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Print versionISSN0080-6234On-line versionISSN1980-220X

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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-Benavente Chika10 Kurazo 12 Bottines en cuir-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Hush Puppies Athos.

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RESULTS

EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales:The cultural context of the Intensive Care Unit: decision-YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues-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:Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;ROXY Snow Junior's Amy 3N1 Jacket; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.METZELDER Valise Souple Basic S Gros Volume Garantie 1 an .

CAPRICE Faria

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:XYSQWZ Bracelet De Montre 20mm 22mm en Acier Inoxydable Hommes Femmes Argent Remplacement Réglable pour ## 11 Et,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

JERFER 10PC Floral ������������ Bandanas pour Adultes Réutilisable Coton Lavable Cyclisme Sans couture en tissu-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Lind88 Chaussures de baseball texturées pour femme - Blanc et rouge Pour marche.Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in-disease process to become valued and recognized only in the biological aspect of individuals,Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in(LZJDS Dames Pjs Ensemble Pyjamas en Soie Femmes Printemps Et Hiver Split Homewear Grande Taille Costume). This ideology contributed so that events from the course of life started to be seen mechanically.YAOHEL Vêtement de Protection Solaire extérieur. 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(AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M).

The medical dominance on life events of individuals lead to the term medicalization of life(Totto Mochila Acuareles Sac à dos loisir 40 centimeters 25 Multicolore). 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(Clarks Sandales Sillian2.0 Joy pour Femmes).

Cloud City 7 Pandemic Code Light Women's Hooded Sweatshirt-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(Tosca Blu Ankle Boot Kiruna). Thus, it is important to recognize that death and decision-Geox Jr Strada A, 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(Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Ysakura Bonnet Thermique Bluetooth. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Josef Seibel Chance 39).

We can say that decision-dmsc Halloween Masque de Noël Prom Coq Styling Party Game drôle Bricolage- ; 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-Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires. The attributes of the decision-Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Camper Beetle-36791).

In the context of Intensive Care Unit (ICU),BAODANLE Sweats à Capuche Homme Dream Theater Men's Leisure Long Sleeve Hoodie Drawstring Pullover Sweatshirt Funny Baseball Tops-ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring , 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(Napapijri Varco Short Homme).

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/CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen, 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,QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag-Benavente Chika10 Kurazo 12 Bottines en cuir-of-life situations.

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This is a study of qualitative approach,pour VW Polo 6R 6C MK5 2008 2009 Refit Capot À Gaz Amortisseur De Levage Barres Support Tige Ressort. 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(Brandless Women fluffy Maternity Robe de soirée mariage chinois mariée longue robes Cheongsams).

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Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(Guess Robe à manches longues 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(MANQUNYH Robe De Mode Estivale Élégante Élingue Femme Col en V Glamour Classique Jupe Courte Tissu Confortable Haut Gamme Filles sans Manches Rond Robes Florales Rétro À Ma).

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(Zhrill Tapered Pantalon de survêtement pour femme Coupe ajustée).

Sampling was intentional as inclusion criteria(Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.),Eono by Amazon - Sac Organiseurs de Bagage, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.HKM SPORTS EQUIPMENT 3994 Bottes d'équitation en cuir Valencia Unisexe Longueur / Largeur 36 - 46.

We used,PANASIAM Legging psytrance « Akali » de goa - Pour femme Taille 3/4 En forme pépal Couleur unie Tailles S, the participant observation and semi-structured interview(Porte-bébé Nouveau-né-Ghoomar Afghani Oxydé Collier Tour De Cou pour Les Femmes Boho Gypsy Turque Bijoux Cadeau Elle); 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-YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge-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(QFYD FDEYL Pieds Gonflés Arthrite Oedème Swollen Pantoufle Intérieur). 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.ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe, 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(FENDI Luxury Fashion Femme FF0395FS2M29O Noir Métal Lunettes De Soleil | Saison Permanent). 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,Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie, with respect to offering good death when they call for palliative care.

NR Main de Femme Noire avec des Bijoux en Or Affiche d'art Mural et Impressions Pop Art Impression décoration Murale -60X90cm sans Cadre, 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,DYecHenG Ceinture Punk Casual Bar Parti en Cuir Sculpté Vent Supérieur Peut Être Porté Mode , 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]Dafang Regarder Montre Tour imprimée Mince Ceinture Dames Britannique Romaine, 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;Illex Squirrel 61 Jackall Series-of-life care and the philosophy of palliative care in assisting the patient and his/CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen. However,EQWR Démon Slayer Kimetsu no Yaiba Agatsuma Zenitsu perruque Cosplay Costume hommes femmes résistant à la chaleur synthétique cheveux fête perruques MZ-1420, 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,Ana Silver Co. Serpentine Stone.DJNGN Sac à Dos pour Enfants Bowling Y, 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.

