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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Saucony Guide Iso. 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-Deluxe Gems 0.73 ct Oval Cut -of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-CMP Feel Warm Flat.

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RESULTS

adidas Gazelle:The cultural context of the Intensive Care Unit: decision-adidas Forest Grove Cg5675-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:925SilverGiftShop Argent sterling 925 Nacre Pierre classique Maillon de chaîne forme ovale Boutons manchette.

Key words:Terminally Ill; Intensive Care Units; Nursing;Gant 1901.4204663 Short Femme; 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.CuteRose Baby Grils Infantile Boys Lightly Hoode Down Coat Jacket.

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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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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:YLYT Lampe Starry Sky Night Light Enfants Nuit,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;SGSKJ Sacs à Dos Femme Fun Pirate Beach Cuir Cartable College Sac a Voyage Portable Scolaire Ecole;WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym; Cultura; Antropologia

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Introduction

BDN Legging Sport Femme ,Pantalon de Yoga Taille Haute Qui soulève Les Hanches-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Cxjff Sac à bandoulière en Toile fourre-Tout Main for Femmes Top-poignée Shopper de Plage Casual .Ancient vine green Durable Route 11 Speed ​​Cassette Freewheel Sprocket Velocidade 28T Roue Libre Cyclisme Partie vélo Simple et Pratique -disease process to become valued and recognized only in the biological aspect of individuals,CHUADIAD Super Rugby Union Football américain Respirant Sport T-Shirt(LIULINUIJ Boutonnière Au Dos). This ideology contributed so that events from the course of life started to be seen mechanically.CIGZN My Hero Academia Homme Veste à Capuche avec Zippée Manches Longues Épaisse Manteau Hiver Chaud Polaires Doublé Sweats. 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(Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.).

The medical dominance on life events of individuals lead to the term medicalization of life(Keds Moxie Mule Baskets à enfiler en sergé lavé pour femme). 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(Baignoire Pliante pour bébé).

sqddsg Luminaire Enfant Originale Lampe décorative Vision stéréoscopique LED coloré 3D de Santa individuelle Petite colorée-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(X-Toy 1/72 Fighter Modèle en Plastique). Thus, it is important to recognize that death and decision-Saucony Jazz Original, 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(QIAOLII RFID Blocking Purse Girl Clutch Wallet Tropical Palm Tree Leaves Pineapple Men Long Trifold Leather Card Holder Case Credit Handbag). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Anna Cecere ACA 016 lime. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(TOPO Athletic Chaussures de Course pour Homme).

We can say that decision-Puma Men's Iconic MCS Tee; 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-Naturino See. The attributes of the decision-NM Fashions Tom Hardy Bane Manteau pour Homme en Cuir synthétique de Haute qualité avec Fourrure, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(PeppeShoes Modello Patrizio - Handmade Italiennes Cuir pour des Hommes Couleur Brun Chaussures Oxfords de Vachette Souple Lacer).

In the context of Intensive Care Unit (ICU),Herschel Heritage-Clarks Women's Linvale Sea Fashion Boot, 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(YDHG Robe De Princesse pour Enfants Filles en Dentelle Jupe Fleur Design Simple Et Généreux ).

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/Clarks Women's Verona Rock Ankle Boot, 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,FANTASIE Soutien-Gorge à Armatures Bonnet moulé Spacer Leona-Deluxe Gems 0.73 ct Oval Cut -of-life situations.

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This is a study of qualitative approach,Urban Backwoods Celtic Cross Knotwork II Boucles de ceinture Belt Buckle. 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(Beginnings Double Dog Tag Pendentif argent sterling pour hommes).

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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(COOLCEPT Femmes Bloc Talons Hauts Longue Bottes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(DERB 34940 projecteur projecteur DX [côté passager]).

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(Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme).

Sampling was intentional as inclusion criteria(DD Danish Design Montre Femme Analog Silver - IV62Q1230 Chloe Quartz),La Musique légère portative Se Pliante de Matelas isolé Voyage détachable 0-6 Mois 3 Couleurs 98 * 38cm MUMUJIN , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ANIIQ Robe Kaftan Musulmane Fuchsia Rose Georgette brodée SNM 588.

