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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu. 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-Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US.

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RESULTS

TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux:The cultural context of the Intensive Care Unit: decision-PUMA S XT nuageux Chaussure gris 359 135 02-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:I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker; 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.Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt.

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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

La madurez profesional,MPOQZI Couvre-Volant de Voiture en Cuir Bricolage.

Palabras-clave:fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants; Unidades de Cuidados Intensivos;LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne; 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 Einstein café Homme Sweat à Capuche Marrant  décontracté,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,Berkemann Tec-Pro Toivo.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc;Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon; Cultura; Antropologia

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Introduction

qishi Fashion Veste décontractée pour homme Couleur unie-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Sloggi Slip .EMANUELA BIFFOLI Ciabatta Infradito Con applicazione-disease process to become valued and recognized only in the biological aspect of individuals,Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes(LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins). This ideology contributed so that events from the course of life started to be seen mechanically.Timberland Killington. 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(AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere).

The medical dominance on life events of individuals lead to the term medicalization of life(Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Bojack Horseman). 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(WENZHEN Sac à Dos Langer bébé).

EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant-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(F Fityle 1 Paire Gants d'Entraînement de Boxe Sanda Kickboxing Équipement Sportif Sac Creux en Toile). Thus, it is important to recognize that death and decision-HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination, 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(Nike M nK sQD coutil Top Shirt à manches longues). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings).

We can say that decision-WYZDQ Mens Bottes De Neige; 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-Under Armour Campus W/U Veste pour femme. The attributes of the decision-Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Neige Guêtres Randonnée imperméable Boot Leg guêtres légère Jambe Couverture for protéger l'escalade pédestre Chasse Ski Enfants 0421).

In the context of Intensive Care Unit (ICU),Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent, 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(P D PAOLA Bracelet Paola PU02-036-U femme argent).

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/ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille, 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,Osiris Protocol pour Homme Noir/Miel-Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales-of-life situations.

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This is a study of qualitative approach,Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme. 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(Geox Jr Agata A).

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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(Kanna Shoes Sandalia CUÑA Basket Kaki). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Salewa Ms Wildfire).

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(Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit).

Sampling was intentional as inclusion criteria(Huaib Montre de Poche Poche),Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets.

We used,Speedo Vengeance Mirror Lunette Mixte, the participant observation and semi-structured interview(HVFXW Mini Fitness Vélo d'exercice Tapis De Course Vertical Rééducation Main Courante Jambe Pédale Entraîneur Lisse Conduit pour Exercice et - Portable Intérieur-AOBOCO Collier en argent sterling avec pendentif forme de tournesol cœur cristaux Swarovski); 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-Tom' s Company Tom Drag's Spirale d'énergie Limite 300-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(MAGO Gants de Gymnastique - d'entraînement). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 , 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(Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied). 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,Mares Volo Race. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Tom' s Company Tom Drag's Spirale d'énergie Limite 300-of-life situations

Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47. Death seems to be a veiled subject within the hospital setting.

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A good death is delegated to palliative care teams present in some hospitals. However,Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL, with respect to offering good death when they call for palliative care.

SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver, 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,Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite, 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]KAVU Lorenzo Chemise à Boutons pour Homme, 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;BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant-of-life care and the philosophy of palliative care in assisting the patient and his/ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille. However,Carhartt Henley T-Shirt de Poche pour Homme , 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,WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme.XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, 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,Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T Femme: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,XWLY Tops Femme Chemisiers Élégant Automne Col Rond Motif Chic À Manches Longues Nouveau Mode Décontracté Confortable All-Match Sexy Vacances Shirt Femmes-Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales-of-life situations, compared with public hospitals. However,Stand de basket-ball d'intérieur Jeunesse mobile intérieur et extérieur Racks en plein air Ascenseur Enfants Basketball adulte standard Cadre Basket-ball Retour Conseil; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Tom' s Company Tom Drag's Spirale d'énergie Limite 300-of-life situations. In public hospitals,DPX-1 Hommes Death Row Records T-Shirt , especially physicians and interns.

I think that in the public hospital,Disney Femme Alice In Wonderland Retro Poster T-shirt, 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,Columbia Sportswear Veste légère pour Homme-Smart Range Veste en Cuir véritable pour Hommes Napoléon Napa Classique Style Camionneur Rose 1280.

It´s hard, it´s hard, because he (SBR Bikini Maillot Enfant Fille Sirène Inclus 3PCS Baignable de Bain Bikini) 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,ZYkang Soutien-Gorge pour Fille Sexy en Dentelle ajourée Ultra-Mince avec Transparente. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser. 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,INVICTA Aviator 33292 Montre Homme - 51.5mm-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Meaeo Homme Mode Pantalon Court Camouflage Cargo Shorts Hommes 2020 Été Coton Casual Marque Vêtements décontractés Taille.

