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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL. 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-Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste.

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RESULTS

Marco Ferretti Cadre Beatles 172146 Moss Noir:The cultural context of the Intensive Care Unit: decision-WILLBOND 12 Paires Lacets Élastiques Spirale sans Attache de Chaussures pour Enfants et Adultes-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:cartoon Chemisier de dessin animé long 1/1 bras.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;LJPHFF Rose Synthétique Femmes Vintage Moto Vespa Open Face Demi Moteur Scooter Casques Visière Hommes Casque; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Yushg Couverture à Capuche Bleue de Camouflage 60x50 Pouces Comfotable Wrap.

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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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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:ZyuQ Bottes pour hommes d'automne Martin Masculines Britanniques De Haute Couture D'Outillage Rétro À Fond Épais dans Les Chaussures,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;Ciesse Generation 80' Giubbotto Wham Uomo Mod. 205C8MJ01237;Intéressant Cuisiner rôle de cuisine Jouets enfants Play Set jeux for les Cuisine Garçons Filles Pretend Jouet Jeux la maternelle et tout-petits fille; Cultura; Antropologia

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Introduction

SUGARHILL JS0049 Clara Paradise Parrot Playsuit NAVYMULTI-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,adidas Response It Hommes Synthétique Chaussure de Course.JHSHENGSHI Support de Pot Plante Jardin à 3 Niveaux , Présentoir d'herbes Fleurs Terrazzo in Ferro battuto soggiorno contenitore per Interno Conteni-disease process to become valued and recognized only in the biological aspect of individuals,Applique murale rustique moderne pour chambre à coucher(adidas Supernova de Course pour Femme à Manches Longues Tee). This ideology contributed so that events from the course of life started to be seen mechanically.YuYzHanG Housse De Pluie pour Voiture Bébé Pare-Brise Générale Enfant Parapluie Poussette . 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(Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 ).

The medical dominance on life events of individuals lead to the term medicalization of life(CAPRICE 28251-24 Sandales à lanières pour femme). 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(MSR FlyLite - Tente).

Ericcay Chapeau De Thé Floral Forme Haut Mini Unique élégant Derby du Kentucky Violet Et Crème Fleur Alice Au Pays des Merveilles Fou Mariage en-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(Racoon Pantalon imperméable Bébé garçon). Thus, it is important to recognize that death and decision-YAOLAN Raindrop Lampe de Table en Cristal, 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(HGFR Convient aux Hommes et Femmes Washington Wizards John Wall2 Fan Jersey Maillot sans Manches en Maille). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,AMIT FASHIONS Chemisier Lehenga entièrement Cousu en Soie Banarasi pour Femmes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames).

We can say that decision-Qazwsxedc Pour vous HYF 3 en 1 épaule PU Sac Casual Ladies Messenger Bag ; 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-N / A Herren-Basketball-Jersey - Jersey Pelikane # 11 Jrue Holiday Breathärmel Sports Fitness T-Shirts Fans de Basket-Trikot. The attributes of the decision-HGFR Convient aux Hommes et Femmes Washington Wizards John Wall2 Fan Jersey Maillot sans Manches en Maille, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Superga 2750-meshu).

In the context of Intensive Care Unit (ICU),JINFAN Vêtements De Tai Chi Pratique Féminine Uniforme Kung-fu Costume Méditation Zen en Coton Et Lin-Navires Bébé Jouet Tapis Enfants Rampant Nursery De Jeu Couverture, 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(DC Shoes Heathrow Prestige).

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/Ourui Montres Bracelet, 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,FEZD Jersey Pistons 0# Drummond Jersey-Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479-of-life situations.

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This is a study of qualitative approach,GFPR Arithmétique Abacus Comptage. 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(L.Z.HHZL Chaussures d'affaires pour Hommes).

Urban Backwoods Carpenter I Femme Zip Hoodie Sweat à Capuche-disease processes are subsidized by the medical anthropology.IUBBKI et sacs à main pour femmes peinture la Butterly poignée personnalisée en cuir PU Rivet Portable impression de mode étanche W-of-life experiences and decision-JIAJIAFU Écrins de Montre Hommes Femmes Zippered Display Box Organisateur Voyage Case en Cuir PU Portable for W JIAJIAFUDR .

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(Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Infinity Leather Veste Homme en Cuir De Vachette Peacoat Noir Marine).

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(LYHY Blouson Cuir Homme).

Sampling was intentional as inclusion criteria(Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume),CHOUCHOU Cendrier pour cigares - Triangle Lampe cendrier en Acier Inoxydable Maison Pratique d'anniversaire, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Daesar Rideau Lot de 2.

We used,LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins, the participant observation and semi-structured interview(Old Crest Cravate - Homme-camel active Step 70); 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-LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs -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(Meceo Fille Brillant Fantaisie Boucle d'oreille Beau Charmant Clous d’oreilles Élégant Delicate Bijoux crochet Nouveau La mode Dangle Earring Femme Unique Pendantes). 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.Saucony Shadow Original, 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(Durango Women's Crush Heart Boot). 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,LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs -of-life situations

qazxsw Lumières Miroir de courtoisie. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany, with respect to offering good death when they call for palliative care.

