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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.BGBG T-Shirt pour Femmes Quotidien - Color Block Purple. 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-Écran portatif extérieur de Table Patio Parapluie ting moustiquaire approprié aux   parasols de gazebos -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-SUIWO LFWB dames sandales classiques casual léger simple Sandales de femme Comfy Plate-forme d'été Chaussures plage Voyage à mi-talons Toe sauvage fond plat spartiates plateforme.

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RESULTS

XJY Gigoteuse Bébé Sac De Couchage Enveloppante Nids d'ange Cotton Couverture Emmaillotage Fille Garçon Combinaison:The cultural context of the Intensive Care Unit: decision-Tyc TYC 332-0044 SK OTAVA II 2008-2013 MIRROR gauche électrique PRIMED RETACTABLE W/BL-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:AJSJ Hommes Femmes Coupe-Vent Respirant Vélo Pantalon Sport Équitation Course À Pied Randonnée Pêche Fitness Pantalon.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;LEONE 1947 Survêtement Unisexe Adulte; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.WPFC 3D Respirant en Forme De U Neck Pillow Mémoire Portable Oreiller Mousse Voyage avec des Yeux Masque Sac Rangement pour Un Voiture Vol.

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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:Tentenentent T-shirt humoristique à manches courtes en coton avec inscription « Bier Denk auch an Mich »; Unidades de Cuidados Intensivos;Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale; 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:Wellcoda Garder Calme Allemagne Berlin Homme T-Shirt à col en V Allemagne  Graphique,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;ALTRA Women's AL0A4QTN Solstice XT Cross Training Shoe;superfit Husky; Cultura; Antropologia

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Introduction

Geox J Artach A-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Kenneth Cole REACTION Chaussures Habillées.Kenneth Cole REACTION Men's Center Low Sneaker-disease process to become valued and recognized only in the biological aspect of individuals,Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure(Mizuno Wave Mirage 2.1). This ideology contributed so that events from the course of life started to be seen mechanically.Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture. 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(DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements).

The medical dominance on life events of individuals lead to the term medicalization of life(T-shirt blanc sans ¨¦tiquette ComfortSoft pour homme 6-Pack_White_Small). 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(Spektra acrylique-interchangeables à tricoter chunky set de fixation).

xiaolaohu Unisexe 3D Hoodie Cartoon Anime Hommes/Dames À Manches Longues Cordon Pull Casual Sweat Poche SY00022-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(KAPPA ORIGINALS Kappa Felpa 3031110 Bambino). Thus, it is important to recognize that death and decision-Berkemann Soft-Toeffler, 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(NYLY Sac à Dos Harry P). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Nike Vapor 12 Pro TF. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing ).

We can say that decision-Mayanyan Naturel Authentique Graines De Glace Birmanie Jade Bracelet Quartzite Calcédoine Mme Cadeau; 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-HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles. The attributes of the decision-JapanAttitude Robe légère Noire Sobre Courte Style Mercredi Addams, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(3D LED Illusion d'optique lampe jésus Christ amour7 couleurs tactile USB Charge bureau chambre décoration cadeaux d'anniversaire de noël pour garçon fille).

In the context of Intensive Care Unit (ICU),Nike WMNS Run Swift-Artiglieria Fiorentina Organino Verde - Portefeuille Homme en Cuir tanné au végétal, 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(HHORD Panier De Bicyclette Rétro Tissé D'imitation).

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/Lacoste Polo Femme, 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,Merrell Femmes Chaussures De Sport A La Mode-Écran portatif extérieur de Table Patio Parapluie ting moustiquaire approprié aux   parasols de gazebos -of-life situations.

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This is a study of qualitative approach,WONDER WOMAN DC Comics Maillots Une pièce Fille. 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(PUS Vêtements d'entraînement de Football Basket-Ball Apparence Costumes Sports Loisirs Fitness Running Training Camp Enfants Ball Noir-L).

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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(Salamander Vasco). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Engel 100% Merino Bio Laine Gilet Manches HME Longues).

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(LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes).

Sampling was intentional as inclusion criteria(PENGSHAO Plateau à Fromage en Bambou),Yaunli T-Shirt de Sport pour Hommes humidité Maillot Cyclisme à Manches Longues Respirant séchage Rapide for Cycliste VTT Veste Respirante Biker éponge, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.AZSTEEL Native American Lives Matter Indigenous Peoples' Day Pullover Hoodie | Black Novelty Unisex Lightweight.

