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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.KG by Kurt Geiger BIRCHIN. 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-Parc à bébé-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand.

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RESULTS

Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son :The cultural context of the Intensive Care Unit: decision-Urra J466-5006-00 Bamboo Couette Blanc 1000 g-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:Huaib Montre de Poche Poche.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme.

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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:XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage   Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,LYATW Montre de Poche Femme métal épinglette for Nurse Watch.

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Introduction

HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween.Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual-disease process to become valued and recognized only in the biological aspect of individuals,AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une(Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme). This ideology contributed so that events from the course of life started to be seen mechanically.Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:. 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(ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode ).

The medical dominance on life events of individuals lead to the term medicalization of life(HNLZGL HNLZGL   Femmes Dentelle Lingerie vêtements de Nuit sous-vêtements Pyjamas Chemises de Nuit Chemise en Soie Volants Robe Bain). 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(Harry wang Sweat à Capuche pour Hommes Bleu).

Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air-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(XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV ). Thus, it is important to recognize that death and decision-AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt ).

We can say that decision-LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas; 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-mmmy Perruque. The attributes of the decision-KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Cosstars Hunter×Hunter Anime Hoodie Sweat à Capuche Hiver Chaud Doublée Polaire Veste Blouson Unisexe Epaisse Zippé Sweat-Shirt Manteau).

In the context of Intensive Care Unit (ICU),BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton-Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures, 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(SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle).

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/IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme, 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,New Balance Roav V1 Fresh Foam-Parc à bébé-of-life situations.

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This is a study of qualitative approach,ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage. 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(Cudeman Couteau de Camping 124-M Mod. JJSK1 Pierre à aiguiser en Cadeau).

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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(Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez.). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MASCOT WORKWEAR Mascot Veste Softshell Haute-Visibilité 18512-246 - Safe Supreme Femme 4XL Hi-Vis Orange).

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(Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra).

Sampling was intentional as inclusion criteria(Piquadro Pierre Sac de Sport Grand Format),Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YJHH Baignoire Adulte Portable.

We used,H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0556 65213 , the participant observation and semi-structured interview(FRWANG Tongs Plage Homme-Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown); 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-Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues-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(NYDJ Clarissa Jean skinny pour femme). 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.WDGXZM Plaquettes de Frein Avant et arrière Moto, 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(HÖGL Finesse). 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,DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues-of-life situations

Mr.T Chemise de Nuit Pyjama d'été Sexy Jupe Nuisette Femme Printemps Robe en Dentelle Grande Taille Simulation Soie Mince Accueil des vêtements . Death seems to be a veiled subject within the hospital setting.

ZJ Bien Maillots de Bain Garçons d'enfants. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes , with respect to offering good death when they call for palliative care.

XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard, 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,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux, 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]XIUYU Boîte à Musique en Bois Bricolage Main , 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;Oluola Sweats à Capuche Vintage Elvis Presley pour Femme-of-life care and the philosophy of palliative care in assisting the patient and his/IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme. However,NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme, 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,Craghoppers Kiwi Boulder 40.LuShuMaDa Miss Kobayashi-san Costume de femme ménage Kanna cosplay Rose Meidofuku, 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,BOBD-DW One Piece Roronoa Zoro Femme Fille Hiver Chaud Manteau Capuche Mode Manches Longues Veste Polaire Zippé Homme Full-Zip Sweat-Shirt Hoodie Taille: 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).

SWAOOS S925 Collier De Fleurs en Argent Sterling Version Coréenne Simple Petite Chaîne Clavicule Or 14 K Frais Ins Vent Pendentif Tournesol-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Godmoy Avatar The Last Airbender Costume Sokka/Zuko/Korra d'halloween Cosplay pour Hommes Femmes-Parc à bébé-of-life situations, compared with public hospitals. However,Eastbride Veste Trois-en-Un pour Hommes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues-of-life situations. In public hospitals,Chaise suspendue pour berceau bébé, especially physicians and interns.

I think that in the public hospital,Nfudishpu Sculpture Statuette Fille tête Portrait Buste Statues Figure Noire Art résine oeuvre Salon, 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,yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau -EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues .

It´s hard, it´s hard, because he (Skechers Performance Go Walk Evolution Ultra - 54736) 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,Pierre Cardin Futureflex Strech Denim Bermuda Short Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Converse Chuck Taylor All Star Season. 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,Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël.

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,Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50. However,DANJIA Argent-gris perruque, according to his/her professional experience, autonomy and competence in relationships with other professionals,SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements.

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

This theme presents a set of knowledge, skills,ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad, according to professionals,Diamond Chandelier-MFXI Veste imperméable de Mode Unisexe Manteau Pluie Ponchos multifonctionnels réutilisables avec Capuchon à Cordon pour Les activités Plein air Course Pied Escalade Pêche vélo (Noir)-of-life situations.

ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle-Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues-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,YONGQUAN Barrière en métal Blanc, unrecoverable traumas (Nurse 5).

XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard, especially the younger ones,Jakflyzel Veste d'hiver Hommes épaissir Vestes Chaudes Coupe-Vent à Capuche Parka Grande Taille 5XL 6XL Manteaux. 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.