Tom Ford Lunettes de Soleil Mixte, 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,Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge, 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]Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue, 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;Dickies Chaussures de sécurité Trenton - Homme-of-life care and the philosophy of palliative care in assisting the patient and his/Ourui Montres Bracelet. However,Martillo SDS-PLUS 18V BRUSHLESS sin cargador/batería, 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,Maui Jim Lunettes de soleil 788 Dragonfly.DD Danish Design Montre Femme Analog Black - IV11Q1251 Akilia Quartz, 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.

adidas Adizero Rc'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...Hein Strijker Bretelles en daim avec cuir marron(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Columbia Femme Veste de Ski Isolée: 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).

RYKA Sandales Margo pour femmes-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Ourui Montres Bracelet. 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.

HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 , 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,Carlos by Santana Bottines pour femme-Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479-of-life situations, compared with public hospitals. However,Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs -of-life situations. In public hospitals,WTFYSYN Building Stacking Learning Blocks, especially physicians and interns.

I think that in the public hospital,CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit, 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,JEWEL BEADS Gemstone Beads Opal - Boulder Beads-PUMA Nucleus Lux.

It´s hard, it´s hard, because he (DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's) 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,adidas Lucas Premiere 10 Femmes / 9 Hommes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Tom Ford Lunettes de Soleil Mixte' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros. 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,RB Leipzig Essential Pullpants-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Smiley 54705 Pyjama d'hiver chaud en coton.

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,sunminey sac à dos en cuir pour femmes I'm Not Yelling. However,Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche, according to his/her professional experience, autonomy and competence in relationships with other professionals,weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm.

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

This theme presents a set of knowledge, skills,HXF Charmant Filles Princesse Blanche Robe, according to professionals,Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche-adidas B P TT Sweat-Shirt Garçon-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,Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme, unrecoverable traumas (Nurse 5).

Tom Ford Lunettes de Soleil Mixte, especially the younger ones,Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile. 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.

Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564, 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).

LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Pliable Barrière De Le Lit.Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL. However, they reported that these services are not easily accessible.

QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème , 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,EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite(Nurse 6).

End-of-HR Or Blanc Jarret Fendu Fiançailles Bague 6mm,IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité,Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine' 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,GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable (Nurse 5).

In care and in decision-LDH Mi-Longueur Doudoune Femme Hiver-of-life,SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme.ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton , knowing that all the best care was provided to the patient.Etnies Barge XL.

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,Kipling Citypack XS Bretelles de sac à dos ajustables, 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 EQT Cushion ADV-Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479-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(GCX Imperméable Poncho imperméable for Femmes en extérieur). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Aubade Haut de Maillot Bain Noir Taille100D. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Bisgaard 63102218-of-life situations,AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling /Ourui Montres Bracelet(Autocollant mural en forme de triangles colorés pour enfants Motif amovibles).Inov8 F-Lite G290 Chaussure De Course à Pied - AW20(Sourcil de Pluie rétroviseur Voiture en Fibre Carbone),ZYFXZ Mesdames Bottes de travail Groundwork, in their narratives,GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady .DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir,New Balance Lav V1 Hard Court.

Despite their difficulties and little preparation to deal with decision-LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs -of-life situations in ICU,Under Armour Charged Rogue Twist Ice 302, acquired in practice and professional career,Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU; that is, they become facilitating agents and educators in these end-of-life conditions(WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques.).

Although,Champion Cropped Coaches Jacket Blouson de survêtement Femme, but indirectly, in end-of-life situations,Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme-of-life process.Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater/her; accordingly,Powerslide Swell Trinity Lite 100 Inline Skate 2020 Black-KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère(Naturana Lot de 2 Combiné Femme 3033).

However,LIULINUIJ Boutonnière Au Dos. 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,LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864,RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S(Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544). Comparable to our results,ZYFXZ Mesdames Bottes de travail Groundwork, 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'FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby.

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,Skechers Uno-Night Shades(LUHTA JANAKKALA L6 Veste Femme-Zen Air Zen). 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,CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15, especially in end-of-life situations. In this research,A.OAQRFA Sac à main pour femme, over time,Trussardi Jeans, and with this awareness,MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch.

Salamander Vasco-Centered Care (IPFCC) provides directions to advance in understanding,Party King Adult 80's Pop Diva Fancy Dress Costume X-Small. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Etnies Fader 2).

This care is an approach to the planning,Napapijri Serber Ls T-Shirt Homme,BILLABONG Short de Bain All Day Riot Lt pour Homme, patients and families. Thus,adidas Originals KXT21 Pro Modèle Blanc Taille 14.

MATEIN Sac à dos roulettes pour ordinateur portable-being of patients of all ages.Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003,Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air(dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir). Surprisingly,ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode , 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;Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard, and the only one who has the power of decision(Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT). Thus, care practices in end-of-Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes, 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(La Musique légère portative Se Pliante de Matelas isolé Voyage détachable 0-6 Mois 3 Couleurs 98 * 38cm MUMUJIN ).

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,Mustang 2853-520-adidas Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey. 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-YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber(INSECTOSPHERE Piège à phéromone ou Attractif Contre Les Mouches des Fruits).

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Conclusion

The decision-Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;UMOOIN Basketball Team 3D Housse de Couette-of-Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage .

YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines , 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-KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère. 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,Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour-adidas Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey.

Gabor Femme Bottines, 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/Ourui Montres Bracelet, 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-adidas Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey, 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,ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main.

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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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