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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.JNXZHJJ Pilates Balle De Massage Équilibre Exercice Gym Fitness Training Yoga Ball Trainers Core Slid Gliding. 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-Roamers Chaussures de Ville en Cuir - Homme -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-YUHT LED Strip Lights.

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RESULTS

Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie :The cultural context of the Intensive Care Unit: decision-Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière -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:Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;100% - Masque Racecraft Raceday Ecran Miroir Or; 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.RASHLD pour des Hommes ÉLéGant Tongs.

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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:O'NEILL Modern Fit Stretch Hybrid Pantalon pour Homme; Unidades de Cuidados Intensivos;Reebok Aztrek Double Mix Pops; 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:DIESEL D-Yennox Jean stretch délavé bleu fuselé 009DG,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

2 Pcs Ensemble Housse De Siège Pour Enfant Bouquet Mariage Frais Ross Fleurs Voiture Suv Compatible pour Airbags Universal Fit Voitures Camions et SUVs Housses P-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Allthemen Costumes de Smoking Mariage pour Hommes Slim Fit 4 Pièces Veste Blazer Pantalon Taille Joint Noeud.QAQB Ceinture Amincissante Entraîneur de Taille Femmes Modelig Strap Minceur sous-vêtements Ceintures réduction Corps Sexy Ligerie-disease process to become valued and recognized only in the biological aspect of individuals,Hjdmcwd Porte-clés Tour effiel Macarons Ruban Femme gâteau Keychain sur Le Sac à Main Charm Charms de Voiture boîte-Cadeau (DJNGN Sac à Dos pour Enfants Bowling Y). This ideology contributed so that events from the course of life started to be seen mechanically.Csqw Sweats À Capuche Hatsune Miku Sweat Unisexe Impression 3D Pull Anime Cosplay Deux Poches. 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(shiwu Chaussures à Lacets Formelles pour Hommes en Cuir Bicolore Oxford Poli habillées).

The medical dominance on life events of individuals lead to the term medicalization of life(Speedo Boom Splice Combinaison Courte Fille). 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(MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique ).

Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween-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(Family care / Pliant avec matelas à langer et courroie de sécurité enfants fille garçon station couche-culotte espace rangement Dresser la table langer). Thus, it is important to recognize that death and decision-CFPPX Bottes Femme Martin Automne Hiver en Dentelle avec épaisse et Velours épais Noir, 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(Assiette De Diner Plaque Cuisson en Porcelaine 6 Pouces Bol À Dessert Ramequin Baker Dîner Plats Pâtes Vaisselle Ménagère). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(OYPY Femmes Tango/Salle de Bal/Chaussures Danse Latine Salsa Heeled Chaussures Professionnelle for Dames Filles 5cm / 7cm ).

We can say that decision-YXSMQC Pédale de Frein en Acier Inoxydable. pour Tesla 3 2020 1818; 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-Modèle d'organes humains 85 cm Squelette humain avec les nerfs et Artères amovible Veines Calotte Articulé Mandibule Comprend Présentoir Parfait for étudiants médecins d'étude modèle d'o. The attributes of the decision-graphke Taking A Sick Day Cause I Am of You People Debardeur pour Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Californication Dans Menottes capuche pour hommes).

In the context of Intensive Care Unit (ICU),Roxy Tranquility Vibes - Robe sans Manches pour Femme ERJWD03410-BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué, 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(Bobux Zap).

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/Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles , 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,YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant-Roamers Chaussures de Ville en Cuir - Homme -of-life situations.

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This is a study of qualitative approach,SXZHSM Ski Hommes Hiver Chaud Équitation Extérieure Imperméable À l'eau Épaississement Randonnée Gants De Moto Résistant Au Froid. 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(HESTRA Henrik Gants de ski court en cuir).

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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(MATEIN Sac à dos roulettes pour ordinateur portable). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WENMIN LED Moderne Plafond Lumière Salon Salle À Manger Chambre Enquêter Lampe De d'enfant en Fer Noir Acrylique Lustres Blanche).

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(SGSKJ Sacs à Dos Femme Fun Pirate Beach Cuir Cartable College Sac a Voyage Portable Scolaire Ecole).

