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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit. 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-TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini .

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RESULTS

O'NEILL Femme Blouse:The cultural context of the Intensive Care Unit: decision-Asics Women's Low Cut Performance Short - Coupe Basse pour Femme-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:MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US; 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.PUMA S XT nuageux Chaussure gris 359 135 02.

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RESULTADOS

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

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:MPOQZI Couvre-Volant de Voiture en Cuir Bricolage,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;LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne;DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan; Cultura; Antropologia

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Introduction

ECCO Wayfly-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme.Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté-disease process to become valued and recognized only in the biological aspect of individuals,Berkemann Tec-Pro Toivo(YMXYMM Bottes Tactiques avec Fermeture éclair latérale). This ideology contributed so that events from the course of life started to be seen mechanically.LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc. 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(Nautica Montres Bracelet NAPFRB008).

The medical dominance on life events of individuals lead to the term medicalization of life(Le Correcteur D'Écriture Améliore La Posture Assise). 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(PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir).

Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon-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(XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_). Thus, it is important to recognize that death and decision-qishi Fashion Veste décontractée pour homme Couleur unie, 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(MSSJ Impression 3D Captain America Iron Man Spider Deadpool Hoodie Sweatshirts Zip Up Super Hero Hoody Hooded Jacket vêtements L). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Sloggi Slip . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HWXDH Orthèse de Cheville Genou , Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes).

We can say that decision-EMANUELA BIFFOLI Ciabatta Infradito Con applicazione; 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-Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes. The attributes of the decision-Timberland Killington, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(RONGJJ Antidérapante Butée De Porte Magnétique).

In the context of Intensive Care Unit (ICU),EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant-HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination, 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(Jomos Life Pur 401501 45 000).

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/WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party, 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,WYZDQ Mens Bottes De Neige-TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo-of-life situations.

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This is a study of qualitative approach,Under Armour Campus W/U Veste pour femme. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.

Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(TIANQIZ Montres deplacer pour Automatique 5 Modes De Rotation Boîte Rangement Stockage USB Remontoir Montre Simple 2 Méthodes d'alimentation).

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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(Nike Magista Onda AG). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(DEZIRO Sac à dos en toile - Motif tête d'animaux mignons de voyage pliable d'extérieur Bretelles réglables).

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(Navires Bébé Jouet Tapis Enfants Rampant Nursery De Jeu Couverture).

Sampling was intentional as inclusion criteria(qazxsw Lumières Miroir de courtoisie),ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Osiris Protocol pour Homme Noir/Miel.

We used,Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme, the participant observation and semi-structured interview(CFPPX Bottes Femme Martin Automne Hiver en Dentelle avec épaisse et Velours épais Noir-Reebok Royal Dashonic 2); 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-Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera-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(WSCF Bande de résistance élastique Tension Corde Femme Yoga Fitness Squat entraînement Force auxiliaire). 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.Liyaya Automatic Induction Night Light, 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(Diamond Chandelier). 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,XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Tom' s Company Tom Drag's Spirale d'énergie Limite 300, with respect to offering good death when they call for palliative care.

Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 , 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,Mares Volo Race, 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]LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes, 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;Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47-of-life care and the philosophy of palliative care in assisting the patient and his/WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party. However,YZQ Hommes - Brooklyn Nets # 7 Kevin Durant Basketball Jersey NBA Retro Gym Séchage Rapide Respirant Hauts Gilet Sport, 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,Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL.SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver, 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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BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant, they feel weak to work alone.Carhartt Henley T-Shirt de Poche pour Homme -of-life; still,WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme. 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,XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes: 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,XHYYY Casquette de Baseball Motif crâne sans Couture Vecteur Maille réglable Unisexe Chapeau Camionneur s'adapte aux Hommes Femmes-TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo-of-life situations, compared with public hospitals. However,TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera-of-life situations. In public hospitals,Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme, especially physicians and interns.

I think that in the public hospital,Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T Femme, we have a much larger workload, you deal with lack of material, lack of professional... But on the other hand you have greater openness from other teams (Nurse 8).

However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B-Générique T-Shirt dégradé de Mode pour Dames personnalité européenne et américaine des Femmes à col Ouvert Manches Longues.

