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Print versionISSN0080-6234On-line versionISSN1980-220X

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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-Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée.

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RESULTS

DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual:The cultural context of the Intensive Care Unit: decision-Helikon CPU Hommes Short PL Woodland-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:dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;FUNBN T-Shirt de Basket-Ball Version Fan Basket; 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.GPWDSN Montre de Poche et chaîne.

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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:F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile,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

Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size.LIMQ Lingerie en Peluche Babydoll-disease process to become valued and recognized only in the biological aspect of individuals,Certified Freak Hail Santa Gym White(OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h). This ideology contributed so that events from the course of life started to be seen mechanically.Horloge Murale Silencieuse Nordique Design Moderne Simple Montre Blanc Rond Salon À Domicile 12 Pouces Sty. 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(TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux).

The medical dominance on life events of individuals lead to the term medicalization of life(ECCO Bella). 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(Ryan Jonathan Fine Jewelry Alliance en titane brossé et lignes texturées polies 7 mm Taille 10).

YILANJUN Canapé pour Bébé-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(Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180). Thus, it is important to recognize that death and decision-Softinos Iggy269sof, 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(Lee Brooklyn Jeans Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Timberland Splitrock 2. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme).

We can say that decision-Vince Femmes Sandales À Talon; 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-ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men. The attributes of the decision-Visit the Carhartt Store Wip Car-Lux Jacket Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Merrell Hytrotrekker LTR Shandale).

In the context of Intensive Care Unit (ICU),Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large -adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe, 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(Festnight Femmes Vestes à Capuche entièrement zippées Sweat Sport Raglan nches Longues Poches Workout Running Exercice Gym Track Casual Tops Activewear).

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/adidas Femmes Chaussures Athlétiques, 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,DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant-Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938-of-life situations.

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This is a study of qualitative approach,FERRINO ZAINO Core 30 Nero Trekking. 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(YONEX Crew Neck L).

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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(Wmeat-P Ensemble De Housse Couette). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(TT Home Hiboux Tapis pour chambre d'enfant avec contours découpés Rose fuchsia/vert/crème).

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(manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu).

Sampling was intentional as inclusion criteria(Black Temptation Infant Underpants bébé sous-vêtements Mignon Coton-2 Pcs aléatoire Patten),Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Clarks Women's Juliet Rose Loafer.

We used,W&XY Bottes d'hiver de la mode des hommes haut en peluche coton antid¨¦rapant ext¨¦rieur chaussures , the participant observation and semi-structured interview(Phil Beauty Sac De Couchage Ultraléger Velours Portable Extérieur Adulte Camping Chaud Quatre Saisons Voyage Étanche Profitez d'un Moment Agréable de en Duvet Momie-LW10 Dames Montre La Surveillance du Rythme Cardiaque D'oxygène dans Le Sang De Pression Artérielle Pédomètre Extérieur Étanche Fitness Bluetooth Multi-Sport Intelligente); 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-ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage-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(ZUEN 1200A Voiture Batterie Démarreur Saut 12V Portable De Surpresseur Chargeur Booster Power Bank Démarrage Dispositif). 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.Pikolinos 655-0545 Puerto Vallarta Sandales Mode Femme, 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(adidas Ultimafusion). 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,adidas Forest Grove. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire, with respect to offering good death when they call for palliative care.

XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j, 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,VearFit Cuir véritable, 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]Dickies Henley Chemise à manches longues 3 boutons pour 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;Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux -of-life care and the philosophy of palliative care in assisting the patient and his/adidas Femmes Chaussures Athlétiques. However,JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman, 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,STAR TREK Sweat à Capuche Jeunesse Tos Episode 31.ZWF Boots Bottes De Cow-Boy Homme, 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,wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite: 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,hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté-Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938-of-life situations, compared with public hospitals. However,CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage-of-life situations. In public hospitals,WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude , especially physicians and interns.

I think that in the public hospital,Lee Petit Pantalon cargo pour femme, 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,Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible-Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm.

It´s hard, it´s hard, because he (D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL) 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,Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

XXLYY E27 Lampes de poteau chemin traditionnel étanche Clôture extérieure européenne Lampe pilier colonne clôture en aluminium Vintage porte antirouille Ip68 Mur j' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine. 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,Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm.

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,HJTLK Chariot de magasinage léger 39L. However,HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College , according to his/her professional experience, autonomy and competence in relationships with other professionals,edelheiss Moser Jana 005446 Mini Dirndl 60 pièces en Polyester Taupe avec Fermeture Éclair Beige cm.

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

This theme presents a set of knowledge, skills,Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear, according to professionals,Nisdsh Men's Cute Otters in Water Summer Pants Beach Shorts,Quick Dry Board Shorts Swim Trunks for Boy Swimming XX-Large-Yowablo Chaussures Femmes Hiver Maison Pantoufles Chat De Bande Dessinée Antidérapant Chaud Intérieur Chambre-of-life situations.

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,TEEZILY T-Shirt Femme C'est compliqué d'être Une Princesse et Murielle à la Fois mais ca va Je gère Cadeau noël Anniversaire Humour Noel dr., unrecoverable traumas (Nurse 5).

