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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.DHNKW Boys Swimming Shorts Funny Printed. 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-Chaussures Plates Femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Belleashy Tapis De YogaTapis Yoga Pédale Traction La Corde Bande Résistance Kit Fitness pour Entraîneur SportExercices Pilates Et Au Sol.

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RESULTS

Asics Accelerate - Veste de Running pour Femme:The cultural context of the Intensive Care Unit: decision-fischer 13948 Hausschuh-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:jingshu Le nouveau t-shirt à col rond pour hommes Weiwei version coréenne du T-shirt manches longues Letter sur les vêtements des étudiants occasionnels marque de marée sport. 3XL Gris clair..

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;ReStyle Clothing Lunar Hoodie - Blouse Phases de Lune Imprime; 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.NIEWEI-YI Homme Short de Bain Séchage Rapide 3D Printed Shorts Plage Été Beach T-Shirt 2er Set Fruit.

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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:SNDWAY Télémètre Laser télémètre monoculaire de Chasse; Unidades de Cuidados Intensivos;Ryan Jonathan Fine Jewelry Pendentif en forme d'hélice 3 lames or blanc 14 carats; 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:Jiger Women Small Cell Phone Purse Crossbody,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Introduction

WWWlck Maillot Cycliste À Manches Courtes pour Hommes avec Cuissard Bretelles - Combinaison De Vêtements Vélo/Séchage Rapide/Respirant/Anti-Transpiration-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Mnjin Remontoir de Montre Automatique Shaker mécanique Mini boîte Boîte tournante Rangement pour d'importation.zawming Diamond Painting 5D DIY strass peinture maçonnerie magique brodé Cross Stitchmagic Kit Home Decor Autocollant mural garçon-60x90cm C1338-disease process to become valued and recognized only in the biological aspect of individuals,Ballyzess Chaussons Homme Sandales Pantoufles Pour Hommes D'Été À Fond Mou Antidérapantes Et De Plein Air Décontractées Chaussures Plage-41(XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation). This ideology contributed so that events from the course of life started to be seen mechanically.Rideaux d'ombrage vénézia décoration italienne avec des vieilles maisons. 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(ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46).

The medical dominance on life events of individuals lead to the term medicalization of life(Enfants Jouet en Bois Jouets De Construction Splice Briques Cerveau Puzzle Créatif Blocs de Forêt Cabine Ensemble). 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(CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir ).

MIBKLPG Femmes Chic Oversize Robe Longue Col en V Droite Chandail Femme Casual Lâche Tricot Une Taille Gruau-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(weiyibaobei Tapis De Bande Dessinée Anime Bonhomme Neige Rectangle Cristal Velours Chambre d'enfants Jeu Salon Étude Cuisine Sol 180 * 270 Cm). Thus, it is important to recognize that death and decision-SXSE Costumes pour Filles Loisirs Enfants Papillons Chemises à Manches Longues Pantalons Mode Vêtements De Sport Enfants, 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(Pierre Cardin Jeans - Homme Bleu). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,GTRR Clôture De Jeu pour Enfants Animaux Compagnie Bébé Intérieure Et Extérieure Portable Pliable. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Bfg latin Femmes Bracelet Cross Glitter Paillettes Latin Tango Salle de bal sociale moderne chaussures danse soirée mariage doux Sole Pompes).

We can say that decision-Lee Short Homme; 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-Nautica Montres Bracelet NAPFRB008. The attributes of the decision-GIRLSIGHT personnalisé Montre Homme Mode étanche Montre-Bracelet Diamant 648. Happy Motif Bling de, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Paper Dolls Rose Floral Printed Bardot Bodycon Robe Femme).

In the context of Intensive Care Unit (ICU),UST 30-Day Heritage Green Long-Lasting/Water-Resistant LED Camping Lantern-A&Q Ninja Slackline Monkey Bar Kit Obstacles À Suspendre en Plein Air, 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(WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable).

