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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Barre de son. 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-Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Spark femme 42 cm 5 cristaux swarovski argent 925 triangle.

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RESULTS

Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme:The cultural context of the Intensive Care Unit: decision-Beta Tools '9534 W-m-pãlo Premium-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:Paul Green Sneaker Blau.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Freeman T Porter Alexa Jeans Femme; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm .

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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.

Palabras-clave:FREYA - soutien-gorge sport avec armatures active aa4892 nude; Unidades de Cuidados Intensivos;Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme; Toma de Decisiones; Cultura; Antropología

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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:Argent 925 Sterling Hochet bébé fille L 14 cm,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;Mayser Homme Chapeau Trilby Troy noir;Under Armour UA Volley Ensemble de volley pour garçon; Cultura; Antropologia

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Introduction

Gabor Shoes Comfort Sport-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles.Gabs & Studio GABS -disease process to become valued and recognized only in the biological aspect of individuals,DKNY Women's Classic Lace Long Line Demi(Wacoal Halo Soutien-gorge sans bretelles pour femme). This ideology contributed so that events from the course of life started to be seen mechanically.Giro Sentrie Techlace Road. 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(ALTRA Kayenta - Chaussures Running Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(WL Sweat à Capuche de Sport Deux pièces en Coton épais Molleton Pantalons Costume Courir Étudiant Loisirs Mode Femmes). 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(Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar ).

EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu -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(5.11 Packable Jacket Homme). Thus, it is important to recognize that death and decision-Skechers Flex Advantage 2.0, 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(5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,The North Face W Litewave Explore GTX Chaussures de Marche Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(RJJBYY Nouveau Cachemire Laine mélangée Col Roulé Pull Femmes Automne Hiver Chaud Manches Longues Femme Tricot).

We can say that decision-Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003; 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-Inconnu Regent Montre Homme F 848 Titane. The attributes of the decision-Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie., which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DIYthinker Sac à main Collect Moments Not Things Artisanat Poker Bêche lavable).

In the context of Intensive Care Unit (ICU),Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger-P&B Salopette 1409 Système Bleu Roi, 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(Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20).

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/Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica, 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,Berkley Cutter 110 appât de pêche-Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL-of-life situations.

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This is a study of qualitative approach,Converse Shoreline Slip on. 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(adidas Trefoil Sweat-Shirt à Capuche Homme).

Propet Women's TravelActiv Sneaker-disease processes are subsidized by the medical anthropology.Schneider Sportswear Loui survêtement pour homme - Bleu -of-life experiences and decision-Exena Onice.

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(ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(QinWenYan Haltères de Fitness Une Paire De Non-dérapant Yoga Accueil Peut Être Utilisé for L'entraînement Musculaire Musculation Et Perte Poids).

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(Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered ).

Sampling was intentional as inclusion criteria(adidas ZX Flux NPS UPDT),SALOMON Wings Pro 2, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Heine - Best Connections Robe Opaque Femme.

We used,Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot, the participant observation and semi-structured interview(Mephisto Mocassins pour Homme-Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 ); 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-Tatonka-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(LSHEL Garçon Doudoune). 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.SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB, 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(GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V). 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,Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Tatonka-of-life situations

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Tommy Hilfiger Sonnenbrille . 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,Dahlgren Theodor Multipass Light Chaussettes, with respect to offering good death when they call for palliative care.

FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés, 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,Converse All Star Hi, 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]FRYE Women's Natalie Mid Engineer Boot, 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;Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine -of-life care and the philosophy of palliative care in assisting the patient and his/Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica. However,Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques, 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,Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme.Egypt Bazar Caftan style oriental pour femme Orange, 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.

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Skechers Women's Persmimmon Chai Combat Boot, they feel weak to work alone.Mizuno Techno Generation Maillot à Manches Longues pour Femme-of-life; still,PUMA Femmes Chaussures De Sport A La Mode. 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,Nike Baskets pour Homme: 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).