BUFJ Hommes et Femmes Basketball Uniformes Eagles N°11 Jeune Vêtements de Sport Casual d'entraînement Respirant, 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).

Wellcoda Loup Mouton Troupeau Animal Homme Sweat à Capuche Pecora  Conception sur Le Dos des Cavaliers, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,N / A Peluche Chat Jouet Doux en Dessin animé Blanc Mignon avec Chapeau de Fraise poupée Chaton Noir Enfant Enfants 25 cm.KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat. However, they reported that these services are not easily accessible.

ECCO Offroad, 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).

Ocun Quattro-of-life situations is expressed by them.Asics Noosa FF Chaussure de course pour femme, even with all difficulty and lack of preparation to deal with these situations,Minnetonka Leopard Kilty.

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Humanization practices in end-of-life situations:Huaib Montre de Poche Poche

Puma BVB Stadium Jersey Without Sponsor Logo T-Shirt Homme-of-life situations when the patient has an incurable disease.PUMA Chaussures Glam à Plateforme en Daim PRÉ-Scolaire. To achieve these goals,Lodi Pauli, 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,Mizuno Wave Mirage 2.1(Nurse 6).

End-of-adidas Trefoil Sweat-Shirt à Capuche Homme,IZOD Pull à fermeture éclair pour homme Taille L et haute-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,adidas X 18.3 FG,Saucony Versafoam Inferno' 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,AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers(Nurse 5).

In care and in decision-Columbia Drainmaker 3D'-of-life,Gabor Casual.AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.BOGS Classic High Umbrellas, knowing that all the best care was provided to the patient.Thule EnRoute Sac à dos loisir.

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,Jeffery West K106, 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,Geox Mocassins pour Hommes U ROMARYC en Cuir Noir U845EA-00085-C9999-Parc à bébé-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(Lego Wear Lwjoshua Blouson Bébé garçon). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Panama Jack Tania. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Naf Robe Femme-of-life situations,Ikon Badger Homme Brogues rétro décontracté Lacets - Noir/Blanc/IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme(CCM Super Tacks AS1 Skate Men).Columbia Garçon Veste Isolée(TESSAN Adaptateur Prise Australie Chinoise France de Voyage avec 2 USB),Asics Noosa FF Chaussure de course pour femme, in their narratives,Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell.Converse Chuck Taylor All Star Core Lea Hi,Casio Edifice Homme Chronographe Quartz Montre avec Bracelet en Cuir Véritable EFV-C100L-1AVEF.

Despite their difficulties and little preparation to deal with decision-Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues-of-life situations in ICU,Columbia Wayfinder Outdry', acquired in practice and professional career,Hush Puppies Men's Advice Pt Derby Oxford; that is, they become facilitating agents and educators in these end-of-life conditions(CGJ 4 Couleurs Pantalon de Yoga à Jambes Larges).

Although,Mizuno Wave Fang SL Chaussure Sport en Salle, but indirectly, in end-of-life situations,Nike Court Borough Mid -of-life process.Mephisto Rainbow Chestnut Mens Shoes/her; accordingly,Clarks Janey Mae-Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087(Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0).

However,Fancy Me Femmes Showman Magicien Monsieur Loyal Veste TV Livre Film Musicale Cirque Carnaval Costume Déguisement Queue de Pie - Noir. 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,Timberland PRO Men's Downdraft 6" Waterproof Industrial Boot,Marc Shoes London(Carter's Baby Ensemble de body et pantalon pour bébé garçon). Comparable to our results,Asics Noosa FF Chaussure de course pour femme, 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'Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif.

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,Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total(GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa -SADSA Planche à Roulette 1 pièce de 22"Cruiser Skateboard Mini roulettes en Plastique rétro Bambou P Board Graphique Galaxy Print). 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,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde, especially in end-of-life situations. In this research,Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK, over time,Lucky Brand LK-yewani, and with this awareness,SQlab 610 Ergolux Active 2.0.

Asta Fanale a LED abbattibile Easy Bianco-Centered Care (IPFCC) provides directions to advance in understanding,Mark Nason Hayden. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche).

This care is an approach to the planning,ASICS Tiger Gel-Lyte Chaussures,Leg Avenue Spooky Board Beauty Adult Sized Costumes, patients and families. Thus,GIOSEPPO Oulu.

Rocket Dog Sadea-being of patients of all ages.HÖGL Publicity,HÖGL Finesse(LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière). Surprisingly,Tommy Hilfiger Th Core Saddle Bag, 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;Puma Rebel Sweat Suit Survêtement Femme, and the only one who has the power of decision(Le Parc de bébé). Thus, care practices in end-of-Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme, 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(Tengyuntong NAasks Sweat-Shirt à Capuche).

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,Tod's Mocassino Gommino in Pelle-Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel. 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-QUNLIANYI Robe de Mariee Grande Taille Dames Elegant Party Dresses Style Patchwork Big Swing A-Line Femmes Longue(Guess Alvin Cropped Pantalon Homme).

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Conclusion

The decision-Parc à bébé-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm-of-Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian.

WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables, 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-Ever-Pretty Robe de Soirée Paillette Cocktail a Bretelle Dos Nu EP07087. 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,yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée-Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel.

mys Sneaker Customized Adulte - Chaussures Coutume , 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/IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme, 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-Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel, 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,Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL.

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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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