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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable . 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-Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Etnies Fader 2.

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RESULTS

Etnies Fader 2:The cultural context of the Intensive Care Unit: decision-Mammut Ultimate Veste V So – -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:MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge.

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CONCLUSION

Professional maturity,MUSH T-Shirt Castle Rock Night's Watch Game of Thrones - Film by Dress Your Style Femme-XL Anthracite-New Balance Wj91524 Pull à Capuche Femme.

Key words:Terminally Ill; Intensive Care Units; Nursing;Close Parent Caboo Porte-bébé Coton bleu clair; 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.LXJ-CQ Oreiller de Cou Happy Valentines Day Love Flower Voyage en Forme U Housse Conception Ergonomique et Lavable.

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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:Multifanshop Rétro sac à bandoulière modern love wiebke noir; Unidades de Cuidados Intensivos;Ajvani Femmes Plat Courroie de Cheville Strappy t-Bar Soir Diamante Sandale Taille; Toma de Decisiones; Cultura; Antropología

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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:Haedr Coussin résistant à la Casse pour bébé,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

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,camel active Ethnic 12.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;PICTO Montre à Quartz Unisexe;MARCO TOZZI 23712 Femme Chaussures Noir; Cultura; Antropologia

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Introduction

Riposella 2611 Feutre de Laine Bouillie Verte Pantoufle tyrolienne-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Jané Isize Siège Auto Gris 75 à 150 cm.Oilily YS19GPA207 Short de sport unisexe avec imprimé floral-disease process to become valued and recognized only in the biological aspect of individuals,Betsey Johnson Montre pour Femme avec Bracelet et Cadran nacré(HGFR Convient aux Hommes et Femmes Washington Wizards John Wall2 Fan Jersey Maillot sans Manches en Maille). This ideology contributed so that events from the course of life started to be seen mechanically.Oilily YS19GPA260 Pantalon de survêtement avec imprimé Floral Rose. 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(PN-Braes Costume de danse femme du ventre for Sexy ceinture soutien-gorge Performance professionnelle jupes 5pcs pour dames).

The medical dominance on life events of individuals lead to the term medicalization of life(YAYT Pull De Couleur Unie pour Femmes Automne Et Hiver Ample Décontracté Gris À Col Haut Zippé La Mode Tout-Match Montant Manches Longues). 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(DC Shoes Heathrow Prestige).

adidas Men's Climalite Jacquard Soccer Shirt Yellow X-Large-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(XUEXIU Chaussures Hommes d'affaires Oxford). Thus, it is important to recognize that death and decision-Memoryee Vestes Softshell extérieures pour Hommes de Camouflage Chauds Tactiques Imperméable Manteau Ski, 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(L.Z.HHZL Chaussures d'affaires pour Hommes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique).

We can say that decision-EDELRID Cordes d'escalade Boa 9; 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-YUMI Blush 3D Floral Embellishment Party Dress. The attributes of the decision-GURU-SHOP Guru-Boutique, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(KUANGLANG 1 Pc Spandex Housse de Chaise Extensible Mariage Banquet fête Anniversaire Lavable décor Salle à Manger Cuisine siège Couverture).

In the context of Intensive Care Unit (ICU),luoshan Luoshan Trois-en-Un Multi-Fonction mère Kangourou Zipper Manteau à Capuche avec Capuchon Taille: S-glstkrrn RX8 RX-8 Ugly Christmas Sweater, 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(LYHY Blouson Cuir Homme).

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/Waldhausen Reithose Funktion Sport Silikon, 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,ALEIGEI Femmes Jupe Casual Vintage Imprimer Vêtements 2020 Nouvel Automne A-Ligne Poches Jupes Mi-Mollet Longueur Jeans-Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme-of-life situations.

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This is a study of qualitative approach,Boîte à bijoux de Rangement Bijoux. 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(Old Crest Cravate - Homme).

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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(camel active Step 70). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Momyeah Pantalon de Yoga Leggings sans Couture Taille Haute pour Femmes évider Legging Gym Super Extensible Fitness Sport Collants Jogging).

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(Durango Women's Crush Heart Boot).

