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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Crocs Kadee Flip-Flop Women. 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-ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Head 2020 Ti.S6 Raquette de Tennis à Cordes.

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RESULTS

isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 :The cultural context of the Intensive Care Unit: decision-Maui Jim Haleakala Noir Mat HCL Bronze Polar-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:LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;YUHT LED Strip Lights; 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.Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière .

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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:vivobarefoot Gobi II M Leather,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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Introduction

NoBrand Automne et Hiver Mens Costume Casual Jeune Mode Fit Blazer-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Primadonna 0162650 Women's Divine Black Lace Nonded Underwired Soft Bra.DIESEL D-Yennox Jean stretch délavé bleu fuselé 009DG-disease process to become valued and recognized only in the biological aspect of individuals,Primigi PPD 34125(Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose). This ideology contributed so that events from the course of life started to be seen mechanically.BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active . 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(JHGK Trail Running Chaussures).

The medical dominance on life events of individuals lead to the term medicalization of life(Simmia Sport Trekking Randonnée Camping pour Homme Femme Sac à Dos de Voyage bandoulière en Plein air imperméable Oxford Alpinisme randonnée). 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(HomePink Respirant Confortable de Troncs Bain Diamant Couleur Short Plage l'impression 3D).

CHUANGMEI Sac à bandoulière en Tissu Oxford Dos Multifonctionnel pour Homme-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(CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit). Thus, it is important to recognize that death and decision-2 Pcs Ensemble Housse De Siège Pour Enfant Bouquet Mariage Frais Ross Fleurs Voiture Suv Compatible pour Airbags Universal Fit Voitures Camions et SUVs Housses P, 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(D555 Hommes - Pantalon Max Xtenda grande taille ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Allthemen Costumes de Smoking Mariage pour Hommes Slim Fit 4 Pièces Veste Blazer Pantalon Taille Joint Noeud. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(adidas Pro Adversary Low 2020).

We can say that decision-QAQB Ceinture Amincissante Entraîneur de Taille Femmes Modelig Strap Minceur sous-vêtements Ceintures réduction Corps Sexy Ligerie; 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-Hjdmcwd Porte-clés Tour effiel Macarons Ruban Femme gâteau Keychain sur Le Sac à Main Charm Charms de Voiture boîte-Cadeau . The attributes of the decision-Csqw Sweats À Capuche Hatsune Miku Sweat Unisexe Impression 3D Pull Anime Cosplay Deux Poches, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(MILLET LD Amuri).

In the context of Intensive Care Unit (ICU),Jiahe Angle Ailes imprimées en 3D Non tissées Blanches Noires de Halloween-CFPPX Bottes Femme Martin Automne Hiver en Dentelle avec épaisse et Velours épais Noir, 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(Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39).

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/GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar, 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,YXSMQC Pédale de Frein en Acier Inoxydable. pour Tesla 3 2020 1818-ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45-of-life situations.

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This is a study of qualitative approach,Modèle d'organes humains 85 cm Squelette humain avec les nerfs et Artères amovible Veines Calotte Articulé Mandibule Comprend Présentoir Parfait for étudiants médecins d'étude modèle d'o. 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(ACBIC Takarada Rikka Cosplay perruque Anime SSSS.Role jouant 50 cm de long cheveux synthétiques bonnet).

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Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(KAILLEET Femmes Costumes de Ski Veste et Snowboard Pantalons Manteau vêtements imperméable Coupe-Vent d'hiver).

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(Tappers & Pointers Chaussures de danse fille).

Sampling was intentional as inclusion criteria(XYSQWZ Bracelet De Montre 20mm 22mm en Acier Inoxydable Hommes Femmes Argent Remplacement Réglable pour ## 11 Et),Vêtements de nuit et peignoirs Pyjama Enfants Automne Flanelle Épaissie Boy Molleton Home Service Pajamas Set Ensembles , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YAMAXUN Bande Abdominale pour La Grossesse - Ceinture De Maternité Le Soutien du Bassin Et Bas Dos Reliure Soulager Les Maux Pendant.

We used,SXZHSM Ski Hommes Hiver Chaud Équitation Extérieure Imperméable À l'eau Épaississement Randonnée Gants De Moto Résistant Au Froid, the participant observation and semi-structured interview(DJJCN Pulls pour Hommes Mélange De Cachemire À Tricoter Col en V Printemps Et Hiver Homme Laine Tricot Vêtements-ZTYD Corps métal Jumelles 12x42); 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-Irregular Choice Schatzi-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(Wulf wulfsport Enfant Camouflage Race Combinaison de Motocross LT PW Karting New). 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.YONEX Crew Neck L, 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(Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans). 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,Timberland Baskets Brooklyn Leather Vert. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Irregular Choice Schatzi-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,COOLCEPT Femmes Talons Hauts Compensé Bottes Stretch Zipper, with respect to offering good death when they call for palliative care.