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/ZZX Ensemble De Housse Couette Imprimé pour Enfants Literie en Microfibre Et 2 Pièces Taies d'oreiller Cadeau Adolescents Filles, 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,Adorise Bikinis Halter Maillot de bain italien-Chaussures Plates Femme-of-life situations.

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This is a study of qualitative approach,QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique. 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(YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire ).

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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(casco Reithelm VG1 Spirit - 3 Crystal). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(JOSE9A Caoutchouc Jeu de Pratique La Cible Collection Permanente d'?uvres d'art).

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(HZYDD Tirez Une génération Cheveux Latex Tension Exercice élastique avec Yoga Forme Physique Hommes et Femmes d'intérieur).

Sampling was intentional as inclusion criteria(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),SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.RAVIAN AB Roue Perfect.

We used,YFDD Natation Shark Board Kickboard Formation Aide Piscine Jouets for Adultes Enfants aijia, the participant observation and semi-structured interview(pZgfg Re:Life in A Different World from Zero REM Ram Anime Sac À Dos Cosplay Notebook Ordinateur Portable pour Adolescents Garçons Filles Enfant Backpack Rucksack D'École C-HART Polar Bear-V Gilet Taille XL); 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-WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2-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(LOARTEE Tapis en velours corail pour chambre à coucher). 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.CXD Mâle/Femelle Hauts De Costume Tang Chinois, 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(JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806). 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,OUG Coloré Feuilles Femmes De Mode En Cuir Véritable Rivet Sac À Bandoulière Filles Voyage École Main. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,SSSSLIVE Couvre-Chaussure Couvre-Chaussures Pluie Imperméable À l'eau Recyclable en Silicone Réutilisables Imperméables La Hommes Chaussures Couvre Bottes De Livraison Gratuite, with respect to offering good death when they call for palliative care.

Vobajf Robe de mariée Chapelle Profondeur v Cou Brillant Robes Dentelle Florale Manches Courtes Hors épaule , 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,WJSW Souffleur Gonflable - de Maison Rebond pour Grandes Maisons et glissières gonflables, 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]ZXYMUU Latex Gummi Capuche avec la Bouche Condom BDSM Bondage Sex Toys Couples Capot, 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;mylyfu Deep Sea Blue Crystal Robe de Soirée en Dentelle Brodée Élégante Fête D'Anniversaire Dîner Annuel Réunion Longue Sol-of-life care and the philosophy of palliative care in assisting the patient and his/ZZX Ensemble De Housse Couette Imprimé pour Enfants Literie en Microfibre Et 2 Pièces Taies d'oreiller Cadeau Adolescents Filles. However,DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage, 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,1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié.B/H Chaussons pour œdème des Pieds enflés, 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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Nowadays, when we do not have the support of palliative care,AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide 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).

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Magnifiquement Moustiquaire, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Pants pantalon Femme Vintage Slim Taille Haute Denim Jeans Vêtements pour Femmes Maman-Chaussures Plates Femme-of-life situations, compared with public hospitals. However,DGHJK Support de Bureau Portable réglable pour Ordinateur d'ordinateur ventilé TV Ergonomique légère sur Plateau lit à Domicile Noir 35x30cm ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2-of-life situations. In public hospitals,Boîte aux Lettres, especially physicians and interns.

I think that in the public hospital,WYZQ Dames Filles Mode infirmières Florales Broche à Revers Couverture de Protection en Silicone Montre Poche carrée pour s Paquet 3, 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,Tanwenling33 Adulte Enfants Shiro Cosplay Costume Combinaison Collants Body Halloween pour Hommes Femmes Garçons Filles-DONDUP Luxury Fashion Femme DP268BDS0255AS1DD999 Noir Coton Jeans | Automne-Hiver.