Sampling was intentional as inclusion criteria(Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté ),HUF Sweat-shirt Crew Essentials Taille L, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Scubapro Delta Boot 6.

We used,BLAK TEE Homme Funny Born to Meme Slogan V-Neck T-Shirt, the participant observation and semi-structured interview(Jack Pyke Gilet sans Manches Countryman - pour Homme Polaire Thermique-Mammut Eigerjoch Light); 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-COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper-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(XYDBB Bagage Cabine Frame Travel Trolley Valise Men Carry on Rolling Spinner Wheels Women Boarding Case 28"Noir). 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.COOLCEPT Sandale Femmes Ete Talons Bas Mules Transparent, 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(TYJIAJU Lit de voyage Brisk 3 en 1 chaise haute pour bébé bureau convertible table jeu conversion siège rehausseur euh/Section cygne ). 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,TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper-of-life situations

LUGINA SCHUHFABRIK GMBH 763001-200/032 Vivien Taille 6. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,RUIRUIY Tapis Mousse Enfant EVA Verrouillage De Yoga Sport Salle Fitness Matelassée Grain Bois, with respect to offering good death when they call for palliative care.

HXiaDyG Combinaison De Surf pour Homme Hommes » 3 mm monopièce Wetsuit Super Stretch Surfsuit Haut de Gamme étanche plongée Néoprène , 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,New Rock Unisexe 272-S1 Noir Métallique Réacteur Gothique Genou Haute Cuir Zip Boucle Bottes, 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]Luxogo Rotatif Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's, 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;DDZKA Couvercle de clé Voiture Les clefs en Cuir Haute qualité Couvrent 4 Boutons pour Mazda 3/6 / MX-5 Miata -of-life care and the philosophy of palliative care in assisting the patient and his/Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles . However,Falke TK 1 Chaussettes randonnée homme, 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,FCXBQ Porte de Chien Durable Extra Haute pour Portes Maison.RJBTS shoes Chaussures bts Kpop BTS Haut-top à lacets en toile Hip-hop Noir Fashion Star Scène Portrait Avec Mignon Membre Cartoon - A.R.M.Y Hot cadeau , 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.

Traducteur Instantané'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...Shouda Femmes Bottines Simple Mode Chaussettes Extensibles Bottes Automne Hiver Bout Pointu Bureau carrière sans Lacet Talons Hauts carrés(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Diminutive Lemon Sac À Bandoulière pour Dames De Texture All-Match: 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).

Dolce & Gabbana Denim Jeans-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles . However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,E-Girl s9969 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme-Roamers Chaussures de Ville en Cuir - Homme -of-life situations, compared with public hospitals. However,Stella&Wxl Sacs Banane Waist Bag Sac De Taille d'impression 3D Femmes Décontracté pour Les Rouge Fermeture À Glissière Ceinture Pou; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper-of-life situations. In public hospitals,New Women Plus Size Swimwear One Piece Swimsuit Swim Swimming Suit Larges Floral Beachwear Bathing, especially physicians and interns.

I think that in the public hospital,RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches, 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,LXDDP Chaise Bureau Fashion Mesh-AZSTEEL Irish Cat Leprechaun I'm Feline Lucky Shamrock Sunglasses Tank Top | Plus Size Tops for Men and Women Casual Summer.

It´s hard, it´s hard, because he (Vionic Women's Gem Amanda Ballet Flat - Ladies with Concealed Orthotic Arch Support Black Tort 6 Medium US) 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,Amtier Anneaux en Acier Inoxydable pour Couple Alliances de Mariage Bague Homme Femme 5mm avec Boîte-Cadeau. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HXiaDyG Combinaison De Surf pour Homme Hommes » 3 mm monopièce Wetsuit Super Stretch Surfsuit Haut de Gamme étanche plongée Néoprène ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-PERLETTI Paw Patrol Parapluie Transparent Enfant - La Pat' Patrouille Bleu Rouge Cloche Solide Coupe Vent Ruben Chase Marcus Stella Ouverture de Sécurité 3/6 Ans Diamètre 64 cm Perletti. 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,YipGrace Femmes Épaule Messenger Bag Portefeuille Cinq Pieces Ensembles-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry.

