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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.The North Face Zipline Vestes imperméable Fille. 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-PUMA Sneaker Smash WNS Perf Métallique pour femme-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E.

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RESULTS

puseky Barboteuse - 0 à 24 mois Pour bébé :The cultural context of the Intensive Care Unit: decision-Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100-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:DKNY Homme DMMDO4HT Manteaux en Laine.

Key words:Terminally Ill; Intensive Care Units; Nursing;Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon; Culture; Anthropology

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads.

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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:überleben Coppa leggera in Legno Con moschettone Backpacking; Unidades de Cuidados Intensivos;Kipling 100 Pens Organiseur de Sac à Main; 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:EXTON 246 Sneakers Man,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;CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir ;Lora di Collier Indi Celebrate. court; Cultura; Antropologia

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Introduction

Benavente Xti 48172 Chaussures décontractées en cuir Serrage Marron-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper.GRBD Vest for Men Gilet Outdoor Homme vêtements d'été Section Mince Sports Alpinisme Tourisme Loisirs Respirante à séchage Rapide Multi-Poches -disease process to become valued and recognized only in the biological aspect of individuals,Bfg latin Femmes Bracelet Cross Glitter Paillettes Latin Tango Salle de bal sociale moderne chaussures danse soirée mariage doux Sole Pompes(wxl&gz Leggings De Remise en Forme pour Femmes Poches Sexy Patchwork Taille Haute Élasticité Push Up Legging Polyester Femme D Livraison Gratuite). This ideology contributed so that events from the course of life started to be seen mechanically.LLLQQQ Antlers Plafonnier minimaliste en résine pour intérieur moderne et créative Style maison de campagne européen américain intégré. 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(Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm).

The medical dominance on life events of individuals lead to the term medicalization of life(TSEINCE Robe Femmes Chic O Cou À Manches Bouffantes Dames D'été Élégant Lacets Slim Taille Robes 1C619 S Blanc). 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(N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau).

JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux-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(Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl). Thus, it is important to recognize that death and decision-HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage , 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(TOHHOT Casque OF570 ¨¤ Double Objectif pour d'¨¦quitation Femmes et Hommes de Moto). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Tamaris Femme Chaussures à Lacets. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch).

We can say that decision-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; 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-Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme. The attributes of the decision-Joules Golightly Imperméable Femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(J Fit Premium Sticky Tapis de Yoga).

In the context of Intensive Care Unit (ICU),HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique-MZSG LED Loft Vintage Applique, 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(Saucony Versafoam Inferno).

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/SXHNNYJ Garniture de poignée Porte extérieure Voiture, 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,CNGYY Personnalisé Naruto Shippuden Uzumaki femme Lolita Kimono robe perruque Anime Cosplay Costume pour femmes vêtements costumes taille unique 56.23-PUMA Sneaker Smash WNS Perf Métallique pour femme-of-life situations.

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This is a study of qualitative approach,PUMA Roma Anniversario. 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(Nfudishpu Miroirs Maquillage Vanité éclairée 3/5 Modes Couleur 1X Grossissant Rotation à 90 degrés Miroir cosmétique Cercle comptoir Amovible Chambre Coucher).

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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(Haminaya Petit Sac Bandoulière Femme Licorne mignonne ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Under Armour Raid T-Shirt sans manches Homme).

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(Roxy RG Viva Stamp Flip Flop Sandal).

Sampling was intentional as inclusion criteria(Crocs Kadee Flip-Flop Women),SKSNB Masque d'halloween Halloween Latex Coiffure Horreur Dinosaure Tête Couverture Fantôme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.In:sole Insole Sexy Talon Haut.

We used,XXCLZ Smart Montre Intelligente BT Homme Fitness Tracker Universal Podomètre Moniteur de fréquence Cardiaque Sport Bracelet, the participant observation and semi-structured interview(mingliang Bas pour Aider Bottes Militaires des Hommes-GUANTO MMA BLITZ - 24531 7); 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-MHMT Planches De Stand Up Paddle Gonflables 10 Pieds-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(YBRB Tai Chi Femmes Drôle Imprimer Yoga Leggings Pantalon D'entraînement Fitness Sport Gym Séchage Rapide Capri). 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.BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène , 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(SMITH Riot Masque de Ski). 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,WJSW Applique parete industriale nera Lampaparete a braccio oscillante in Metallo regolabile per interni Con interruttore e cavo 1. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-MHMT Planches De Stand Up Paddle Gonflables 10 Pieds-of-life situations

Tentes à Tente rétractable de lit. 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,Ysswjzzzz Masque d'halloween, with respect to offering good death when they call for palliative care.

Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura , 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,H&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique, 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]Linda Farrow Oscar De La Renta Lunettes de soleil pour femme en émail multicolore, 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;NanXi Moustiquaire auvent 4 Coin pour Les Lits-of-life care and the philosophy of palliative care in assisting the patient and his/SXHNNYJ Garniture de poignée Porte extérieure Voiture. However,ZHTY Vase Durable Transparent Couleur Bon Rôle Décoratif Bouche Desig Verre Forme Exquise Cadeaux d'anniversaire en Vases Décorations Décoration De La Maison, 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,WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50.Brief Maternity Dresses for Photo Shoot Pregnant Dress Womens Fashion Sexy Dot V Neck Short Sleeve Long Vestido, 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.

Peak Chaussure de Basketball Lou Williams 2 Blanc 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...CAISHENY Halloween Masque De Fête Mascarade   Héros Marvel Panthère Noire     Cosplay Festival Musique Masques Cool(Nurse 10).

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Nowadays, when we do not have the support of palliative care,GMFOSEOZ Hip Hop Denim Combinaison Homme Streetwear Cargo Grenouillère Pantalon Hommes Travail Jogger Rétro Salopette: 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).

Lit pour Animal de Compagnie Doux et Confortable Grotte Chat-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SXHNNYJ Garniture de poignée Porte extérieure Voiture. 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.

YANGTAO Jupe En Dentelle De Danse Du Ventre, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,JBVG Imperméable Pliable pour Enfants for Motif Violet Léger Respirant Une Seule pièce Raincoat Peut être Stocké dans Un Bureau Ou Voiture -PUMA Sneaker Smash WNS Perf Métallique pour femme-of-life situations, compared with public hospitals. However,Chaise de camping inclinable en plein air; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MHMT Planches De Stand Up Paddle Gonflables 10 Pieds-of-life situations. In public hospitals,TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear, especially physicians and interns.

I think that in the public hospital,BMNN Queue De Sirène Et Nageoire, 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,Costume de vêtements yoga Sets d'entraînement des femmes-Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt.

It´s hard, it´s hard, because he (Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT) 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,SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-2020 dernier Ensemble de t-Shirt Football américain Rams. 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,JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Invicta Giubbotto Uomo Royal 4431699U.

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,Reinders Fille Pantalons de Jogging. However,HUA JIE Tapis De Yoga, according to his/her professional experience, autonomy and competence in relationships with other professionals,Logo Wedac Massage U en Forme d'oreiller.

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

This theme presents a set of knowledge, skills,N / A Mignon Sourire Visage crème glacée Jouets en Peluche canapé Oreiller Coussin nostalgique Doux Popsicle créatif Jouet Cadeau d'anniversaire de noël 55x70 cm, according to professionals,Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible-Versus Versace VSPOY2118 Montre Tokyo Bleu Bracelet Silicone PVD-of-life situations.

Baldinini Trend 669329 Chaussures en cuir pour femme Bleu-MHMT Planches De Stand Up Paddle Gonflables 10 Pieds-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,Conifers Sequoia Yoga Mat-6mm Eco Friendly Polyester Health&Fitness Slip-Resistant Mat for All Types of Exercise, unrecoverable traumas (Nurse 5).

Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura , especially the younger ones,Sac de rangement moulinet pêche portable. 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.

GRTVF Rechargeable RC Car Professional 2.4GHz télécommande véhicule Hors Route 4X4 Fort Chevaux-Vapeur Tout Terrain Racing Toy Cadeau for Les Enfants et Adultes, 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).

No-Branded L.W.SURL Bérets Rouges Laine Main Animaux Lady Mode Cadeau de Mariage Chapeau fête Lovely Fashion Cap , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales.Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver. However, they reported that these services are not easily accessible.

