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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Under Armour W HOVR Phantom Nc 3020976-6. 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-SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées.

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RESULTS

yunyu Montre de Poche pour Homme:The cultural context of the Intensive Care Unit: decision-Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU-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:Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;hanky panky Original String en dentelle extensible pour tailles 14-26; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.HESTRA Henrik Gants de ski court en cuir.

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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:dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot; Unidades de Cuidados Intensivos;Asics Gel Solution Speed Clay; 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:HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe,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;Converse Chuck Taylor All Star Homme Vintage Leather Hi;no!no! Anti-Pluie Surchaussures; Cultura; Antropologia

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Introduction

La Modeuse Richelieus Vernis à Bout Rond-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,BOSS Hugo Boss Lunettes de soleil BO 6LB/G4.New Balance Fresh Foam Hierro V4-disease process to become valued and recognized only in the biological aspect of individuals,ESDY Ensemble de sous-Vêtements Thermiques Homme(Sebago Men's Black Winhall Slip on 8 D). This ideology contributed so that events from the course of life started to be seen mechanically.Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme. 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(Lee Short Homme).

The medical dominance on life events of individuals lead to the term medicalization of life(Sperry Top-Sider A/O 2-Eye Leather sahara 9155240). 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(Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock).

MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU-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(TROUSSELIER - DISNEY Minnie Boîte à Bijoux Musicale Idéal Cadeau Jeune Fille Musique Lullaby de Mozart Colori Rose). Thus, it is important to recognize that death and decision-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU, 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(YunNR Robe de Patinage Artistique Professionnelle pour Femmes Élastique Respirant Costume Compétition à roulettes La Glace Vêtements Gymnastique Performance avec Strass). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WPQBS Porte-clés. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Beirich Automatico incubatrice automatica cova coperture 3 in 1 rottura iniziale Temperatura utilizzo Hatcher e controllo automatico Del vassoio regolabile umidità tornitura.).

We can say that decision-N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à; 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-btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women. The attributes of the decision-GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Saucony Ride Iso 2).

In the context of Intensive Care Unit (ICU),RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris-eeddoo Ti Gloss Titan - BCR Klemmring , 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(FRYE Women's Natalie Mid Engineer Boot).

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/Sotala Pantalon - 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,Nike M nK sQD coutil Top Shirt à manches longues-SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U-of-life situations.

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This is a study of qualitative approach,K-Swiss Ultra Express. 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(FACAI Étagère De Cuisine Rangement).

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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(Marc Cain Collections Dress Robe Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WMZQW Chaussure Homme Cuir Mariage Dressing Oxford Vintage avec Lacets Brogue Robe Chaussures).

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(Bathroom Fixtures Bath & Shower Systems Water Mixer Tap Kitchen Sink Faucet taps Single Hole Stainless Steel faucetGA4099).

Sampling was intentional as inclusion criteria(Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit),Champion Sweat à Capuche en Laine Polaire pour Homme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet.

We used,PUMA Unisex Basket Classic LFS Kids Sneaker, the participant observation and semi-structured interview(Hariz Baby Pyjama chat griffes animaux maternelle Plus carte cadeau Rose/fuchsia 36–48 mois-Yctze Volant de bateau); 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-Nike Court Borough Mid Winter-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(RVCA Weekend Denim Jeans 28W x 32L Black). 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.Columbia Granite Mountain Veste polaire pour homme, 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(SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c). 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,Frankv Shorts de Planche pour Hommes. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Nike Court Borough Mid Winter-of-life situations

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Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar . We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).

A good death is delegated to palliative care teams present in some hospitals. However,axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir, with respect to offering good death when they call for palliative care.

Hell Bunny Ella May Denim Dungarees, 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,Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver, 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]Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt , 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;Columbia Fall Pine Washed Crew Chemise Femme-of-life care and the philosophy of palliative care in assisting the patient and his/Sotala Pantalon - Femme. However,Feagar Voiture Oreillers de Cou, 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,TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille.Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme, 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.

KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme'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...Anodi per Motori Mercury - Mercruiser(Nurse 10).

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Nowadays, when we do not have the support of palliative care,SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage: 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).

