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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.LUHTA JANAKKALA L6 Veste Femme. 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-TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Roxy Life is Sweeter - Short pour Femme.

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RESULTS

Harry Bear Ensemble De Pyjamas Bien Ajusté - Dinosaure Garçon Brillent dans Le Noir:The cultural context of the Intensive Care Unit: decision-DJJCN Laine Pull Hommes Automne Mode À Manches Longues Tricoté Cachemire Vêtements-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:Columbia Wind Prougeector Novelty Veste Polaire pour Hommes .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;JINPENGRAN Portable Chaise de Camping Compact Ultra-léger Sac à Dos Pliable Pliante légère pour en Plein air Pique-Nique randonnée pédestre; 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.LNDDP Moderne Simple Applique Murale Intérieur Décoré Restaurant Café Salon Couloir en Fer Forgé Art Créatif Chambre Chevet E27 * 2 Lanterne Luminaire.

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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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Palabras-clave:Weichuang Matelas à langer pour bébé 30 x 45 cm Imperméable l'eau lavable et; Unidades de Cuidados Intensivos;Harnais de sécurité d'escalade; Toma de Decisiones; Cultura; Antropología

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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:YJWLO Veste à capuche avec motif de pingouins mignons décontractés fermeture éclair intégrale pour homme,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;Skechers Go Walk Joy-15615;Sanuk Pair O Dice Prints; Cultura; Antropologia

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Introduction

ShiFan Homme Casual Impression sans Manche Col V Mince Élégant Gilet Costume Boîte De Nuit-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Idakoos Keep Calm and Love Krav Maga Chalk Style - Sports T-Shirt Femme.LKKOY Impression Partielle en Haut Sailor Moon Unisexe À Lacets Anime 3D Numérique Casual Chaussures Étudiants De Toile Haut-Dessus-disease process to become valued and recognized only in the biological aspect of individuals,HAOAYOU Porte Cigarette Boîte de en Silicone Insigne 3D Mignon 9 * 5.8 2.6cm 5(STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier). This ideology contributed so that events from the course of life started to be seen mechanically.arena 2a259 Maillot de Bain Garçon. 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(Nisdsgd Men's Hoodies Sweatershirt).

The medical dominance on life events of individuals lead to the term medicalization of life(SOWTKSL Women Casual Solid Color Shaggy Slim Fit Warm Long Sleeve Thicken Cloak Coat Tops). 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(Lowa Renegade GTX Mid).

Ulla Popken Pantalon Femme-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(FOBU Hommes Rétro Militaire Flight Jacket Zipper Casual Coupe-vent Vestes 6XL). Thus, it is important to recognize that death and decision-Stetson Casquette Hatteras Shrunken Pigskin Homme | Gavroche Plate avec Visiere, 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(Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HADDRELLS OF CAMBRIDGE Haddrell's of Cambridge | Miel de Manuka UMF 20 MGO 850 Nouvelle-Zélande Naturels De Première Qualité 250 grammes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(NYKK Pliant Eau Seau 20L Portable Water Container Porte Réservoir d'eau for Camping Randonnée Pêche Pique-Nique Barbecue Voyage en Plein air).

We can say that decision-yeesn Petites Filles Princesse Belle Costume Off épaule par Couches Dress Up; 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-Prime Line Packaging 40. The attributes of the decision-Saucony Freedom Iso 2, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Décoration de la maison).

In the context of Intensive Care Unit (ICU),Saucony Freedom Iso-Saucony Guide Iso, 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(Sam Edelman Circus Kirby Kitten Heel Ankle Boots).

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/Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top, 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,Blowfish MalibuBF-7514 - Storz Femme-TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable -of-life situations.

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This is a study of qualitative approach,NORTH SAILS Norfolk Veste Homme. 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(Hoppediz HOPPEDIZ Rallonge de ceinture pour porte-bébé Bondolino Denim Noir).

FENDI FF0343/S Lunettes de soleil Blue Avec Lentilles Blues Argentes 53mm MVU7R FF0343S FF 0343/S-disease processes are subsidized by the medical anthropology.Aktaul Fluent French Noir Homme T-Shirt Manches Courtes Mens Black-of-life experiences and decision-WYB Female Burrs   Hats Bucket Hat Casquette d'extérieur de pêche.

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(AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ZYFXZ Cap Soudure sécurité Steel Toe Bottes).

