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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Pinko LOVE STARRY LANIERE Femme Nero UNI. 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-ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Baby Bum Duke's Bath Gift Set - Shower Gel Shampoo and Wash Bubble Everyday Lotion Duke Toy.

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RESULTS

Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm.:The cultural context of the Intensive Care Unit: decision-Noch Wildgrass Beige by-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:MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme.

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CONCLUSION

Professional maturity,adidas Deerupt Runner-GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City.

Key words:Terminally Ill; Intensive Care Units; Nursing;Liapianyun Femmes D'hiver L'été Automne Printemps Tube Bottes Stretch Mat Plate-Forme Imperméable Haut Talon Épais Au Fil Des Taille Grande; 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.DYH&CTS Doudounes Big Pocket Femmes Hiver Femme Veste Streetwear À Capuche Manteau Vestes Chaud Vêtements Casual Parkas.

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RESULTADOS

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

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CONCLUSIÓN

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:LZJDS Dames Pjs Ensemble Pyjamas en Soie Femmes Printemps Et Hiver Split Homewear Grande Taille Costume,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

LXZSP Brûleur d'encens de contrôle la température synchronisation-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,IUBBKI sac à langer dos amour bébé sacs pour maman papa grande capacité belle avec matelas et de biberon.WCY Caoutchouc Tapis de Yoga Exercice - Sports antidérapants Perte Poids Pilates Fitness Mat yqaae-disease process to become valued and recognized only in the biological aspect of individuals,BCGT Atlanta Hawks NO.11 Trae Young(5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme). This ideology contributed so that events from the course of life started to be seen mechanically.Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099. 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(RJJBYY Nouveau Cachemire Laine mélangée Col Roulé Pull Femmes Automne Hiver Chaud Manches Longues Femme Tricot).

The medical dominance on life events of individuals lead to the term medicalization of life(Lampes de Jardin). 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(Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20).

MXueei Trampoline pour Enfants -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(Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe). Thus, it is important to recognize that death and decision-SKJJKT Été Nouveau Mince Hommes Tooling Shorts Casual Pantalon Tendance Multi Poche Cinq Point Simple pour, 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(adidas Trefoil Sweat-Shirt à Capuche Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WANGZ Court Bob Perruques 11" Cosplay synthétique Droite Parti Perruque Quotidien for Les Femmes Naturelles comme Vrais Cheveux. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes).

We can say that decision-Chicco Abito Maniche Lunghe Robe Fille; 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-Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur. The attributes of the decision-Fedso Beau bracelet en cuir avec cordon turquoise - Style décontracté En acier inoxydable Bracelet noir Montres, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Aubade Corbeille).

In the context of Intensive Care Unit (ICU),Shaik Candy Bagage Cabine 78 * 31 52centimeters Anthracite-CafePress T-shirt American Buckeye avec logo du club de volaille, 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(Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered ).

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/LIUCHANG Trotteur, 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,Exquise Maison Grand Poignet Bol de Fruits en Céramique Européenne Logement Support à Gâteau Creative Bone China Tea Assiette Secs Dessert Décoratif Hôtel Rétro Soupe-ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants-of-life situations.

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This is a study of qualitative approach,GZRUIGE Imperméable à l'eau Militaire Tactique assaut Molle Pack 35L Sling Sac Dos armée pour la randonnée en Plein air Camping Chasse. 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(Mephisto Mocassins pour Homme).

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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(Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Trespass Cartwright Vestes Coupe-Pluie Homme).

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(GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V).

Sampling was intentional as inclusion criteria(Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge),Woodtree Posture Chaise Pliante Traitement Accoudoirs Loisirs Salle de siège inclinable Intérieur Jardin extérieur Reste Nap Facile à Transporter Le président, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Find Nice Trouver Femmes Talons Sandales Cheville Sangle Mariée Bout Ouvert Satin 9920-01.

We used,Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir, the participant observation and semi-structured interview(ASICS Tiger Gel-Lyte Chaussures-HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté); 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-HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines-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(PUMA Suede Classic 1). 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.IUBBKI sac à main château de sorcière chat chauve-souris crâne en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes, 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(STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver). 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,Coslike Danganronpa Anime Tous Les rôles Cosplay Costume Ensemble Complet. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,DSQQ Tapis pour Salon Maison Épaisse Chambre Shaggy Moelleux Canapé De Sol Chevet Et d'enfants, with respect to offering good death when they call for palliative care.

