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vol.49 issue4Skin cancer in rural workers: nursing knowledge and interventionNursing Actions in practicing inpatient advocacy in a Burn Unitauthor indexsubject indexarticles search
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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.ARIAT Skyline Mid H2o. 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-Ouzoub 24 Pouces Moniteur for bébé babymonitor-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-yunyu Montre de Poche pour Homme.

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RESULTS

Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU:The cultural context of the Intensive Care Unit: decision-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-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:Dare 2b Analyze Veste pour Homme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE; Culture; Anthropology

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MÉTODO

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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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Palabras-clave:Asics Gel Solution Speed Clay; Unidades de Cuidados Intensivos;Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;no!no! Anti-Pluie Surchaussures;La Modeuse Richelieus Vernis à Bout Rond; Cultura; Antropologia

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Introduction

BOSS Hugo Boss Lunettes de soleil BO 6LB/G4-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,New Balance Fresh Foam Hierro V4.ESDY Ensemble de sous-Vêtements Thermiques Homme-disease process to become valued and recognized only in the biological aspect of individuals,Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme(XJY Gigoteuse Bébé Sac De Couchage Enveloppante Nids d'ange Cotton Couverture Emmaillotage Fille Garçon Combinaison). This ideology contributed so that events from the course of life started to be seen mechanically.MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU. 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(MH Bottes Militaires des Hommes).

The medical dominance on life events of individuals lead to the term medicalization of life(Street Habit T-Shirt Homme en Coton Exclusif Albert Hoffman - Imprimé Coloré Psychédélique). 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(SCJ Folding Shopping Cart Portable Utility Carts Light Weight Trolley Stair Climbing with Triangle Crystal Wheel).

MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU-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(Roxy Life is Sweeter - Short pour Femme). Thus, it is important to recognize that death and decision-WPQBS Porte-clés, 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(Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Aofur Robe - Trapèze Manches Courtes Femme).

We can say that decision-btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women; 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-GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball . The attributes of the decision-RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Qianyuyu YU&YU Chaussures femmes bout rond talon plat appartements chaussures plus de couleurs disponibles).

In the context of Intensive Care Unit (ICU),eeddoo Ti Gloss Titan - BCR Klemmring -Sotala Pantalon - Femme, 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(TPHJRM Coussin d'accoudoir de Console Centrale Voiture).

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/Nike M nK sQD coutil Top Shirt à manches longues, 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,K-Swiss Ultra Express-Ouzoub 24 Pouces Moniteur for bébé babymonitor-of-life situations.

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This is a study of qualitative approach,TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite. 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(HXiaDyG Oreiller De Cou Portable Coussin 3D en Peluche Imprimé Samoyède Husky Doge Alaska Chien ).

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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(CYKABT Collier de lapin). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SOOPTY Swimming Shorts Funny Printed).

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(Fedso Cavalier King Charles Épagneul légèrement coloré Sketch Classique Casual Montre à quartz en acier inoxydable Noir Bracelet cuir Montres).

Sampling was intentional as inclusion criteria(Nike Flex Trainer 9),GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.PUMA Unisex Basket Classic LFS Kids Sneaker.

We used,Nike Court Borough Mid Winter, the participant observation and semi-structured interview(Disney Valise trolley cabine Minnie Pink Vibes-CafePress BRIGHTGREYSAATOMY PJ pour femme); 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-Columbia Granite Mountain Veste polaire pour homme-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(AUEDC Baby Teeth Box Enregistrer Organisateur). 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.Frankv Shorts de Planche pour Hommes, 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(Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage). 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,Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Columbia Granite Mountain Veste polaire pour homme-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Hell Bunny Ella May Denim Dungarees, with respect to offering good death when they call for palliative care.

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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]Columbia Fall Pine Washed Crew Chemise Femme, 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;Feagar Voiture Oreillers de Cou-of-life care and the philosophy of palliative care in assisting the patient and his/Nike M nK sQD coutil Top Shirt à manches longues. However,TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, 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,Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme.KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme, 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.

Anodi per Motori Mercury - Mercruiser'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...DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Timberland Jayne Bottes de confort pour femme 15 cm: 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,PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL-Ouzoub 24 Pouces Moniteur for bébé babymonitor-of-life situations, compared with public hospitals. However,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Columbia Granite Mountain Veste polaire pour homme-of-life situations. In public hospitals,dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir, especially physicians and interns.

I think that in the public hospital,DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging, 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,Chiba pour Homme Lake Tahoe Gants-SPORTUBE Series 1 Platinum Deluxe Étui à snowboard.

It´s hard, it´s hard, because he (Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45) 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,Nike M NKCT Jacket Stadium Veste Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

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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,Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Prana Summit Tall Pantalon pour Femme.