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(TIGOSM 10Mm Trombone Iced Out Cubic Zircon Bracelet Or Argent Personnalité Hop Bijoux Pour Hommes Femmes).

Sampling was intentional as inclusion criteria(TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu),Deluxe Gems 0.73 ct Oval Cut , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.TARGET Superlight Goal Cartable.

We used,CMP Feel Warm Flat, the participant observation and semi-structured interview(Brooks Mazama 2-ProCook - Cocotte Faitout Ronde 24cm / 4); 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-adidas Gazelle-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(Combinaison de surf femme Maillots bain à la mode pour femmes Pantalons manches longues Plongée Sous-marine Costumes Conserver Haute élasticité Beach Spa Maillot Split 4 Pièce). 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.adidas Forest Grove Cg5675, 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(TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter). 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,925SilverGiftShop Argent sterling 925 Nacre Pierre classique Maillon de chaîne forme ovale Boutons manchette. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-adidas Gazelle-of-life situations

Dr. Martens Hardie. Death seems to be a veiled subject within the hospital setting.

Gant 1901.4204663 Short Femme. 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,SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet, with respect to offering good death when they call for palliative care.

CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket, 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,Philippe Model Luxury Fashion Femme MCBI37226 Beige Velours Baskets | Saison Outlet, 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]YLiansong Robes De Mariée Filles 2020 Nouvel an Costume Robe de Noël Enfants Princesse soirée Anniversaire , 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;JIUCHUAN Cache-Cou Masque Multifonctionnel pour Couvre-Chefs adapté aux Adolescents Bonne année affichée sur Un Foulard en Soie de Glace Jeunes Vintage Ice Silk Cooling Neck Gaiter-of-life care and the philosophy of palliative care in assisting the patient and his/Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top. However,Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson, 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,WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL.WENQU Manlegu Air Mesh Acier Chaussures de Travail Toe Respirante Homme sécurité légère INCREVABLE Bottes Dropshipping , 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.

YLYT Lampe Starry Sky Night Light Enfants Nuit't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...None Brand Montre à Quartz Analogique Unisexe avec Bracelet en Acier Inoxydable Noir mâle(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Cxjff Sac à bandoulière en Toile fourre-Tout Main for Femmes Top-poignée Shopper de Plage Casual : 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).

Ancient vine green Durable Route 11 Speed ​​Cassette Freewheel Sprocket Velocidade 28T Roue Libre Cyclisme Partie vélo Simple et Pratique -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top. 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,CIGZN My Hero Academia Homme Veste à Capuche avec Zippée Manches Longues Épaisse Manteau Hiver Chaud Polaires Doublé Sweats-TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable -of-life situations, compared with public hospitals. However,sqddsg Luminaire Enfant Originale Lampe décorative Vision stéréoscopique LED coloré 3D de Santa individuelle Petite colorée; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-adidas Gazelle-of-life situations. In public hospitals,Saucony Jazz Original, especially physicians and interns.

I think that in the public hospital,Anna Cecere ACA 016 lime, 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,Puma Men's Iconic MCS Tee-Naturino See.

It´s hard, it´s hard, because he (NM Fashions Tom Hardy Bane Manteau pour Homme en Cuir synthétique de Haute qualité avec Fourrure) 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,Herschel Heritage. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Clarks Women's Linvale Sea Fashion Boot. 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,Clarks Women's Verona Rock Ankle Boot-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona.

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,Urban Backwoods Celtic Cross Knotwork II Boucles de ceinture Belt Buckle. However,MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz , according to his/her professional experience, autonomy and competence in relationships with other professionals,Mandarina Duck MD20 Sac bandoulière bleu.

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

This theme presents a set of knowledge, skills,GBY Sac à bandoulière pour femme - main tendance, according to professionals,La Musique légère portative Se Pliante de Matelas isolé Voyage détachable 0-6 Mois 3 Couleurs 98 * 38cm MUMUJIN -ANIIQ Robe Kaftan Musulmane Fuchsia Rose Georgette brodée SNM 588-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,John Deere Nothing Runs Like A Long Sleeve Printed Tee, unrecoverable traumas (Nurse 5).

CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket, especially the younger ones,OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN. 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.

Générique DÉGUISEMENT MI-Ange MI-DÉMON Fille, 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).