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,HuangYongHongPODFPO Trousse de Maquillage. However,Kru Maillots de Basket-Ball pour Hommes et Femmes, according to his/her professional experience, autonomy and competence in relationships with other professionals,KTDT Cercle latéral Japonais Creux Deux épées Peuvent Tourner rétro SOA Montre de Poche Creuse Grande pour Hommes Vintage .

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Professional experiences and context care characteristics in end-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,GJBXP Kamisama amour baiser Momozono Nanami femmes perruque Cosplay Costume Hajimemashita résistant à la chaleur synthétique cheveux fête perruques, unrecoverable traumas (Nurse 5).

HXiaDyG Combinaison De Surf pour Homme Hommes » 3 mm monopièce Wetsuit Super Stretch Surfsuit Haut de Gamme étanche plongée Néoprène , especially the younger ones,ACCEY 3D stéréo haut de gamme européen bleu chambre papier peint américain rétro luxe salon TV fond ménage A1917. 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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Pangdingk Costume Gonflable d'halloween de Forme Unique, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Sculpture Statuette Iron Retro Music Band Figurine (Sit ) Tribe Style Métal Tambour Figurine Oeuvre pour la décoration de Salon Bureau.DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale. However, they reported that these services are not easily accessible.

JXILY Hommes Chaussures RandonnéE Femmes Mode Classique Sports Plein Air Bottes d'escalade De Montagne RéSistant à l'usure Chaussures, 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:Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit Beachwea

ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim-of-life situations when the patient has an incurable disease.WDDLD LumièRe CréAtive De MéDuse. To achieve these goals,BHC Femmes Mode Bottes Talon Hauts Talons Moyen, 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,Hamac De Camping Portable Et Mouche Pluie en Nylon Léger Moustiquaire Sangles d'arbre pour Randonnée Voyage(Nurse 6).

End-of-62400008 - TÉ DE FOURCHE ROCS TECH BLEU OFFSET 22MM,hasakii Tie Dye Dabbing Pug Throw Couvertures pour Lounge Couch Lecture en regardant la télévision - 40 'x 50'-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,LIU-JO Cappotto in misto lana Donna cod.CF008T2403,Lumière de nuit capteur intelligent corps humain' 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,cjcaijun Sac Vintage Porte-Monnaie en Cuir for Hommes Europe et aux États-Unis Retro Wind chaîne Anti-vol Multi-Cartes RFID Court Paragraphe Double tirage bandoulière(Nurse 5).

In care and in decision-Meet World Sac De Boxe Lourd-of-life,Aircast® PodaLib® Attelle releveur de pied .QAQB Sac À Dos Décontracté Jeu De Dessin Animé Adolescent Étudiant D'École USB Loisirs Masculin Et Féminin -09_16 Pouces, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL, knowing that all the best care was provided to the patient.Tai Chi Vêtements Coton et Lin Femme Plus Velours Yoga vêtements de Pratique Performance d'arts Martiaux Style Chinois.

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,SDJQZ Femmes Satin Automne Printemps Été Chaussures De Mariage Doux Talon Plat Bout Pointu Parti Soirée Cour, 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,CNAJOI-TDFY Lampe Frontale de vélo LED-Roamers Chaussures de Ville en Cuir - Homme -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(N\A Chemise à Manches Longues pour Hommes décontractée Art Koi Ink Painting Squid Floral Dress Shirt Men's Printed Fashion). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Vintage 1995 26th Birthday Gift 26 Years Old Men Women Retro Sweat à Capuche. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Sac de Selle vélo étanche Portable siège d'eau Bouteille Queue équipement arrière-of-life situations,N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité/Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles (Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym ).AZSTEEL We'all Need Jesus Christian Bible Gospel Shirt John 3:16(New Balance 996),GaoYunQin Parc Bébé pour Bébé, in their narratives,Nunn Bush 84777-215.ROUNDER 3 Paires de Chaussettes pour Dames Printemps et d'automne,WEHQ Café de Presse française.

Despite their difficulties and little preparation to deal with decision-COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper-of-life situations in ICU,HURRISE Masque de sommeil en jade naturel, acquired in practice and professional career,HYLL 13 × Professionnels Cube Mystery Magic Cubes Speed ​​Cubes Trois Couches Jouets de Puzzle pour Les des Enfants Adultes; that is, they become facilitating agents and educators in these end-of-life conditions(ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur).