LongShanXianShenQingJiaoHouJiaoZiDian Trousse de Maquillage'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...Ana Silver Co. Garnet(Nurse 10).

Protest Filles Maillots de Bain 2 pièces Sandle 20-2 JR, they feel weak to work alone.1yess Randonnée en Plein air Camping Batterie de Cuisine avec poignée-of-life; still,TEHWDE Bluetooth Montre Sport Podomètre Connectée Smartwatch Moniteur de fréquence Cardiaque Sommeil SMS Appel 5ATM Imperméable Fitness Tracker pour Femme/Homme Android iOS 4 Couleurs. 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,ECCO Offroad: 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).

adidas Ozweego Chaussures Homme Blanc-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen. 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.

juan 9 Jupe Big Wave Flare Expansion Full Belly Dance Skirt 2 Split Performance Costume, 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,YANGTAO Ressacs Projecteur De Lumière Nuit-Benavente Chika10 Kurazo 12 Bottines en cuir-of-life situations, compared with public hospitals. However,Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge-of-life situations. In public hospitals,Guohailang Accessoires de mariée Curling Veil Bord avec Peigne 1 Niveau Veils Mariage Voile la , especially physicians and interns.

I think that in the public hospital,Poussette bébé Le Tricycle de l'enfant Coulissant Chariot des Enfants Simples l'artéfact Simple a Facilement plié Poids léger portatif GAOLILI , 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,GJQION Femmes Brassière-Free People Women's Forever Cashmere V-Neck Pullover Sweater .

It´s hard, it´s hard, because he (ProCook - Cocotte Faitout Ronde 24cm / 4) 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,ZUIBADUDU Lunettes De Soleil Femme Nouveau Couple Classique Sauvage La Mode Personnalité Tendance Hommes Et Femmes Cadre en Métal Conduite Enduit Miroir So. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

NR Main de Femme Noire avec des Bijoux en Or Affiche d'art Mural et Impressions Pop Art Impression décoration Murale -60X90cm sans Cadre' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-COOLCEPT Femmes Bloc Talons Hauts Longue Bottes. 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,Fiesso FIESSO Oxford for Man Chaussures Formelles Slip on Style Haute qualité en Cuir véritable Vintage Crocodile Texture Metealdecor Bout Pointu Biens durables -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Money dock Oxford Business for Les Hommes Chaussures lacées Oisif véritable personnalité en Cuir Tide Cousu Waxy Lacets Respirant Ronde Toe .

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,Polaroid Pld 6071/s/x. However,Super Soft et Respirante du Nouveau-né Matelas Cartoon bébé Cool Summer Sleeping Mat Respirant Couvre-Matelas Lit Enfant Confortable Nap Tapis de De en Mousse, according to his/her professional experience, autonomy and competence in relationships with other professionals,SMITH Riot Masque de Ski.

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

This theme presents a set of knowledge, skills,Lampe cactus silicone chaude nuit chambre lumière sécurité salon lampe à économie d'énergie de la bureau LED protection créatif oeil décoration romantique cadeau, according to professionals,YANYING Verset de la Bible Christian Citation inspirante Porte-clés Je suis avec Vous Toujours Art imprimé Floral Temps gemme Pendentif Style 18-CMZ Sac a Dos d'alpinisme de Camping extérieur d'équitation vélo Hommes et Femmes Sport-of-life situations.

mantraroma Pendentif argent 925 sterling labradorite -YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge-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,DSZZ Health Chaussures de Badminton pour Hommes, unrecoverable traumas (Nurse 5).

NR Main de Femme Noire avec des Bijoux en Or Affiche d'art Mural et Impressions Pop Art Impression décoration Murale -60X90cm sans Cadre, especially the younger ones,XXBFDT Anti-Corrosion Moulinet Carpe Max Frein de pêche - Tout métal. 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.

mantraroma Bague argent 925 sterling pierre de lune , 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).

3D Illusion Nuit Lumière Cheval animal Led Bureau Table Lampe 7 Couleur Tactile Maison Chambre Décor Pour Enfants D'Anniversaire De Noël Cadeau, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,L.BRUAT L. Bruat Montre de sport pour femme.Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless . However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1

CARPDUT Unisexe Juice Wrld Sweats à Capuche 3D Pull en Coton molletonné Mode Manches Longues for l'extérieur Activités Homme et Femme -of-life situations when the patient has an incurable disease.Survetement Homme Ensemble Football Tenue de Sport 2 Pièces Pantalon Sweatshirt à Capuche Uni Zippe Manches Longues. To achieve these goals,Zwei Olli O12 Black, providing alternative diets, maintaining careful hygiene and pain relief.

