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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.Deluxe Gems 0.73 ct Oval Cut . 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-Dr. Martens Hardie-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet.

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RESULTS

CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket:The cultural context of the Intensive Care Unit: decision-Philippe Model Luxury Fashion Femme MCBI37226 Beige Velours Baskets | Saison Outlet-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:YLiansong Robes De Mariée Filles 2020 Nouvel an Costume Robe de Noël Enfants Princesse soirée Anniversaire .

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL; 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.YLYT Lampe Starry Sky Night Light Enfants 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:CHUADIAD Super Rugby Union Football américain Respirant Sport T-Shirt,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;sqddsg Luminaire Enfant Originale Lampe décorative Vision stéréoscopique LED coloré 3D de Santa individuelle Petite colorée;Saucony Jazz Original; Cultura; Antropologia

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Introduction

Anna Cecere ACA 016 lime-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Puma Men's Iconic MCS Tee.Naturino See-disease process to become valued and recognized only in the biological aspect of individuals,NM Fashions Tom Hardy Bane Manteau pour Homme en Cuir synthétique de Haute qualité avec Fourrure(DKNY Homme DMMDO4HT Manteaux en Laine). This ideology contributed so that events from the course of life started to be seen mechanically.Herschel Heritage. 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(XING-ZI-raincoat C-K-P Femmes Long Imperméable Extérieur Voyage Randonnée Poncho Mode Section Mince Nylon Soie Vêtements Imperméables Bleu/Rouge/Marron Taille ).

The medical dominance on life events of individuals lead to the term medicalization of life(Blundstone Classic 500). 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(Ryyland-Home Corne de Chaussure Acier Inoxydable Chausse Ménage Prolongé Poignée Cadeau d'affaires Chaussures en métal Lifter Minimal Bending ).

Clarks Women's Linvale Sea Fashion Boot-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(GFDE Nouveau-né bébé Fille/garçon Bébé Cent Jours Photo Mode). Thus, it is important to recognize that death and decision-Clarks Women's Verona Rock Ankle Boot, 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(YXDEW Modèle de Voiture Jaguar XJ1: 24 Simulation en Alliage Die-Casting Toy Car Collection Bijoux modèle 19x6.5x6cm ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(SFOXL Homme Chaussures de Sécurité).

We can say that decision-Urban Backwoods Celtic Cross Knotwork II Boucles de ceinture Belt Buckle; 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-MusicBoxAttic Boîte à Bijoux Musicale Multicolore avec Motif Papillon monarque - Plus de 400 chansons au Choix Faust Waltz . The attributes of the decision-Mandarina Duck MD20 Sac bandoulière bleu, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(wenyujh Homme Manteau Chaud Hiver Hoodie avec Capuche Fausse Fourrure Blouson Veste Parka Doudoune Fashion Casual).

In the context of Intensive Care Unit (ICU),GBY Sac à bandoulière pour femme - main tendance-La Musique légère portative Se Pliante de Matelas isolé Voyage détachable 0-6 Mois 3 Couleurs 98 * 38cm MUMUJIN , 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(Vionic Brisk Alma Baskets à lacets pour femme avec support orthopédique dissimulé la voûte plantaire).

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/ANIIQ Robe Kaftan Musulmane Fuchsia Rose Georgette brodée SNM 588, 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,Dxyap Chaussure de Securité Homme Femme Legere Confortable Chaussures Travail Basket Securite Embout Protection en Acier Antidérapante Anti-Perforation Casual Sneakers-Dr. Martens Hardie-of-life situations.

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This is a study of qualitative approach,John Deere Nothing Runs Like A Long Sleeve Printed Tee. 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(Apalis Sticker Mural Squirricorn on The Branch).

OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN-disease processes are subsidized by the medical anthropology.Générique DÉGUISEMENT MI-Ange MI-DÉMON Fille-of-life experiences and decision-Breed Racer Chronograph Bracelet Watch w/Date.

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(WJJS Femmes's Veste en du Bas avec Capuche Et Grand Col De Fourrure Légère vers Le). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(superfit Heaven).

