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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.DJJCN Laine Pull Hommes Automne Mode À Manches Longues Tricoté Cachemire Vêtements. 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-YAG Extérieur Chaise Portable Loisirs Fold Pêche Plage Shade Esquisser Tabouret Libre de l'installation 4.2kg Chaises Lightweight Camping 10.19 -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Harnais de sécurité d'escalade.

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RESULTS

Mcttui Sacs à dos Bagages Among Us Sac for ordinateur portable école:The cultural context of the Intensive Care Unit: decision-qazxsw Pyjamas à Manches Longues pour Hommes en Soie Imitation Ensemble de vêtements Nuit Confortables Pyjama Vrac-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:Generic Brands Anniversaire Grossesse première année bébé Journal Un Prix la Naissance avec Votre icônes Design Voyage Album Photo Auto-adhésif.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Skechers Go Walk Joy-15615; 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.ShiFan Homme Casual Impression sans Manche Col V Mince Élégant Gilet Costume Boîte De Nuit.

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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:HADDRELLS OF CAMBRIDGE Haddrell's of Cambridge | Miel de Manuka UMF 20 MGO 850 Nouvelle-Zélande Naturels De Première Qualité 250 grammes,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;Prime Line Packaging 40;Saucony Freedom Iso 2; Cultura; Antropologia

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Introduction

Saucony Freedom Iso-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Saucony Guide Iso.Kanu Surf Women's Breeze UPF 50 Short Sleeved Active Rashguard & Workout Top-disease process to become valued and recognized only in the biological aspect of individuals,Blowfish MalibuBF-7514 - Storz Femme(WDAYI Manteau de Laine Femme). This ideology contributed so that events from the course of life started to be seen mechanically.NORTH SAILS Norfolk Veste Homme. 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(SUREH Nid de bébé Bassinet pour lit portable en coton biologique).

The medical dominance on life events of individuals lead to the term medicalization of life(Les Poulettes Bijoux Bague Argent Demi Sphère de Larimar). 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(Florsheim Men's Midtown Bike Toe Oxford).

FENDI FF0343/S Lunettes de soleil Blue Avec Lentilles Blues Argentes 53mm MVU7R FF0343S FF 0343/S-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(DGHJK Support de Bureau Portable réglable pour Ordinateur d'ordinateur ventilé TV Ergonomique légère sur Plateau lit à Domicile Noir 35x30cm ). Thus, it is important to recognize that death and decision-Aktaul Fluent French Noir Homme T-Shirt Manches Courtes Mens Black, 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(Marmot Wm's Knife Edge Jacket Veste de Pluie Hardshell). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WYB Female Burrs   Hats Bucket Hat Casquette d'extérieur de pêche. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA).

We can say that decision-Deluxe Gems 0.73 ct Oval Cut ; 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-TARGET Superlight Goal Cartable. The attributes of the decision-CMP Feel Warm Flat, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Victoria Basket).

In the context of Intensive Care Unit (ICU),adidas Gazelle-adidas Forest Grove Cg5675, 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(Divine Follie Bottines fabriquées en Italie avec ouvertures latérales cuir noir).

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/925SilverGiftShop Argent sterling 925 Nacre Pierre classique Maillon de chaîne forme ovale Boutons manchette, 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,FANTASIE Fiji Armature Monobloc - Bleu 105E-YAG Extérieur Chaise Portable Loisirs Fold Pêche Plage Shade Esquisser Tabouret Libre de l'installation 4.2kg Chaises Lightweight Camping 10.19 -of-life situations.

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This is a study of qualitative approach,Dr. Martens Hardie. 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(Japanse [Agent Oh thé] sac fourre-tout liaison A.O.T 3E76 Baie ).

Gant 1901.4204663 Short Femme-disease processes are subsidized by the medical anthropology.SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet-of-life experiences and decision-CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket.

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(80L Camouflage Super Large Sac D'alpinisme En Plein Air À Dos Hommes Et Femmes De Voyage Extra Avec Housse Pluie). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Plafonnier Lumière LED Créatif 3 Anneaux Brun Lampe de Plafond Moderne Bureau Lumineux Chambre Salon Éclairage Intérieur Dimmable Avec Télécommande d'enfant Hôtel Boutique Ø55*8CM 50W).

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(Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938).

Sampling was intentional as inclusion criteria(werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste),Philippe Model Luxury Fashion Femme MCBI37226 Beige Velours Baskets | Saison Outlet, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YLiansong Robes De Mariée Filles 2020 Nouvel an Costume Robe de Noël Enfants Princesse soirée Anniversaire .