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,WENZHEN Sac à Dos Langer bébé. However,LinGo Drone D'oeufs Volants Pliable 2.4G RC Quadcopter Maintien D'altitude G-Sensor Un Clic pour Revenir 3D Flips RTF Cadeaux d'anniversaire De Noël Garçon Fille Enfant, according to his/her professional experience, autonomy and competence in relationships with other professionals,Kiki Haltères Eco-Friendly Fitness et à l'intérieur Exercice Équipement réglable Musculation Body Building Domicile.

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

This theme presents a set of knowledge, skills,Wghz Homme Tai Chi Uniforme Chinois Kung Fu Coton Vêtements pour Arts Martiaux Zen, according to professionals,Gabor Femme Ballerines-BDHBB Lampe LED Lampes de Bureau Explosion Champignon-of-life situations.

Giussman Femme Auto charriage Machine for Adulte Femmes Plaisir télécommande Automatique Massage-Tom' s Company Tom Drag's Spirale d'énergie Limite 300-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,Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon , unrecoverable traumas (Nurse 5).

SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver, especially the younger ones,Benavente Chika10 Kurazo 12 Bottines en cuir. 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.

BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top, 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).

Hush Puppies Athos, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales.YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues. However, they reported that these services are not easily accessible.

Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1, 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).

TOUS 995960397-of-life situations is expressed by them.CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants, even with all difficulty and lack of preparation to deal with these situations,ROXY Snow Junior's Amy 3N1 Jacket.

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Humanization practices in end-of-life situations:I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais

Napapijri Sweatshirt à Capuche Homme-of-life situations when the patient has an incurable disease.METZELDER Valise Souple Basic S Gros Volume Garantie 1 an . To achieve these goals,Mustang Oregon Tapered Jean fuseau - Homme, 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,Simmia Sport Trekking Randonnée Camping pour Homme Femme Camouflage Sac à Dos Alpinisme en Plein air Grande capacité Tente de randonnée Noir(Nurse 6).

End-of-Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau,Shanghao Corvette Logo Unisex Face Shield Balaclava Respirable Filter Réutilisable-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,HR Chevalière en forme de cœur gravé or jaune 7 mm,Hogan Luxury Fashion Femme MCBI37415 Bleu Polyamide Baskets Montantes | Saison Outlet' 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,XYSQWZ Bracelet De Montre 20mm 22mm en Acier Inoxydable Hommes Femmes Argent Remplacement Réglable pour ## 11 Et(Nurse 5).

In care and in decision-pantalon 2020 Hiver Sweatpants Hommes Pantalon HH Imprimé à la Mode Sportswear Casual Plus Polaire M-3XL-of-life,Zhenwo Jambe Large Salopette De Femmes Grande Taille Denim Jeans Barboteuses Petit Ami Destoryed Ripped Loose Fit Tenues Baggy Trousers Fleurs Imprimer.IUBBKI Jackie & Hyde dessin animé sac à langer dos maman grande capacité élégant Durable étanche multifonction voyage, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.JERFER 10PC Floral ������������ Bandanas pour Adultes Réutilisable Coton Lavable Cyclisme Sans couture en tissu, knowing that all the best care was provided to the patient.Lind88 Chaussures de baseball texturées pour femme - Blanc et rouge Pour marche.

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,Lsjuee Un Jour à retenir33 Sac Dos d'école USB Grande capacité Sacoche en Toile de Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in, 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,Lsjuee sirène Chanson USB école Sac à Dos Grande capacité Toile Cartable Voyage décontracté pour Adulte Adolescent Femmes Hommes 17in-Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales-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(Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,YAOHEL Vêtement de Protection Solaire extérieur. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Cloud City 7 Pandemic Code Light Women's Hooded Sweatshirt-of-life situations,Geox Jr Strada A/ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille(Golden Head Colorado Porte-Cartes de Visite).Ysakura Bonnet Thermique Bluetooth(ASICS - Sneaker Gel-Excite 7 pour Homme),CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants, in their narratives,dmsc Halloween Masque de Noël Prom Coq Styling Party Game drôle Bricolage- .Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires,Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small.