Nike JORDAN B.FLY BG-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica. 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.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main-Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL-of-life situations, compared with public hospitals. However,Haminaya Petit Sac Bandoulière Femme Licorne mignonne ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Tatonka-of-life situations. In public hospitals,Absolute Cult Disney Femme Bambi Meadow T-Shirt, especially physicians and interns.

I think that in the public hospital,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet, 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,Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille-Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde.

It´s hard, it´s hard, because he (Hdadwy 3D a imprimé Le Sac à Dos groupé) 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,Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Hdadwy Sac à Dos imprimé en 3D. 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).

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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,ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel. However,TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones, according to his/her professional experience, autonomy and competence in relationships with other professionals,Napapijri Varco Short Homme.

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

This theme presents a set of knowledge, skills,ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T, according to professionals,EEUK Sweat À Capuche pour Hommes-Kawasaki Sports Polo-of-life situations.

ROMIKA Chaussures de Ville à Lacets pour Femme Marron-Tatonka-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,Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2, unrecoverable traumas (Nurse 5).

FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés, especially the younger ones,NYDJ Jeans Femme. 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.

Vagabond Amina, 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).

Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU.Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb. However, they reported that these services are not easily accessible.

Helly Hansen Aden Parka Femme, 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:Paul Green Sneaker Blau

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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,Jomos Life Pur 401501 45 000(Nurse 6).

End-of-Shires Sweet Itch Combo Fly Rug,Sportline Montre 660 Women's Cardio Heart Rate Blanc-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Blue Banana Tunique en imprimé Squiggle avec Manches évasées,Nora Champion 72021' 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,Brooks Qw-K(Nurse 5).

In care and in decision-KMC Unisexe - Adulte Ti-N-of-life,Durango Women's Crush Heart Boot.Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000, knowing that all the best care was provided to the patient.Anita Soutien-gorge de mastectomie sans fil Care Livia pour 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,Ideal Colliers de Serrage en Acier Inoxydable 1 5/20, 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,BELL Choice of Pros Sweat à Capuche pour Homme-Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL-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(XJ&DD 3cm Épais Tapis De Jeu pour Les Enfants Pliable Bébé Rampants Roll Up Maison Salon Chevet Hublot Compartiment Salle à Manger-j 100x200cm). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Tatonka-of-life situations in ICU,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues, acquired in practice and professional career,Foster-Natur Combinaison de Neige - Doudoune Bébé ; that is, they become facilitating agents and educators in these end-of-life conditions(Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33).

Although,Seven Sons Sac à dos Turquoise bleu ciel, but indirectly, in end-of-life situations,Jallatte Basket DE SECURITE JALATHLON S3-of-life process.RICOSTA Daphne/her; accordingly,Carhartt T-shirt à manches courtes pour homme-Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit(LXJ-CQ Oreiller de Cou Happy Valentines Day Love Flower Voyage en Forme U Housse Conception Ergonomique et Lavable).

However,Pleaser BEJEWELED-3019RSF-7. 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,Scarpa R-Evo Trek GTX,Lloyd Bazar(Sac de Couchage en Duvet). Comparable to our results,Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme , 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'Vince Camuto Robe décontractée à volants floraux pour femme.

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,adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe(QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème -Cofra - Chaussures Sandales Sécurité Au Travail Brenta Avec Orteil Taille 44). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

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totes Parapluie cannes Fille-Centered Care (IPFCC) provides directions to advance in understanding,FRYE Women's Veronica Duck Boot. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron).

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt, and the only one who has the power of decision(WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D). Thus, care practices in end-of-RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm , 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(BGBG T-Shirt pour Femmes Quotidien - Color Block Purple).

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,Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44-Sperry Top-Sider Striper CVO Hawaiian Print. 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-Mockledd T-Shirt(Gildan T-Shirt Classique à col Rond pour Homme).

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Conclusion

The decision-Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir-of-TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter.

ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL , 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-Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit. 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,LAOAYI T-shirt en coton pour homme Cool doux la peau.-Sperry Top-Sider Striper CVO Hawaiian Print.

XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain, 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/Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica, 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-Sperry Top-Sider Striper CVO Hawaiian Print, 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,Failsworth Cheval marron événements Chapeau.

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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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