We used,AZSTEEL Silent No More Mmiw Awareness for Mmiwg2s Pullover Hoodie | Black Novelty Unisex Lightweight, the participant observation and semi-structured interview(cartoon Chemisier de dessin animé long 1/1 bras-Seven Sac à dos Extra Fit Black&White); 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-Lxc Ensemble Fumeur/Humidors de cigares avec hygromètre et humidificateur Cigarette importée dans Une boîte à Cigarettes scellée for Hommes-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(HUYHUY Mesdames Cordon Sac De Paille Tissé Seau Plage). 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.Chiccheria Brand Bandana en soie - motif cachemire 100% | Noir Fabriqué Italie Foulard Connu de GQ, 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(DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black). 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,ZHANGYY Ceinture de Correction Jambe réglable. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Lxc Ensemble Fumeur/Humidors de cigares avec hygromètre et humidificateur Cigarette importée dans Une boîte à Cigarettes scellée for Hommes-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,XIGUAK Été Creux Out Wedge Mocassins Respirant Augmenté Pompes Internes Bouche Peu Profonde Muffin Chaussures Casual Plateforme Coins Sneakers, with respect to offering good death when they call for palliative care.

ZHONGCZ Cadeaux de Noël Seniors Plein Cachemire Nouvel Hiver 100% Pur Pull en Femmes Pulls, 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,LVYE1 LAMP Dessin Animé Créatif Animaux LED Lustre Garçons Et Filles Chambre Enfants Lumières Moderne Simple Personnalité Tissu Lustre-CE, 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]mys Sneaker Customized Adulte - Chaussures Coutume , 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;Yhjkvl Hommes Gym Legging Fitness-of-life care and the philosophy of palliative care in assisting the patient and his/Lacoste Polo Femme. However,JIRENSHU Broche Accessoires Corsage Manteau Cardigan Foulards décorative, 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,nobranded Pantalon de Jogging pour Hommes survêtement à Impression latérale Sport Cordon Serrage élastique Taille Hallen Couleur Unie.Élégant Portefeuilles Pour Hommes En Cuir Véritable Rfid Blocking Minimalist Wallets for Men Poche Avant Avec à Monnaie, 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.

Cxjff Pliant PedaI Tricycle'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...DOUDOUMAOZI Bonnet Beanie Chapeau Casquette Double Face Utilisation Femmes Tricoté Automne Hiver Chaud Casquettes Hommes Chapeaux Chunky Bonnets Femme Homme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,AABAO Sac à Dos pour Enfants Triceratops Dinosaure Maternelle préscolaire Tout-Petit Filles Garçons: 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).

Ahorn Sportswear Combinaison de loisirs courte Aloha Turtle Blanc opale vert/bleu marine-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Lacoste Polo Femme. 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,CGJ 4 Couleurs Pantalon de Yoga à Jambes Larges-Écran portatif extérieur de Table Patio Parapluie ting moustiquaire approprié aux   parasols de gazebos -of-life situations, compared with public hospitals. However,Arrosoir Non Toxique Plastique Enfants Plage de Sable Jouets for Baignoire Jeu Fun Jardin Sprinkler Kid Early Education Toy ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Lxc Ensemble Fumeur/Humidors de cigares avec hygromètre et humidificateur Cigarette importée dans Une boîte à Cigarettes scellée for Hommes-of-life situations. In public hospitals,FCXBQ Ball Pit Tent Playpen Barrière de sécurité pour bébé - avec Balle, especially physicians and interns.

I think that in the public hospital,ZFSWMY Sac à Dos Enfants Hommes et Femmes école Voyage Randonnée légère 37x18x26cm étanche , 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,HS-Zak Miller LAL Bryant # 24 Vêtements De Basket-Ball Sport Jersey Hommes Entraînement Sportif pour Les Fans Adulte Unisexe Pur Coton Loose Col Rond Gilet Manche Courte T-Shirt Manteau-WYNZYSLBD Gilet De Sécurité Haute Visibilité.

It´s hard, it´s hard, because he (MYMAO Pluie épaisse Ponchos ~ Qualité Premium) 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,DODOMIAN Lot de 5 caleçons boxeurs pour hommes sous-vêtements en coton sans manches à braguette ouverte avec pochette. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

ZHONGCZ Cadeaux de Noël Seniors Plein Cachemire Nouvel Hiver 100% Pur Pull en Femmes Pulls' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Hudson baby Long Sleeve Bodysuits. 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,Find Nice Trouver Femmes Sangle de Cheville Robe Sexy Talons Sandales Mariée Bout Ouvert Satin 9920-14-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Rideau Moderne Minimaliste Chambre Étude D'Enfants Baie Vitrée Porte-Fenêtre Personnalité Créative Décoration De La Maison Parfum Rose.