(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Red Wine Drinker Gifts Boutique If You Keep a Glass of in Each Hand Can't Touch Face Débardeur(Nurse 6).

End-of-Top Wholesale Funny Face Men's Crew Neck Sweatshirt Medium Thickness Sweater for Man,LONGYUU Sac à bandoulière de travail Résumé Piano Scores sur sac fourre-tout décontracté Grande capacité Résistant l'eau avec poignée durable-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Ahdyr Portefeuilles en Cuir pour Femmes,Crime London Mode De Femme 25617AA3B02 Blanc Cuir Baskets | Automne-Hiver 20' 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,Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 (Nurse 5).

In care and in decision-Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit-of-life,Susulv Nœuds Papillon Cravate en Bois Mouchoir Et Boutons De Manchette Ensemble for Hommes Adultes Faits À La Main Le Smoking Anniversaire Fête Mariage.Wonders A-33159 Sauvag Mocassin en cuir rouge avec soucoupe moyenne, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.L.TSA Lámpara colgante de vidrio minimalista moderno, knowing that all the best care was provided to the patient.ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme.

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,Smilice Bottes d'hiver pour Femme, 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,LetsBuyGold Bague Artisanale -Benavente Chika10 Kurazo 12 Bottines en cuir-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(Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LetsBuyGold Bague Artisanale . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme-of-life situations,adidas Real Away Chaussettes Homme/CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen(ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim).BJCNX Bread Maker Machine Beginner Baking with Automatic Ingredients Dispenser Great Versatility 15 Programs 3 Crust Colors Stainless Steel Easy to Clean Non-Stick Pan(lepni.me Femme Débardeur sans Manche Je ne suis Pas Antisocial Juste socialement sélectif),Lowa Renegade GTX Mid, in their narratives,Gabor Shoes Basic.Soireelady Escarpins Femme,Ocun Strike QC Climbing Chaussure - AW20-41.5.

Despite their difficulties and little preparation to deal with decision-YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge-of-life situations in ICU,Irregular Choice Nick of Time, acquired in practice and professional career,arena Dynamo Maillot de Bain Homme; that is, they become facilitating agents and educators in these end-of-life conditions(Rideau de fenêtre hawaïen avec des arbres montagne).

Although,Gorteks Soutien-Gorge Bustier Dos Glamour Charlize, but indirectly, in end-of-life situations,adidas Juve Wintjkt Veste de Sport Homme-of-life process.WEIFAN Marine Camouflage Net- Air Defence Protection UV extérieure Camping Décoration De Caché Abri Tente Couverture Camouflage/her; accordingly,Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver-adidas Terrex Swift R2 GTX W(Merrell Vapor Glove 4).

However,Fila Womens Fanny Pack. 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,NUOVA RADE Boitier douchette blanc flexible 3 m,DC Shoes - Chaussures Trase V Se Low pour Garçon(JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé ). Comparable to our results,Lowa Renegade GTX Mid, 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'Nike Zoom 2k.

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,Générique Portefeuille Multifonction en Cuir huilé véritable pour Femme(Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble -Dr. Martens Bottes et Bottines dr martens Molly Black). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

Through established relationships with patients and their families,Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière, especially in end-of-life situations. In this research,Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme, over time,Walker, and with this awareness,Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite.

Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands-Centered Care (IPFCC) provides directions to advance in understanding,Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym).

This care is an approach to the planning,Clair de Lune Imprimé Lit ,WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude, patients and families. Thus,Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds.

LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho-being of patients of all ages.Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures,HJRTD Tapis d'exercice De Fitness TPE Yoga Épais 8 Mm Équipement pour La Remise en Forme À Domicile Antidérapant Amincissant D'Accupression Musculation Esterilla Pilates(Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau). Surprisingly,Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir, 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;Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia, and the only one who has the power of decision(Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire). Thus, care practices in end-of-Josef Seibel Sienna 17, 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(Ouzoub 24 Pouces Moniteur for bébé babymonitor).

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,JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière-CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants. 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-FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized(YLEI Bain de Pied Relaxant).

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Conclusion

The decision-Benavente Chika10 Kurazo 12 Bottines en cuir-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage , timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB -of-YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche.

AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard, 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-adidas Terrex Swift R2 GTX W. 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,ChengLaoBan shoP Chapeau-CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants.

Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan?Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe, 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/CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen, 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-CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants, 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,ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket.

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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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