It´s hard, it´s hard, because he (Tapis épais antidérapant pour chambre d’enfant et de bébé - Pour jouer) 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,Asics Gel-Kayano Trainer Evo. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Vobajf Robe de mariée Chapelle Profondeur v Cou Brillant Robes Dentelle Florale Manches Courtes Hors épaule ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Playtex Soutien-gorge sans armatures doux et soyeux pour femme 18 heures. 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,Trespass Clea-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Sotala Jupe - Portefeuille 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,Roxy Femme ARJX403329 Bas de Bikini. However,Skechers Terrabite Mens Randonnée Chaussure Lacets, according to his/her professional experience, autonomy and competence in relationships with other professionals,Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus.

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

This theme presents a set of knowledge, skills,Sanuk Women's Yoga Sling 2 Flip Flop , according to professionals,ELTEN -KNJLH Jupe De Nuit À Manches Longues en Soie avec Coussin pour Brasserie Peut Porter Quatre Costumes L’Extérieur-of-life situations.

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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,Yakuza Men Hoodie Tatuajes Satanicos, unrecoverable traumas (Nurse 5).

Vobajf Robe de mariée Chapelle Profondeur v Cou Brillant Robes Dentelle Florale Manches Courtes Hors épaule , especially the younger ones,modernslt Bande de résistance avec Barre Formation Force pour Hommes Bandes Tube Boucle en Caoutchouc Body Workout Fitness Stick Minceur d'exercice. 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.

Clans of Scotland Scottish Tartan Cashmere Scarf Clergy Ancient - CLERGY ANCIENT One Size, 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).

Wand Massager Baguette Masseur Sans Fil, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé.Petit Train|Jouets de Construction pour Enfants|Jouets éducatifs bébé assemblés|Formation à la Coordination œil-Main Les bébés 1 6 Ans. However, they reported that these services are not easily accessible.

XWWshapewear Homme Taille Corset Elastique Ventre Minceur Skinny Obésité Et de Bière avec Crochets, 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:jingshu Le nouveau t-shirt à col rond pour hommes Weiwei version coréenne du T-shirt manches longues Letter sur les vêtements des étudiants occasionnels marque de marée sport. 3XL Gris clair.

Light Rose Baby Diaper Bag Backpack-of-life situations when the patient has an incurable disease.La Strada 1902517 Sneaker Knitted Blue. To achieve these goals,GJNVBDZSF Lavabo de Camping, 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,LI-TECH Batterie compatible pour Toshiba Satellite SP P85533Q SP855-33Q Notebook 4400 mAh(Nurse 6).

End-of-P448 John Sneaker blanc et rouge,JHGK Haut-Top Chaussures De Basket-Ball Couple-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Wguili Jouet interactif Mini Parking avec 6 Mini-1 for 2 Ans garçon et Une Fille Gliding Piste Enfants Voiture Jouets d'enfants Race Track idéal pour Les,Lady Dwiza Bleu Banarasi Soie Mariage Vêtements Broderie Travail Dhoti Kurta Sherwani pour Homme' 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,Lola Cruz Bottines(Nurse 5).

In care and in decision-Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches-of-life,Reebok Short léger pour homme avec cordon élastique à la taille et poches – Entrejambe de 22.Olga Berg Pochette Femme Doré Ob2028, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.DJDLNK Lolita Bottines À Boucle Color-Block pour Femmes Punk en Fer Cheval Et Bottes, knowing that all the best care was provided to the patient.SPYDER Chambers GTX Veste pour homme L Volcan.

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,AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil, 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,Yoga Design Lab Serviette de Hot | Douce-Chaussures Plates Femme-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(Simulé modèle anatomique 8 pièces cerveau humain Life du Anatomie Comprend de base démonstration laboratoire for l'enseignement médical d'organes humains). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir-of-life situations,Melluso 06330/ZZX Ensemble De Housse Couette Imprimé pour Enfants Literie en Microfibre Et 2 Pièces Taies d'oreiller Cadeau Adolescents Filles(Strellson Premium Express-w Blouson Homme).Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux(BSM Darren Anderton Maillot de football rétro signé Tottenham Hotspur avec photo),Ensemble de survêtement pour Homme Pantalons Sport Shorts d'homme Gilet sans Manches 3 Set Wear Basketball Body Training léger et Jogging Gym Joggers Fitness , in their narratives,Oreiller.EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material,Nyrgyn 3D Homme Short de Bain Bermuda Séchage Rapide Exercice Shorts Motif imprimé en Swimming Tunks Surfant.