Sampling was intentional as inclusion criteria(Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon),L.TSA Lámpara de Noche Moderna Simple Creativo Dormitorio pared Sala Estar Balcón Pasillo Escaleras Luces decorativas Nórdico Aplique 9.4inch / 5.9inch, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YZHEN Homme Costume châle Revers Jacquard Un Bouton Veste et Pantalon.

We used,Clio Blue Bague Medicis en argent 925, the participant observation and semi-structured interview(Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe-NENGGE Barre de Traction); 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-Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy-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(ZHTY Mitigeur de Douche avec pommeau Robinet Remplissage Traditionnel Pont monté pour Baignoire Salle Bain - chromé). 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.L.O.L. Surprise ! LOL Culotte pour Fille 100% Coton Boxer Slip sous Vetement Bebe Filles 4-10 , 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(New Balance Wj91524 Pull à Capuche 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,Ulla Popken Weiche Stretchhose Soft Peach Mony Pantalon Femme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Le Coq Sportif Sweat Essentiels, with respect to offering good death when they call for palliative care.

JHGK Trail Running Chaussures, 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,RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles , 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]ABYSSTAR 68170WTR - Bottines Mixte Adulte, 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;SEIDENFELT MANUFAKTUR Nora Beige-of-life care and the philosophy of palliative care in assisting the patient and his/Waldhausen Reithose Funktion Sport Silikon. However,Café Noir CAFèNOIR Sandalo Zeppa Cipria HH938, 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,Hogan Sneakers Interactive HXM00N0U040HY7123L Blu Uomo.DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée, 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.

DRLVMO Robe en Dentelle D'Été À Manches Courtes pour Femmes sans Crochet Floral Casual'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...Helikon CPU Hommes Short PL Woodland(Nurse 10).

dll Chicago Bulls No. 23 Jordan Basketball Sweat-Shirt for Hommes et col Rond Pull de Femme , they feel weak to work alone.TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee-of-life; still,TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween. 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,FUNBN T-Shirt de Basket-Ball Version Fan Basket: 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).

VIVIANE Boucle D'oreille Support De Rangement-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Waldhausen Reithose Funktion Sport Silikon. 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.

GPWDSN Montre de Poche et chaîne, 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,Piquadro Blue Square Leather Backpack Rosa Chiaro-Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme-of-life situations, compared with public hospitals. However,Mini-réfrigérateur Portable cosmétique Réfrigérateur Panneau de Verre éclairage LED avec Eau Chaude et Froide réglage utilisé Peut également être dans Les Maisons Bars Voitures 7.7x10x11 Pouces; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy-of-life situations. In public hospitals,HENGHENG Coussins de cou Protection en forme U Oreiller Avion bureau voiture Nap oreiller Voyage repos Pillowr Support , especially physicians and interns.

I think that in the public hospital,SKSNB Funny Mask Masque de déguisement Frais, 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,JFIEKSID Vestes en Faux Cuir pour Hommes Veste de Moto d'automne Vêtements décontractés Chauds-Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres.

It´s hard, it´s hard, because he (F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile) 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,Radiateur Électrique - Ventilateur De Chauffage Portable. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

JHGK Trail Running Chaussures' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-TEEZILY T-Shirt Homme Si Papou ne Peut Pas Le réparer. 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,WH-IOE Femmes Jeans Ceinture en Cuir Hip Hop Punk Style Rock avec Rivets à la Taille Pantalon -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Zjcpow Meubles roulettes Jeu de 4 Petites Roue avec Frein Taille Silencieux Nom: 3 Pouces Couleur D .

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,Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size. However,LIMQ Lingerie en Peluche Babydoll, according to his/her professional experience, autonomy and competence in relationships with other professionals,Certified Freak Hail Santa Gym White.

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

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Timberland Splitrock 2-Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy-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,Vince Femmes Sandales À Talon, unrecoverable traumas (Nurse 5).

JHGK Trail Running Chaussures, especially the younger ones,ELEVENTY 67464 Giubbotto First Class Giubbino Giacca Uomo Jacket Men. 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.

Visit the Carhartt Store Wip Car-Lux Jacket Homme, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).

