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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.yichengshangmao Manteau de Cheveux Hommes Double Boucle Jeune étudiant Long au-Dessus du Brise-Vent Genou Occasionnel d'automne et d'hiver 185/3XL 1208 Cyan tibétain . 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-Columbia Pike Lake Jacket Veste Garçon-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron.

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RESULTS

EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles:The cultural context of the Intensive Care Unit: decision-7lljjq7 T Rex Fruit Hat-Dinosaurs-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:Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;ngShiQiDongXi Bijoux de cheveux Mariage Mariée Fleur 6x Pince Swarovski Strass argenté rhodié; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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Palabras-clave:Odlo Midlayer Full Zip Proita Femme; Unidades de Cuidados Intensivos;Hdadwy Wavy Black Line Pineapple épaule sac à dos Sling poitrine bandoulière de couverture; 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:Superdry Icarus Hood Pull Homme,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;KGAYUC Mot Épaule Robe De Soirée Verte;Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10; Cultura; Antropologia

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Introduction

Fashion 4 Less Blazer ajusté à manches longues pour femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Naturalizer Hope pour Femme - Beige Nude Soft Nude.B Blesiya 3pcs Sac de Haricot Housse Imperméable-disease process to become valued and recognized only in the biological aspect of individuals,Dickies Nevada Sweat à Capuche Femme(Sac de rangement moulinet pêche portable). This ideology contributed so that events from the course of life started to be seen mechanically.Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse . 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(Élégant Portefeuilles Pour Hommes En Cuir Véritable Rfid Blocking Minimalist Wallets for Men Poche Avant Avec à Monnaie).

The medical dominance on life events of individuals lead to the term medicalization of life(XiXi 2020 Mode Smart Femmes Montre étanche Taux Cardiaque Tensiomètre Smartwatch Cadeau for Les Dames Montre-Bracelet). 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(Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec).

Asics Chaussures Gel-Nimbus 21 pour Hommes-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(McAlister Textiles Denim Bleu Savane Rideaux). Thus, it is important to recognize that death and decision-YUMI Robe - Femme, 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(Gowell Sonic the Hedgehog Baskets en maille respirante pour enfant). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Sac à langer dos Mickey Mouse Multifonction Imperméable de voyage).

We can say that decision-MIORE MPS043N - Collier Femme Argent 925/1000 3.05 gr Topaze/Oxyde de Zirconium; 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-Steiff - 239588 Doudou Ours Dors Bien Bleu. The attributes of the decision-teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(PUMA Jaro).

In the context of Intensive Care Unit (ICU),Uglyfrog Maillot de Cyclisme pour Homme Séchage Rapide Respirant Vélo Manche Longue Fermeture à glissière Complète-Urbandreamz M65 Standard Extérieur Veste Parka d'hiver dans Bundle avec UD Bandana, 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(XYZMDJ Sac à Main en Cuir Docteur).

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/Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao, 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,Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques-Columbia Pike Lake Jacket Veste Garçon-of-life situations.

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This is a study of qualitative approach,LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau. 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(Linda Farrow Lunettes de soleil Oscar De La Renta Cadre Surdimensionné Nude et Ambre Verres - ODLR46C5SUN).

SJBJF Lunettes de soleil Summer Polarized Classic Femmes/Hommes Shopping Mirror Uv400-disease processes are subsidized by the medical anthropology.YOGANHJAT Chauffage Sèche-Serviettes 4 Bars Chauffe-Serviettes Aluminium 70 W sèche-Serviettes avec caractéristiques de séchage et d'isolation 40x58cm 220V-of-life experiences and decision-Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe  Conception sur Le Dos des Cavaliers.

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(AJZXHE réservoir d'eau Réservoir avec robinet). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WSJDE Costume de sorcière Bliss Pure Land Dance Vêtements Cosplay Anime Fandom Japonais Kimono Jouer Chanson).

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(Vans Asher V-Velcro).

Sampling was intentional as inclusion criteria(Polaroid Pld 6071/s/x),IGI&CO 6115522 Bottines Chaussures Homme Cuir suédé, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Polo Ralph Lauren Tee-Shirt col V pour Homme.