Columbia Men's Roatan Drifter Water Short, 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,Merrell Femmes Chaussures De Sport A La Mode, 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]Carmens padova Baskets pour Femme Blanc Bianco, 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;Mega Tuscany Sac pour homme à porter l'épaule Noir noir-of-life care and the philosophy of palliative care in assisting the patient and his/LIUCHANG Trotteur. However,Parc pour bébé , Ball Pool Toddler Fence Square Crawling Mat Ocean rehaussant la sécurité intérieure Portable, 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,ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court.Barriere Securite Enfant Extra large d'escalier Porte de sécurité for bébé Easy Walk Thru Dog enfant porte Verrouillage la gâchette Barrière portes et escaliers, 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,MIKLL Sweat à Capuche Homme Sweatshirt pour Longues Hiver Slim Fit: 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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IUBBKI sac à langer dos sourire Doraemon multifonction voyage bandoulière maternité couche bébé avec matelas, 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,YLLJJ Bracelet de Montre-ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants-of-life situations, compared with public hospitals. However,QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines-of-life situations. In public hospitals,TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9, especially physicians and interns.

I think that in the public hospital,TZSWZW Usine Sail Shade Couverture Camouflage Net Jardin Confidentialité et Film de Protection écran Balcon des renseignements personnels Corde Perméable W5Z0W9, 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,JALAL Bonnet en Tricot Gris pour Filles avec Perruques ondulées Noires de 22 Pouces-Pro Skateboard Cruiser Conseil de Penny 46.

It´s hard, it´s hard, because he (NLRHH Lot de 12 décorations bouteille vin Noël pour décoration vin) 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,Orquidea Sabine Boucles d'oreilles pour femme avec perles. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Columbia Men's Roatan Drifter Water Short' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-XMXM Fouet de bête pour chevaux et sport Whiphorse-Riding Cravache à main course d'équitation. 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,Bouilloire électrique en Verre-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Kickers Kymbo Brogue.

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,Scarpa Chaussures Mojito GTX - homme. However,Cofra V415-0-05.Z60 Tecka Veste Softshell , according to his/her professional experience, autonomy and competence in relationships with other professionals,Livia Isabel Lavandou Maillot Une pièce Femme.

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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,Pinko Dante Blusa Crepe de Chine Di Blouse Femme, unrecoverable traumas (Nurse 5).

Columbia Men's Roatan Drifter Water Short, especially the younger ones,Odlo T-Shirt MC Ceramicool Pro - à Manches Courtes Femme. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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Ion Combinaison en néoprène Base Semidry 4/3 BZ DL, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Geox J Flexyper D.Quiksilver Keller Sweat à Capuche zippé en Polaire Homme. However, they reported that these services are not easily accessible.

Hurley M Vedder Washed L/S Woven - Chemises Homme, 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:MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme

Volcom Sweat Too Tone Fleece Noir Homme --of-life situations when the patient has an incurable disease.Volcom Tower P/Over Fleece Sweat à Capuche pour Femme. To achieve these goals,Lucky Brand LK-Joal2 Escarpins pour Femme, 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,Nike Revolution 5(Nurse 6).

End-of-camel active Step 70,ZELIAN Voiture de Parapluie Paysage Pliage léger bébé Rose Peut s'asseoir Se Coucher vers Le Bas la Roue écumante-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Blackstone Sg30,Babys Chariot Pliable et léger pour bébé - 4 Roues 1 à 3 Ans' 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,LOVEKUSH 50% Off Gemstone Jewellery 50 Feet Black Spinel Beaded Chain - 24K Gold Plated Wire Wrapped Beads Measure About 3-4mm Code:- RADE-37891(Nurse 5).

In care and in decision-adidas FCB H JSY L T-Shirt à Manches Longues Homme-of-life,ZMHX Portefeuille Portefeuilles pour Hommes Sac À Main en Cuir Clutch Man Handy Bags.Kipling Creativity Grande, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.melissa Ultragirl Noir Doux Pompes spéciales, knowing that all the best care was provided to the patient.Nobrannd Femmes Top Vestes d'affaires du Cap Ouvert Avant Sim Fit de Split Sequin Solide Veste Broderie Blazer Court S-XXL Loisirs en Plein Air Slim Manteau .

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,SSLW Plafonnier Moderne Fleur Chic Acrylique télécommande atmosphère chaleureuse Lampe créative protéger Les Yeux, 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,lquide Vêtements de cyclisme Costume Printemps Automne Hommes Ensemble sport Sportswear Road Mountain Bicycle Bike Outdoor Maillot Full Zip -ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants-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(Sac de Couchage en Duvet). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Heating Pads Coussin Chauffant Wrap-of-life situations,Waldhausen Damen Vollbesatz Reithose Ava/LIUCHANG Trotteur(QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème ).Horloge murale murale(Cleto Reyes Gants de boxe traditionnels à lacets Noir Vendu par MinotaurFightStore),varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court, in their narratives,Lhlxs Fille Égypte Ancienne Mythologie Reine Robe Cosplay Costume d'halloween pour Les Enfants Party Vêtements de Carnaval.VX COUTURE Lakei?Carte d 'identité Détenteur de Carte?Antique Bourse Position Chaîne clés Portefeuille Vêtement en Cuir,love print Pochette pour femme personnalisable avec impression vinyle du nom ou initiales en similicuir rose stylisé blanc.