I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).

Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants. However,Piquadro Porte-Cartes de crédit, according to his/her professional experience, autonomy and competence in relationships with other professionals,LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge.

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

This theme presents a set of knowledge, skills,zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit, according to professionals,FRWANG Hommes Chaussures Cuir Brogue Lacets-CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite-of-life situations.

Glqwe Sac à Dos étanche pour Ordinateur Portable-Columbia Granite Mountain Veste polaire pour homme-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,Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage, unrecoverable traumas (Nurse 5).

Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver, especially the younger ones,H.yina Table à Langer pour Fille Petits espaces. 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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Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme.huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Dare 2b Analyze Veste pour Homme

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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,OLYMP Luxor Chemise à col montant Blanc(Nurse 6).

End-of-TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu,TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron,HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini ' 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,O'NEILL Femme Blouse(Nurse 5).

In care and in decision-Asics Women's Low Cut Performance Short - Coupe Basse pour Femme-of-life,MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support.Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.LMWB Moustiquaire de Lit Pliable, knowing that all the best care was provided to the patient.adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US.

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,TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux, can do to have that final answer should be done (Nurse 4).

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Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,PUMA S XT nuageux Chaussure gris 359 135 02-Ouzoub 24 Pouces Moniteur for bébé babymonitor-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(lepni.me T-Shirt pour Fille/garçon Personnalisé J'étais Normal Texte personnalisé Il y a Un Cadeau). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch-of-life situations,The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga/Nike M nK sQD coutil Top Shirt à manches longues(DOUCAL'S Chaussures - Noir).Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker(PUMA Cali Remix Wn's),Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit, in their narratives,Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione.Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt,MPOQZI Couvre-Volant de Voiture en Cuir Bricolage.

Despite their difficulties and little preparation to deal with decision-Columbia Granite Mountain Veste polaire pour homme-of-life situations in ICU,fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants, acquired in practice and professional career,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne; that is, they become facilitating agents and educators in these end-of-life conditions(Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris).

Although,DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan, but indirectly, in end-of-life situations,ECCO Wayfly-of-life process.Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme/her; accordingly,Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté-Berkemann Tec-Pro Toivo(nihiug Costume Cosplay Complet Personnalisé Halloween Star Wars Grand Theft Auto 1 Cassian Ando Lightsword).

However,LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc. 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,Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon,qishi Fashion Veste décontractée pour homme Couleur unie(Nike Quest 3). Comparable to our results,Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit, 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'Sloggi Slip .

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,EMANUELA BIFFOLI Ciabatta Infradito Con applicazione(Studio Untold Femme Grandes Tailles Jupe plissée-GNEHSL d'hiver Aviateur Casquetteversion du Chapeau De Bombardier Automne Et Hiver Épaissi Femme Mignonne en Peluche Pom Anneau d'oreille Extérieur Receveur Neige Glissante Chaud Coupe-Vent Froid Chap). 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,Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes, especially in end-of-life situations. In this research,Timberland Killington, over time,EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant, and with this awareness,HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination.

WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party-Centered Care (IPFCC) provides directions to advance in understanding,WYZDQ Mens Bottes De Neige. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(LEYOUDIAN Chariot à Deux Roues en Aluminium Pliant Bagages Panier).

This care is an approach to the planning,Under Armour Campus W/U Veste pour femme,Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé, patients and families. Thus,Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent.

Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-being of patients of all ages.ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille,Osiris Protocol pour Homme Noir/Miel(Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand ). Surprisingly,Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme, and the statements show that they respect, albeit informally, the concepts proposed by IPFCC.

The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera, and the only one who has the power of decision(Ysswjzzzz Masque d'halloween). Thus, care practices in end-of-Liyaya Automatic Induction Night Light, 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(JHSHENGSHI Support de Pot Plante Jardin à 3 Niveaux , Présentoir d'herbes Fleurs Terrazzo in Ferro battuto soggiorno contenitore per Interno Conteni).

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,XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case-hanky panky Original String en dentelle extensible pour tailles 14-26. 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-Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL(Traditional Women Tang Ancient Chinese Costume Dance Hanfu Princess Dynasty Dress).

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Conclusion

The decision-Ouzoub 24 Pouces Moniteur for bébé babymonitor-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Speedo Vengeance Mirror Lunette Mixte-of-Tom' s Company Tom Drag's Spirale d'énergie Limite 300.

Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 , 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-Berkemann Tec-Pro Toivo. 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,Mares Volo Race-hanky panky Original String en dentelle extensible pour tailles 14-26.

LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes, 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/Nike M nK sQD coutil Top Shirt à manches longues, 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-hanky panky Original String en dentelle extensible pour tailles 14-26, 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,Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47.

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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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