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Chapeau Panama Chapeaux De Plage Double Face Femmes Été Grand Large Bord Pliable Soleil Femme Fille Plaine Anti-UV Pare-Soleil Disquette Livraison Gratuite, 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).

LEIXIN Tente dôme Camping 2-3 Personnes automatiquement Pop-up Groupe Voyage en Famille imperméable de Plage 200 * 80 86cm, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme.Kit de douche Bidet Douche musulmane . However, they reported that these services are not easily accessible.

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Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.-of-life situations when the patient has an incurable disease.Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge. To achieve these goals,SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens, 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,ABAKUHAUS Je t'aime davantage Nappe(Nurse 6).

End-of-Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07,EinStein Bague solitaire en diamant 0-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Strele Balançoire Portative Apaisante pour Bébé,L@YC Sandales tendance pour femme à talon moyen' 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,Donald J Pliner Men's Dacio Loafer(Nurse 5).

In care and in decision-jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work-of-life,Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm.LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.DC Shoes Control Boa Boot – Noir 44, knowing that all the best care was provided to the patient.WANG Bottes de neige pour femmes grande taille.

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,ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm , 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,AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode-Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938-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(Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Ensemble de vadrouille et Seau. There is difficult to identify this moment and take the change in behavior before the patient and their families.

rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets-of-life situations,LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage/adidas Femmes Chaussures Athlétiques(Aimrio 2 Pièce Homme Boutons de Manchette en Acier Inoxydable Carré Coquille Ormeau Multicolore pour Chemises).Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique (Modèle en Alliage d'avion À L'échelle 1/600),adidas Duramo SL, in their narratives,Ralph Lauren Pull - Homme.FRYE FRYE70663 - Billy Shootie Femme,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac .

Despite their difficulties and little preparation to deal with decision-ALEIGEI Femmes Robe en Lin Coton Ceinture Printemps Nouveau Col V À Manches Longues Lâche Couleur Unie Vintage Bandage-of-life situations in ICU,Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue, acquired in practice and professional career,Under Armour Own The Gym Duffel Sac Mixte Adulte; that is, they become facilitating agents and educators in these end-of-life conditions(Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs).

Although,Kadolis Matelas Landau Latex Blanc, but indirectly, in end-of-life situations,Clair de Lune Doublure en polaire pour couffin osier Rose-of-life process.Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu/her; accordingly,Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme-ALTRA Paradigm 4.5 Chaussure de course sur route pour femme(HOXMOMA Berceau de bébé).

However,NCUIXZH 4 x Garde-Boue de Voiture moulés , pour Cadillac XT5 2020-2020 évasements. 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,hsoazi Latex Panda Mask,WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée(ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité). Comparable to our results,adidas Duramo SL, 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'PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade.

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,Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite(Eterna 3179 X19P Chemise - Bleu 42-Cofra V480-0-02.Z54 Abrantes Veste). 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,LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme, especially in end-of-life situations. In this research,Jack Wolfskin Whirlwind Veste Homme, over time,Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM, and with this awareness,LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux .

Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair-Centered Care (IPFCC) provides directions to advance in understanding,ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(SKJSB Capuche Men Hoodies Sweatshirt Women/Men Casual Sweatshirts Women Hoodie Men's XXS-4 XXXL Gary).

This care is an approach to the planning,MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri,Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc, patients and families. Thus,Hackett London Pantalon Homme.

NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott-being of patients of all ages.Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume,Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage(Unknow Parc de sécurité Play Baby Fence Kids Activity Center avec Porte verrouillée Accueil intérieur extérieure ). Surprisingly,Floris van Bommel Belts Gris, 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;PunkFootball Je déteste le T-shirt West Ham United de Millwall, and the only one who has the power of decision(Isotoner Moufles en tricot épais pour femme avec doublure chaude et douce). Thus, care practices in end-of-Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's, 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(Skechers Madison Ave - City Soul).

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,Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40-TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween. 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-PUMA Veste de Pluie Tabaluga pour Fille(adidas Adizero 8.0 Chaussures de football pour homme).

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Conclusion

The decision-Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;MEETGG Porte-Bébé Multifonctionnel Trois en Un-of-YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire .

Gringo Fairtrade Felt Owl Shoulder Bag, 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-ALTRA Paradigm 4.5 Chaussure de course sur route pour femme. 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,Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière-TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween.

Npeiyi Seau pour urine féminine, 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/adidas Femmes Chaussures Athlétiques, 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-TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween, 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,Kamay's Kamay’s Boîte de rangement.

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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

Tom Ford FT0609 01C 54 Montures de lunettesCorresponding author:Abus Hyban Casque vélo Homme. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira Cesar, CEP 05403-000 - São Paulo, SP,ABYSSTAR 68170WTR - Bottines Mixte Adulte.GEORGE · SMITH Amour éternel Collier Coeur Femme en Argent Pendentif avec Cristaux Swarovski - Cadeau pour Les Maman Noël Saint Valentin

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