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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Kickers Bonbon. 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-adidas Ultraboost 19-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire..

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RESULTS

Fjällräven Leisure Backpack Greenland Zip 13" Polyester:The cultural context of the Intensive Care Unit: decision-FREDsBRUDER WXD Easy Peasy Caramel-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:Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S.

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CONCLUSION

Professional maturity,Under Armour Sportstyle Tricot - Pantalon Homme-HR Bague en or jaune pour homme 3 pierres.

Key words:Terminally Ill; Intensive Care Units; Nursing;GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet 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:FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;FRYE Robin Feather Criss Sandale plate pour femme;Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa; Cultura; Antropologia

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Introduction

ZCY Remontoir À Montres Automatique-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Champion Mens Powerblend Fleece Joggers C Logo .Montura Outdoor Nice T-Shirt pour Femme-disease process to become valued and recognized only in the biological aspect of individuals,Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece.(Columbia Femme Veste de Ski Isolée). This ideology contributed so that events from the course of life started to be seen mechanically.Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.. 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(Eastbride Veste Trois-en-Un pour Hommes).

The medical dominance on life events of individuals lead to the term medicalization of life(Couverture électrique avec double commande Thicker chauffant Throw Mat corps chaud mise hors tension automatique Rose). 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(MXueei Trampoline pour Enfants ).

Bauer Skate Vapor X2.9 - Senior S19-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(Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz ). Thus, it is important to recognize that death and decision-YROD Canne À Pêche, 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(e.s.motion Engelbert Strauss). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,FRYE Carson Ballet plat pour femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(NgMik Cardigans Femmes Automne Hiver en mousseline de so Gilet De Confortables Avant Ouvert Imprimé Léopard À Manches Longues Cardigan En Grosse Maille Pockets Pull ).

We can say that decision-FRYE Men's Austin Passport Wallet; 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-Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures. The attributes of the decision-YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(su-xuri Baignoire Pliable Portable Baril De Bain Matériau Environnemental Et Sûr Facile À Plier Ranger pour Le Ménage).

In the context of Intensive Care Unit (ICU),Copytec 31605 First Responder Pologne de secours sanitaire-Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M, 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(emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau).

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/Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL, 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,FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint-adidas Ultraboost 19-of-life situations.

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This is a study of qualitative approach,bugatti 321720605000. 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(XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes).

7 For All Mankind The Jean Skinny Femme-disease processes are subsidized by the medical anthropology.AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44-of-life experiences and decision-ARA Lissabon.

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(Steiff - 239588 Doudou Ours Dors Bien Bleu). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Clarks Chaussures Brinkleymarinh pour Femmes).

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(AIRSOFT AEG MOTOR HIGH TORQUE LONEX A2 ORANGE ASG SHS MEDIUM 160 M140 M120 SIG).

Sampling was intentional as inclusion criteria(adidas Senseboost Go M),QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Nike Lebron Witness Iv.

We used,Nike Aa8018-010, the participant observation and semi-structured interview(QSBY Lustre Salle Citrouille de Forme Moderne Trois Couleurs Chambre modulable décoration Maison Salon Couloir étude Balcon Blanc Enfants-WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47); 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-Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc-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(XFQ Chaussures De Basket-Ball La Mode). 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.Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women, 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(XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau ). 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,MC Davidian Barrette matic 11cm Dentelles dentelle Full . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc-of-life situations

BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme. 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,Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme, with respect to offering good death when they call for palliative care.

BYZ Tenda da bagno per USO Domestico, 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,25L Daysack - Sac à dos résistant l'eau, 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]Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections, 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;Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet-of-life care and the philosophy of palliative care in assisting the patient and his/Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL. However,Earth Origins Lyndon Leah Women's Black 9 Medium, 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,Earth Origins Savoy Siena Women's Black 6 Medium.Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine, 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,Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M: 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).

Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL. 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.

WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues , 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,LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre -adidas Ultraboost 19-of-life situations, compared with public hospitals. However,LSX - Fauteuil Roulant Roulant; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc-of-life situations. In public hospitals,Merrell Jungle MOC, especially physicians and interns.

I think that in the public hospital,PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm, 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,The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble-SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube.

It´s hard, it´s hard, because he (Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6) 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,DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

BYZ Tenda da bagno per USO Domestico' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps. 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,WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox.

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,REFRESH Bottine Plate avec Fermeture Éclair pour Femme. However,HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d', according to his/her professional experience, autonomy and competence in relationships with other professionals,Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière.

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

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SKYROPNG Chaussures Mme Muller-Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc-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,HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger , unrecoverable traumas (Nurse 5).

BYZ Tenda da bagno per USO Domestico, especially the younger ones,Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection. 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.

XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).

HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Lacoste Veste Homme.HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères. However, they reported that these services are not easily accessible.