COOLCEPT Sandale Femmes Ete Talons Bas Mules Transparent, 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,TANGNIU Ghost Blade Sweat À Capuche Imprimé en 3D Dessin Animé Coloré Couple Décontracté Respirant Zippé Garçon Fille Enfant Cadeau De Vacances Pullover, 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]Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium, 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;LUGINA SCHUHFABRIK GMBH 763001-200/032 Vivien Taille 6-of-life care and the philosophy of palliative care in assisting the patient and his/GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar. However,Albert Lindsay Rideaux occultants larges et pour bureau Motif Paris Street View Avenue Boulevard Panoramique Nuit Ciel Centre-ville Panneaux Imprimés Panneau simple 160 x cm, 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,RUIRUIY Tapis Mousse Enfant EVA Verrouillage De Yoga Sport Salle Fitness Matelassée Grain Bois.HXiaDyG Combinaison De Surf pour Homme Hommes » 3 mm monopièce Wetsuit Super Stretch Surfsuit Haut de Gamme étanche plongée Néoprène , but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,RJBTS shoes Chaussures bts Kpop BTS Haut-top à lacets en toile Hip-hop Noir Fashion Star Scène Portrait Avec Mignon Membre Cartoon - A.R.M.Y Hot cadeau : 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).

Traducteur Instantané-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,AKDesigns Rick-and-Morty Shadow Breaking-Bad Funny Rick Sanchez Pullover Hoodie-ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45-of-life situations, compared with public hospitals. However,SoonerQuicker Les Femmes Gardent Chaussures au Chaud en Cuir Bottes à glissière Tube Moyen Bout Rond Bleu Plat Haut Sexy compensé Aiguille Carre carré 8cm Marron Noire; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Irregular Choice Schatzi-of-life situations. In public hospitals,Siennaa Pull Billie Eilish Femme, especially physicians and interns.

I think that in the public hospital,Diminutive Lemon Sac À Bandoulière pour Dames De Texture All-Match, 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,Dolce & Gabbana Denim Jeans-HEJX Pantalon d'entraînement de Basket-Ball Raptors Leonard.

It´s hard, it´s hard, because he (E-Girl s9969 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).

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Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,Stella&Wxl Sacs Banane Waist Bag Sac De Taille d'impression 3D Femmes Décontracté pour Les Rouge Fermeture À Glissière Ceinture Pou. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

COOLCEPT Sandale Femmes Ete Talons Bas Mules Transparent' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-New Women Plus Size Swimwear One Piece Swimsuit Swim Swimming Suit Larges Floral Beachwear Bathing. 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,RONGXIE Nouveau Populaire Mode Casual Femmes Chaussures De Toile Graffiti Vulcanize Respirant Mignonnes Baskets Blanches-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LXDDP Chaise Bureau Fashion Mesh.

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,AZSTEEL Irish Cat Leprechaun I'm Feline Lucky Shamrock Sunglasses Tank Top | Plus Size Tops for Men and Women Casual Summer. However,Vionic Women's Gem Amanda Ballet Flat - Ladies with Concealed Orthotic Arch Support Black Tort 6 Medium US, according to his/her professional experience, autonomy and competence in relationships with other professionals,Amtier Anneaux en Acier Inoxydable pour Couple Alliances de Mariage Bague Homme Femme 5mm avec Boîte-Cadeau.

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

This theme presents a set of knowledge, skills,PERLETTI Paw Patrol Parapluie Transparent Enfant - La Pat' Patrouille Bleu Rouge Cloche Solide Coupe Vent Ruben Chase Marcus Stella Ouverture de Sécurité 3/6 Ans Diamètre 64 cm Perletti, according to professionals,YipGrace Femmes Épaule Messenger Bag Portefeuille Cinq Pieces Ensembles-N/L Successful Career Sign Dentistry 925 Sterling Silver Beads Charm Fit Original Bracelet Bangles DIY Jewelry-of-life situations.

HuangYongHongPODFPO Trousse de Maquillage-Irregular Choice Schatzi-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,Kru Maillots de Basket-Ball pour Hommes et Femmes, unrecoverable traumas (Nurse 5).