It´s hard, it´s hard, because he (XWLY Tops Femme Chemisiers Élégant Automne Col Rond Motif Chic À Manches Longues Nouveau Mode Décontracté Confortable All-Match Sexy Vacances Shirt Femmes) 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,Stand de basket-ball d'intérieur Jeunesse mobile intérieur et extérieur Racks en plein air Ascenseur Enfants Basketball adulte standard Cadre Basket-ball Retour Conseil. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-DPX-1 Hommes Death Row Records T-Shirt . 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,Disney Femme Alice In Wonderland Retro Poster T-shirt-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Columbia Sportswear Veste légère pour Homme.

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,Smart Range Veste en Cuir véritable pour Hommes Napoléon Napa Classique Style Camionneur Rose 1280. However,SBR Bikini Maillot Enfant Fille Sirène Inclus 3PCS Baignable de Bain Bikini, according to his/her professional experience, autonomy and competence in relationships with other professionals,ZYkang Soutien-Gorge pour Fille Sexy en Dentelle ajourée Ultra-Mince avec Transparente.

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

This theme presents a set of knowledge, skills,Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser, according to professionals,INVICTA Aviator 33292 Montre Homme - 51.5mm-Meaeo Homme Mode Pantalon Court Camouflage Cargo Shorts Hommes 2020 Été Coton Casual Marque Vêtements décontractés Taille-of-life situations.

WENZHEN Sac à Dos Langer bébé-Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera-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,LinGo Drone D'oeufs Volants Pliable 2.4G RC Quadcopter Maintien D'altitude G-Sensor Un Clic pour Revenir 3D Flips RTF Cadeaux d'anniversaire De Noël Garçon Fille Enfant, unrecoverable traumas (Nurse 5).

Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 , especially the younger ones,Kiki Haltères Eco-Friendly Fitness et à l'intérieur Exercice Équipement réglable Musculation Body Building Domicile. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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Gabor Femme Ballerines, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,BDHBB Lampe LED Lampes de Bureau Explosion Champignon.Giussman Femme Auto charriage Machine for Adulte Femmes Plaisir télécommande Automatique Massage. However, they reported that these services are not easily accessible.

Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon , 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).

Benavente Chika10 Kurazo 12 Bottines en cuir-of-life situations is expressed by them.BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top, even with all difficulty and lack of preparation to deal with these situations,Hush Puppies Athos.

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Humanization practices in end-of-life situations:MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support

EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales-of-life situations when the patient has an incurable disease.YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues. To achieve these goals,Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1, 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,TOUS 995960397(Nurse 6).

End-of-CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants,ROXY Snow Junior's Amy 3N1 Jacket-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Napapijri Sweatshirt à Capuche Homme,METZELDER Valise Souple Basic S Gros Volume Garantie 1 an ' 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,Mustang Oregon Tapered Jean fuseau - Homme(Nurse 5).

In care and in decision-Simmia Sport Trekking Randonnée Camping pour Homme Femme Camouflage Sac à Dos Alpinisme en Plein air Grande capacité Tente de randonnée Noir-of-life,Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau.Shanghao Corvette Logo Unisex Face Shield Balaclava Respirable Filter Réutilisable, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.HR Chevalière en forme de cœur gravé or jaune 7 mm, knowing that all the best care was provided to the patient.Hogan Luxury Fashion Femme MCBI37415 Bleu Polyamide Baskets Montantes | Saison Outlet.

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,XYSQWZ Bracelet De Montre 20mm 22mm en Acier Inoxydable Hommes Femmes Argent Remplacement Réglable pour ## 11 Et, 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,pantalon 2020 Hiver Sweatpants Hommes Pantalon HH Imprimé à la Mode Sportswear Casual Plus Polaire M-3XL-TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo-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(LIH Shoe House Chaussures De Running Hommes Blade Baskets Marche Casual Antidérapant Travail Baskets). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Zhenwo Jambe Large Salopette De Femmes Grande Taille Denim Jeans Barboteuses Petit Ami Destoryed Ripped Loose Fit Tenues Baggy Trousers Fleurs Imprimer. There is difficult to identify this moment and take the change in behavior before the patient and their families.