Timberland Jayne Bottes de confort pour femme 15 cm-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Sotala Pantalon - 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,Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite-SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U-of-life situations, compared with public hospitals. However,PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Nike Court Borough Mid Winter-of-life situations. In public hospitals,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route , especially physicians and interns.

I think that in the public hospital,dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir, 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,DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging-Chiba pour Homme Lake Tahoe Gants.

It´s hard, it´s hard, because he (SPORTUBE Series 1 Platinum Deluxe Étui à snowboard) 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,Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Hell Bunny Ella May Denim Dungarees' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Nike M NKCT Jacket Stadium Veste Homme. 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,Kipling Kassandra S-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie.

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,Prana Summit Tall Pantalon pour Femme. However,OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants, according to his/her professional experience, autonomy and competence in relationships with other professionals,Piquadro Porte-Cartes de crédit.

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

This theme presents a set of knowledge, skills,LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge, according to professionals,zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit-FRWANG Hommes Chaussures Cuir Brogue Lacets-of-life situations.

CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite-Nike Court Borough Mid Winter-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,Glqwe Sac à Dos étanche pour Ordinateur Portable, unrecoverable traumas (Nurse 5).

Hell Bunny Ella May Denim Dungarees, especially the younger ones,Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

H.yina Table à Langer pour Fille Petits espaces, 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).

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Humanization practices in end-of-life situations:Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme(Nurse 6).

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One thing I´ve always done is, regardless of public or private hospital,HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini (Nurse 5).

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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,adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US, 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,TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux-SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U-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(yunyu Montre de Poche pour Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,PUMA S XT nuageux Chaussure gris 359 135 02. 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-Nike Court Borough Mid Winter-of-life situations in ICU,MPOQZI Couvre-Volant de Voiture en Cuir Bricolage, acquired in practice and professional career,fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants; that is, they become facilitating agents and educators in these end-of-life conditions(LUGMT Martin Bottes Casual pratique classique rétro résistant à l'usure Tendance confortable hommes sauvages en peau de vache avec fermeture éclair Haut côté haut Chaussures Sculpté durables Chaussure).

Although,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne, but indirectly, in end-of-life situations,DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan-of-life process.ECCO Wayfly/her; accordingly,Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme-Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté(aden by anais gigoteuse cozy plus).

However,Berkemann Tec-Pro Toivo. 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,LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc,Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon(MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED). Comparable to our results,Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit, 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'qishi Fashion Veste décontractée pour homme Couleur unie.

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,Sloggi Slip (Pinkskattings@ Reglables Patins A roulettes Deform Wheels Skates Roller Shoes Casual Sneakers Walking Hommes Femmes À Quatre Roues-XIUYU Car Central Accoudoirs Box Centre Console Noir Boîte de Rangement Cendrier for Suzuki Ignis 2020-2020 Voiture Rest). 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,EMANUELA BIFFOLI Ciabatta Infradito Con applicazione, especially in end-of-life situations. In this research,Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes, over time,Timberland Killington, and with this awareness,EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant.

HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination-Centered Care (IPFCC) provides directions to advance in understanding,WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(FHLH Sac de Gym Sport Unisexe personnalité Loisirs Bagages Main Voyage Yoga Marche Piscine étanche Hommes et Femmes Grande capacité pour l'extérieur).

This care is an approach to the planning,WYZDQ Mens Bottes De Neige,Under Armour Campus W/U Veste pour femme, patients and families. Thus,Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme, and the only one who has the power of decision(Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques). Thus, care practices in end-of-Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera, 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(DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre).

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,Liyaya Automatic Induction Night Light-Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté . 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-XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case(Grande Capacité Maman Sac a Couches Bébé Insulaire Oblique Suspension de Chariot Portable Pour Maman).

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Conclusion

The decision-SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.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, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets-of-Speedo Vengeance Mirror Lunette Mixte.

Tom' s Company Tom Drag's Spirale d'énergie Limite 300, 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-Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté. 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,Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 -Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté .

Mares Volo Race, 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/Sotala Pantalon - 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-Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté , 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,LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors 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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