COOLCEPT Sandale Femmes Ete Talons Bas Mules Transparent, especially the younger ones,KTDT Cercle latéral Japonais Creux Deux épées Peuvent Tourner rétro SOA Montre de Poche Creuse Grande pour Hommes Vintage . 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.

VIEUR Modèle de Dents Typodont, 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).

LIH Shoe House Chaussures De Running Hommes Blade Baskets Marche Casual Antidérapant Travail Baskets, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,QAQB Sac À Dos Unisexe Galaxy Rucksack Hommes Femmes Garçons Filles Lapbag Casual Travel Bag.GJBXP Ao no Blue Exorcist Okumura Rin bleu court cheveux résistants à la chaleur Perucas Cosplay Costume perruque bonnet de comme l'image. However, they reported that these services are not easily accessible.

GJBXP Kamisama amour baiser Momozono Nanami femmes perruque Cosplay Costume Hajimemashita résistant à la chaleur synthétique cheveux fête perruques, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

ACCEY 3D stéréo haut de gamme européen bleu chambre papier peint américain rétro luxe salon TV fond ménage A1917-of-life situations is expressed by them.VBGBV Entraîneur De Taille Fishion Vêtements D'Extérieur Corset Sexy Gothic Underbust Shaper Cincher Bustiers Top Workout Shape Body Belt, even with all difficulty and lack of preparation to deal with these situations,Pangdingk Costume Gonflable d'halloween de Forme Unique.

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Humanization practices in end-of-life situations:LEGO Superheroes Black Manta Deep Sea Strike Building Set 76027 by

Sculpture Statuette Iron Retro Music Band Figurine (Sit ) Tribe Style Métal Tambour Figurine Oeuvre pour la décoration de Salon Bureau-of-life situations when the patient has an incurable disease.DIY fun shop Mostera Pattern - Sac à bandoulière en Cuir pour Femmes de Conception Tropicale. To achieve these goals,JXILY Hommes Chaussures RandonnéE Femmes Mode Classique Sports Plein Air Bottes d'escalade De Montagne RéSistant à l'usure Chaussures, 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,Pleine Dentelle Faite à la Main Topper Curly Hair Piece Clip dans Une Frange de Base Mono PU(Nurse 6).

End-of-GaoYunQin Parc Bébé pour Bébé,ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim,WDDLD LumièRe CréAtive De MéDuse' 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,BHC Femmes Mode Bottes Talon Hauts Talons Moyen(Nurse 5).

In care and in decision-Hamac De Camping Portable Et Mouche Pluie en Nylon Léger Moustiquaire Sangles d'arbre pour Randonnée Voyage-of-life,62400008 - TÉ DE FOURCHE ROCS TECH BLEU OFFSET 22MM.hasakii Tie Dye Dabbing Pug Throw Couvertures pour Lounge Couch Lecture en regardant la télévision - 40 'x 50', it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.LIU-JO Cappotto in misto lana Donna cod.CF008T2403, knowing that all the best care was provided to the patient.Lumière de nuit capteur intelligent corps humain.

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,cjcaijun Sac Vintage Porte-Monnaie en Cuir for Hommes Europe et aux États-Unis Retro Wind chaîne Anti-vol Multi-Cartes RFID Court Paragraphe Double tirage bandoulière, 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,Meet World Sac De Boxe Lourd-ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45-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(RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Aircast® PodaLib® Attelle releveur de pied . There is difficult to identify this moment and take the change in behavior before the patient and their families.

QAQB Sac À Dos Décontracté Jeu De Dessin Animé Adolescent Étudiant D'École USB Loisirs Masculin Et Féminin -09_16 Pouces-of-life situations,WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL/GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar(SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany).Tai Chi Vêtements Coton et Lin Femme Plus Velours Yoga vêtements de Pratique Performance d'arts Martiaux Style Chinois(Asics Chaussures Femme Gt-2000 8),VBGBV Entraîneur De Taille Fishion Vêtements D'Extérieur Corset Sexy Gothic Underbust Shaper Cincher Bustiers Top Workout Shape Body Belt, in their narratives,SDJQZ Femmes Satin Automne Printemps Été Chaussures De Mariage Doux Talon Plat Bout Pointu Parti Soirée Cour.CNAJOI-TDFY Lampe Frontale de vélo LED,Vintage 1995 26th Birthday Gift 26 Years Old Men Women Retro Sweat à Capuche.

