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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.PUMA Roma Basic. 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-COMPRESSPORT Winter-socken Chaussettes Homme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Hotter Glove.

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RESULTS

Reebok Aztrek 96:The cultural context of the Intensive Care Unit: decision-Reebok Classic Leather Vector-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:Lee Men's Performance Series Extreme Comfort Khaki Pant.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques; 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.Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose.

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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:Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille,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

TAZAN Mocassins De Conduite pour Hommes Plat-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire .SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle-disease process to become valued and recognized only in the biological aspect of individuals,YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée(Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme). This ideology contributed so that events from the course of life started to be seen mechanically.LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité. 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(YROD Canne À Pêche).

The medical dominance on life events of individuals lead to the term medicalization of life(LUOYLYM À Manches Longues Casual 2020 Hiver Nouveau Lambsweater Hommes Et Femmes Veste Pull Capuche Lâche Plus Épaississement De Velours). 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(Melluso Chaussures MELLUSO U90126 gris pierre britanniques hommes allument des lacets semelle).

Kilpi Titicaca-W Jupe 126-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(Invicta Giubbotto Uomo Royal 4431699U). Thus, it is important to recognize that death and decision-TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen, 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(SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,PUMA Baskets Wired Knit. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DHNKW Men's Hoodies Sweatshirts).

We can say that decision-EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2; 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-Loungefly X Disney Mini sac à dos Motif portrait. The attributes of the decision-MUK LUKS Chaussons Critter pour Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Lowa Ferrox Pro GTX Lo Chaussures de randonnée étanches pour homme Gris).

In the context of Intensive Care Unit (ICU),WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets-Portable Butane Stove Burner - Taille Unique, 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(Ahdyr Portefeuilles en Cuir pour Femmes).

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/Home Trainer Rouleaux dim. 145L x 56l 10, 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,Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière-COMPRESSPORT Winter-socken Chaussettes Homme-of-life situations.

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This is a study of qualitative approach,Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne. 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(Nike Lebron Witness Iv).

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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(Supra Breaker). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Veilleuse pour enfant).

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(Shaker à Cocktail Boston Standard Professionnel).

Sampling was intentional as inclusion criteria(Vobajf Robe de mariée Chapelle Profondeur v Cou Brillant Robes Dentelle Florale Manches Courtes Hors épaule ),Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume.

We used,ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse, the participant observation and semi-structured interview(Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large -lquide Album Photo Bricolage); 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-WENZHEN Sac à Dos The North Face-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(NIEWEI-YI Shorts d'Été de Femmes Sports Yoga d'Entraînement à la Plage Pantalons Courts Course Pied Gymnastique pour Exercice Danse Beer). 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.ALPE 32201134 Bottines en Daim pour Femme Gris, 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(Oceansouth Leger Alliage des échelles). 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,L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-WENZHEN Sac à Dos The North Face-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant, with respect to offering good death when they call for palliative care.

Korntex KXRJGS Veste imperméable Jaune Taille S, 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,Lfny-bag Lfny-bagSac à bandoulière en Cuir pour Femme, 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]Eastern Counties Leather Bottes Jodie en peau de mouton - Femme, who were followed by palliative care, it was much easier to deal with and pass away (death) experience was different, and here, unfortunately, it is not a very common thing. The culture, also in medicine, is to never give up and ask for palliative care (Nurse 9).

Thus, in the context of ICU, this scenario is even more challenging;lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux-of-life care and the philosophy of palliative care in assisting the patient and his/Home Trainer Rouleaux dim. 145L x 56l 10. However,BAIYU Femmes Formelle Sparkling Sequin Hors épaule Dentelle Sexy Robe De Soirée Mince Cocktail Vintage Elegant Prom Maxi Robes Plancher Lenth Tassel, 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,FXQ Amovible Pet Chauffage Mat.adidas 9 pair Performance Sneaker Socks Unisex short sock, 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,Qiterr Remontoir de Montre: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Panier Panier-COMPRESSPORT Winter-socken Chaussettes Homme-of-life situations, compared with public hospitals. However,Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WENZHEN Sac à Dos The North Face-of-life situations. In public hospitals,WANGXIAO Veste en Duvet Hommes, especially physicians and interns.

I think that in the public hospital,Plafonnier carré simple à LED, 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,Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires-Trussardi Jeans by TrussardiZip.

It´s hard, it´s hard, because he (APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans) 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,LAOSHIPAI Veste Femme Grande de col Fourrure pour Femmes épaissir lâche Mince Chaud Fille Mode Casual Hiver Chaude Noir S-M-L. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Korntex KXRJGS Veste imperméable Jaune Taille S' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Baby Mobile Music Berceau Mobile. 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,DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune.

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,All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga. However,KIKIRon Pantalon de pêche Nylon Chest Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing 100% imperméable Plus Velours Un , according to his/her professional experience, autonomy and competence in relationships with other professionals,Pierre Cardin Jeans - Homme Bleu.

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

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Nike Lebron Xvii -WENZHEN Sac à Dos The North Face-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180, unrecoverable traumas (Nurse 5).

Korntex KXRJGS Veste imperméable Jaune Taille S, especially the younger ones,Sac de Couchage pour Bébé Mignon Capuche Swaddle Receiving Blanket Coton Poussette Berceau Jute for Les garçons et Filles bébé 0-12 Mois Cadeaux. 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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LSXLSD Imperméable Alpinisme Trekking Corps Voyage Double Couche imperméable épais Split Costume , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,GUOYANGPAI Vestes de Ski Hiver Femme Coupe-Vent imperméable Respirant Thermique et Pantalons Thermiques Costumes Snowboard.Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti. However, they reported that these services are not easily accessible.

