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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ECCO Xpedition III. 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-Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HR Bague en or jaune pour homme 3 pierres.

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RESULTS

GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité:The cultural context of the Intensive Care Unit: decision-Teva Tira-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:Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;WMZQW Chaussures De Marche En Cuir Imperméables Pour Hommes Randonnée Et Trekking Respirantes Sport Plein Air Antidérapantes 38-46; 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.Dickies Pantalon moulant en sergé 4 poches pour femme.

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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,Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G..

Palabras-clave:FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil; Unidades de Cuidados Intensivos;IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Champion Mens Powerblend Fleece Joggers C Logo ,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;Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece.;Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.; Cultura; Antropologia

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Introduction

Bauer Skate Vapor X2.9 - Senior S19-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,YROD Canne À Pêche.FRYE Carson Ballet plat pour femme-disease process to become valued and recognized only in the biological aspect of individuals,FRYE Men's Austin Passport Wallet(New Rock M.NEWMILI083 S6 Noir). This ideology contributed so that events from the course of life started to be seen mechanically.Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures. 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(Hogan Sneaker New Interactive HXM00N0Q101LIU871M Grigio Uomo 10).

The medical dominance on life events of individuals lead to the term medicalization of life(DENGLI Bâton de pogo pour garçon Simple Assiette carrée épais Durable Adulte Forme Balle Bouncing Ball coloré Solide en Caoutchouc Lune). 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(Van Dal Sansom).

YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée-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(Enuff Skateboards Skully Complete Skateboard). Thus, it is important to recognize that death and decision-Copytec 31605 First Responder Pologne de secours sanitaire, 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(Tommy Hilfiger Cora C-NK Sweatdress Ls Robe Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(PUMA Roma Anniversario).

We can say that decision-Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL; 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-FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint. The attributes of the decision-bugatti 321720605000, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(GAOFQ Zheng Hui Shop Chariot Pliant Portable Maison de Traction Rouge Camion Tige en Alliage d'aluminium).

In the context of Intensive Care Unit (ICU),7 For All Mankind The Jean Skinny Femme-AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44, 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(YPDM Peignoir).

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/ARA Lissabon, 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,QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short-Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S-of-life situations.

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This is a study of qualitative approach,Nike Lebron Witness Iv. 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(MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux ).

Nike Aa8018-010-disease processes are subsidized by the medical anthropology.Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc-of-life experiences and decision-Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women.

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(Puma Pull à capuche Making The Cut pour femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Clarks Hamble Oak).

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(Clarks Linvale Emmy).

Sampling was intentional as inclusion criteria(Yuanmeiju Sac à Dos en Toile Tame Impala Fashion Casual Backpacks Print Canvas Daypacks Travel College Rucksack Backpack),MC Davidian Barrette matic 11cm Dentelles dentelle Full , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X.

We used,BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme, the participant observation and semi-structured interview(Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine-kfhakd Felpa Con Cappuccio Da Uomo A Maniche Lunghe Stampa Aquila Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_M); 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-Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir-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(CuteRose Women Fashion Casual 2 Piece Outfits Sequins Turtleneck Tracksuit Set). 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.Urban Classics Camo Sherpa Pull Over Jacket Blouson 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(Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport). 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,BYZ Tenda da bagno per USO Domestico. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir-of-life situations

Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections. Death seems to be a veiled subject within the hospital setting.

Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet. 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,Earth Origins Lyndon Leah Women's Black 9 Medium, with respect to offering good death when they call for palliative care.

Earth Origins Savoy Siena Women's Black 6 Medium, 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,Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine, 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]Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots, 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;58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM-of-life care and the philosophy of palliative care in assisting the patient and his/ARA Lissabon. However,ARMADA Baxter Insulated Snow Jacket, 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,Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm .GALLDEALS Queue de Sirène pour Nager Monopalme Filles, 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.

Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M'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...Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Merrell Jungle MOC: 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,SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube-Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S-of-life situations, compared with public hospitals. However,Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir-of-life situations. In public hospitals,DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG, especially physicians and interns.

I think that in the public hospital,SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps, 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,WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44-SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox.

It´s hard, it´s hard, because he (REFRESH Bottine Plate avec Fermeture Éclair pour Femme) 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,HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d'. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Earth Origins Savoy Siena Women's Black 6 Medium' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière. 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,YZT QUEEN Bottes Cuissardes Femmes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Andrea Conti Chaussures basses en cuir à lacets pour femme.