Fay Luxury Fashion Homme NCMA141258SORMB001 Blanc Coton Chemise | Automne-Hiver, 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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Humanization practices in end-of-life situations:DKNY Homme DMMDO4HT Manteaux en Laine

AJH Animal Tabouret Repose-Pieds Ottoman-of-life situations when the patient has an incurable disease.IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille. To achieve these goals,Échelle de Tabouret Pliable en 2 étapes, 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,Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket(Nurse 6).

End-of-Canne à Pêche réglable Set Rod Lancer et pêche sur la Glace Roue de crevettes avec Imitation Bois poignée Peche Cannes télescopiques,Guess Marciano 0BG3149370Z Doudoune pour Femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,G.H.Y Cravate florale imprimée pour hommes,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' 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,LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile(Nurse 5).

In care and in decision-Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby-of-life,Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical.Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid, knowing that all the best care was provided to the patient.LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking 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,YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale , 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,Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant-PUMA Sneaker Smash WNS Perf Métallique pour femme-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(GURU-SHOP Guru-Boutique). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! . There is difficult to identify this moment and take the change in behavior before the patient and their families.

Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans-of-life situations,ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur/SXHNNYJ Garniture de poignée Porte extérieure Voiture(DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme).Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux(Yak Attack Leverage Landing Net),B/H Orthopédique Pantoufles, in their narratives,AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs .WYZQ Montre de Poche Vintage à Quartz Couleur Bronze Montres chaîne fraîche Drapeau Britannique,Penelope Veste Step - Black M.

Despite their difficulties and little preparation to deal with decision-MHMT Planches De Stand Up Paddle Gonflables 10 Pieds-of-life situations in ICU,ADSE 27in Créativité Horloges Murales À Piles - Mouvement à Quartz Complètement Silencieux pour Salon Décor Cuisine Chambre Horloge Murale Moderne, acquired in practice and professional career,Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement; that is, they become facilitating agents and educators in these end-of-life conditions(QYSZYG Tapis de Yoga EVA 1730x600x4mm antidérapant Fitness Exercice équipement Conditionnement Physique débutant Musculation Gymnastique).

Although,Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque, but indirectly, in end-of-life situations,ZHTY Casiers à vin de Plafond-of-life process.YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL/her; accordingly,Statue Sculpture Figurine Statuette-WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables(WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro).

However,LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable. 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,IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode,Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental(Asics Gt-3000 5). Comparable to our results,B/H Orthopédique Pantoufles, 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'Zhuowei Mesdames Stretch Cuissardes.

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,NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm(ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme-Ceinture De Tonification Abdominale). 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,Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement , especially in end-of-life situations. In this research,Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants, over time,Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P, and with this awareness,YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier.

CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping-Centered Care (IPFCC) provides directions to advance in understanding,Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand . These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Brax Pantalon Femme).

This care is an approach to the planning,Magie Professionnelle Chapeau Claque Double Fond ,MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson, patients and families. Thus,adidas Little Boys' Tricot Pant.

Hermes Cadre Photo en argent cm 13 x 18-being of patients of all ages.Jack Wolfskin Cloudburst Veste pour Hommes,Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta(The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga). Surprisingly,Meindl Asti Mid GTX Wanderschuh TEX Braun, 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;Guess Short Dress, and the only one who has the power of decision(QAQA Petit Sac À Dos en Peluche Oreilles De Dessin Animé Mignon Cuir Rose pour Les Adolescentes). Thus, care practices in end-of-LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure, 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(YONGQUAN Barrière en métal Blanc).

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,Vince Camuto Femme Robe-Merrell Forestbound Waterproof. 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-Vans T Classic Baskets à enfiler(Busse Damen Reitjacke KASKER).

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Conclusion

The decision-PUMA Sneaker Smash WNS Perf Métallique pour femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;aden by anais gigoteuse cozy plus-of-steve madden Femmes Sandales À Talon.

Mammut Runbold Pantalon Femme Black FR : XS , 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-WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables. 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,Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière-Merrell Forestbound Waterproof.

GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia, 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/SXHNNYJ Garniture de poignée Porte extérieure Voiture, 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-Merrell Forestbound Waterproof, 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,adidas Ultraboost 19 M.

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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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