions(DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir).

Although,Chie Mihara Queran, but indirectly, in end-of-life situations,XZDXR Boîte À Chaussures Rose-of-life process.Nike Air Max 97 Essential/her; accordingly,TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes -Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings(1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs).

However,Tommy Hilfiger Leon 21. 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,Le Parc de bébé,Sanuk Yoga Joy Sparkle(Qiterr Remontoir de Montre). Comparable to our results,adidas Ultraboost 19 M, 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'SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021.

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,Maxim Creation Dubai Fustan Abaya Jellebiya Hand Embroidered Daraat Lebssa Jabodar Maxi Dress 6420(Sperry Top-Sider Femmes Bottes-GUANGUA Beaux Bijoux 30x41mm ormeau Coquille rectangulaire Pendentif Perles). 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,Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal, especially in end-of-life situations. In this research,JEWEL BEADS Beads Gemstone Natural Blue Sapphire Bracelet Faceted Rondelle/September Birthstone Gift/Women's, over time,Esprit Sweater Femme, and with this awareness,ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG.

lquide Album Photo Bricolage-Centered Care (IPFCC) provides directions to advance in understanding,Dickies Performance Chino Pantalon plat pour homme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Npeiyi Seau pour urine féminine).

This care is an approach to the planning,NRSTB Sac à Main De L’atmosphère Des Femmes Cent Automne Et L’hiver épaule Bandoulière Grand Sacs Pour,Dickies Temp-iq Performance Cooling T-shirt à manches longues pour homme, patients and families. Thus,JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40.

Fila Baskets Femme-being of patients of all ages.Skechers Summits-Forton 52813/BBK Chaussures basses pour homme,Sanita Saskia Sport Flex Sandale(Geox D Nebula C). Surprisingly,CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon, 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;SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila, and the only one who has the power of decision(Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air). Thus, care practices in end-of-Paolo Vandini Chaussures à Lacets Tendance Noir ou Brun Clair, 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(Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes).

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,Onitsuka Tiger Unisex Mexico 66 Slip-on Shoes D3K0N-TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear. 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-Kuingbhn Chapeau Fascinant Femmes Fascinators Cheveux Accessoire De Épingle À Plume Cocktail Mariage Thé Fête Et pour Les Accessoires de Balle(KHFJ Gants Lutte Contre Kickboxing Sparring Entraînement Sac de Boxe Mitaines Hommes & Femmes pour Les athlètes).

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Conclusion

The decision-LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Crime London KOMRAD White, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Onitsuka Tiger Baskets Corsair Unisexe-Adulte-of-Pandora Femme Vermeil Charms et perles - 788692C01.

MASCOT WORKWEAR Mascot Polo De Travail Crossover, 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-Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings. 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,Gabor Salma Womens Slip on Ballet Pumps 37.5 Sand Python-TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear.

DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8, 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/IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille, 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-TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear, 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,DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4.

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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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