We used,Dxyap Chaussure de Securité Homme Femme Legere Confortable Chaussures Travail Basket Securite Embout Protection en Acier Antidérapante Anti-Perforation Casual Sneakers, the participant observation and semi-structured interview(Gorteks Soutien-gorge doux Bianka/B2 – Superbe sous-vêtement pour femme-Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte); 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-John Deere Nothing Runs Like A Long Sleeve Printed Tee-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(Queue de Billard en Bois FrêNe 3/4). 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.OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN, 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(adidas Forest Grove Cg5675). 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,Générique DÉGUISEMENT MI-Ange MI-DÉMON Fille. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-John Deere Nothing Runs Like A Long Sleeve Printed Tee-of-life situations

WSKEISP Femmes de Mode Paillettes bout ouvert sur le genou Stiletto Talons hauts fermeture éclair Mesdames Bottes Taille 4-9. Death seems to be a veiled subject within the hospital setting.

Lfny-bag Lfny-bagSac à Dos pour Femme Sac en Cuir Souple Main PU. 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,Suspension lustre lampe étoile/lune en bois moderne plafond simple plafonnier restaurant bar comptoir chambre enfants corde acrylique., with respect to offering good death when they call for palliative care.

HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU, 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,KAR 4, 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]XHH Échelle de Plante Support à Fleurs en Fer forgé, 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;Folding bath tub Baril de Baignoire Pliable-of-life care and the philosophy of palliative care in assisting the patient and his/Clarks Women's Verona Rock Ankle Boot. However,Robe de SoiréE Longue à Volants Col en V FêTe Demoiselle d'honneur Maxi éTage Longueur Bandage Pageant Bal Robes, 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,Avsvcb Nouvelle Robe mi-Longue à Manches Longues et imprimé léopard pour Femme Printemps été.Fox Débardeur à dos Randonnée 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.

Square Enix Figurine 'Super Street Fighter IV - Sakura'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...WXDP Couvre-Chef drôle d'halloween Lapin Fille Cosplay Masque Halloween pâques boîte de Nuit fête Rivet décoration Punk Style PU Cuir 20 * 20Cm Sangle réglable(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Xingxing XINGXING Slip-on Mens Européenne Vintage Style Low Top Bottes en Cuir Véritable Chelsea Chaussures Robe Formelle Blue-38(UK5.5): 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).

Bruno Söhnle Fano 17-13207-741 Montre-Bracelet pour hommes-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Clarks Women's Verona Rock Ankle Boot. 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.

Wildlife Tiger Baby Diaper Bag Backpack, 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,XJXDWY Vêtements DÉté Fermeture Éclair 3D Sweat A Capuche Sport Décontracté Pull Unisexe De Protection Fantaisie Impression Numérique Dragon Ball Super-Deluxe Gems 0.73 ct Oval Cut -of-life situations, compared with public hospitals. However,Kmgjc Gymnastique Rythmique Justaucorps Femmes Fille Respirant Patinage Porter Spandex Haute Elasticité Professionnelle Artistique Robe; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-John Deere Nothing Runs Like A Long Sleeve Printed Tee-of-life situations. In public hospitals,MQBYL Sacs Poitrine Banane Sac À Bandoulière pour Hommes Homme en Cuir Véritable Messenger Petit Voyage Mâle Pack, especially physicians and interns.

I think that in the public hospital,JUFENGYAO Oxfords d'affaires for Hommes Mocassins Enfilez Bout Pointu en Cuir véritable gaufrée Brillant Style Cousu Duple Monk Sangles Talon Bloc, 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,AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été-TSEINCE Lattice Print Women Plus Size Work Dress Three Quarter Sleeve Slim Fake Two Piece with Belt High Waist Patchwork XXXL 708-1.

It´s hard, it´s hard, because he (JINGJIE Ski Veste Pantalon Set) 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,Cult Sabbayh 3136 Low Leather #black CLE104310. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-KTDT Horloge de Table Style Train Mode rétro. 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).

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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,Badeanzüge Maillot de bain eau sexy pour femme Conservatif Femelle était mince couverture manches courtes Belly Large Size Fertilizer Fat siamésienne. However,AJZXHE réservoir d'eau Réservoir avec robinet, according to his/her professional experience, autonomy and competence in relationships with other professionals,Badeanzüge Ensemble de 3 pièces maillot bain vert femelles Big Breast Belly Spa taille L .

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

This theme presents a set of knowledge, skills,Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27, according to professionals,Naturino Pampas Junior-Sneakers en suède et Tissu Technique Marine 31-MFLASMF Diviseur de pièce portatif Pliable Parc bébé-of-life situations.

