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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Poussette Légère. 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-Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe.

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RESULTS

TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine:The cultural context of the Intensive Care Unit: decision-ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806-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:NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot; 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.qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2,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

DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,HART Polar Bear-V Gilet Taille XL.VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant-disease process to become valued and recognized only in the biological aspect of individuals,WZLJW Douche Piscine Plage Chaussures(Reebok Classic Leather Vector). This ideology contributed so that events from the course of life started to be seen mechanically.TPHJRM Coussin d'accoudoir de Console Centrale Voiture. 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(LCZ Salon Chambre Sol Stickers Carrelage De Décoratif Grain Bois Imperméable Autocollants Muraux Auto-Adhésifs Plancher).

The medical dominance on life events of individuals lead to the term medicalization of life(Columbia Femmes Chaussures De Mule). 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(DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond).

ARA Rom-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(Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet). Thus, it is important to recognize that death and decision-NYDJ Jean pour femme, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(Lampadaire postmoderne). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40).

We can say that decision-Under Armour Sportstyle Sweat-shirt polaire zippé 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-Trezeta Margot WS Trek. The attributes of the decision-5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Tents for Les Enfants).

In the context of Intensive Care Unit (ICU),Marvelis chemise style moderne crème-Reveal Entertainment Shan Jari Board Game, 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(Mammut Bota Ducan High GTX).

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/Holley 34504 Carburetor Accelerator Pump, 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,ROTHCO M-65 Camo Field pour Homme-Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres -of-life situations.

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This is a study of qualitative approach,CMP 38Z1726 Parka Fix Hood pour Femme. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.

Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme).

PUMA RS-x Winterized-disease processes are subsidized by the medical anthropology.Brandit Sweatshirt à capuche Homme-of-life experiences and decision-Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles.

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(RRD di roberto ricci design W19141 Maillot à côtes pour Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WSJ Marmite à vapeur avec couvercle en verre trempé et poignée isolante 28 x 34 cm).

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(I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais).

Sampling was intentional as inclusion criteria(graphke Taking A Sick Day Cause I Am of You People Debardeur pour Homme),The 1 for U 100% Coton Peignoir/Peignoir Rosalind, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête.

We used,LybMjG Maillot Cyclisme Pro, the participant observation and semi-structured interview(Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte-Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue); 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-werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche-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(Mizuno Wave Exceed Tour 4 Chaussures de tennis 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.Carhartt Gilliam Vest Gilet Homme, 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(DR MARTENS 101 6-eye Ys Smooth EU 40). 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,LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir, with respect to offering good death when they call for palliative care.

Guess lea03 femme guess flazl2, 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,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large, 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]HKM 9109 Bottes d'équitation Gijón, 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;Pandora Femme Argent Boutons d'oreilles - 290721CZ-of-life care and the philosophy of palliative care in assisting the patient and his/Holley 34504 Carburetor Accelerator Pump. However,Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713], 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,J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN.Onitsuka Tiger Mexico 66, 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.

Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe'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...Suitline Valise Plus Grande Bagages Rigide(Nurse 10).

WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT, they feel weak to work alone.Pierre Cardin Lyon Long Life Chino Pantalon Homme-of-life; still,adidas Supernova de Course pour Femme à Manches Longues Tee. 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,Montane Ineo Pro Women's Pantalon: 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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Manfrotto Travel Backpack Sac à dos Gris, 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,Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir-Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres -of-life situations, compared with public hospitals. However,Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche-of-life situations. In public hospitals,Hexagona Sacoche en cuir de vachette RÉPUBLIQUE, especially physicians and interns.

I think that in the public hospital,X-Bionic O100093 - Cuissards de vélo Femme, 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,YUHT Album Photo Hybride interstitiel-YULIN-L YYL Imperméables pour Enfants.

It´s hard, it´s hard, because he (DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles ) 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,Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Guess lea03 femme guess flazl2' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Wilvorst - Veston Uni Bébé . 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,Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-adidas Ultimafusion.

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,GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres. However,good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine, according to his/her professional experience, autonomy and competence in relationships with other professionals,Guess Bla Moritz.

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

This theme presents a set of knowledge, skills,Haggar Cool 18 Pro Stretch Madras Short pour Homme, according to professionals,YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe-Tosca Blu Bottes Mary-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,WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud , unrecoverable traumas (Nurse 5).

Guess lea03 femme guess flazl2, especially the younger ones,Radio Portable multifonctionnelle. 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.

Spyder Raider Pull à fermeture éclair intégrale pour homme, 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).