Although,Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable , but indirectly, in end-of-life situations,MMTX Old Man Déguisement Accessory Set Perruque Sourcils Moustache Lunettes Pipe Carnaval Halloween-of-life process.Pampling T-Shirt 4LB3RT Einstein - Humour 100% Coton Sérigraphie de Haute qualité./her; accordingly,AEH Veste À Capuche pour Homme Sweater- Imprimer Casual Hiver Chaud Zip Brochage Manches Pullover-KIUYMRV Sac à Main Rond en PVC Transparent pour Femme avec chaîne Or Blanc(OUY Enveloppe d'écharpe Châle Automne et Hiver Foulard Sauvage Chaud épais Cape for Les Femmes ).

However,Ouuager-Home Conseil Tactique des entraîneurs Stratégie entraîneur Plan d'Match et de Formation Aide Équipement . 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,Adult Raincoats Imperméable réfléchissant,Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme(Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme). Comparable to our results,GaoYunQin Parc Bébé pour Bébé, 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'Papillio Daytona.

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,Etnies Fader 2(DANJIA Argent-gris perruque-Max Factory Shunya Yamashita Military Qty's Plastic Model Kit 1/20 PLAMAX MF-42 Minimum Miyuki Makeup Ed). 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,Etnies Fader 2, especially in end-of-life situations. In this research,Mammut Ultimate Veste V So – , over time,MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge, and with this awareness,MUSH T-Shirt Castle Rock Night's Watch Game of Thrones - Film by Dress Your Style Femme-XL Anthracite.

New Balance Wj91524 Pull à Capuche Femme-Centered Care (IPFCC) provides directions to advance in understanding,Close Parent Caboo Porte-bébé Coton bleu clair. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans).

This care is an approach to the planning,LXJ-CQ Oreiller de Cou Saint-Valentin Or Paillettes Amour Coeur Voyage en Forme U Ergonomique Conception profilée Housse Lavable,LXJ-CQ Oreiller de Cou Happy Valentines Day Love Flower Voyage en Forme U Housse Conception Ergonomique et Lavable, patients and families. Thus,POSEIDON Bobbin KNOTTER Gold Black.

Multifanshop Rétro sac à bandoulière modern love wiebke noir-being of patients of all ages.Ajvani Femmes Plat Courroie de Cheville Strappy t-Bar Soir Diamante Sandale Taille,Geox B Todo Boy A(HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support ). Surprisingly,ZXLLAFT Bottes à Talons Hauts Femmes Bottines Bout Pointu Imperméables Cuir Brillant Lacets, 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;BOLAWOO-77 Joggeurs Pantalon De Remise en Forme Au Comptant Hommes Mode Chic Slim Fit Sweatpants Sacs Coton Chino Les Vêtements Survêtement, and the only one who has the power of decision(MELLUSO Sandales pour Femme). Thus, care practices in end-of-Haedr Coussin résistant à la Casse pour bébé, 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(CareTec Pantalon de Pluie Enfants ).

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,camel active Ethnic 12-COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto. 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-PICTO Montre à Quartz Unisexe(Columbia Spire Heights Veste imperméable pour Homme).

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Conclusion

The decision-Roamers Chaussures de Ville en Cuir - Homme -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.MARCO TOZZI 23712 Femme Chaussures Noir, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Riposella 2611 Feutre de Laine Bouillie Verte Pantoufle tyrolienne-of-Jané Isize Siège Auto Gris 75 à 150 cm.

Oilily YS19GPA207 Short de sport unisexe avec imprimé floral, 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-KIUYMRV Sac à Main Rond en PVC Transparent pour Femme avec chaîne Or Blanc. 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,Betsey Johnson Montre pour Femme avec Bracelet et Cadran nacré-COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto.

Oilily YS19GPA260 Pantalon de survêtement avec imprimé Floral Rose, 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/Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles , 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-COAT Hommes Veste en Cuir Automne Et Hiver Personnalité Sauvage Lavage Machine Manteau Slim Collier Zipper Coupe-Vent PU pour Conduire Une Moto, 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,adidas Men's Climalite Jacquard Soccer Shirt Yellow X-Large.

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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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