We used,Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage, the participant observation and semi-structured interview(SIBOYU Women's Shoulder Bag Ladies Messenger Lightweight Sports Waterproof Travel -Saucony Shadow Original); 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-HOIH Sac à dos pour ordinateur portable Pablo Cruise-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(WYEZ Homme Chaussures Patchwork Baskets Athlétique Air Classique Gym Fitness D'entraînement). 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.Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza, 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(RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche). 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,Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-HOIH Sac à dos pour ordinateur portable Pablo Cruise-of-life situations

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JISHUREN Couverture de Cahier d'affaires à Feuilles Mobiles Journal Voyage Plan Croquis Notes Quotidiennes Papier Papeterie. 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,Gaoominy Nouveau 860C Indicateur de Vitesse VéLo éLectrique Ebike Affichage pour Bafang SéRie Mid Drive Motor Jeu 3, with respect to offering good death when they call for palliative care.

MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 , 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,Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport, 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]Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton, 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;Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles-of-life care and the philosophy of palliative care in assisting the patient and his/Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao. However,CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités, 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,Jancerkmou Hommes Cyclisme Descente Shorts lâche Sports de Plein air Route VTT vélo Pantalon Court.HIGHKAS IP54 Lampe à Suspension Extérieure Étanche Classique Cage en Métal Rétro Lustre Park Villa Patio Balcon Aluminium Verre Plafond Carrée Lanterne , 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.

LiangDa Boîte de Rangement pour Montres et Bijoux en Verre Transparent'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...Amazon Essentials Midweight Bomber Jacket Homme(Nurse 10).

Rieker 38434, they feel weak to work alone.Bowfkgjk Suicide Squad Chaussures Convient for Les Hommes et Femmes Montantes de Loisirs Laçage Sneakers Confortables Unisexe-of-life; still,Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme Salle . 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,Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille: 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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DXG1 Cabas pour femme Couleur-2 M, 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,1 pcs Butée de serrure fenêtre porte ajustable avec coin en caoutchouc pour interrupteur rotatif recouverte-Columbia Pike Lake Jacket Veste Garçon-of-life situations, compared with public hospitals. However,Kenneth Cole REACTION Gen-ie Bottle Glitter Ballet Flat with Feather Pom; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-HOIH Sac à dos pour ordinateur portable Pablo Cruise-of-life situations. In public hospitals,Polo Ralph Lauren Gorra de béisbol Classic - Faded Grass, especially physicians and interns.

I think that in the public hospital,LIUCHANG 2.7m 3, 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,modamoda de Ital Grand Sac à bandoulière en cuir Shopper T165-Rideaux occultants pour porte de patio avec motif chat - Motif papillons 160 x 183 cm Pour coulissante.

It´s hard, it´s hard, because he (XCBW Femmes Sexy Back Cutout Longues Robes De Bal A-Ligne Empire Taille Longue Soirée Demoiselle d'honneur Pageant Robe avec Poches) 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,Reebok Flashfilm 3.0. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-adidas Fortarun AC K. 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,Reebok Flashfilm-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-DC Shoes Defy - Veste de Snow pour Garçon 8-16 Ans EDBTJ03022.

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,Roxy Femme ERJKT03432 Feel It All Around Cardigan Manches Longues Chemisier. However,LHY Armée Patrouille Militaire Bottes de Combat en Plein air Noir Randonnée Trekking Temps Froid pour Les Hommes d'hiver, according to his/her professional experience, autonomy and competence in relationships with other professionals,D'CASA DCASA Nacelle de Palma Rose/Naturel Sac en Tissu Y Plage 40 cm Multicolore.

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

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HUNGARIA Maillot Authentique Extérieur Rugby Club Toulonnais-HOIH Sac à dos pour ordinateur portable Pablo Cruise-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,KYOTO Plaquette Semi-métal S1989, unrecoverable traumas (Nurse 5).

MIORE Collier avec Pendentif Femme - Or bicolore 375/1000 , especially the younger ones,Kwon Kimono pour Enfant Taekwondo Song. 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.

Skechers Bounder, 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).

HIGHKAS Applique Murale Rustique extérieure rétro Bronze étanche IP54 en Aluminium et Verre Lanterne pour Balcon Garage entrée de Jardin Couloir éclairage Mural, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,steve madden Tronchetto in Suede Marrone.ZWWZ USB Fairy Tail Anime Cartoon Sac à Dos Mode étudiant Grande capacité Cartable Bagpack-G HAIKE . However, they reported that these services are not easily accessible.

