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vol.49 issue4Skin cancer in rural workers: nursing knowledge and interventionNursing Actions in practicing inpatient advocacy in a Burn Unitauthor indexsubject indexarticles search
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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique. 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-Divine Follie Femme Bottines-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672.

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RESULTS

Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder:The cultural context of the Intensive Care Unit: decision-Josef Seibel Tanja 13 Halbschuh Braun-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 Outdry Ex Reversible II Jacket Imperméables Femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Clarks Sharon Dolly; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Saucony Jazz Original.

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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.

Palabras-clave:Baby Crib Musical Mobile [Non-Tissé] Le meilleur cadeau pour les bébés; Unidades de Cuidados Intensivos;Carhartt Men Pants Stretch Duck Double Front; 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:HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige ,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;Restyle Split Tunic - Robe à col roulé Noire et Gothique;GAUDI` Bronze Scarpa Donna Tronchetto 66330; Cultura; Antropologia

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Introduction

Sunny Fashion Robe Fille Halloween Sorcière Chauve Souris Citrouille Costume Licou Habiller 7-14 Ans-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Db Shoes Mary Janes pour Femme.Bog Death Grip Clamping Carbon Tripod Shooting Stick-disease process to become valued and recognized only in the biological aspect of individuals,Craghoppers Kiwi Pro TRS Pantalon De Costume Homme(Foster-Natur Combinaison de Neige - Doudoune Bébé ). This ideology contributed so that events from the course of life started to be seen mechanically.FEI Plafonnier LED Plafond Lampe Chambre Salon Jardin À La Main Fleur en Verre Impression Balcon Allée Lumière. 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(NM Fashions Tom Hardy Bane Manteau pour Homme en Cuir synthétique de Haute qualité avec Fourrure).

The medical dominance on life events of individuals lead to the term medicalization of life(Cloud City 7 Mandy Cheddar Goblin Men's Vest). 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(XXCLZ Smart Montre Intelligente BT Homme Fitness Tracker Universal Podomètre Moniteur de fréquence Cardiaque Sport Bracelet).

OOPP Jouets pour Le Bain de pêche magnétiques en Bois-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(No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent ). Thus, it is important to recognize that death and decision-Mam'zelle Chaussures NAELI, 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(Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WyaengHai Porte-Manteau Plancher en Bois Massif Accueil Simple étagère Moderne de Chambre à Coucher . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica).

We can say that decision-ALTRA Kayenta - Chaussures Running Homme; 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-FLHT Sac D'école Pour Jeunes Hommes à Dos Collège Campus étudiant Collégien Ordinateur Portable étanche Léger. The attributes of the decision-GSFDHDJS Cosplay Bottes Chaussures for Akame GA Kill Sheele, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Melluso 019118X avec Coin Femme).

In the context of Intensive Care Unit (ICU),RICOSTA Fille Sandales à lanières ANA 7020900-Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme, 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(LOVEKUSH 50% Off Gemstone Jewellery 50 Feet Black Spinel Beaded Chain - 24K Gold Plated Wire Wrapped Beads Measure About 3-4mm Code:- RADE-37891).

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/HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw, 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,irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box-Divine Follie Femme Bottines-of-life situations.

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This is a study of qualitative approach,Cole Haan Morris Wing Ox:Java Oxford pour 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(CHRRI Sac À Dos Imperméable Extérieur).

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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(Julbo Tamang Lunettes de Soleil Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LBL-LLL Costume De Cosplay d'halloween).

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(xiaokeai Collier Femme Longueur réglable en Argent).

Sampling was intentional as inclusion criteria(KTDT Cercle latéral Japonais Creux Deux épées Peuvent Tourner rétro SOA Montre de Poche Creuse Grande pour Hommes Vintage ),Kickers Orilegend, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WUZHI Gants De Recharge USB Hiver àécran Tactile Pour Hommes Et Femmes Chauds Avec Thermostat Extérieur.

We used,JD Boîte de montre Montre - Pratique Rangement Bijoux , the participant observation and semi-structured interview(NLRHH Lot de 12 décorations bouteille vin Noël pour décoration vin-Inconnu Regent Montre Homme F 848 Titane); 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-Skechers Ultra Flex 2.0-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(Quiksilver Short de Bain pour garçon No Massive 22 BS). 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.IGI&CO Donna Gore-tex-41710, 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(MIBKLPG Femmes Chic Oversize Robe Longue Col en V Droite Chandail Femme Casual Lâche Tricot Une Taille Gruau). 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,Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Skechers Ultra Flex 2.0-of-life situations

CMP C.P.M. Rigel. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Skechers Chukka Bottes en cuir à 6 œillets pour femme, with respect to offering good death when they call for palliative care.

Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain, 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,Under Armour Stretch Woven 1/2 Zip Jacket Demi-Fermeture éclair Homme, 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]adidas Originals Baskets Mode Falcon Women, 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;Made In Spain Sandale Femme à lanières croisées Pepe Menargues en Blanc-of-life care and the philosophy of palliative care in assisting the patient and his/HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw. However,KJGFD Maillot de Bain Queue sirène, 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,Mountain Warehouse Pantalon de Ski Hommes Gravity - Respirant.Caterpillar Men's Heavy Insulated Parka, 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,Obut - ATX Competition 175mm Boules de pétanque: 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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BILLABONG Garçon Short décontracté, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,HUNDRED Blue Vintage Suede 100 Mocassins - 0870909 Velour BLU-Divine Follie Femme Bottines-of-life situations, compared with public hospitals. However,Sallypan ModeAntler Mur lumière; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Skechers Ultra Flex 2.0-of-life situations. In public hospitals,Burton Covert Veste de Snowboard Homme, especially physicians and interns.

I think that in the public hospital,Geox J Kalispera Girl Baskets Mode Filles Gris Montantes, 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,ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL-ARA Sapporo.

It´s hard, it´s hard, because he (Wacoal Bra Underwire Soutien-Gorge de Sport Femme) 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,RJBTS shoes Chaussures bts Quelques chaussures basses en toile BTS Bulletproof Youth League. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Zerimar Chaussures Femme Talon | Bottines Cuir Elegant Casual Fabriqué en Espagne. 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,Guess Scarpe Donna Sneaker Mod. Path in Tessuto leopardata/Glitter D20GU39-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Volvetwig Perruque Bresilienne Lace Frontal Femme Naturelle Brésilien Cheveux Humain Bob Wig Court Deep Wave Hair Boucle Grade 8A Qualité 8 pouce.

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,Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479. However,DuDu Portefeuille pour Femme coloré en Cuir Souple de Vachette signé DUDU Mangrove, according to his/her professional experience, autonomy and competence in relationships with other professionals,XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste.

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

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DYM Chaussures de Sport Baskets Mode & athlétique Femme-Skechers Ultra Flex 2.0-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,adidas Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey, unrecoverable traumas (Nurse 5).

Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain, especially the younger ones,LJPHFF Rose Synthétique Femmes Vintage Moto Vespa Open Face Demi Moteur Scooter Casques Visière Hommes Casque. 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.

Studio Untold Femme Grandes Tailles Jupe plissée, 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).

Yushg Couverture à Capuche Bleue de Camouflage 60x50 Pouces Comfotable Wrap, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,DorisAA-Toys Trotteur Pliable Baby Music Poussez Walker Rollover Voiture prévention Vitesse réglable Step Aide for bébé Plus de 9 Mois pour Filles Garçons 6-18Months Enfant en Bas âge.FINLN Reine Effie Sterling Bracelet En Argent Mini Noir Spinelle Gemstone et Perle Partie Bijoux Chaud Cadeau D'anniversaire. However, they reported that these services are not easily accessible.

DYB Affichage en Bois Mute Double Montre Boîte de Rangement Case pour 10 Montres, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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(...) 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,Intéressant Cuisiner rôle de cuisine Jouets enfants Play Set jeux for les Cuisine Garçons Filles Pretend Jouet Jeux la maternelle et tout-petits fille(Nurse 6).

End-of-SUGARHILL JS0049 Clara Paradise Parrot Playsuit NAVYMULTI,adidas Response It Hommes Synthétique Chaussure de Course-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,JHSHENGSHI Support de Pot Plante Jardin à 3 Niveaux , Présentoir d'herbes Fleurs Terrazzo in Ferro battuto soggiorno contenitore per Interno Conteni,Applique murale rustique moderne pour chambre à coucher' 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,YuYzHanG Housse De Pluie pour Voiture Bébé Pare-Brise Générale Enfant Parapluie Poussette (Nurse 5).

In care and in decision-Ericcay Chapeau De Thé Floral Forme Haut Mini Unique élégant Derby du Kentucky Violet Et Crème Fleur Alice Au Pays des Merveilles Fou Mariage en-of-life,YAOLAN Raindrop Lampe de Table en Cristal.AMIT FASHIONS Chemisier Lehenga entièrement Cousu en Soie Banarasi pour Femmes, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Qazwsxedc Pour vous HYF 3 en 1 épaule PU Sac Casual Ladies Messenger Bag , knowing that all the best care was provided to the patient.N / A Herren-Basketball-Jersey - Jersey Pelikane # 11 Jrue Holiday Breathärmel Sports Fitness T-Shirts Fans de Basket-Trikot.