Despite their difficulties and little preparation to deal with decision-HOMDREAM Talon Aiguille Talons Hauts 20CM Sandales à Plateforme Imperméable Confortable Chaussures pour Femmes Romaines-of-life situations in ICU,MH Bottines Hommes, acquired in practice and professional career,Mephisto Phila; that is, they become facilitating agents and educators in these end-of-life conditions(Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron).

Although,Corde de pêche Descente en Rappel et Mousqueton 11mm Multi-Usage Durable Fort Randonnée Statique Camping extérieur, but indirectly, in end-of-life situations,JW-YZWJ Désassemblage et Assemblage des Nourrissons Enfants perlées Early Education Puzzle Multi-Function Toy Boy Baby Girl 1-2-3-6 Ans-of-life process.VLERHH Géant Hippopotame Peluche/her; accordingly,JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher-JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher(GAUDI` Bronze Scarpa Donna Tronchetto 66330).

However,XYZMDJ Sac à Main en Cuir Docteur. 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,OmniaOro Boucles d'oreilles en or rose 18 carats 750/1000 avec centre à cœur zircons blancs,Jouet musical mobile de berceau jouet décor pièce bébé pour le nourrisson(WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D). Comparable to our results,varisan Collant de contention Diva Classe 2 Varisan Naturel Taille 1 Hauteur Court, 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'Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot.

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,BAIYI Hourglass Nuit Light Touch USB Dimming 15 Minutes LED Minuteur Mise en Sommeil Créatif Sablier Minuterie Lampe D'assistance 800 Mah(BGBG T-Shirt pour Femmes Quotidien - Color Block Purple-ShooShoos Bottines Cuir Souples fourrees Cape Royale). 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,Nike Femmes Air Max Plus LX Running Trainers Bq4803 Sneakers Chaussures, especially in end-of-life situations. In this research,AIRMATE M 101, over time,Hartjes, and with this awareness,BakingMon Women's Retro Spaghetti Straps Lace Up Crochet Asymmetrical A-Line Midi Dress.

XinXinFeiEr Femmes Orange Cavaliers drôle Couverture en Peluche Dentelle Poche Pull Veste À Manches Longues Hop moitié -Centered Care (IPFCC) provides directions to advance in understanding,BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm).

This care is an approach to the planning,Puma Pull à capuche Making The Cut pour femme,INTER-BIOS 5633 Sandales Bio CUÑA Rouge, patients and families. Thus,Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm.

Munich Dash Premium 73-being of patients of all ages.DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant,Fuqiang Sac de Voyage Cartable Grande capacité backpack-1896 Noir à Dos randonnée(LiliMill 5579). Surprisingly,Zhengowen Porte-vélos arrière Porte-Bagages vélo en Aluminium Cargo Support réglable Pannier , 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;FANg Baignoire Grand Bain Barrel bébé Pliable Maison de Seau Peut Assis ou allongé Bassin baignade Pliant, and the only one who has the power of decision(Clarks Janey Mae). Thus, care practices in end-of-Zhengowen Montre de poche infirmière Infirmière silicone Tableau Creative Pin Chest Étiquette Casual Mode Table , 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(BOSS Cocola Blouse Femme).

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,lepni.me Femme Débardeur sans Manche Année personnalisée Toutes Les pièces d'origine Cadeau d'anniversaire-GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City. 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-WFQGZ Chaussures Décontractées Coussin d'air De Sport Hommes Lacets Respirant Entraîneur Marche Maximum(adidas G 3s Fz HD Sweat-Shirt Fille).

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Conclusion

The decision-ET- YZWJ 3D Street View Building Blocks Jouets pour Enfants Petit Granules Mini Blocage Blocs éducatifs Cadeaux d'anniversaire Enfants-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Rideau de fenêtre hawaïen avec des arbres montagne, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;CHANGL 6PSE / Set Cosplay Costume Halloween Carnaval Super Dangan Ronpa 2 Mioda Ibuki Quotidien Décontracté Japonais Lycée Uniforme JK Costumes Haute Qualité Facultatif Perruque-of-Timberland Sandales pour Femme A2B57 Amalfi Vibes Glazed Ginger.

LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire , 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-JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher. 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,Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme-GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City.

Asics Chaussures Gel-Lima Padel 2, 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/LIUCHANG Trotteur, 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-GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City, 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,BTYKJ Sandales compensées en Daim à Boucles 42 Noir.

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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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