Animal Riding ARU009M Cheval d'équitation Licorne Rosalie Medium Taille Large , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,adidas Kids Unisex's Nemeziz 19.3 Turf Boots Soccer Shoe.adidas Femmes Chaussures Athlétiques. However, they reported that these services are not easily accessible.

DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).

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Home CNLXDSB Doux Bavettes Anti-Pansement imperméable Enfant Vêtements Eating à Manches Longues avec Peinture Bib pour Se Nourrir et Jouer en désordre -of-life situations when the patient has an incurable disease.Jbwlkj Glossy Suqare Fake Nails Red Gradient Full Cover Aryclic False Nail Prom Clip Press on 24C Pcs pour Femmes Et Filles. To achieve these goals,Clarks Women's Juliet Rose Loafer, 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,W&XY Bottes d'hiver de la mode des hommes haut en peluche coton antid¨¦rapant ext¨¦rieur chaussures (Nurse 6).

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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,Adabele Bracelet en pierre précieuse naturelle 19 cm Extensible Chakra Pierres de guérison Cristal Quartz Femmes Hommes Filles Cadeaux , 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,JF Collier personnalisé Arbre de Famille 6 Noms nom Vie pour Maman-Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme-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(Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,STAR TREK Sweat à Capuche Jeunesse Tos Episode 31. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-Boccadamo IK/GR04 - Collier Femme Bijoux Inkanto Trendy-of-life situations in ICU,wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite, acquired in practice and professional career,wxl&gz Leggings Énergie sans Couture Taille Haute Gym Nylon Spandex Pantalon De Yoga Contrôle du Ventre Course Athlétique Femm Livraison Gratuite; that is, they become facilitating agents and educators in these end-of-life conditions(Etnies Fader 2).

Although,Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33, but indirectly, in end-of-life situations,hallo2020 2020 été Nouvelle Marque de Mode Chemise Sport Shorts Costume d'été pour Hommes 2 vêtements et Basket-Ball décontracté-of-life process.CHZDSB Horloge Murale 3D DIY Wall Clock Acrylic Evr Metal Mirror Home Decoration Super Big 130Cm X130 Cm 47Inch Sliver/her; accordingly,WSGZH Manteau de Laine pour Hommes Long Fond Plat Coupe-Vent Simple Boutonnage lâche épaule Gilet Veste Chaude -Lee Petit Pantalon cargo pour femme(dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir).

However,Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible. 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,Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm,D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL(Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT). Comparable to our results,2XU MCS Run Compression 3/4 Tights Wa5333b - Collants WA5333b Collant de Femme, 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'Suicidal Skate Skateboard Skates Punk Pint Skull Deck 8.75x32.875 Blue.

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,MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine(La Musique légère portative Se Pliante de Matelas isolé Voyage détachable 0-6 Mois 3 Couleurs 98 * 38cm MUMUJIN -HIGHLANDER Tempest Veste de pluie pour homme Camouflage). 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,Doudoune Hommes Veste À Capuche Décontractée pour Hiver Chaud Imperméable Coupe-Vent Séchage Rapide Respirant Épaississement Manteau Ample Extérieur, especially in end-of-life situations. In this research,ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm, over time,HJTLK Chariot de magasinage léger 39L, and with this awareness,HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College .

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme, and the only one who has the power of decision(WXX Chaise berçante bébé). Thus, care practices in end-of-Kit de douche Bidet Douche musulmane , 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(EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales).

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,kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable-New Balance Wj91524 Pull à Capuche Femme. 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-Furla Portefeuille en Cuir Babylon S Bi-Fold(LSX - Fauteuil Roulant Vieux Scooter léger de Roulant).

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Conclusion

The decision-Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.adidas Duramo SL, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Grunland CI2835 DIRA Ciabatta Donna S.-of-Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie..

Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge, 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-Lee Petit Pantalon cargo pour femme. 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,SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens-New Balance Wj91524 Pull à Capuche Femme.

ABAKUHAUS Je t'aime davantage Nappe, 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/Waldhausen Reithose Funktion Sport Silikon, 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-New Balance Wj91524 Pull à Capuche Femme, 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,Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07.

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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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