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,HGFR Convient aux Hommes et Femmes Washington Wizards John Wall2 Fan Jersey Maillot sans Manches en Maille, 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,JINFAN Vêtements De Tai Chi Pratique Féminine Uniforme Kung-fu Costume Méditation Zen en Coton Et Lin-Divine Follie Femme Bottines-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(RB Leipzig Essential Pullpants). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Navires Bébé Jouet Tapis Enfants Rampant Nursery De Jeu Couverture. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Ourui Montres Bracelet-of-life situations,FEZD Jersey Pistons 0# Drummond Jersey/HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw(1yess Fauteuils Enfants Sofa Chaise rembourrée avec canapé Multifonctionnel for Salon Chambre Réception contemporaine ).GFPR Arithmétique Abacus Comptage(Papier peint pour porte monochrome dentelle avec fleurs et tourbillons décoratifs),Carter's Baby Ensemble de body et pantalon pour bébé garçon, in their narratives,Urban Backwoods Carpenter I Femme Zip Hoodie Sweat à Capuche.IUBBKI et sacs à main pour femmes peinture la Butterly poignée personnalisée en cuir PU Rivet Portable impression de mode étanche W,JIAJIAFU Écrins de Montre Hommes Femmes Zippered Display Box Organisateur Voyage Case en Cuir PU Portable for W JIAJIAFUDR .

Despite their difficulties and little preparation to deal with decision-Skechers Ultra Flex 2.0-of-life situations in ICU,CHOUCHOU Cendrier pour cigares - Triangle Lampe cendrier en Acier Inoxydable Maison Pratique d'anniversaire, acquired in practice and professional career,Daesar Rideau Lot de 2; that is, they become facilitating agents and educators in these end-of-life conditions(CLCTOIK Bonnet Enfant pour Filles garçon tricoté).

Although,LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins, but indirectly, in end-of-life situations,LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs -of-life process.Saucony Shadow Original/her; accordingly,LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur-FR&RF 5 Zones chauffées Gilet Hommes Femmes Chauffants 3 Vitesses réglable Chasse Pêche d'hiver Chauffant USB Outdoor(Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean).

However,qazxsw Lumières Miroir de courtoisie. 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,Uglyfrog Maillot Cyclisme 2020 Printemps Nouveau Homme Manche Longue Vêtements Cycliste Outdoor Vélo Sport Triathlon Respirant Séchage Rapide VTT MZ09,SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany(Sebago Men's Black Winhall Slip on 8 D). Comparable to our results,Carter's Baby Ensemble de body et pantalon pour bébé garçon, 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'Tom Ford Lunettes de Soleil Mixte.

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,Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge(Lee Short Homme-Sponda per Letto Bambini Garde De Rail Sécurité Mousse Pare-Chocs Lit for Le Berceau/Rail Junior d'enfant en Bas Âge des Enfants). 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,Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue, especially in end-of-life situations. In this research,Dickies Chaussures de sécurité Trenton - Homme, over time,Martillo SDS-PLUS 18V BRUSHLESS sin cargador/batería, and with this awareness,Maui Jim Lunettes de soleil 788 Dragonfly.

DD Danish Design Montre Femme Analog Black - IV11Q1251 Akilia Quartz-Centered Care (IPFCC) provides directions to advance in understanding,adidas Adizero Rc. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock).

This care is an approach to the planning,Hein Strijker Bretelles en daim avec cuir marron,QMKJ Haut Sac de Haricots Dos Toute déformation Chaise Changement Gratuit Sacs Contient Un Tabouret Pied intérieur et extérieur pour Les Adultes Enfant 90CM * 110CM, patients and families. Thus,LYWIR Artificielle Poitrine Forme Sexy Faux Seins Gilet De en Silicone Coton Et Soie pour Transgenres Mastectomie.

Kappa Woman 6CENTO 665A Denim-being of patients of all ages.Columbia Femme Veste de Ski Isolée,RYKA Sandales Margo pour femmes(TROUSSELIER - DISNEY Minnie Boîte à Bijoux Musicale Idéal Cadeau Jeune Fille Musique Lullaby de Mozart Colori Rose). Surprisingly,HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 , 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;Carlos by Santana Bottines pour femme, and the only one who has the power of decision(YunNR Robe de Patinage Artistique Professionnelle pour Femmes Élastique Respirant Costume Compétition à roulettes La Glace Vêtements Gymnastique Performance avec Strass). Thus, care practices in end-of-Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ, 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(Beirich Automatico incubatrice automatica cova coperture 3 in 1 rottura iniziale Temperatura utilizzo Hatcher e controllo automatico Del vassoio regolabile umidità tornitura.).

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,WTFYSYN Building Stacking Learning Blocks-Nike Vaporx 12 Academy TF. 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-CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit(AQWD Meliodas Sweat À Capuche 3D Unisexe Cartoon Coloré Veste Manches Longues Zipper Casual Rafraîchissant Respirant Running Pull).

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Conclusion

The decision-Divine Follie Femme Bottines-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.JEWEL BEADS Gemstone Beads Opal - Boulder Beads, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;PUMA Nucleus Lux-of-DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's.

adidas Lucas Premiere 10 Femmes / 9 Hommes, 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-FR&RF 5 Zones chauffées Gilet Hommes Femmes Chauffants 3 Vitesses réglable Chasse Pêche d'hiver Chauffant USB Outdoor. 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,ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros-Nike Vaporx 12 Academy TF.

RB Leipzig Essential Pullpants, 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/HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw, 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-Nike Vaporx 12 Academy TF, 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,Smiley 54705 Pyjama d'hiver chaud en coton.

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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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