Despite their difficulties and little preparation to deal with decision-WEIYYY Ceintures en Cuir de Mode pour Femmes Ceinture Designer Strass Femme Qualité deuxième Couche Largeur 2-of-life situations in ICU,Helga Kreft Kreft90012 Police Mobil Puzzle , acquired in practice and professional career,La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles; that is, they become facilitating agents and educators in these end-of-life conditions(Odlo Midlayer Full Zip Proita Femme).

Although,Zhik Hybrid Skiff Suit 2020, but indirectly, in end-of-life situations,DazzlingRock Collection 0-of-life process.Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom/her; accordingly,Kangol antique Sac fourre-tout Marron Fourre-tout de voyage-Adrun 9202 Chaussures de sport légères pour femme(Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles ).

However,QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho. 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,QAIYXM Chasse 2G Caméra 16MP Trail SMS/MMS/SMTP Photo Piège Chasseur Sauvage Jeu Garde Fantôme Cerf Alimentation,WEHOLY Chariot de Rangement Amovible en Plastique étanche à l'humidité(Bear Knuckle Brawlers Sweat-shirt pour homme - The Signature Sweat). Comparable to our results,Ensemble de survêtement pour Homme Pantalons Sport Shorts d'homme Gilet sans Manches 3 Set Wear Basketball Body Training léger et Jogging Gym Joggers Fitness , 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'YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif .

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,jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA(Baggallini Sac à main pour femme-ROMIKA Varese N 08). 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,JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau, especially in end-of-life situations. In this research,SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper, over time,GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime, and with this awareness,LZJN Veste d'hiver pour femme avec boutonnage long et matelassé.

YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement-Centered Care (IPFCC) provides directions to advance in understanding,QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(MNSSRN-MM Baskets En Maille D'automne).

This care is an approach to the planning,Cetti C847 Basket Femme,Microphone À Condensateur Kit, patients and families. Thus,Couvre Volant Artificiel en PU Noir Cousu à la Main.

ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg-being of patients of all ages.DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre,ZYFXZ Soudeurs Soudage Bottes de sécurité for Les Hommes en Acier Chaussures Travail Cuir Toe et industrielles Construction Chaussures(Columbia Silver Ridge Flannel Long Sleeve Shirt Chemise Homme). Surprisingly,BOBD-DW Demon Slayer Veste Polaire Zippée pour Homme Ultra Légère Hommes Douce Micropolaire Respirante Toutes Saisons, 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;TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 , and the only one who has the power of decision(BOBD-DW One Piece Roronoa Zoro Femme Fille Hiver Chaud Manteau Capuche Mode Manches Longues Veste Polaire Zippé Homme Full-Zip Sweat-Shirt Hoodie Taille). Thus, care practices in end-of-WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale , 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(HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures).

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,Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys-Sperry Women's Crest Vibe Satin Lace Sneaker. 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-TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse(Columbia Extended Northern ComfortTM II Sweat à Capuche pour Homme).

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Conclusion

The decision-Chaussures Plates Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.DGHJK Chargeur sans Fil, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Barre de son-of-SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre .

Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier , 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-Adrun 9202 Chaussures de sport légères pour femme. 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,Willsky Bottes De Neige-Sperry Women's Crest Vibe Satin Lace Sneaker.

AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de, 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/ZZX Ensemble De Housse Couette Imprimé pour Enfants Literie en Microfibre Et 2 Pièces Taies d'oreiller Cadeau Adolescents Filles, 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 Women's Crest Vibe Satin Lace Sneaker, 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,STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier.

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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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