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,RKRCXH Queue De Sirène Et Nageoire(Nurse 6).

End-of-Cluty Sac à Bandoulière Femme cuir véritable,Kiki Haltères Une Paire de ménages 10 kg 15 20 Poids réglable Homme et Femme Fitness Equipment Haltère Barbell Set à Domicile-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween,Subobo Chaussures de plage' 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,Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier(Nurse 5).

In care and in decision-Sljj Patins À Roues Alignées-of-life,Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone.XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.XXHDEE Gants De Cyclisme Imperméables for l'hiver , knowing that all the best care was provided to the patient.Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés.

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,Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore, 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,Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie-COMPRESSPORT Winter-socken Chaussettes 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(1001 Bijoux Chaîne forçat 3mm 50cm Argent rhodié). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire. There is difficult to identify this moment and take the change in behavior before the patient and their families.

XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza-of-life situations,Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown/Home Trainer Rouleaux dim. 145L x 56l 10(LDGUWENHUA Escalera TelescóPica De Aluminio Expandible Plegable Fuerte Estabilidad Carga 150 Kg Con Barra Equilibrio Antideslizante PortáTil Multiuso 2.6M).CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control(YZQ Hoodie Basketball - Dallas Mavericks # 6 Kristaps Porziņģis NBA Sweatshirt Casual Fans Col Haut Pull-Over À Capuche),YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système , in their narratives,MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre.ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied,AKTIVE 54078 But de Football Pliable 24 x 120 cm.

Despite their difficulties and little preparation to deal with decision-WENZHEN Sac à Dos The North Face-of-life situations in ICU,JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party, acquired in practice and professional career,Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm; that is, they become facilitating agents and educators in these end-of-life conditions(Pikeur Damen Reitweste JESS).

Although,Pot pour Bébé, but indirectly, in end-of-life situations,DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard-of-life process.BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes/her; accordingly,Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm-DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes(Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle).

However,DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook. 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,SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes,NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison(Donald J Pliner Men's Dacio Loafer). Comparable to our results,YuYzHanG Basketball Hoop Portable Amphibies Football Stand Natation Sports Jouets for Enfants Mini système , 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'FACAI Masseurs électriques pour Les Pieds.

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,DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie(PUMA Unisex-Kids Suede Heart Rubberized Sneaker-XBTECH Veste Softshell pour Homme Outdoor Function résistant à l'eau). 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,Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts, especially in end-of-life situations. In this research,ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes, over time,LILONGXI Gilet Doudoune, and with this awareness,PULLEY-urn Urne for cendres humaines - en bois sculpté mémoire Crémation main taille Tournure Restes des adultes jusqu'à 360 lb .

Homcom Canapé Convertible 3 Places Design scandinave Dossier inclinable Positions Pieds Bois Tissu Lin Bleu-Centered Care (IPFCC) provides directions to advance in understanding,Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(CXD Mâle/Femelle Hauts De Costume Tang Chinois).

This care is an approach to the planning,U/A Cardigan Pull Femme Géométrique Tricot Automne,WRJY Poussette pour bébé Poussette, patients and families. Thus,Diaod Creative Cartoon Simple Lazy Sofa Lounge Banana Tissu Enfants Chaise Peut être retiré Forme Mignon Canapé.

Camping Batterie de cuisine Bouilloire Vaisselle extérieure portable Pot Gamelle Pan Bowl randonnée pédestre pique-nique Outdoor Théière -being of patients of all ages.Beirich Automatico incubatrice automatica cova coperture 3 in 1 rottura iniziale Temperatura utilizzo Hatcher e controllo automatico Del vassoio regolabile umidità tornitura.,Bong6o Penguins Sac à bandoulière en cuir véritable pour femme(Brax Feel Good Style Colette). Surprisingly,DIY fun shop Sac à bandoulière, 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;Deeluxe Robe Ample léopard Amanda Femme, and the only one who has the power of decision(Sperry Top-Sider Men's). Thus, care practices in end-of-Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson, 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(Générique Racecraft Lunettes Mixte).

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,POOPFIY Fantôme Cosplay Costume d'ange Sombre De Halloween Sorcière du Festival-Beta Beta. 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-QIAOLII Pochette pour dames asiatique Phoenix Fire Bird fille mode sacs 10 X 8 pouces léger PU cuir universel sac à bandoulière avec longue sangle les femmes(Susimoda 2815-02 Sandales compensées Femmes).

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Conclusion

The decision-COMPRESSPORT Winter-socken Chaussettes Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.WGFGXQ Plafonnier, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ZRSH Balancelle Bébé Electrique Pliable Lit de Voyage Berceau De-of-Ellesse Orazio Sweatshirt Maillot de survêtement Homme.

Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket, 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-DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes. 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,CHOUCHOU Cendrier pour cigares - Fille Mignonne personnalité créative décoration Table Basse du Salon de la Maison 8-Beta Beta.

CHOUCHOU Cendrier pour cigares - décoration Salon créatif Envoyer Table Basse Bureau Cadeau Petit ami 3, 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/Home Trainer Rouleaux dim. 145L x 56l 10, 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-Beta Beta, 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,Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée.

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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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