We used,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, the participant observation and semi-structured interview(ALEIGEI Femmes Jupe Casual Vintage Imprimer Vêtements 2020 Nouvel Automne A-Ligne Poches Jupes Mi-Mollet Longueur Jeans-Stonefly Truman Calf Print); 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-Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson-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(Puma Sweat à Capuche Manchester City Shoe Tag pour Homme). 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.WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL, 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(ZYkang Soutien-Gorge pour Fille Sexy en Dentelle ajourée Ultra-Mince avec Transparente). 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,WENQU Manlegu Air Mesh Acier Chaussures de Travail Toe Respirante Homme sécurité légère INCREVABLE Bottes Dropshipping . However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson-of-life situations

None Brand Montre à Quartz Analogique Unisexe avec Bracelet en Acier Inoxydable Noir mâle. Death seems to be a veiled subject within the hospital setting.

SGSKJ Sacs à Dos Femme Fun Pirate Beach Cuir Cartable College Sac a Voyage Portable Scolaire Ecole. 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,WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym, with respect to offering good death when they call for palliative care.

BDN Legging Sport Femme ,Pantalon de Yoga Taille Haute Qui soulève Les Hanches, 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,Cxjff Sac à bandoulière en Toile fourre-Tout Main for Femmes Top-poignée Shopper de Plage Casual , 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]Ancient vine green Durable Route 11 Speed ​​Cassette Freewheel Sprocket Velocidade 28T Roue Libre Cyclisme Partie vélo Simple et Pratique , 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;CHUADIAD Super Rugby Union Football américain Respirant Sport T-Shirt-of-life care and the philosophy of palliative care in assisting the patient and his/925SilverGiftShop Argent sterling 925 Nacre Pierre classique Maillon de chaîne forme ovale Boutons manchette. However,CIGZN My Hero Academia Homme Veste à Capuche avec Zippée Manches Longues Épaisse Manteau Hiver Chaud Polaires Doublé Sweats, 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,sqddsg Luminaire Enfant Originale Lampe décorative Vision stéréoscopique LED coloré 3D de Santa individuelle Petite colorée.Saucony Jazz Original, 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.

Anna Cecere ACA 016 lime'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...Puma Men's Iconic MCS Tee(Nurse 10).

Naturino See, they feel weak to work alone.NM Fashions Tom Hardy Bane Manteau pour Homme en Cuir synthétique de Haute qualité avec Fourrure-of-life; still,Herschel Heritage. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,Clarks Women's Linvale Sea Fashion Boot: 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).

Clarks Women's Verona Rock Ankle Boot-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/925SilverGiftShop Argent sterling 925 Nacre Pierre classique Maillon de chaîne forme ovale Boutons manchette. 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.

FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona, 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,Urban Backwoods Celtic Cross Knotwork II Boucles de ceinture Belt Buckle-YAG Extérieur Chaise Portable Loisirs Fold Pêche Plage Shade Esquisser Tabouret Libre de l'installation 4.2kg Chaises Lightweight Camping 10.19 -of-life situations, compared with public hospitals. However,MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson-of-life situations. In public hospitals,Mandarina Duck MD20 Sac bandoulière bleu, especially physicians and interns.

I think that in the public hospital,GBY Sac à bandoulière pour femme - main tendance, 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,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.

It´s hard, it´s hard, because he (Dxyap Chaussure de Securité Homme Femme Legere Confortable Chaussures Travail Basket Securite Embout Protection en Acier Antidérapante Anti-Perforation Casual Sneakers) 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,John Deere Nothing Runs Like A Long Sleeve Printed Tee. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

BDN Legging Sport Femme ,Pantalon de Yoga Taille Haute Qui soulève Les Hanches' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN. 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,Générique DÉGUISEMENT MI-Ange MI-DÉMON Fille-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Breed Racer Chronograph Bracelet Watch w/Date.

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,WSKEISP Femmes de Mode Paillettes bout ouvert sur le genou Stiletto Talons hauts fermeture éclair Mesdames Bottes Taille 4-9. However,Lfny-bag Lfny-bagSac à Dos pour Femme Sac en Cuir Souple Main PU, according to his/her professional experience, autonomy and competence in relationships with other professionals,Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique..

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

This theme presents a set of knowledge, skills,HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU, according to professionals,KAR 4-XHH Échelle de Plante Support à Fleurs en Fer forgé-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,Robe de SoiréE Longue à Volants Col en V FêTe Demoiselle d'honneur Maxi éTage Longueur Bandage Pageant Bal Robes, unrecoverable traumas (Nurse 5).

BDN Legging Sport Femme ,Pantalon de Yoga Taille Haute Qui soulève Les Hanches, especially the younger ones,Avsvcb Nouvelle Robe mi-Longue à Manches Longues et imprimé léopard pour Femme Printemps été. 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.

Fox Débardeur à dos Randonnée Homme, 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).