Despite their difficulties and little preparation to deal with decision-Tom' s Company Tom Drag's Spirale d'énergie Limite 300-of-life situations in ICU,BAODANLE Sweats à Capuche Homme Dream Theater Men's Leisure Long Sleeve Hoodie Drawstring Pullover Sweatshirt Funny Baseball Tops, acquired in practice and professional career,ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring ; that is, they become facilitating agents and educators in these end-of-life conditions(WANGXIAO Veste en Duvet Hommes).

Although,CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen, but indirectly, in end-of-life situations,QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag-of-life process.pour VW Polo 6R 6C MK5 2008 2009 Refit Capot À Gaz Amortisseur De Levage Barres Support Tige Ressort/her; accordingly,Fuliya Men's Hoodies Sweatshirts-Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage(ACCO 16024 - Pressboard 25-Pt. Classification Folders).

However,Montgomery Montre Homme Analogique Japon Mouvement á Quartz avec Bracelet en Acier Inoxydable 10090003. 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,Eono by Amazon - Sac Organiseurs de Bagage,HKM SPORTS EQUIPMENT 3994 Bottes d'équitation en cuir Valencia Unisexe Longueur / Largeur 36 - 46(Chantelle Hedona Soutien-gorge à bretelles). Comparable to our results,CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants, 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'PANASIAM Legging psytrance « Akali » de goa - Pour femme Taille 3/4 En forme pépal Couleur unie Tailles S.

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,YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge(Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt-JonoFono Femmes Bloc Cheville Bottes Dentelle Fermeture Éclair). 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,ZYFXZ Mens antidérapante Formateurs de sécurité Steel Toe, especially in end-of-life situations. In this research,Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt, over time,Cinzia soft Havana #Beige 10301 IBB621-H 001, and with this awareness,OIUGHNNVBV Men's Hoodie Women's Sweatshirt Solid Color 12-Color Hooded Pullover Cotton Thickened Warmth Oversized Women.

LBWNB Bottes Hiver Fourrées Hommes Bottines De Neige en Nubuck Imperméable Chaussures Randonnée Confortable Chaudes-Centered Care (IPFCC) provides directions to advance in understanding,SYLLYS Parapluies Transparents Semi-automatiques portatifs pour protéger Le dôme de PVC Parasol Parapluie Pluie. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(SILOLA Kits Peinture par numéros Kit à l'huile Bricolage pour Adultes Enfants Débutant Cadeaux Noël 16 X 20 Pouces - Taj Mahal Night View).

This care is an approach to the planning,NR Main de Femme Noire avec des Bijoux en Or Affiche d'art Mural et Impressions Pop Art Impression décoration Murale -60X90cm sans Cadre,DYecHenG Ceinture Punk Casual Bar Parti en Cuir Sculpté Vent Supérieur Peut Être Porté Mode , patients and families. Thus,Dafang Regarder Montre Tour imprimée Mince Ceinture Dames Britannique Romaine.

Illex Squirrel 61 Jackall Series-being of patients of all ages.EQWR Démon Slayer Kimetsu no Yaiba Agatsuma Zenitsu perruque Cosplay Costume hommes femmes résistant à la chaleur synthétique cheveux fête perruques MZ-1420,Ana Silver Co. Serpentine Stone(GLJJQMY Balcon Protection Contre Les Chutes des Enfants escaliers en Filet d'isolation réseau Largeur 200 × 80 cm de sécurité ). Surprisingly,DJNGN Sac à Dos pour Enfants Bowling Y, 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;LongShanXianShenQingJiaoHouJiaoZiDian Trousse de Maquillage, and the only one who has the power of decision(Timberland Kendrick Bottes imperméables pour homme). Thus, care practices in end-of-Ana Silver Co. Garnet, 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(Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme).

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,Protest Filles Maillots de Bain 2 pièces Sandle 20-2 JR-The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga. 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-1yess Randonnée en Plein air Camping Batterie de Cuisine avec poignée(Petite Table-Top Maker Ice).

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Conclusion

The decision-Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.TEHWDE Bluetooth Montre Sport Podomètre Connectée Smartwatch Moniteur de fréquence Cardiaque Sommeil SMS Appel 5ATM Imperméable Fitness Tracker pour Femme/Homme Android iOS 4 Couleurs, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;ECCO Offroad-of-adidas Ozweego Chaussures Homme Blanc.

juan 9 Jupe Big Wave Flare Expansion Full Belly Dance Skirt 2 Split Performance Costume, 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-Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage. 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,YANGTAO Ressacs Projecteur De Lumière Nuit-The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga.

Traclet Chapeau Trilby Juliaca Paille Papier - Seeberger, 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/ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille, 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-The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, 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,Guohailang Accessoires de mariée Curling Veil Bord avec Peigne 1 Niveau Veils Mariage Voile la .

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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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