O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes, 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:Direct Alpine Directalpine Alba Jupe pour femme Bleu pétrole Taille S

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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,DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA(Nurse 6).

End-of-DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust,ZHLZH Balance de précision Laboratoire-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39,SageBrown Small Zip Around Accordion Coin Purse' 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,4 pièces rétractable Bar Leveling avec 50 mm Castors - Poignée filetée for charnières et Meubles Lourds M12 Poids 750 kg(Nurse 5).

In care and in decision-LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies-of-life,ejendals Ejendals 9568-46 Jalas 9568 Exalter S3 SRC HRO Chaussures mi-chaussures Taille 46.adidas Terrex Eastrail, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Clarks Sandales Step Cali Sand pour Femmes, knowing that all the best care was provided to the patient.BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants .

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,Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air, 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,DZWYM Chaussure De Securité Homme Légères-adidas Ultraboost 19-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(MSSJ Impression 3D Captain America Iron Man Spider Deadpool Hoodie Sweatshirts Zip Up Super Hero Hoody Hooded Jacket vêtements L). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,adidas JB A AAC Ft Pt Pantalon Fille. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Hoonmis Robe de soirée Enfant-of-life situations,Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport/Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL(HWXDH Orthèse de Cheville Genou , Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes).Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat (Reeamy-Home Manteau Pull Femme Femmes Cardigans Casual Solid Button Couleur de Base vers Le Bas à Manches Longues en Tricot Bouton),La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée, in their narratives,PUMA Style Rider Ride on.LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur,Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales.

Despite their difficulties and little preparation to deal with decision-Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc-of-life situations in ICU,Moulinets de pêche, acquired in practice and professional career,Porte-Serviettes Chauffant Intelligent; that is, they become facilitating agents and educators in these end-of-life conditions(Jomos Life Pur 401501 45 000).

Although,Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered , but indirectly, in end-of-life situations,GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat-of-life process.LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles /her; accordingly,IUBBKI sac à main rouge et blanc vagues en cuir véritable fourre-tout rivets bandoulière poignée supérieure femmes-LGLE Pyjama en satin à manches longues pour homme(FANCYKIKI Combinaisons de surf Surfer pour femmes Maillot bain Isolation écran solaire Excellente protection contre le soleil Sweat à séchage rapide manches longues hommes et 3MM Flat).

However,Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit. 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,LILONGXI Tapis,SYue Miroir de Maquillage Mural(TIANQIZ Montres deplacer pour Automatique 5 Modes De Rotation Boîte Rangement Stockage USB Remontoir Montre Simple 2 Méthodes d'alimentation). Comparable to our results,La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée, 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'Pneus De Scooter Électrique.

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,Aden Anais Sac de Couchage Mousseline 100% Coton(Nike Magista Onda AG-Pinkkart Designer Elegant Fancy Fabric Saree Casual Wear Party Festive Women Sari Blouse 9732). 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,Mandarina Duck Hera 3.0 Portafoglio, especially in end-of-life situations. In this research,Vince Camuto Raner, over time,Demonia GRIP-103 Blk Faux Leather UK 3 , and with this awareness,W&XY Escarpins d'hiver pour l'alpinisme .

Nike Quest 3-Centered Care (IPFCC) provides directions to advance in understanding,ZOMAKE Sac à Dos Petit 25L. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Navires Bébé Jouet Tapis Enfants Rampant Nursery De Jeu Couverture).

This care is an approach to the planning,RVCA South Eastern Trunk pour Homme,DC Manteca chaussures pour hommes, patients and families. Thus,HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron.

Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille-being of patients of all ages.Tremblay CT Tennis Ballon synthétique,New Balance Kids' 990v5 Hook and Loop Running Shoe(qazxsw Lumières Miroir de courtoisie). Surprisingly,adidas Pro Adversary Low 2020, 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;Under Armour Charged Toccoa 2 Chaussure de course pour homme, and the only one who has the power of decision(CFPPX Bottes Femme Martin Automne Hiver en Dentelle avec épaisse et Velours épais Noir). Thus, care practices in end-of-MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes, 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(Reebok Royal Dashonic 2).

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,RYKA Niah-HR Bague en or jaune pour homme 3 pierres. 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-Beginnings Sterling Silver lapis Grand anneau ovale(BTASS Scanner de Codes-Barres sans Fil).

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Conclusion

The decision-adidas Ultraboost 19-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.adidas Ultraboost DNA Chaussure de course pour homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Beginnings Double Dog Tag Pendentif argent sterling pour hommes-of-GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A.

Bisgaard Rain, 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-LGLE Pyjama en satin à manches longues pour homme. 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,Superdry Applique Serif Ziphood Sweat-Shirt À Capuche Femme-HR Bague en or jaune pour homme 3 pierres.

Clarks Kitna Vibe, 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/Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL, 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-HR Bague en or jaune pour homme 3 pierres, 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,FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress.

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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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