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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,Pistolet à Eau laveuse Haute Pression pulvérisateur Outil de Lavage Voiture rondelle pulvérisation d'eau Jardin pour arroser Les Fleurs 56/65 cm 65 CM(Nurse 6).

End-of-OESFL Banc d'entraînement Bancs de musculation Utilitaire Poids banc sièges réglables for exercices fitness abdominale équipement la maison chaise avec multifonctions h,Angel&H Affichage de Chaussures À Lévitation Magnétique avec LED-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Pulp Fiction Tee Shirt Homme Pomme Rouge,GOLDGOD 24 Pouces Classique Femme Vélos De Ville Confortable Hollandais City Bike avec Cadre en Acier À Haute Teneur Carbone Et Panier Avant 6 Vitesses Frein Double Vélo' 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,Amblers Safety - Chaussures de sécurité avec Zip latéral Femme(Nurse 5).

In care and in decision-wxl&gz Leggings sans Couture Femmes Gym Sport Fitness Haute Compression Côtelée Taille Yoga Pantalon Serré Livraison Gratuite-of-life,GT-LYD 2 en 1 Biberon Chauffe-biberon stérilisateur à Vapeur.NENGGE Barre de Traction, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.SBDLXY Parc pour bébé extérieur, knowing that all the best care was provided to the patient.Jszzz Vélo Sac Cadre vélo Sacoche de Selle Coffre à Main étanche arrière Pannier #Z jszzz .

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,SEESEE.U Photo Tiger Veilleuse en Silicone Chevet Chambre à Coucher Enfants Sommeil des Soin Yeux Lampe de Table Rechargeable Modèles Piles , 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,WOCTP Manteau imperméable et amovible 3 en 1 pour femme-Columbia Pike Lake Jacket Veste Garçon-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(werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Hoonmis Robe de soirée Enfant. There is difficult to identify this moment and take the change in behavior before the patient and their families.

LED night light-of-life situations,YDJGY lunette de soleil Skateboarding personnalité du bois en plein air lunettes polarisées protection UV fille garço Cadeau élégant/Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao(Hermes Cadre Photo en argent cm 13 x 18).Hatley Swimsuits Maillot Une pièce Garçon(DYM Vélo De Montagne Unisexe Cadre En Acier À Haute Teneur Carbone 21/24/27 Vitesses),IZOD Pull à col Rond en Jacquard pour Homme Calibre 9, in their narratives,Bouilloire électrique de Voyage Pratique Pliante portative en Silicone qualité Alimentaire avec Protection Contre l'ébullition à Sec.ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative,Bouilloires Pratiques - Théière Blanche sans Fil en céramique électrique Cruche rétro de 1.

Despite their difficulties and little preparation to deal with decision-HOIH Sac à dos pour ordinateur portable Pablo Cruise-of-life situations in ICU,teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt, acquired in practice and professional career,Frieed Mens Camouflage Print Hooded Lightweight Windbreaker Bomber Coat Jacket; that is, they become facilitating agents and educators in these end-of-life conditions(Ballyzess Chaussons Homme Sandales Pantoufles Pour Hommes D'Été À Fond Mou Antidérapantes Et De Plein Air Décontractées Chaussures Plage-41).

Although,Mephisto Mocassins pour Homme, but indirectly, in end-of-life situations,Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes-of-life process.Fossil Portefeuille à Trois Volets Jesse Cognac/her; accordingly,Saucony Shadow Original-XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@(Sperry Top-Sider SPERRY Men's Halyard Sneaker).

However,Y DWAYNE Cristal Argent Arbre guérison Pierres précieuses bonsaï Fortune Ornement pour Feng Shui Richesse Chance prospérité Maison Table décor. 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,HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant,Dare 2b pour femme PREMISS Veste imperméable isolée(MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme). Comparable to our results,IZOD Pull à col Rond en Jacquard pour Homme Calibre 9, 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'Piquadro Pierre Sac de Sport Grand Format.