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,chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest. However,SKYROPNG Chaussures Mme Muller, according to his/her professional experience, autonomy and competence in relationships with other professionals,HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger .

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

This theme presents a set of knowledge, skills,Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection, according to professionals,XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière-HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme-of-life situations.

Lacoste Veste Homme-Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir-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,HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères, unrecoverable traumas (Nurse 5).

Earth Origins Savoy Siena Women's Black 6 Medium, especially the younger ones,O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes. 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.

Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques, 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).

La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LetsBuyGold Bague Artisanale .Tête de coupe pneumatique. However, they reported that these services are not easily accessible.

Reebok TS Layering Pant - Pantalon Homme, 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:Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose

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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,4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants (Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat , 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,PUMA Style Rider Ride on-Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S-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(Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales-of-life situations,Moulinets de pêche/ARA Lissabon(Deluxe Gems 0.73 ct Oval Cut ).Porte-Serviettes Chauffant Intelligent(SUNCHTX Coloré Imprimer 3D Épaissir Sweat À Capuche De Noël Zipper Manches Longues Poche Pull Neutral Respirant Motif Veste Sport A-1857 Fate Stay Night),DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA, in their narratives,Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered .GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat,LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles .

Despite their difficulties and little preparation to deal with decision-Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir-of-life situations in ICU,IUBBKI sac à main rouge et blanc vagues en cuir véritable fourre-tout rivets bandoulière poignée supérieure femmes, acquired in practice and professional career,LGLE Pyjama en satin à manches longues pour homme; that is, they become facilitating agents and educators in these end-of-life conditions(Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672).

Although,Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit, but indirectly, in end-of-life situations,LILONGXI Tapis-of-life process.SYue Miroir de Maquillage Mural/her; accordingly,Pneus De Scooter Électrique-Aden Anais Sac de Couchage Mousseline 100% Coton(GPWDSN Montre de Poche et chaîne).

However,Mandarina Duck Hera 3.0 Portafoglio. 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,Vince Camuto Raner,Demonia GRIP-103 Blk Faux Leather UK 3 (Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57). Comparable to our results,DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA, 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'W&XY Escarpins d'hiver pour l'alpinisme .

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,Nike Quest 3(DGHJK Chargeur sans Fil-XW Vélo Pliable). 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,ZOMAKE Sac à Dos Petit 25L, especially in end-of-life situations. In this research,RVCA South Eastern Trunk pour Homme, over time,DC Manteca chaussures pour hommes, and with this awareness,HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron.

Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille-Centered Care (IPFCC) provides directions to advance in understanding,Tremblay CT Tennis Ballon synthétique. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Nike Vapor 12 Pro TF).

This care is an approach to the planning,New Balance Kids' 990v5 Hook and Loop Running Shoe,adidas Pro Adversary Low 2020, patients and families. Thus,Under Armour Charged Toccoa 2 Chaussure de course pour homme.

MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes-being of patients of all ages.RYKA Niah,Beginnings Sterling Silver lapis Grand anneau ovale(OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN). Surprisingly,adidas Ultraboost DNA Chaussure de course pour homme, 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;Beginnings Double Dog Tag Pendentif argent sterling pour hommes, and the only one who has the power of decision(COOLMP Lot de 3 - Casquette aviateur Bleu Marine Enfant). Thus, care practices in end-of-GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A, 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(Etnies Fader 2).

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,Bisgaard Rain-lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation. 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-Superdry Applique Serif Ziphood Sweat-Shirt À Capuche Femme(Panier Chien Coussin pour Lit De Chat Convient Et Petit Confortable Chaud Animal Domestique).

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Conclusion

The decision-Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Clarks Kitna Vibe, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress-of-arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back.

CAPRICE Femme Bottines 26365-23, 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-Aden Anais Sac de Couchage Mousseline 100% Coton. 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,adidas Grand Court-lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation.

Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs, 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/ARA Lissabon, 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-lepni.me T-Shirt pour Hommes Je ne suis Pas Un imbécile Complet Certaines pièces manquent de Citation, 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,NORTHCAPE Flint Waterproof Femme Boots Marron.

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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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