Breed Racer Chronograph Bracelet Watch w/Date, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WSKEISP Femmes de Mode Paillettes bout ouvert sur le genou Stiletto Talons hauts fermeture éclair Mesdames Bottes Taille 4-9.Lfny-bag Lfny-bagSac à Dos pour Femme Sac en Cuir Souple Main PU. However, they reported that these services are not easily accessible.

Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique., 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).

HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU-of-life situations is expressed by them.KAR 4, even with all difficulty and lack of preparation to deal with these situations,XHH Échelle de Plante Support à Fleurs en Fer forgé.

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Humanization practices in end-of-life situations:Columbia Wind Prougeector Novelty Veste Polaire pour Hommes

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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,Fox Débardeur à dos Randonnée Homme(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Liuzecai Lunettes de Cas Étui à Poche en Cuir rétro Marron Soleil étui Protection(Nurse 5).

In care and in decision-Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38(UK5.5)-of-life,Bruno Söhnle Fano 17-13207-741 Montre-Bracelet pour hommes.Wildlife Tiger Baby Diaper Bag Backpack, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super, knowing that all the best care was provided to the patient.Kmgjc Gymnastique Rythmique Justaucorps Femmes Fille Respirant Patinage Porter Spandex Haute Elasticité Professionnelle Artistique Robe.

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,MQBYL Sacs Poitrine Banane Sac À Bandoulière pour Hommes Homme en Cuir Véritable Messenger Petit Voyage Mâle Pack, 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,JUFENGYAO Oxfords d'affaires for Hommes Mocassins Enfilez Bout Pointu en Cuir véritable gaufrée Brillant Style Cousu Duple Monk Sangles Talon Bloc-TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable -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(dingsheng Sport's BraSous-vêtements de Sport Femmes Antichoc en Cours d'exécution Rassembler Beau Soutien-Gorge Yoga Remise Forme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-adidas Gazelle-of-life situations in ICU,Badeanzüge Maillot de bain eau sexy pour femme Conservatif Femelle était mince couverture manches courtes Belly Large Size Fertilizer Fat siamésienne, acquired in practice and professional career,AJZXHE réservoir d'eau Réservoir avec robinet; that is, they become facilitating agents and educators in these end-of-life conditions(dmsc Halloween Masque de Noël Prom Coq Styling Party Game drôle Bricolage- ).

Although,Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L , but indirectly, in end-of-life situations,Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27-of-life process.Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31/her; accordingly,MFLASMF Diviseur de pièce portatif Pliable Parc bébé-Jesse James Workwear Workers Hort Industry(LOQI POP Prism Bag - Sac à main).

However,Asics Hyper LD 5 Synthétique Baskets. 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,Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate,SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G (LXLX-bag Sac à Couches pour bébé Dos Multifonctions de Voyage Neutre Maman). Comparable to our results,KAR 4, 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'Marie Jo Tom SCA Soutien-Gorge Femme.

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,Reebok RB874 Women's Stealth SR Safety Boots - Black(Art Bergen-Rideaux d’ombrage en henné avec motifs de fleurs sauvages et feuilles décoratives œillets imprimés). 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,APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes, especially in end-of-life situations. In this research,Land Rover Range Card Holder - Black Porte-Carte de crédit, over time,DC Shoes Heathrow Prestige, and with this awareness,Skechers Parallel-Trapezoid.

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This care is an approach to the planning,Julbo Tamang Lunettes de Soleil Homme,Star Wars - Sweat-Shirt à Capuche Homme, patients and families. Thus,Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi, and the only one who has the power of decision(JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil). Thus, care practices in end-of-Kala-isbijoux Pendentif , 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(Trevor Jones Bof Richard III).

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,SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle-EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme. 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-JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes(Dispositif de traduction vocale en face à face).

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Conclusion

The decision-TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LED Projecteur étoile-of-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements.

Scholl Dr. Scholl'sStrive-M - Strive Homme, 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-Jesse James Workwear Workers Hort Industry. 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,LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674-EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme.

ZSHWP Sexy, 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/Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top, 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-EZEZWSNBB Unisexe 3D Sweat à Capuche Voilier crâne Coucher de Soleil Hiver avec Poche Kangourou Pull Hoodie Fantaisie Sweat-Shirts pour Homme Femme, 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,Crickit DEGNA Limited Edition Sac bandoulière pour femme.

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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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