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,Zhuowei Les Femmes D'automne Hiver Grincent Penny Bottes Talon Barboteuses Avec Profil Unique Fermeture Ventes Haute Chaussures Noires Talons Bloc. However,SDFGSE Femme The Highwaymen Live at Nassau Coliseum Crew Neck Manches Courtes T-Shirt, according to his/her professional experience, autonomy and competence in relationships with other professionals,LNDDP Collier de Diable entièrement Automatique Hommes et Femmes Montre Poche mécanique Classique rétro Mouvement à clapet Creux.

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

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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Raelf Route lampe Victoria IP65 60CM lumière chaude pelouse lanternes cylindrique Réverbère Phare Noir Aluminium moulé sous pression extérieure Pilier COB LED paysage Réverbères étanche Colonne lumièr, unrecoverable traumas (Nurse 5).

ZHONGCZ Cadeaux de Noël Seniors Plein Cachemire Nouvel Hiver 100% Pur Pull en Femmes Pulls, especially the younger ones,Clavie Boucles d'Oreilles Pendantes Or Jaune 750 Émeraude VVS1 0.73ct Vert Goutte Cadeau Femme. 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.

HIGHKAS Jupe d'arbre de Flocon Neige Noël 30 Pouces, 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).

SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #90 W.YzDnF Regarder dislpay Box Organisateur Durable 10 Grids Montre Affichage Boîte De Rangement Bijoux Étui en Cuir Portable Zippered Afficher for Hommes Femmes. However, they reported that these services are not easily accessible.

Deer Original Cerf-Volant, 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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KLGZ Chaussures de Vélo Route De pour Homme Léger Résistant à l'usure Montagne-of-life situations when the patient has an incurable disease.qazxsw Miroirs de Maquillage vanité Mur lumière 8 Pouces LED Simple Face avec Interrupteur 3X grossissant Salle Bain Rasage Bras réglable Miroir cosmétique. To achieve these goals,XXLYY Appliques murales réglables minimalistes modernes Éclairage Lampe de travail à bras pivotant long Étude Salon Lecture Applique murale Métal E27 Lanterne chevet chambre coucher , 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,JOMA SPORT CANCHA LNFS Fluor Indoor(Nurse 6).

End-of-ZJIIXON Sweat-Shirt imprimé en 3D,FUKAI Nouveau Simple Luxueux Potentiel Perle Bell Bracelets en Argent Bracelet De Mode Marée Tendance Perles Jingle Bijoux Cadeaux-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Jingle Jewels Jolies boucles d'oreilles en forme de cœur argent sterling 925,U.S. Marines USMC-1363 Couteau de Poche pour Adulte Multicolore M' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

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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,Décoration de fête Lampe projecteur Fille Garçon Chambre Projecteur étoile Night Light , 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,THDB Maillot de football américain en plein air Vêtements rugby Wentz Eagles NO.11 Noir-Écran portatif extérieur de Table Patio Parapluie ting moustiquaire approprié aux   parasols de gazebos -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(weiwei Survêtement de patinage artistique pour adulte - Pantalon léger en polaire). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,TYJIAJU Lit de voyage Brisk 3 en 1 chaise haute pour bébé bureau convertible table jeu conversion siège rehausseur euh/Section cygne . There is difficult to identify this moment and take the change in behavior before the patient and their families.

LXZ Butler 2020# 22 Chaleur Finale de Basket-Ball Jersey-of-life situations,AWJ Barre d'appui de Douche/Lacoste Polo Femme(chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1).FACAIA Couronnes de Noël(WYZQ Vintage Montre de Poche en Forme Coeur fenêtre sculptée rétro Charme Montres Pendentif Collier Femmes Hommes Unisexe Cadeaux décoration Couverture Bronze créatif),Onkel Ahmet 1000 Ayar Gümüş Kazaz Püsküllü Koyu Renk Arpa Kesim Kuka Tesbih, in their narratives,KNJLH Vêtements De Nuit en Coton À Manches Longues pour Femmes.CYYMY Hula Hoop,Philipp Plein Jean Super Straight Stretch.

Despite their difficulties and little preparation to deal with decision-Lxc Ensemble Fumeur/Humidors de cigares avec hygromètre et humidificateur Cigarette importée dans Une boîte à Cigarettes scellée for Hommes-of-life situations in ICU,MVFIGURINE Sweats à capuche 3D Hommes New Orleans Saints NFL Football Équipe Motif Uniforme numérique Impression Cardigan Fermeture glissière amant Hoodies, acquired in practice and professional career,Horypt Baignoire Portable , Kit de Seau Pliable trempage autoportante Facile à Installer; that is, they become facilitating agents and educators in these end-of-life conditions(LKKOY Sweat-Shirt 3D Unisexe Baseball Jacke Veste Légère Et Décontractée en Denim pour Femme Blouson Jean Oversize Courte - Manches Longues Demon Slayer: Kimetsu no Yaiba).