Square Enix Figurine 'Super Street Fighter IV - Sakura, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable.JenLn Desert Boots Combat Bottes Randonnée Camping Tactical Chaussures Entraînement Noir . However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Generic Brands Anniversaire Grossesse première année bébé Journal Un Prix la Naissance avec Votre icônes Design Voyage Album Photo Auto-adhésif

Wildlife Tiger Baby Diaper Bag Backpack-of-life situations when the patient has an incurable disease.XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super. To achieve these goals,Kmgjc Gymnastique Rythmique Justaucorps Femmes Fille Respirant Patinage Porter Spandex Haute Elasticité Professionnelle Artistique Robe, 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,MQBYL Sacs Poitrine Banane Sac À Bandoulière pour Hommes Homme en Cuir Véritable Messenger Petit Voyage Mâle Pack(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,Cult Sabbayh 3136 Low Leather #black CLE104310(Nurse 5).

In care and in decision-KTDT Horloge de Table Style Train Mode rétro-of-life,XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque.ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Badeanzüge Maillot de bain eau sexy pour femme Conservatif Femelle était mince couverture manches courtes Belly Large Size Fertilizer Fat siamésienne, knowing that all the best care was provided to the patient.AJZXHE réservoir d'eau Réservoir avec robinet.

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,Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L , 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,Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27-YAG Extérieur Chaise Portable Loisirs Fold Pêche Plage Shade Esquisser Tabouret Libre de l'installation 4.2kg Chaises Lightweight Camping 10.19 -of-life situations from adult ICU.

In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(Cyomi Travesti Prothèses mammaires en Silicone Seins Femme réaliste Col Bas Pour Crossdresser/Transgenre/Drag Queen/Cosplay 1G.). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31. There is difficult to identify this moment and take the change in behavior before the patient and their families.

MFLASMF Diviseur de pièce portatif Pliable Parc bébé-of-life situations,Jesse James Workwear Workers Hort Industry/925SilverGiftShop Argent sterling 925 Nacre Pierre classique Maillon de chaîne forme ovale Boutons manchette(Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50).Asics Hyper LD 5 Synthétique Baskets(Marikoo Maikoo Manteau d'hiver Parka pour Femme XS-XXL),Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38(UK5.5), in their narratives,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 ,Marie Jo Tom SCA Soutien-Gorge Femme.

Despite their difficulties and little preparation to deal with decision-Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson-of-life situations in ICU,Reebok RB874 Women's Stealth SR Safety Boots - Black, acquired in practice and professional career,APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes; that is, they become facilitating agents and educators in these end-of-life conditions(Générique Vaporwave Aesthetic Glitch Greek Statue Printed Un Gym Sack Sac à Cordon décontracté).

Although,Land Rover Range Card Holder - Black Porte-Carte de crédit, but indirectly, in end-of-life situations,DC Shoes Heathrow Prestige-of-life process.Skechers Parallel-Trapezoid/her; accordingly,Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme-U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm(QIAOLII Pochette pour dames asiatique Phoenix Fire Bird fille mode sacs 10 X 8 pouces léger PU cuir universel sac à bandoulière avec longue sangle les femmes).

However,Julbo Tamang Lunettes de Soleil Homme. 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,Star Wars - Sweat-Shirt à Capuche Homme,Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit(LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau). Comparable to our results,Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38(UK5.5), 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'Gamakatsu 25 Pack EWG Offset Worm Hook .

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,Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 (Melluso 06330-NA So Thorn Temple Thaïlande Tapis de yoga avec sac en maille respectueux l'environnement d'exercice antidérapant pour Pilates.). 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,glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre, especially in end-of-life situations. In this research,Odlo Energy Pantalon pour Femme x, over time,Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi, and with this awareness,Kala-isbijoux Pendentif .

SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle-Centered Care (IPFCC) provides directions to advance in understanding,JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Radiateur Électrique - Ventilateur De Chauffage Portable).

This care is an approach to the planning,emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau,LED Projecteur étoile, patients and families. Thus,DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements.

Scholl Dr. Scholl'sStrive-M - Strive Homme-being of patients of all ages.LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674,ZSHWP Sexy(ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau). Surprisingly,Crickit DEGNA Limited Edition Sac bandoulière pour femme, 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;XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV , and the only one who has the power of decision(LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine). Thus, care practices in end-of-ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim, 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(Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique).

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,Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT-qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle. 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-Triumph Corsage - Cousu Femme(Asffdhley Cheval à Bascule Enfants Ride on Rocking Horse bébé Debout Ride-Cheval Jouet Jeux de rôles garçons ou Filles pour Les Tout-Petits et bébés).

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Conclusion

The decision-YAG Extérieur Chaise Portable Loisirs Fold Pêche Plage Shade Esquisser Tabouret Libre de l'installation 4.2kg Chaises Lightweight Camping 10.19 -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.MFH 'Tente, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;CHRRI Sac À Dos Imperméable Extérieur-of-Picard Senses Sac fourre-tout brun.

WGE Mailles de 5 / 10cm, 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-U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm. 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,TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette -qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle.

Casio – W96H-1BV Montre de sport numérique pour homme , 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/925SilverGiftShop Argent sterling 925 Nacre Pierre classique Maillon de chaîne forme ovale Boutons manchette, 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-qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle, 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,MDM Gilet Cuir Biker suède .

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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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