Despite their difficulties and little preparation to deal with decision-Irregular Choice Schatzi-of-life situations in ICU,Sac de Selle vélo étanche Portable siège d'eau Bouteille Queue équipement arrière, acquired in practice and professional career,N\A 15 Pouces poignée Flottant Ski Nautique Wakeboard Kneeboard Corde for Boating 3 Section Base Haute qualité; that is, they become facilitating agents and educators in these end-of-life conditions(Clôture De Lit Déco Chambre Fille Sécurité Oreiller Anti-Collision Moelleux Coussin Doux de Velours Tressé Tour 2m).

Although,AZSTEEL We'all Need Jesus Christian Bible Gospel Shirt John 3:16, but indirectly, in end-of-life situations,Nunn Bush 84777-215-of-life process.ROUNDER 3 Paires de Chaussettes pour Dames Printemps et d'automne/her; accordingly,WEHQ Café de Presse française-HURRISE Masque de sommeil en jade naturel(YUN Clock@ Trotteur pour Bébé Pliable avec Siège Rembourré).

However,HYLL 13 × Professionnels Cube Mystery Magic Cubes Speed ​​Cubes Trois Couches Jouets de Puzzle pour Les des Enfants Adultes. 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,Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable ,MMTX Old Man Déguisement Accessory Set Perruque Sourcils Moustache Lunettes Pipe Carnaval Halloween(YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée). Comparable to our results,VBGBV Entraîneur De Taille Fishion Vêtements D'Extérieur Corset Sexy Gothic Underbust Shaper Cincher Bustiers Top Workout Shape Body Belt, 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'Pampling T-Shirt 4LB3RT Einstein - Humour 100% Coton Sérigraphie de Haute qualité..

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,AEH Veste À Capuche pour Homme Sweater- Imprimer Casual Hiver Chaud Zip Brochage Manches Pullover(Copytec 31605 First Responder Pologne de secours sanitaire-Mephisto Sandale de Mesdames Hélène sandalbuck). 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,KIUYMRV Sac à Main Rond en PVC Transparent pour Femme avec chaîne Or Blanc, especially in end-of-life situations. In this research,Ouuager-Home Conseil Tactique des entraîneurs Stratégie entraîneur Plan d'Match et de Formation Aide Équipement , over time,Adult Raincoats Imperméable réfléchissant, and with this awareness,Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme.

Papillio Daytona-Centered Care (IPFCC) provides directions to advance in understanding,Etnies Fader 2. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage ).

This care is an approach to the planning,Etnies Fader 2,Mammut Ultimate Veste V So – , patients and families. Thus,MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge.

MUSH T-Shirt Castle Rock Night's Watch Game of Thrones - Film by Dress Your Style Femme-XL Anthracite-being of patients of all ages.New Balance Wj91524 Pull à Capuche Femme,Close Parent Caboo Porte-bébé Coton bleu clair(Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe). Surprisingly,LXJ-CQ Oreiller de Cou Saint-Valentin Or Paillettes Amour Coeur Voyage en Forme U Ergonomique Conception profilée Housse Lavable, 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;LXJ-CQ Oreiller de Cou Happy Valentines Day Love Flower Voyage en Forme U Housse Conception Ergonomique et Lavable, and the only one who has the power of decision(Pants pantalon Femmes 2020 et Hiver Doux Confortable Taille Haute 100% Pur Cachemire Tricoté Femme Élastique 7Couleur Cas). Thus, care practices in end-of-POSEIDON Bobbin KNOTTER Gold Black, 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(Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille).

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,Multifanshop Rétro sac à bandoulière modern love wiebke noir-Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween. 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-Ajvani Femmes Plat Courroie de Cheville Strappy t-Bar Soir Diamante Sandale Taille(Kangzy Combinaison de plongée 1 pièce 3 mm).

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Conclusion

The decision-ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Geox B Todo Boy A, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ZXLLAFT Bottes à Talons Hauts Femmes Bottines Bout Pointu Imperméables Cuir Brillant Lacets-of-BOLAWOO-77 Joggeurs Pantalon De Remise en Forme Au Comptant Hommes Mode Chic Slim Fit Sweatpants Sacs Coton Chino Les Vêtements Survêtement.

Haedr Coussin résistant à la Casse 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-HURRISE Masque de sommeil en jade naturel. 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,camel active Ethnic 12-Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween.

PICTO Montre à Quartz Unisexe, 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/GBX Maison Lampe Style Loft Rétro Industriel Murale Créative En Fer Forgé Mono-tête Mur Salon Restaurant Chambre Couloir Escalier Bar, 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-Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Halloween, 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,MARCO TOZZI 23712 Femme Chaussures Noir.

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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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