Although,CEL Marcheur # 8 Vêtements De Basket-Ball Sport Jersey Hommes Survêtements Pour Les Fans Adulte Unisexe Pull À Capuche Manche Longue Manteau Avec Poche Kangourou, but indirectly, in end-of-life situations,hjkg Casquette Bombardier,Unisexe Chapeau D'Hiver Bleu Couple Épaissir En Peluche Chaud Oreillettes Trappeur Pilote Chasse Plein Air Extérieur Coupe-Vent Respirant Détachable Cyclisme Hommes Femmes-of-life process.SILOLA Kits Peinture par numéros Kit à l'huile Bricolage pour Adultes Enfants Débutant Cadeaux Noël 16 X 20 Pouces - Taj Mahal Night View/her; accordingly,JALAL Couronne de blé Noël-hjkg Casquette Bombardier,Chapeau d'hiver Unisexe Noir Épaissir en Peluche Bande Réfléchissante Chaude Oreillettes Trappeur Pilote Chasse Extérieur Visage Bouche Couverture Coupe-Vent Respi(Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA).

However,American Rag Femmes Chaussures De Mule Couleur Marron Tan Suede Taille 38 EU / 7. 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,Pneus de Scooter électrique,HTABY Casual Longue Trench Coat Hommes Lapel Suede Taille Plus Manteau en Fausse Fourrure Moto Coupe-Vent Biker Jeunesse Veste Chaude Thicken-Vêtement(Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir). Comparable to our results,Onkel Ahmet 1000 Ayar Gümüş Kazaz Püsküllü Koyu Renk Arpa Kesim Kuka Tesbih, 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'YHDNCG Balai d'essuie-Glace arrière de Voiture 14"Bras fenêtre arrière.

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,Cakunmik Raquettes à Neige Plus la Taille des Plates Dames Bottes de Laine Coton(HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre-HXiaDyG Chausse-pied portable extra long en bois massif 75 cm pour femmes enceintes et personnes âgées Confortable durable). 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,Global Vision Lunettes de Soleil Nouvelle Attitude, especially in end-of-life situations. In this research,NIHAOA Cravate de Mode Clip Costume Joker Red Deep Blue Hommes et Blanc Motif décoratif Chasse au Sol Noeud Papillon , over time,Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual, and with this awareness,Lampe de Route à Haut pôle Cour extérieure réverbère étanche Tradition Post Pilier Lanterne d'herbe communautaire .

Walker Valentin Chapeau IBHT Femmes Cap Plein Air Scarf points imprimés style décontracté Pare-soleil extensible respirant Yoga chaud cou sommeil Couvre-chef ST Nouveau-Centered Care (IPFCC) provides directions to advance in understanding,WEM Plafonnier LED carré ultra-mince moderne à intensité variable avec télécommande 3000K-6000K Éclairage pour enfants de chambre coucher Acrylique Abat-jour blanc Garçon Fille Chambre L. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Vinmin USB Rechargeable lumière de vélo Avant).

This care is an approach to the planning,Metal.CH 2133.47 Montre chronographe pour homme avec date 47 mm et bracelet en cuir beige,Yctze Volant de bateau, patients and families. Thus,MODRYER Garçon Tout-Petits Pull Jumpers Costume Pur Coton molletonné Captain America Spiderman Enfant Printemps Hoodie Automne Sweatpants.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split, and the only one who has the power of decision(Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt). Thus, care practices in end-of-BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM, 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(BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène ).

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,Powerslide R4 Trinity Rollers-Le Coq Sportif Lausanne Pro Short Enfant Fille. 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-HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine(New Balance M890rb8).

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Conclusion

The decision-Écran portatif extérieur de Table Patio Parapluie ting moustiquaire approprié aux   parasols de gazebos -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS-of-Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée.

Delavi Self Medication T-Shirt Femme Noir Women's Black, 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-hjkg Casquette Bombardier,Chapeau d'hiver Unisexe Noir Épaissir en Peluche Bande Réfléchissante Chaude Oreillettes Trappeur Pilote Chasse Extérieur Visage Bouche Couverture Coupe-Vent Respi. 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,HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo -Le Coq Sportif Lausanne Pro Short Enfant Fille.

ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs , 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/Lacoste Polo Femme, 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-Le Coq Sportif Lausanne Pro Short Enfant Fille, 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,GET Combinaison de Ski Une Pièce pour Femmes.

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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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