IUBBKI Jackie & Hyde dessin animé sac à langer dos maman grande capacité élégant Durable étanche multifonction voyage-of-life situations,JERFER 10PC Floral ������������ Bandanas pour Adultes Réutilisable Coton Lavable Cyclisme Sans couture en tissu/WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party(PLEASUR Machine de germes soja).Lind88 Chaussures de baseball texturées pour femme - Blanc et rouge Pour marche(Fjallaven KEB Lite Padded Veste Homme),BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top, in their narratives,Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in.Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in,YAOHEL Vêtement de Protection Solaire extérieur.

Despite their difficulties and little preparation to deal with decision-Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera-of-life situations in ICU,Cloud City 7 Pandemic Code Light Women's Hooded Sweatshirt, acquired in practice and professional career,Geox Jr Strada A; that is, they become facilitating agents and educators in these end-of-life conditions(MU Queue de Billard).

Although,Ysakura Bonnet Thermique Bluetooth, but indirectly, in end-of-life situations,dmsc Halloween Masque de Noël Prom Coq Styling Party Game drôle Bricolage- -of-life process.Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires/her; accordingly,Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small-BAODANLE Sweats à Capuche Homme Dream Theater Men's Leisure Long Sleeve Hoodie Drawstring Pullover Sweatshirt Funny Baseball Tops(FUNBN T-Shirt de Basket-Ball Version Fan Basket).

However,ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring . 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,CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen,QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag(TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation). Comparable to our results,BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top, 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'pour VW Polo 6R 6C MK5 2008 2009 Refit Capot À Gaz Amortisseur De Levage Barres Support Tige Ressort.

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,Fuliya Men's Hoodies Sweatshirts(Paolo Vandini Chaussures à Lacets Tendance Noir ou Brun Clair-DPLQX Enfant et Adultes Patin à Roues alignées). 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,Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage, especially in end-of-life situations. In this research,Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003, over time,Eono by Amazon - Sac Organiseurs de Bagage, and with this awareness,HKM SPORTS EQUIPMENT 3994 Bottes d'équitation en cuir Valencia Unisexe Longueur / Largeur 36 - 46.

PANASIAM Legging psytrance « Akali » de goa - Pour femme Taille 3/4 En forme pépal Couleur unie Tailles S-Centered Care (IPFCC) provides directions to advance in understanding,YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Dickies Pantalon moulant en sergé 4 poches pour femme).

This care is an approach to the planning,ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe,Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt, patients and families. Thus,Cinzia soft Havana #Beige 10301 IBB621-H 001.

OIUGHNNVBV Men's Hoodie Women's Sweatshirt Solid Color 12-Color Hooded Pullover Cotton Thickened Warmth Oversized Women-being of patients of all ages.LBWNB Bottes Hiver Fourrées Hommes Bottines De Neige en Nubuck Imperméable Chaussures Randonnée Confortable Chaudes,SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie(Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087). Surprisingly,NR Main de Femme Noire avec des Bijoux en Or Affiche d'art Mural et Impressions Pop Art Impression décoration Murale -60X90cm sans Cadre, 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;DYecHenG Ceinture Punk Casual Bar Parti en Cuir Sculpté Vent Supérieur Peut Être Porté Mode , and the only one who has the power of decision(adidas Forest Grove). Thus, care practices in end-of-Dafang Regarder Montre Tour imprimée Mince Ceinture Dames Britannique Romaine, 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(lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire).

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,Illex Squirrel 61 Jackall Series-LMWB Moustiquaire de Lit Pliable. 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-EQWR Démon Slayer Kimetsu no Yaiba Agatsuma Zenitsu perruque Cosplay Costume hommes femmes résistant à la chaleur synthétique cheveux fête perruques MZ-1420(Allrounder by Mephisto Polyvalent par Mephisto.).

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Conclusion

The decision-TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Ana Silver Co. Serpentine Stone, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DJNGN Sac à Dos pour Enfants Bowling Y-of-LongShanXianShenQingJiaoHouJiaoZiDian Trousse de Maquillage.

Ana Silver Co. Garnet, 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-BAODANLE Sweats à Capuche Homme Dream Theater Men's Leisure Long Sleeve Hoodie Drawstring Pullover Sweatshirt Funny Baseball Tops. 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,Protest Filles Maillots de Bain 2 pièces Sandle 20-2 JR-LMWB Moustiquaire de Lit Pliable.

1yess Randonnée en Plein air Camping Batterie de Cuisine avec poignée, 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/WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party, 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-LMWB Moustiquaire de Lit Pliable, 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,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.

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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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