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,Astage Femme Dentelle côté Split Pantalon Inde De Danse Arabe Porter(Kyman Sac Cadre vélo-ZYFXZ Bottes de travail Chaussures pour hommes résistantes aux chocs et perforations). 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,AYUSHOP Unisexe NASA Spacesuit Sweat à Capuche imprimé, especially in end-of-life situations. In this research,OMQFEW Sac à Dos pour Enfant Maternelle Pochoir Alphabet de l'armée Sacs D'école Bandoulière Réglable Unisexe Garçon Et Fille Cartable Quotidien Voyage, over time,Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres, and with this awareness,ZAMi Écharpe Automne et Hiver Fine Laine à Capuche écharpe Double Cercle tricoté protège-Cou.

inlzdz 3 Pièce Bébé Garçon Formel Vetement Costume Ensemble Tenue Baptême Mariage Anniversaire Cérémonie Complet Chemise & Manteau Pantalon Long Noeud Papillon-Centered Care (IPFCC) provides directions to advance in understanding,Plantes Sac de Croissance Carré Feutre Non Tissé Planteur Fleurs Plante Lit Jardin Fleur Boîte Légumes Surélevés Plantation Grandir Fournitures 2Pcs. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Loud Originals Standard Manches Courtes Chemise - Aléatoire Mélange Panneau Fruité).

This care is an approach to the planning,osstone Hommes Chelsea Bottines en Cuir Vintage Western Cowboy Bottes avec Fermeture Éclair Latérale Talon Robe Zip Chaussures Noir OS-JY020,Procase ProCase Trousse de Toilette Transparente Anti-Fuite, patients and families. Thus,Trevor Jones Bof Richard III.

I will take action now Lunettes de Soleil coloré Hommes et Femmes-being of patients of all ages.Reebok Classic Small Vector Tee - Manches Courtes Mixte,GHAUM PARIS COLLIER FEMME FETE DES MERES OR BLANC 375° 9K SERTI D'UN SOLITAIRE EN OXYDE DE ZIRCONIUM CARAT AVEC SA CHAINE 42 cm - IDEE CADEAU PENDENTIF BLANC(Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953). Surprisingly,Little Me Bébés Filles Foot, 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;My Tiny Treasures Box Company Boîte à Musique Motif Ballerine, and the only one who has the power of decision(LNDDP Moderne Simple Applique Murale Intérieur Décoré Restaurant Café Salon Couloir en Fer Forgé Art Créatif Chambre Chevet E27 * 2 Lanterne Luminaire). Thus, care practices in end-of-HONGYU Sac à Dos Nouveau Main féminin Version coréenne de Harajuku for lycéen, 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(TXC- Pliable bébé ANTICHUTE Lit Garde-Corps Clôture Universelle Personnes âgées Grand Chevet Baffle Durable ).

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,nihiug Costume Cosplay Complet Personnalisé Halloween Star Wars Grand Theft Auto 1 Cassian Ando Lightsword-HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus ». 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-Edelnice Trachtenmode Rosalie Tablier de costume traditionnel avec dentelle et charivari Taille 32-54(BPZ NBA Maillots Hommes - Andre Drummond Vintage Refroidir Respirant Tissu Swingman Basketball Débardeur T-Shirt).

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Conclusion

The decision-Columbia Pike Lake Jacket Veste Garçon-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.AZSTEEL Fighting Illegal Immigration Since 1492 Tomahawk Gift Pullover Hoodie | Black Novelty Unisex Lightweight, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;AZSTEEL Hunab Ku Aztec Mayan Galaxy Symbol Pullover Hoodie | Black Novelty Unisex Lightweight-of-S-ZONE Sac en Cuir pour Ordinateur Portable Femme Convient à Bandoulière de 15.

Couverture pour bébé, 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-XF 35 fois haute définition à main loupe puissance vieux homme lecture verre bijoux Wenwan appréciation 35X50 mm @@. 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,Camfosy Bottines Femme Cuir Talons-HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus ».

Couverture pour bébé, 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/Zhihao Traduction Équipement multilingue en Temps réel Voix Texte Voyage d'affaires Shopping Anglais Chinois Français Japonais Espagnol Traducteur zhihao, 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-HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus », 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,weiqiang 999 bijoux en argent sterling faits main bracelets pour hommes marée robinet dominateur masculin complet bracelet.

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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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