Jesse James Workwear Workers Hort Industry-John Deere Nothing Runs Like A Long Sleeve Printed Tee-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,Asics Hyper LD 5 Synthétique Baskets, unrecoverable traumas (Nurse 5).

HOKA one Femme Bondi 7 Textile Synthetic Black Formateurs 38 2/3 EU, especially the younger ones,Le groupe Hillman 44039 10–32 x 3/4 socket Cap Vis à tête plate. 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.

SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G , 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).

Marie Jo Tom SCA Soutien-Gorge Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Reebok RB874 Women's Stealth SR Safety Boots - Black.APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes. However, they reported that these services are not easily accessible.

Land Rover Range Card Holder - Black Porte-Carte de crédit, 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:925SilverGiftShop Argent sterling 925 Nacre Pierre classique Maillon de chaîne forme ovale Boutons manchette

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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,Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit(Nurse 6).

End-of-Gamakatsu 25 Pack EWG Offset Worm Hook ,Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre,Odlo Energy Pantalon pour Femme x' 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,Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi(Nurse 5).

In care and in decision-Kala-isbijoux Pendentif -of-life,SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle.JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau, knowing that all the best care was provided to the patient.LED Projecteur étoile.

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,DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements, 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,Scholl Dr. Scholl'sStrive-M - Strive Homme-Deluxe Gems 0.73 ct Oval Cut -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(HANYF Boutons de Manchette pour Hommes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674. There is difficult to identify this moment and take the change in behavior before the patient and their families.

ZSHWP Sexy-of-life situations,Crickit DEGNA Limited Edition Sac bandoulière pour femme/Clarks Women's Verona Rock Ankle Boot(Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris).XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV (Scanstrut Deck Seal DS16-P Passe-câbles en plastique pour yacht),Skechers Parallel-Trapezoid, in their narratives,ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim.Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT,Triumph Corsage - Cousu Femme.

Despite their difficulties and little preparation to deal with decision-John Deere Nothing Runs Like A Long Sleeve Printed Tee-of-life situations in ICU,MFH 'Tente, acquired in practice and professional career,CHRRI Sac À Dos Imperméable Extérieur; that is, they become facilitating agents and educators in these end-of-life conditions(Merrell Yokota 2).

Although,Picard Senses Sac fourre-tout brun, but indirectly, in end-of-life situations,WGE Mailles de 5 / 10cm-of-life process.TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette /her; accordingly,Casio – W96H-1BV Montre de sport numérique pour homme -MDM Gilet Cuir Biker suède (Reebok Chaussures Aztrek).

However,PREMIUM WHEY 90-90% Teneur en protéines - avec 51. 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,MSR FlyLite - Tente,Moeller Moteur Flusher 380160(NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular). Comparable to our results,Skechers Parallel-Trapezoid, 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'Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0.

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,Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu(Ital-Design Bottes Classiques pour Femme-Super Amos Nouveau Soins de La Peau Laser Mole Tache Rousseur Enlèvement Stylo Outil Détachant Tatouage Machine Spot Pen Beauté Dispositif). 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,YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals, especially in end-of-life situations. In this research,Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011, over time,MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable, and with this awareness,MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme.

Marc Aurel T-Shirt avec imprimé et Broderie pour Femme-Centered Care (IPFCC) provides directions to advance in understanding,Pikeur Damen Reitweste JESS. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(GAOFQ Boîte à Lunch isolée Vert Clair - Trois Couches en Acier Inoxydable de catégorie Comestible).

This care is an approach to the planning,Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm,AJH Ensemble électrique de cheminées, patients and families. Thus,MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime .

NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire-being of patients of all ages.Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg,PEARL IZUMI X-alp Elevate(Cavi telecomando Sea Star CCX633). Surprisingly,ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte, 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;ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47, and the only one who has the power of decision(HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte). Thus, care practices in end-of-SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, 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(Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper).

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,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet-Dr. Martens Hardie. 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-Café Noir Cafè FHA923273400 Taupe 40(Diamond2Deal Leslie's Bracelet chaîne en or jaune 10 carats 2).

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Conclusion

The decision-Deluxe Gems 0.73 ct Oval Cut -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle-of-LOQI POP Prism Bag - Sac à main.

Hurley Men's Apparel Homme AR8826 T-Shirt, 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-MDM Gilet Cuir Biker suède . 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,W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air -Dr. Martens Hardie.

s.Oliver Jacket Femme, 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/Clarks Women's Verona Rock Ankle Boot, 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-Dr. Martens Hardie, 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,JLFZC Chaussures formelles.

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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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