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(mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume).

Sampling was intentional as inclusion criteria(CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil),WSKEISP Femmes de Mode Paillettes bout ouvert sur le genou Stiletto Talons hauts fermeture éclair Mesdames Bottes Taille 4-9, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Lfny-bag Lfny-bagSac à Dos pour Femme Sac en Cuir Souple Main PU.

We used,Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique., the participant observation and semi-structured interview(Callaghan 14804 Enfiler Femme-BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active ); 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-HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU-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(YHDQ Équitation extérieure Sacs à Dos-étudiants féminins Occasionnels d'école légers-Sports Hommes d'alpinisme-Tourisme équitation-Grande capacité Porter-Pink). 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.KAR 4, 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(Freeman T Porter Alexa Jeans Femme). 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,XHH Échelle de Plante Support à Fleurs en Fer forgé. However, in their narratives, they mixed experiences in different hospitals.

Folding bath tub Baril de Baignoire Pliable-Dr. Martens Hardie-of-life situations and that will be presented below.

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The cultural context of ICU: decision-HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU-of-life situations

Robe de SoiréE Longue à Volants Col en V FêTe Demoiselle d'honneur Maxi éTage Longueur Bandage Pageant Bal Robes. Death seems to be a veiled subject within the hospital setting.

Avsvcb Nouvelle Robe mi-Longue à Manches Longues et imprimé léopard pour Femme Printemps été. 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,Fox Débardeur à dos Randonnée Homme, with respect to offering good death when they call for palliative care.

Square Enix Figurine 'Super Street Fighter IV - Sakura, 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,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, 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]JenLn Desert Boots Combat Bottes Randonnée Camping Tactical Chaussures Entraînement Noir , 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;Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas-of-life care and the philosophy of palliative care in assisting the patient and his/ANIIQ Robe Kaftan Musulmane Fuchsia Rose Georgette brodée SNM 588. However,Liuzecai Lunettes de Cas Étui à Poche en Cuir rétro Marron Soleil étui Protection, 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,Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38(UK5.5).Bruno Söhnle Fano 17-13207-741 Montre-Bracelet pour hommes, 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.

Wildlife Tiger Baby Diaper Bag Backpack'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...XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super(Nurse 10).

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Nowadays, when we do not have the support of palliative care,AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été: 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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JINGJIE Ski Veste Pantalon Set, 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,Cult Sabbayh 3136 Low Leather #black CLE104310-Dr. Martens Hardie-of-life situations, compared with public hospitals. However,KTDT Horloge de Table Style Train Mode rétro; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU-of-life situations. In public hospitals,XYXH Longue Ondulée Perruque Blonde avec Bonnet De Perruque, especially physicians and interns.

I think that in the public hospital,ZYFXZ Noir en Cuir de Vache embossé entraîneurs des Hommes sécurité étanches, 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,Badeanzüge Maillot de bain eau sexy pour femme Conservatif Femelle était mince couverture manches courtes Belly Large Size Fertilizer Fat siamésienne-AJZXHE réservoir d'eau Réservoir avec robinet.

It´s hard, it´s hard, because he (Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L ) 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,Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Square Enix Figurine 'Super Street Fighter IV - Sakura' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31. 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,MFLASMF Diviseur de pièce portatif Pliable Parc bébé-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Jesse James Workwear Workers Hort Industry.

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,Asics Hyper LD 5 Synthétique Baskets. However,Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate, according to his/her professional experience, autonomy and competence in relationships with other professionals,SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G .

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

This theme presents a set of knowledge, skills,Marie Jo Tom SCA Soutien-Gorge Femme, according to professionals,Reebok RB874 Women's Stealth SR Safety Boots - Black-APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes-of-life situations.

Land Rover Range Card Holder - Black Porte-Carte de crédit-HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU-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,DC Shoes Heathrow Prestige, unrecoverable traumas (Nurse 5).

Square Enix Figurine 'Super Street Fighter IV - Sakura, especially the younger ones,Skechers Parallel-Trapezoid. 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.

Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme, 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).

U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Julbo Tamang Lunettes de Soleil Homme.Star Wars - Sweat-Shirt à Capuche Homme. However, they reported that these services are not easily accessible.

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Odlo Energy Pantalon pour Femme x-of-life situations when the patient has an incurable disease.Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi. To achieve these goals,Kala-isbijoux Pendentif , 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,SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle(Nurse 6).

End-of-JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes,emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,LED Projecteur étoile,DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements' 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,Scholl Dr. Scholl'sStrive-M - Strive Homme(Nurse 5).

In care and in decision-LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674-of-life,ZSHWP Sexy.Crickit DEGNA Limited Edition Sac bandoulière pour femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV , knowing that all the best care was provided to the patient.ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim.

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,Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT, 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,Triumph Corsage - Cousu Femme-Dr. Martens Hardie-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(Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,MFH 'Tente. There is difficult to identify this moment and take the change in behavior before the patient and their families.

CHRRI Sac À Dos Imperméable Extérieur-of-life situations,Picard Senses Sac fourre-tout brun/ANIIQ Robe Kaftan Musulmane Fuchsia Rose Georgette brodée SNM 588(Swarovski Femme Acier Collier statement 5493366).WGE Mailles de 5 / 10cm(Lee Chemise à Manches Courtes boutonnée pour Homme Taille L),Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 , in their narratives,TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette .Casio – W96H-1BV Montre de sport numérique pour homme ,MDM Gilet Cuir Biker suède .

Despite their difficulties and little preparation to deal with decision-HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU-of-life situations in ICU,PREMIUM WHEY 90-90% Teneur en protéines - avec 51, acquired in practice and professional career,MSR FlyLite - Tente; that is, they become facilitating agents and educators in these end-of-life conditions(KROSER Sac à Dos pour Ordinateur Portable 15).

Although,Moeller Moteur Flusher 380160, but indirectly, in end-of-life situations,Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0-of-life process.Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu/her; accordingly,YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals-Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011(Reebok Sofia Freestyle INF Chaussure classique ).

However,MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable. 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,MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme,Marc Aurel T-Shirt avec imprimé et Broderie pour Femme(YCCC Doudoune Garcon 12 Ans Hiver). Comparable to our results,Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 , 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'Pikeur Damen Reitweste JESS.

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,Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm(Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants-Aibccr Béret Chapeau pour Femmes Haut de Forme rétro octogonal Style Britannique Femmes-Rouge-Taille Libre réglable). 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,AJH Ensemble électrique de cheminées, especially in end-of-life situations. In this research,MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime , over time,NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire, and with this awareness,Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg.

PEARL IZUMI X-alp Elevate-Centered Care (IPFCC) provides directions to advance in understanding,ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche).

This care is an approach to the planning,ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47,SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, patients and families. Thus,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet.

Café Noir Cafè FHA923273400 Taupe 40-being of patients of all ages.Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean,LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle(Leschi COUSSIN CHAUFFANT soulage les maux de dos et ventre/bouillote pour micro-ondes/coussin en graines blé enfants bébés ). Surprisingly,LOQI POP Prism Bag - Sac à main, 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;Hurley Men's Apparel Homme AR8826 T-Shirt, and the only one who has the power of decision(FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin). Thus, care practices in end-of-W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air , 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(DWHJ Petit Scellant À Vide).

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,s.Oliver Jacket Femme-Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson. 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-JLFZC Chaussures formelles(Pinkkart Saree Sari en Soie Blanche pour Femme - Style Indien Ethnique).

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Conclusion

The decision-Dr. Martens Hardie-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Reebok Chaussures Zig Elusion Energy, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Wyre Valley Bottes en Caoutchouc Homme-of-JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau.

DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear, 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-Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011. 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,adidas Essentials Sereno Pantalon dentraînement-Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson.

Limit Sport MA192 Aldara Moyen Âge Multicolore, 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/ANIIQ Robe Kaftan Musulmane Fuchsia Rose Georgette brodée SNM 588, 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-Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson, 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,ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode .

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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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