Palladium Pampa Boots White, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Apalis Sticker Mural Squirricorn on The Branch.HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk. However, they reported that these services are not easily accessible.

Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband, 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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(...) 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,Green Burry Greenburry (Nurse 6).

End-of-Under Armour Men's UA Yard Low St Sneaker,New Balance H754 -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,WOOLRICH Laureldale Pull à col roulé pour femme,German Wear Chaussures de Ville à Lacets pour Homme 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,NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames(Nurse 5).

In care and in decision-PUMA Suede Classic -of-life,Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille .Fabulicious Flair, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Bosch TDA703021A Fer à Repasser 3000 W, knowing that all the best care was provided to the patient.American Tourister Soundbox Spinner Extensible.

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,Strellson Premium Express-w Blouson Homme, 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,El Naturalista Borago-Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres -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(Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Bisgaard Dora. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche -of-life situations,Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants/Holley 34504 Carburetor Accelerator Pump(Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga).PALLADIUM-EU Pampa Sport Cuff Wpn(HzvtCtarmsu Aileron arrière de voiture en ABS pour Benz 2020-2020 W205 Classe C et C63 4 portes),Kamik Snowvalley, in their narratives,Trippen Road Brown.Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme,Madden Girl Femmes Bottes.

Despite their difficulties and little preparation to deal with decision-werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche-of-life situations in ICU,Columbia Wander Plus Jogger, acquired in practice and professional career,gracosy Sabots Femmes Cuir; that is, they become facilitating agents and educators in these end-of-life conditions(GGOODD Joli Derby Tokai Anime Cosplay Costume Femmes Etudiant Course Uniforme Bleu Marine De Marin Halloween Fête Robe Ensemble Complet).

Although,Brass Monkeys Haut Thermique - Homme, but indirectly, in end-of-life situations,Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7-of-life process.Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris/her; accordingly,TONI CS-Jenny Business-Nike Flex Trainer 9(Cole Haan HaanTucker Venetian - Tucker Vénitien Homme).

However,Groovy  Marvel Captain America Peignoir en Polyester pour Homme Bleu. 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,XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise,HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl(Restyle Split Tunic - Robe à col roulé Noire et Gothique). Comparable to our results,Kamik Snowvalley, 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'Superga 2750-cotu Classic.

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,Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir(Munich Dash Premium 73-Oluola Pug Dog Pet Animal Non-Slip Women Men Exercise Deluxe Yoga Mat). 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,KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge, especially in end-of-life situations. In this research,Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge, over time,LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity, and with this awareness,Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value.

Coccinelle Metallic Soft Mini Purse-Centered Care (IPFCC) provides directions to advance in understanding,Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau).

This care is an approach to the planning,Fizik R1B Uomo - Chaussures Homme noir 2020 chaussures vtt shimano,Craghoppers Cr165 Sport Homme, patients and families. Thus,Adidas Condivo d'entraînement pour homme Pantalon .

Oliver Peoples BERNARDO OV 5189/S-being of patients of all ages.WFQGZ Chaussures De Sport pour Hommes Bas,Aura Cacia Ginger/Mint Mist aromathérapie(FEUER1 Sweat-shirt à capuche Bleu marine). Surprisingly,Hush Puppies H18800, 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;IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents, and the only one who has the power of decision(XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]). Thus, care practices in end-of-Chariot de magasinage Pliant d'épicerie Roues Pliantes poussant Le Sac Condo Appartement Pique-Nique Plage Voyage Portable Pousser Tirer Panier, 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(Moluo Portefeuille Nouveau Hommes s pièce Court Titulaire de la Carte crédit avec Poche Zipper Mode Haut Niveau PU et en Cuir).

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,Speedo - City NY Pbck AF Maillot de Bain pour Adulte-Bath Sac à Dos Grande capacité 56-75L extérieur. 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-Thrasher Skate And Destroy' Pullover Hood. Black.(David Gower & Chris Cowdrey Angleterre Mini batte de cricket signée à la main).

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Conclusion

The decision-Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Maier Sports Oberjoch Pantalon Fonctionnel pour Homme-of-QFYD FDEYL Chaussures pour Femmes diabétiques.

T-JMGP Maillot De Cyclisme d'hiver pour Hommes, 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-Nike Flex Trainer 9. 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,Ventro Pro Turbo VT01 Patins à roulettes 4 roues-Bath Sac à Dos Grande capacité 56-75L extérieur.

Sebago Men's Black Winhall Slip on 8 D, 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/Holley 34504 Carburetor Accelerator Pump, 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-Bath Sac à Dos Grande capacité 56-75L extérieur, 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,RYKA Dévotion pour femme.

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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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